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Crain's Detroit News Story: Michigan sued for cutting off adult dental benefits

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Democrats struggle to find unity on health plan

By RICARDO ALONSO-ZALDIVAR (AP) – 44 minutes ago

WASHINGTON — Democrats are struggling to bridge differences among their rank and file to push health overhaul legislation through Congress and fulfill President Barack Obama's goal of signing a bill this year.

In the wake of Senate Majority Leader Harry Reid's announcement that the Democratic bill would include the option of a government insurance plan, moderates in his own party lost no time in voicing their displeasure. The Nevada Democrat needs every Democrat to break the filibusters that Republicans are vowing to mount. But some of the moderates refuse to say whether they'll stick with their leader on procedural votes, let alone those on the merits of the bill.

"We are a long way from reaching conclusion," said Budget Committee Chairman Kent Conrad, D-N.D.

Speaker Nancy Pelosi has been in a similar position in the House, laboring to finalize a consensus health care amid disagreements among Democrats.

House leaders were aiming to bring those negotiations to a close Wednesday, and were making plans to unveil their bill Thursday morning, according to a Democratic aide. The aide, who spoke on condition of anonymity because the plans were not yet public, cautioned that the timing could change. House leaders were scheduled to meet Wednesday afternoon to finalize their plans.

There are nine weeks left in the year to deliver a bill to Obama's desk.

Intense days and nights lie ahead, said Sen. Bill Nelson, D-Fla. Senators who don't like the bill will find themselves the focus of a "prayer session," said Nelson. "They will pray that the retribution of God doesn't come down on them," he joked.

Nonetheless, moderate Democratic senators who control the balance of power on health care were holding their ground. Republican opposition stiffened, and party leaders announced they would attempt to strangle the bill before formal debate begins.

Despite the obstacles, senior Democrats cast Reid's draft legislation as a turning point. Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, said there is now a "sense of inevitability ... that, yes, we're going to pass health care reform."

The government insurance option long ago emerged as the biggest flashpoint in both the House and Senate as Democrats try to pass legislation that extends coverage, bans insurance practices such as denial of coverage because of pre-existing medical conditions and slows the growth of health care spending nationally.

Before any substantive issue can be joined on the Senate floor, Reid's first challenge is to gain 60 votes — the number needed to overcome a filibuster by Republicans — just to bring the bill up, a parliamentary maneuver so routine that a vote is rarely required.

But Sen. Mitch McConnell of Kentucky, the Republican leader, announced that in this case, even procedural votes will count. That's because, in his view, the underlying bill would "cut Medicare, raise taxes and increase health insurance premiums." He suggested Democrats could expect campaign commercials next year on the basis of the vote.

Sen. Tom Carper, D-Del., said he may seek changes on the Senate floor, a move likely to be welcomed by moderates. He backs a government role in states where one or two insurers control the market and premiums are high, along the same lines as a plan supported by Sen. Olympia Snowe, R-Maine.

That general approach, in which a lack of competition in an individual's state would trigger a government insurance option, "is still alive," said Sen. Kent Conrad, D-N.D.

While Reid is expected to eventually secure all 60 Democratic votes on the critical first test to bring the bill to the Senate floor, Sens. Ben Nelson of Nebraska, Mary Landrieu of Louisiana, Evan Bayh of Indiana and Blanche Lincoln of Arkansas all declined to say on Tuesday how they would vote.

In an indication of the pressure Reid faces, Bayh said the majority leader had agreed to cut an earlier proposal for a $40 billion tax on medical device makers.

"He significantly modified that proposal in a way that I understand will not impact thousands of good-paying jobs," said Bayh, whose state is home to Guidant Corp., a maker of cardiovascular devices, among other major industry players. Numerous officials said Reid had agreed to reduce the new tax to $20 billion over a decade. The officials spoke on condition of anonymity because no announcement had been made.

In the House, the principal stumbling block has been disagreement among Democrats over how to set fees for doctors, hospitals and other health care providers participating in the public insurance plan.

Liberals want the government to set the rate unilaterally, pegged to the charges the government pays Medicare beneficiaries. Moderates want the government to negotiate with the providers in setting fees.

Pelosi favors the approach liberals want, but officials say she has all but concluded she cannot gain the necessary majority of 218 votes for it.

House Democrats are also facing internal disagreements relating to federal funding for abortion services.

Associated Press writers David Espo, Julie Hirschfeld Davis, Ben Evans, Andrew Miga, Ken Thomas and Erica Werner contributed to this report.

Copyright © 2009 The Associated Press. All rights reserved

Crain's Detroit News Story: Reform needed to keep health care competitive, experts say

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Obama's health reform push seen buoying health IT

• Reuters, Wednesday November 26 2008

By Debra Sherman and Lewis Krauskopf

CHICAGO/NEW YORK, Nov 26 (Reuters) - A wealth of small companies focused on information technology may be poised to benefit should the U.S. government make good on vows to run the U.S. healthcare system more efficiently.

U.S. President-elect Barack Obama reiterated his commitment at a news conference on Tuesday to increasing investments in the healthcare system as a way to save costs in the long term.

Obama cited as an example the government's role in helping local hospitals and providers set up electronic billing and medical records.

Such words could be music to the ears of small companies that specialize in improving and automating systems, services, and record-keeping in hospitals and doctors' offices.

The industry has been talking about electronic medical records for years, but the divide among political parties has been partly to blame for minimal progress, said Ira Loss, a policy analyst with Washington Analysis.

"There was no leverage to get things done," Loss said. "It may be different now. I think we're going to have a president who is more engaged in this area. He believes in it."

JP Morgan analyst Ipsita Smolinski said a likely first step the new administration would take toward increasing the use of electronic medical records would be to require them for claims under Medicare, the large government health insurance program for the elderly.

"That could happen within the first year (of the new administration)," Smolinski said. "It would have a ripple effect."

Stifel Nicolaus analyst Todd Weller said Obama's administration would likely boost the healthcare IT sector, although he cautioned investors against thinking Obama's election would be a quick windfall for these companies.

"We view it as ... another positive catalyst behind a secular trend of more adoption of health IT; but I don't think it's real prudent to go out and invest in these stocks under an assumption that all of a sudden in 2009 their business is going to accelerate in a big way," Weller said.

"You're going to see doctors and hospitals increasingly adopt technology and automate just like every other industry has done," Weller said.

Analysts said potential beneficiaries from a health IT push would be those focused on establishing electronic medical records in physicians' offices, as well as on billing software and other administrative tasks. Among them are Allscripts-Sisys Healthcare Solutions Inc, Athenahealth Inc, and Quality Systems Inc.

Physicians have been reluctant to spend money on major IT systems, analysts said.

"What we need are more carrots and sticks out there," said Richard Close, managing director of equity research at Jefferies & Co. "Obama could develop grants and enable physicians to access funds to develop systems ... It sounds as though it's a high priority."

Hospital-centered IT companies that could benefit include Cerner Corp, MedAssets Inc, Computer Programs and Systems Inc and Eclipsys Corp. Large pharmaceutical wholesaler McKesson Corp also has a substantial IT business.

Adoption of healthcare IT has lagged in smaller rural hospitals which lack the money to invest compared with larger urban hospitals, Stifel Nicolaus' Weller said. He said there has been an increase in state and federal grants to these hospitals in the past year to finance such purchases.

"I would look for a push to help smaller rural hospitals come up to speed on health IT," Weller said.

Large technology companies are also angling to be involved in healthcare, including Intel Corp, which introduced health monitoring systems to connect patients with clinicians, and Google Inc and Microsoft Corp, which are trying to drive greater penetration of electronic medical records.

Loss, of Washington Analysis, said the government has failed to come up with uniform standards that would ease the way for electronic medical records.

"The first thing that has to happen is ... they have to make one system talk to the other," Loss said.

Analysts cautioned that the timing remains unclear for any new requirements that could lead to greater IT investments. Healthcare reforms may take a backseat as Obama focuses on the weak overall economy.

"It won't be like turning on a faucet full blast," Close said. "I suspect it will take a little while, maybe a year or two." (Editing by Gerald E. McCormick)

Tata to commercialise healthcare portal

  Johannesburg, 27 November 2008 ] - Tata to commercialise healthcare portal

Tata Consultancy Services (TCS), an Indian IT services company, plans to commercialise its WebHealthCentre, an online portal for medical consultations, healthcare information and telemedicine, says PCWorld.

The WebHealthCentre site was set up by TCS in 2000 as part of fulfilling its corporate social responsibility. The site was started to offer patients in rural areas access to specialist doctors.

Using the analogy of Google's YouTube, Debashis Ghosh, VP and head of TCS life sciences and healthcare practice, said having set up WebHealthCentre and making it popular, TCS is exploring a number of revenue streams, including offering new services such as electronic medical records facilities through the site.

Merge offers Web solutions

Merge Healthcare, a medical imaging solutions provider, has unveiled two Web applications, Cedara WebAccess and Cedara WebScheduler, available through its OEM division, says Market Watch.

These solutions give health IT software providers plug-in portals that help expedite and automate tasks such as patient and resource scheduling, and image and information distribution.

Cedara WebAccess is a thin-client viewer, which provides technology for Web distribution of radiology images and reports to the referring physician community and beyond. Cedara WebScheduler helps health IT application developers that add centralised capabilities for managing and scheduling imaging resources.

Internet service keeps families informed

Connect4Healthcare is offering an Internet service that enables long-term care providers to give families regular proactive wellness updates through a secure Web page, e-mail or text message, says Market Watch.

The solution addresses the problems for families of the more than 3.8 million people in the US living in nursing homes, assisted living facilities or receiving home care as they struggle to stay up-to-date with the well-being and needs of their loved ones.

The company is introducing its service to long-term care providers, but plans to begin marketing directly to consumers early next year.