Federal and State Government News Update


Edition Three (2/17/09)

With History and Flourish, Obama Signs Stimulus Bill
Boston.com, 2/17/09
Signing his modern-day equivalent to the New Deal, President Obama declared that the stimulus bill is the most sweeping economic recovery package in the nation's history—one that helps keep his campaign promise to preserve the American dream. President Obama feels strongly about taking "meaningful steps in years towards modernizing our health care system. It’s an investment that will take the long overdue step of computerizing America’s medical records—to reduce the duplication and waste that costs billions of health care dollars and the medical errors that every year cost thousands of lives."

The government created Recovery.gov, so every American can go on-line and see how their money is being spent.

HHS Vacancy Stalls Health Agenda, Advocates Say
Washington Post, 2/17/09
When Thomas A. Daschle, embroiled in controversy over failing to pay more than $100,000 in back taxes, stepped down as director of the White House Office on Health Reform and withdrew his nomination to be secretary of health and human services, it left a hole in President Obama's leadership team. The vacancy is one that health care advocates say has stalled what they hoped would be speedy action on high-priority measures. Administration advisers still are not talking publicly about who might replace Daschle or when a nomination might be made.

On-line Health Data in Remission
Washington Post, 2/17/09
The $19 billion in Congress's economic stimulus package to bring America's health care records into the electronic age is an opportunity for information technology firms seeking to build market share in a still young industry. Although the federal government set a goal five years ago of creating an electronic health record for every American by 2014, the effort has lagged. Roadblocks include concerns over lack of universal protocols for collecting data as well as rules that establish how, with whom and under what circumstances the data can be shared. Many health care providers fear liability if private information gets into the wrong hands. Embedded in all these issues is the cost, an estimated $150 billion, which has proven to be a significant barrier to that 2014 target.

U.S. to Compare Medical Treatments
New York Times, 2/17/09
Under the $787 billion economic stimulus bill approved by Congress, researchers will receive $1.1 billion to compare drugs, medical devices, surgery and other ways of treating specific conditions. The bill creates a council of up to 15 federal employees to coordinate the research and to advise President Obama and Congress on how to spend the money. The program responds to a growing concern about the soaring cost of health care and that doctors have little or no solid evidence of the value of many treatments. Supporters of the research hope it will eventually save money by discouraging the use of costly, ineffective treatments.

Recovery Package Gets Congressional Approval
Wall Street Journal, 2/14/09
The House and Senate gave final congressional approval to sweeping economic-recovery legislation, marking a new milestone of federal intervention in the nation's economy. Not a single Republican backed the package Friday in the House, where seven Democrats joined 176 Republicans in opposition, and 246 voted for it. Hours later, the Senate, voting 60-38, cleared the measure to be sent to the White House for President Barack Obama to sign into law. Three Republicans joined with 57 Senate Democrats in support of the package; 38 Republicans voted against it.

Health Care Debate in Stimulus Package
examiner.com, 2/14/09
Democrats and Republicans disagree as to how the stimulus package will change health care in the United States. Now each party is interpreting the package differently. Congress passed the stimulus package on February 13, 2009, with only the support of three Republicans and a majority of Democrats. To be spent is $11 billion on electronic health records, $1.1 billion on research comparing which treatment work best for a particular disease, $1 billion for a "preventive and wellness fund," $300 million for additional immunizations, and $17 billion in higher Medicare and Medicade payments for doctors and hospitals, beginning in 2011, when they adopt electronic health records.

Privacy Safeguards Included With Stimulus Bill's Health I.T. Funding
Thompson.com, 2/13/09
Economic stimulus legislation awaiting final approval by Congress, then expected to be signed into law by President Barack Obama, includes more stringent medical records privacy requirements along with $19 billion in funding for health information technology. The American Recovery and Reinvestment Act (H.R. 1) would provide grants and payment incentives for physicians, hospitals, nursing homes, and other health care entities to adopt and make meaningful use of technology designed to create and manage electronic health records. The legislation also includes provisions intended to shore up public confidence in the use of EHRs and personal health records by beefing up enforcement of and expanding the scope of businesses covered by HIPAA.

Final Vote on $789B Economic Stimulus Package Expected Today
Kaiser Daily Health Policy Report, 2/13/09
The House and Senate on Friday likely will vote on a $789B billion compromise economic stimulus package that includes a number of provisions related to health care spending. Among other provisions, the stimulus package includes $19 billion for health care information technology, with $17 billion for investments and incentives through Medicare and Medicaid and $2 billion for a discretionary fund for grants and loans; the provision also requires the federal government "to take a leadership role" to develop interoperability standards for health care I.T. by 2010.

Congress Reaches Stimulus Accord
Washington Post, 2/12/09
Congressional leaders agreed on the details of a nearly $790 billion stimulus package, an unprecedented attempt by the federal government to jolt the economy, create millions of jobs, and ease the financial woes facing individuals, businesses, and states. The bill is made up of four broad categories: tax breaks for individuals and businesses; investments in health care and alternative energy; funding for "shovel-ready" infrastructure projects; and aid to state and local governments, including expanded benefits for individuals who are unemployed and lack health insurance.

Congress Strikes $789 Billion Stimulus Deal
Wall Street Journal, 2/12/09
Congress and the White House reached accord on a $789.5 billion economic-recovery package that would shower hundreds of billions of dollars in tax relief on individuals and businesses and spark an infrastructure building boom, from the nation's ports and waterways to its schools and military bases. The stimulus accord is a major win for the high-tech industry, which will receive billions of dollars in subsidies to expand broadband access to rural and other underserved areas and a huge infusion of funds to computerize health care records. In all, $19 billion is set aside for health I.T. Physicians would get bonuses of between $44,000 and $64,000—and hospitals would get as much as $11 million—if they show they have computerized medical records systems. On the stick side of the equation, the measure includes Medicare payment penalties for physicians and hospitals that are not using electronic health records by 2014.

A Health-Tech Monopoly
Wall Street Journal, 2/11/09
The "stimulus" is the bill that keeps on giving, not least for journalists. Health care providers and patients may have a different reaction, however, when they learn that Democrats are using the bill to create a health information monopoly that will help centralize government control of the health-care market. In theory, electronic medical records are among the few stimulus ideas that might do some actual good. Democrats and Republicans agree that exchanging the paper files we mostly use now for digital versions will lower costs, cut down on medical errors, and maybe cure the common cold.

Senate Passage of Stimulus Bill Sets Stage for Conference on Hill

Government Health IT, 2/10/09
House and Senate leaders are preparing to resolve the differences between the health information technology provisions in their economic stimulus bills now that the Senate has passed its version of the legislation. Although President Barack Obama and congressional leaders had hoped to get the bill enacted and signed by mid-February, that might prove difficult. The House version is 679 pages long, and the Senate bill is comparable in length. Within those pages, there are many differences to be resolved.

Analysis: Stimulus Package Ripe with I.T. Opportunities
Washington Technology, 2/10/09
Government contractors are anxiously watching the economic stimulus package as it makes its way through Congress. The package could include as much as $100 billion for technology intiatives and infrastructure spending in areas such as health care, energy, broadband access, and even the government’s shadowy cybersecurity initiative. Health I.T. is the technology receiving the most support, with approximately $20 billion in the House bill and $23 billion in the Senate measure dedicated to expanding the use of electronic health records and building a national health information exchange.

Will We Make History?
H&HN Magazine, 2/09
From the 1930s onward, health reform has been a national concern. With a new, determined president, growing consensus and billions in federal funds, dramatic change may be a hand. Two years ago, then-Sen. Barack Obama stood on the steps of the Old State Capitol in Springfield, Ill., and laid out an ambitious agenda for change, involving a bold action on health care. But February 2007 was a different time where the credit crisis was months off; no Wall Street banks were being bailed out; the big three automakers were not yet on death’s door; and, most important, the overall economy was still 10 months from officially entering the recession. Even as the economic dominoes began to fall, Obama continued to advocate sweeping health care reform. But his message became more nuanced as he campaigned for and ultimately won the presidency: Health care and the health of the economy are intertwined.

Health Care Winners and Losers in the Stimulus Package
Los Angeles Times, 2/17/09
When President Obama and his allies pulled together the $787-billion bill that he is to sign, they talked about helping those rapidly swelling the ranks of America's more than 46 million uninsured. But in the scramble to pass a bill, lawmakers made changes that left out millions of middle-class Americans who have lost their jobs and are struggling to fill a prescription or pay for a visit to the doctor. That reflected a frenzied process in which sometimes arbitrary decisions were made to speed agreements and satisfy an array of political interest groups working to influence the massive bill, according to this article in the Los Angeles Times.

States and Cities Angle for Stimulus Cash
New York Times, 2/14/09
Well before President Obama’s stimulus package completed its tortuous path through Congress last week, state and local officials facing multimillion-dollar budget deficits, crumbling infrastructure and the prospect of massive reductions in services were already jockeying for the upper hand in deciding how the money should be spent.

Health Benefits from Stimulus
San Francisco Chronicle, 2/13/09
The San Francisco Chronicle outlines the health related spending in the federal government's economic stimulus plan, including $87 billion added to Medicaid funding over the next two years; $24.7 billion to subsidize unemployed workers by 60% for up to nine months to stay on their employers' health plan; and $19 billion to modernize health information technology systems.

Medpedia: A Collaborative Encyclopedia for Health Care
New York Times, 2/17/09
Medicine and health are among the most popular topics for Web surfers, but an Internet entrepreneur says the current offerings are inadequate. James Currier has developed Medpedia, a free online medical encyclopedia that addresses what he views as the sector?s shortcomings. However, unlike Wookieepedia, Lostpedia and most social encyclopedias, only trained professionals will be able to write and edit pages on the Medpedia Web site, and all contributors will have individual author pages detailing their qualifications and backgrounds.

Stimulus Prompts Talk of Health Care Rationing
San Francisco Chronicle, 2/12/09
A relatively small provision in the stimulus bill that would devote about $1 billion in government research funds to figure out which drugs and medical devices work better than others has some industry groups, conservative talk-show hosts, and others crying "rationing." To proponents, the research would improve quality of care and reduce health costs by limiting the use of drugs and treatments that do not work well.