In the wake of healthcare reform, many practical questions remain, including: How do I find and select a reasonable plan?
For the previously uninsured who are now interested in purchasing their own healthcare insurance, Claudia Buck of McClatchy Newspapers has put together a “How to Shop for Health Insurance” guide.
It’s quick and cursory — but it gives a decent starting point, especially for anyone overwhelmed by the possibilities. It provides a needed warning about brokers — check if the broker or agent is licensed and in good standing — and it dispenses some good advice for those who are doing their own online shopping (on a site like ehealthinsurance.com):
Pay attention to what’s covered. The lowest premium, for instance, may carry a high deductible (the amount you spend out of pocket before insurance starts paying). And it may not include much or any coverage for prescriptions and hospital stays.
When we typed in a price quote for a single, nonsmoking female, age 27, for instance, there were 124 choices, ranging from a $54-per-month Anthem Blue Cross premium ($5,000 deductible and $40 office visits) to a $375-per-month Health Net premium (no deductible and $25 office visits).
It also includes a useful sidebar of what has and has not yet changed — in terms of pre-existing conditions and dependent coverage, for example — due to provisions in the Affordable Care Act passed in March.
What is most interesting, and potentially ground-breaking, is the advice about paying cash for your healthcare and demanding a “fair price” for specific services from doctors. The story notes that the Healthcare Blue Book — a guide to pricing of a wide variety of procedures — can help someone with a high-deductible (or no insurance) search for bargains.
Harnessing this individual bargain-shopping is, in fact, the latest craze for cutting healthcare costs. Claire Cain Miller writes in The New York Times about how venture capitalists — and at least one major health care provider — are funding efforts to provide more transparent access to healthcare pricing so patients can easily determine (and compare) the costs of a recommended procedure. One start-up, Castlight Health, has visions of patients checking costs on their mobile phone while sitting on the exam table — and promises to have that capacity by next year.
Plus: Speaking of healthcare reform, a new study published in the correspondence section of the New England Journal of Medicine asserts that the great majority of doctors reject the healthcare reform recommendations from the American Medical Association — their supposedly representative professional organization — and support a much more robust public insurance option than the organization has backed.
Our own Judy Norsigian – along with Ellen Shaffer of the Center for Policy Analysis – has a new piece up at Salon. A practical guide forward for progressives on healthcare looks at the myths that have undermined enthusiasm for the new health care reform package and encourages people to build upon its successes.
Norsigian and Shaffer also propose next steps for progressives who share the goal of affordable universal health care. Check it out, and let us know what you think in the comments!
Entrant: Carol Paris Nominee: Margaret Flowers, Citizen Activist
Margaret Flowers is a Maryland pediatrician who for the past several years has devoted all of her energies to speaking out and organizing for a truly universal and comprehensive health care program, one that goes far beyond the law just enacted by Congress.
Rebelling against the daily injustices inflicted upon children and their families by a profit-driven health industry – especially the big insurance and drug companies – she left active medical practice in 2006 and resolved to work full time for a health plan that guarantees everyone the quality care they need and deserve.
Margaret has since become one of our nation’s most prominent advocates for a single-payer health program, an improved and expanded Medicare for All. Unlike the health bill that was just passed, a single-payer plan would cover everyone without exception, allow free choice of doctor and hospital, and require no co-pays or deductibles. It would also cover the full range of women’s reproductive health services.
Margaret has shown great courage and determination in pursuit of this goal, and has inspired me and countless other women (and men) by her example. She encourages others to speak out and to take action because, as she often stresses, millions of lives depend on the outcome.
A year ago, at the outset of the health care debate, she and I were among eight persons who challenged the exclusion of the single-payer model – a model that is supported by a solid majority of the U.S. people – at a key congressional hearing.
Margaret writes: “On May 5, eight health care advocates, including myself and two other physicians, stood up to Sen. Max Baucus, D-Mont., and the Senate Finance Committee during a ‘public roundtable discussion’ with a simple question: Will you allow an advocate for a single-payer national health plan to have a seat at the table? The answer was a loud, ‘Get more police!’ And we were arrested and hauled off to jail.”
Thus began her long odyssey of speaking engagements, rallies, testimony before other congressional committees (Sen. Baucus never invited her back!), television appearances and travel from one end of the country to the other. A retrospective on how she views the past year of struggling for a truly humane health care system appears in the current issue of Tikkun magazine and in an interview on Bill Moyers Journal.
Dr. Flowers obtained her medical degree from the University of Maryland School of Medicine and did her residency at Johns Hopkins Hospital in Baltimore. She has worked as both a hospitalist in a rural setting and in private practice. In addition to her present work as congressional fellow for Physicians for a National Health Program, she is active in Healthcare-Now of Maryland and a co-founder of the state’s Conversation Coalition for Health Care Reform.
Margaret Flowers is a tireless advocate for her patients and for a humane health care system, often making great personal sacrifices to advance our common interests. She’s a women’s hero in my book and a women’s hero in the eyes of millions of Americans.
Wondering what health care reform means for you and your family? You may want to invite Raising Women’s Voices to your community for a special education session. From RWV:
We are bringing groups of experts into the community to meet with women, who often are the key health decision-makers for their families. Our aims are to explain the many ways in which health reform will help families — such as providing coverage for 32 million uninsured Americans — and to note the ways in which the law fell short, such as in covering abortion services and including undocumented immigrants.
Check out the list of available experts and topics to be covered. It seems like a wonderful opportunity to hear directly from women who can discuss individual and community-wide benefits and the nuances of the new law. To learn more, email info [at] raisingwomensvoices.net
“The basic thrust of this law is that all of these nooks and crannies, all these gaps where private insurance has left you without any option, those are going to be taken away,” said DeAnn Friedholm, campaign director of health reform for Consumers Union, the nonprofit publisher of Consumer Reports. “It’s complicated, but it does establish a very key, important policy that you’re going to have options, regardless of your health situation or your employment situation.”
More specific to women’s health is an article by Denise Grady that looks at how health care reform will reduce costs associated with having double X chromosomes.
Among the major changes: Gender rating, the act of charging women more than men for the same insurance policy, even when maternity care is not included, is no longer allowed, and maternity coverage is now considered “an essential health benefit.”
“It has to be a part of the premium just like heart attacks, prostate cancer or any other condition,” said Marcia D. Greenberger, co-president of the National Women’s Law Center. The story continues:
Despite her enthusiasm for many aspects of the new law, Ms. Greenberger said she was profoundly disappointed in provisions that she thought would limit women’s access to abortion services.
Advocates for women’s health said one of the new law’s benefits would be to ban the denial of health coverage to women who have had a prior Caesarean section or been victims of domestic violence. Some companies providing individual policies have refused coverage in those circumstances, regarding Caesareans or beatings as pre-existing conditions that were likely to be predictors of higher expenses in the future.
In a statement issued Thursday, Senator Mikulski said: “One of my hearings revealed that a woman was denied coverage because she had a baby with a medically mandated C-section. When she tried to get insurance coverage with another company, she was told she had to be sterilized in order to get health insurance. That will never, ever happen again because of what we did here with health care reform.”
The success of health care reform will depend on the ability to control soaring health care costs, many experts have argued. Another story in the package looks at how the law will do little to curb unnecessary care, a subject that is also the focus of a piece published this week in the business section. David Leonhardt offers a concise explanation of a major obstacle: Convincing the public — and the medical community — that more care does not necessarily mean better care.
Managed care became loathed in the 1990s. The recent recommendation to reduce breast cancer screening set off a firestorm. On a personal level, anyone who has made a decision about his or her own care knows the nagging worry that comes from not choosing the most aggressive treatment.
This try-anything-and-everything instinct is ingrained in our culture, and it has some big benefits. But it also has big downsides, including the side effects and risks that come with unnecessary treatment. Consider that a recent study found that 15,000 people were projected to die eventually from the radiation they received from CT scans given in just a single year — and that there was “significant overuse” of such scans.
From an economic perspective, health reform will fail if we can’t sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare’s long-term budget deficit will grow.
So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform. “Being able to say no,” Dr. Alan Garber of Stanford says, “is the heart of the issue.”
For more on the economics of health care (and resistance to reform), read Atul Gawande’s piece in The New Yorker, which includes an excellent example of the effectiveness of preventative and comprehensive care — and the conundrum of costs.
And Health and Human Services Secretary Kathleen Sebelius this week announced the appointment of five new HHS regional directors who will work with the states on implementing the Patient Protection and Affordable Care Act.
Entrant: Sandra Gandsman Nominee: Nancy Pelosi, Congresswoman and Speaker of the House
There is no woman in the country who deserves this honor more than Congresswoman Nancy Pelosi.
By sheer strength of will, this woman has led an unruly Congress into passage of the most far reaching health care legislation in the history of our country. She persisted when others might have folded under the stress of constant attacks both personal, ugly and unrelenting.
While there is much still to be accomplished in health care, this is a brave new start, and Congresswoman Pelosi should be applauded for her success.
While some women may argue that she gave in to the right wing and the anti-choice minority with regard to abortion rights, I, however, would argue that she understood the historic movement she was propelling forward and determined the greater good was in providing health care to the many. I, and the millions of women who have found themselves with out insurance or with overpriced policies, who feared losing a job would mean losing insurance, who were denied coverage for preexisting conditions or who had to choose between food or medication, need not fear anymore.
In case you slept through Sunday’s exciting (no really! it was!) health care debate on the House floor, here’s a look at what went down — and, most importantly, what health care reform means for the country and for you.
The Nut Graph
The House approved the Senate bill by a vote of 219-212, with 34 Democrats voting against and zero Republican support. The bill expands insurance coverage to 32 million additional people; approximately 23 million will remain uninsured, about one-third of whom are undocumented immigrants.
Passage was sealed once President Obama placated anti-abortion Democrats by agreeing to issue an executive order reaffirming restrictions against the public funding of abortions.
So it Came Down to Support for Women’s Reproductive Health?
Pretty much. Dana Goldstein of the Daily Beast describes how Obama reneged on his pledge to support reproductive rights.
The only thing worse at this point would have been the original House language proposed by Sen. Bart Stupak (D-Mich.) — who agreed to support the Senate version when given the cloak of the executive order.
I Heard Stupak’s a Baby Killer
The Republicans initially lacked the maturity to ‘fess up to who shouted “baby killer” while Stupak, now an enemy of the Republicans, was speaking on the House floor. Rep. Randy Neugebauer (R-Tex.) finally came forward. Neugebauer, notes the Washington Post, is otherwise known for co-sponsoring a bill requiring presidential candidates to produce birth certificates to prove their eligibility for office.
It’s Not Over Till It’s Over
President Obama is expected to sign the bill on Tuesday, then the Senate takes up debate on the bill’s amendments. What does that mean? In short, House members disagreed with a bunch of items in the Senate bill and, during careful negotiation prior to last night’s vote, both sides agreed to modifications. The House approved the reconciliation measure, essentially trusting that the Senate will do the same. Christina Bellantoni explains all at TPM.
The National Partnership for Women & Families would like you to urge the Senate to pass reconciliation and finish the job.
This is What Change Looks Like
Writing at AlterNet, Adele Stan has a great re-cap of this weekend’s protests (red scare and all), and the deal-making and high drama that resulted in the bill’s passage.
“This isn’t radical reform. But it is major reform,” Obama said after the House vote. “This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like.”
The Immediate Effects Of the Health Reform Bill
That’s the title of this Kaiser Health News story, a good place to start for a discussion of the “early deliverables” — benefits that will kick in this year:
* Dependent children could remain on their parents’ health insurance plans until age 26.
* Senior citizens would get more help paying for drugs in Medicare.
* People with health problems that left them uninsurable could qualify for coverage through a federal program.
* Ban on lifetime limits on medical coverage.
* Tax credits for businesses.
Could You Be More Specific? I found a terrific analysis from the U.S. House Committee on Energy and Commerce that demonstrates the impact health care reform will have on each and every Congressional district. For example, in my district — Ill.-5 (PDF) — the bill is predicted to, among other things:
* Give tax credits and other assistance to up to 142,000 families and 14,100 small businesses to help them afford coverage.
* Extend coverage to 69,500 uninsured residents.
* Guarantee that 13,500 residents with pre-existing conditions can obtain coverage.
* Protect 1,500 families from bankruptcy due to unaffordable health care costs.
* Allow 67,000 young adults to obtain coverage on their parents’ insurance plans.
* Provide millions of dollars in new funding for 23 community health centers.
But What Does it Mean for Me?
That depends. The New York Times has a good interactive graphic that breaks it down based on whether you’re currently insured (and how you’re covered) — or if you don’t have health insurance.
Who Else Benefits?
Glad you asked! The short answer: hospitals and drug makers. And eventually doctors. For insurers, it’s a mixed bag, but they won’t have to worry about competition from a government-run public option — it didn’t make the Senate bill. But Senate Majority Leader Harry Reid (D-Nev.) says maybe this year. To be continued …
If you want the long view, check out this interactive timeline on the history of health reform efforts in the United States.
Last Question: What’s Up With Pelosi’s Giant Gravel? MSNBC’s First Read notes that Rep. John Dingell (D-Mich.), who used the same gavel when the House voted on Medicare in 1965, gave the gavel to Pelosi to use on this momentous occasion. I think it suited her well.
More questions? Ask them in the comments, or leave links to blogs and news coverage.
In it, Sakala discusses maternity care in the context of healthcare reform, noting the lack of focus on maternity care quality, outcomes, and value despite its “major role in the nation’s healthcare system.” She also addresses overused and underused interventions in maternity care; the need to have evidence-based practice guidelines based upon good quality studies rather than expert opinion; VBAC; provider and birth place choices; and barriers to transforming care.
Asked about her vision for the future of maternity healthcare, Sakala responded:
I’d like to answer this question by paraphrasing the final paragraph from the Transforming Maternity Care Vision paper, and I encourage Medscape readers to read that paper and the blueprint as well, and consider becoming involved in blueprint implementation.
In describing the vision, the Vision Team says that:
The 2020 Vision for a High-Quality, High-Value Maternity Care System will be actualized through concerted multi-stakeholder efforts ensuring that all women and babies are served by a maternity care system that delivers safe, effective, timely, efficient, equitable, woman- and family-centered maternity care. The US will rank at the top among industrialized nations in key maternal and infant health indicators, and will achieve global recognition for its transformative leadership.
The whole interview is well worth a read for a good discussion of U.S. maternity care issues. Medscape requires a free registration in order to view the article. Readers may also be interested in Amnesty International’s recent report, “Deadly Delivery: The Maternal Health Care Crisis in the USA.” [PDF]
Democratic leaders say a bill will pass this week. House Minority Leader John A. Boehner (R-Ohio) pledges obstruction, saying Republicans will do “everything we can to make it difficult for them, if not impossible, to pass the bill.”
Too Many Tests, Too Much Treatment: “A spate of recent reports suggests that many Americans are being overtreated. Maybe even President Barack Obama, champion of an overhaul and cost-cutting of the health care system,” reports Lindsey Tanner of the Associated Press.
“More care is not necessarily better care,” wrote cardiologist Dr. Rita Redberg, editor of Archives of Internal Medicine, commenting on Obama’srecent physical, which included prostate cancer screening and a virtual colonoscopy. The PSA isn’t recommended at any age and a colonoscopyisn’t recommended under age 50.
Over-testing may be due to a combination of what is known as “defensive medicine” — doctors ordering tests and procedures because they’re trying protect themselves against lawsuits (or because they’ll be compensated by a fee-for-service system) — and patients insisting on tests and treatments that they’ve heard about or know is commonly prescribed. But the thinking around more care = better care may be shifting.
“This week alone,” writes Tanner, “a New England Journal of Medicine study suggested that too many patients are getting angiograms – invasive imaging tests for heart disease — who don’t really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.”
First, colleges can eliminate the “miscommunication” excuse that many rapists use by creating an on-campus standard that requires any party to a sexual interaction to make sure their partner is actively enthusiastic about what’s happening — not just not objecting. They can create judicial boards equipped to seriously investigate rape accusations, instead of throwing their hands up at the first sign that the accused’s testimony contradicts the accuser’s. They can defend the safety of the entire campus by permanently expelling those found guilty of sexual assault. And they can be transparent about every step of the process.
Plus: Rachel previously noted that the National Library of Medicine is featuring an exhibition on African American midwives. ”Nothing To Work With But Cleanliness: African American ‘Grannies,’ Midwives & Health Reform” tells the story of “granny” midwives and the state and local training programs that educated them and succeeding generations of midwives. View a wonderful set of photos from the exhibition on Flickr.
Utah’s Controversial Law Charges Women and Girls With Murder for Miscarriages: Writing at AlterNet, Rose Aguilar breaks down the problems with Utah’s new law that makes it a criminal offense for having miscarriages caused by “intentional or knowing” acts.
“What happens to women who are in abusive relationships?” asks Planned Parenthood’s Melissa Bird. “What happens if a woman threatens to leave the abuser, falls down the stairs and loses the baby? What if the abuser beats the woman and causes a miscarriage? Could he turn her in? Who would the prosecutor believe? What happens if a drug addict who’s trying to get clean loses her baby? Will she be brought up on murder charges?”
Some critics point out the legislators erred in not considering the lack of access that young people have to comprehensive sex education, and the overall lack of contraception and health services, especially in remote parts of the state.
The Girls Who Kicked in Rock’s Door: Not exactly health related (unless you’re like me and consider loud music essential for well-being), but I am completely intrigued by the “The Runaways,” the new film about the 1970s all-girl rock band, starring Dakota Fanning and Kristen Stewart. Sia Michel writes about the story behind the film and its director, Floria Sigismondi.
Thursday’s bipartisan meeting at the White House (which you can follow live) promises to kick-start what may be the final descent toward healthcare reform. An overview:
Does healthcare reform have a chance? Is bipartisanship a real possibility? David Leonhardt of The New York Times provides some provisional answers.
Igor Volsky over at the Wonk Room brings us up to speed by providing a nice, clear comparison of the House bill, the Senate bill and President Obama’s new proposal.
As far as questions women should be asking about their stake and status in the debate, Lisa Codispoti and Brigette Courtot at the National Women’s Law Center remind us of the “8 Questions” they have been asking all along — and how Obama’s proposal addresses (or fails to address) the issues.
Writing at Raising Women’s Voices, Amy Allina identifies ways in which Obama’s proposal builds on the Senate bill but also notes that it “does not include the changes that Raising Women’s Voices has been urging Congress to make to the restrictive abortion provisions in [the Senate] bill” — namely by eliminating the requirement that policyholders make two separate monthly payments if they want a policy that includes abortion coverage.
Finally, this is politics, and political agendas and expediency can often trump what’s right. Brian Beutler and Christina Bellantoni at Talking Points Memo dissect each party’s strategies, and Ezra Klein at the Washington Post provides a viewer’s guide.
All of this may come down to an arcane Senate procedure known as reconciliation. David M. Herszenhorn at The New York Times offers a primer.
When you feel yourself getting tired of all the red tape, get a pep talk from Ellen Schaffer and Joe Brenner at EQUAL/Center for Policy Analysis, whose PowerPoint — “The Truth About Health Reform: It’s Up to Us” — helps to put priorities in order.
OBOS is committed to expanding our audience and in this spirit we’ve asked former board member Moises Russo to translate into Spanish several of our blog entries. We hope to translate more entries in the coming year.
En OBOS estamos comprometidos a expandir nuestra audiencia de lector@s y en este espíritu le hemos solicitado a Moisés Russo, ex-miembro de la Junta de OBOS, que traduzca al español varios de los blogs que tenemos en la página electrónica. Esperamos continuar con dichas traducciones durante este año.
Un informe dado a conocer este mes por el Instituto Southwest de Investigación sobre las Mujeres y el James E. Rogers Collage de Derecho en la Universidad de Arizona, ha expresado preocupación por el trato a mujeres que se mantienen en centros de detención de inmigración en Arizona.
El informe “Prisioneras Invisibles” (PDF), describe condiciones en tres instalaciones penitenciarias de Arizona. La información fue obtenida a través de entrevistas llevadas a cabo con mujeres actual y anteriormente detenidas en las instalaciones y a abogados y proveedores de servicios sociales “que han trabajado de cerca con mujeres detenidas en el estado”.
Las demoras en recibir servicios médicos, cuidados inadecuados, y la falta de atención a los asuntos de salud mental son algunos de los problemas descritos. Los alegatos incluyen la negación de una bomba mamaria (sacaleche) a una mujer que se encontraba separada de su lactante, el rechazo a proveer vitaminas prenatales, una mujer con cáncer cervicouterino con meses de espera para poder ser atendida por una enfermera y una mujer que había sido víctima de mutilación genital femenina y que estaba teniendo dolor abdominal severo a la cual se le dijo que debía “ejercitarse y cuidar su dieta”, cuando la verdadera causa del dolor era un gran quiste que necesitaba extracción quirúrgica.
Según un artículo del New York Times en el informe, “Katrina S. Kane, quien dirige las operaciones de detención y remoción para la Autoridad de Seguridad de Inmigración y Aduanas de Arizona, descarto el estudio como declaraciones faltas de evidencias de un número limitado de detenidas y sus abogados”.
Ella también afirmó que las denuncias de que una detenida no había recibido tratamiento para cáncer cervicouterino son falsas. Según el Times, un abogado de inmigraciones que tomó parte en el estudio “contrarrestó que las entrevistas con detenidas y mujeres anteriormente detenidas y sus abogados corroboraron el patrón de maltrato endémico”.
Last week, Raising Women’s Voices and Women of Color United for Health Reform delivered a letter [PDF] to House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid and several committee chairs on health care reform. The letter — signed by Our Bodies Ourselves and many other supporting organizations — thanks these leaders for their support of healthcare reform and provides recommendations related to women’s health for inclusion in the final legislation.
The signing organizations believe that the final legislation must not add new barriers or burdens to women’s access to abortion coverage and should eliminate the controversial Nelson/Stupak amendments. Instead, they argue, the legislation should return to the Capps amendment [PDF], which “preserves the ban on use of federal funds for abortion coverage, but does not exclude abortion from private insurance policies for which women will be using their own funds.” (See the Planned Parenthood Action Center for a good discussion of the three provisions.)
The groups also recommend a requirement that women’s preventive health services and screenings be covered without co-pays or deductibles; coverage of more people through expansion of Medicaid eligibility; establishment of an “exchange”; coverage for legal immigrants without a five-year waiting period; and making coverage more affordable while keeping penalties for violating coverage mandates less burdensome for low-income people.
The letter also expresses support for expansion of translation/language services; bringing Medicaid payment rates up to the same level as Medicare payments (in order to increase the number of providers accepting Medicaid); and a mandate that all Health and Human Services agencies collect data on ethnicity and primary language along with gender, race and other categories .
RWV is also running a cartoon postcard campaign to encourage people to contact their legislators and express their dissatisfaction with current versions of health care reform.
Related: The Center for Reproductive Rights recently released a video questioning the singling out of abortion for restriction in health reform legislation. The video asks what else an individual might not want to pay for with their own tax dollars. Watch it below, or read the transcript at Feministe.
Sponsored by the Kaiser Family Foundation, the webcast will examine aspects of the current Senate and House health reform bills that particularly affect women of color, who face additional health and access challenges.
Today’s panel will also address provisions in the bills that would affect access to and coverage of abortions, and recent findings from the U.S. Preventive Services Task Force.
Cara James, KFF senior policy analyst on race, ethnicity and health care, will moderate the discussion with:
Alina Salganicoff, Ph.D., vice president, director, Women’s Health Policy, Kaiser Family Foundation
Judy Waxman, J.D., vice president of Health and Reproductive Rights at the National Women’s Law Center
Paula Johnson, M.D., M.P.H., executive director of the Mary Horrigan Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital and associate professor of Medicine, Harvard Medical School
Panelists will take questions before or during the live program. Send questions to ask [at] kff.org.
The webcast is part of KFF’s series examining current issues in health disparities.
Last week, TPMMuckraker ran a story by Zachary Roth, “Drug-Makers Paying Off Competitors To Keep Cheap Generics Off Market,” about the deals (sometimes called “reverse payment settlements” or “reverse settlements”) made between drug companies in order to keep generic drugs off the shelves after the original patents protecting the brand name drugs have expired.
As Roth explains:
When a generic drug is approved to come to market, the maker of the more expensive name-brand drug sues the generic for patent infringement. But instead of a conventional settlement, in which the generic pays the patent-holder to settle the claim that it infringed the patent, the payment goes the other way: the patent-holder pays the maker of the generic, in exchange for a pledge to delay bringing the generic to market.
As a result of these “pay-for-delay” deals, cheaper generic drugs are often kept off the market for a longer period than they otherwise would be.
While the TPM story doesn’t mention any drugs specific only to women’s health, Prescription Access Litigation provides at least one relevant example — a patent litigation/generic case from the late 1990s over the breast cancer drug Tamoxifen. The Centers for Disease Control and Prevention estimates that 46 percent of Americans used at least one prescription drug in the past month, so many consumers (male and female) are affected by drug prices on a regular basis.
There’s been little action in recent years on proposed legislation to prevent such deals. The “Protecting Consumer Access to Generic Drugs Act of 2009″ — HR 1706 — was introduced earlier this year by Rep. Bobby Rush (D-Ill.), and so far, like similar bills introduced the past, it has not made it past the committee stage.
The House Subcommittee on Commerce, Trade and Consumer Protection held a hearing on the proposed legislation in March and apparently referred the bill on to the full Committee on Energy and Commerce, which does not seem to have considered it.
This past summer, the Department of Justice weighed in on one such case and concluded: “a settlement involving a payment to the alleged drug patent infringer in exchange for its agreement to withdraw its challenge to the patent and delay bringing its generic drug to market is presumptively unlawful and requires the defendant to offer justifications in order to avoid antitrust liability.”
The passage is bittersweet, but finally it’s done … With 6:51 time remaining to vote, Democrats have secured the 218 “yea” votes needed to pass the Affordable Health Care for America Act (HR 3962).
Final tally 220-215; 39 Democrats voted “no.” One Republican — Rep. Joseph Cao, who represents the New Orleans area — voted “yea.”
“Democrats have sought for decades to provide universal health care, but not since the 1965 passage of Medicare and Medicaid has a chamber of Congress approved such a vast expansion of coverage,” reports the Washington Post. “Action now shifts to the Senate, which could spend the rest of the year debating its version of the health-care overhaul. Majority Leader Harry M. Reid (D-Nev.) hopes to bring a measure to the floor before Thanksgiving, but legislation may not reach Obama’s desk before the new year.”
As I watched Democrats congratulate themselves, it was difficult to feel celebratory. Passage of the Stupak amendment — which bars a government-run insurance plan from offering abortion *and* prohibits women who receive government insurance subsidies from purchasing private plans that include abortion coverage — sucked a lot of the energy out of the room.
As Princeton professor Melissa Harris Lacewellsaid on Twitter, “Stupak feels like Prop 8 [which overturned same-sex marriage in California the same night President Obama was elected]. When the ‘win’ is accompanied by legislation that attacks the most marginal it doesn’t feel like a win.”
For a look at how each House member voted, check out this Washington Post graphic. You can sort the list by how much money each member has received in campaign contributions from the health industry and by the percent of people without health insurance in each district . The New York Times does a nice job of showing the geography of the vote (mouseover the states to reveal individual districts).
The House is debating the Stupak amendment limiting access to abortion services — you can watch it on C-SPAN.org, or follow along on the Twitters (hashtag #stupak), where many of us are quoting the representatives for and against. I’m @cmc2
And in case the current House bill’s provisions on abortion are in doubt, read Maggie Mahar’s analysis: “The fact of the matter is that the House bill contains more than two dozen references to abortion and virtually all of them describe how insurers can restrict or deny coverage for the procedure.”
Update: Amendment passed 240-194-1 (Republican Rep. John Shadegg of Arizona cast the lone “present” vote). A surprising number of Democrats – 64 — joined Republicans in passing the amendment. View the roll call here.
Tonight, with the aide of some 60 Democrats, women’s rights were effectively negated by the US Congress as the House passed the Stupak amendment to HR 3200, the Affordable Health Care Act of 2009.
More in-depth analysis of how we got here is forthcoming. But one thing is clear: The US Conference of Catholic Bishops (USCCB) apparently is running the US government, aided by a cadre of “faith-based advocacy groups,” the House Democratic leadership, the White House and members of the Senate.
Remember, this amendment is not a done deal. It still has to pass Senate and then survive the conference committee, and women’s groups are already mulling action in the weeks to come. But what a sad day it is when the only way to gain health care coverage is to lose a legitimate, legal health care procedure.
Another distressing point: The New York Times reports that only one male lawmaker — Rep. Jerrold Nadler of New York — joined women who spoke against the amendment on the House floor. A correction, however, is in order: My own Congressman here in Chicago, Mike Quigley, also spoke out (cheers!). But that may have been it.
Here, from the Times, are bits of what other lawmakers said during the debate:
Representing the abortion-rights segments of the Democratic membership, Representative Diana DeGette of Colorado called the amendment a “wolf in sheep’s clothing” that would deny women access to care. Representative Lois Capps of California argued that the underlying bill already prohibited federal financing of abortions. The amendment, she said, “Actually restricts coverage of a legal medical procedure.”
“Not one other medical procedure is singled out for rationing” in the larger bill, she said.
Others contended that this amendment would result in women having to go out and buy insurance that would cover such a procedure, a prospect one lawmaker scoffed at, saying a woman does not plan for an unplanned pregnancy.
Representative Nita Lowey, Democrat of New York, called it “a disappointing distraction” from the main event. Representative Barbara Lee, Democrat of California, said the amendment would take women “one step back” toward the dark days of back-alley abortions. Representative Rosa DeLauro, Democrat of Connecticut, said, “We should not be injecting this divisive and polarizing issue into our debate.”
And the full speech by Rep. Jan Schakowsky of Illinois:
This Stupak-Pitts Amendment goes way beyond current law. It says a woman cannot purchase coverage that includes abortion services using her own dollars — even middle-class women using exclusively their own money will be prohibited from purchasing a plan including abortion coverage in every single public or private insurance plan in the new Health Care Exchange.
Her only option is to buy a seperate insurance policy that covers an abortion — a ridiculous and unworkable approach since no woman plans an unplanned pregnancy.
This amendment is a radical departure from current law that will result in million of women losing the coverage they already have. Our bill is about lowering health care costs for millions of women and their families, not for further marginalizing women by forcing them to pay more for their care. This amendment is a disservice and an insult to millions of women throughout the country, and I urge a NO vote on this amendment.
These strong responses ultimately weren’t enough to kill the amendment, but they did serve as a reminder of the urgency of electing more pro-choice women to Congress. Anyone else have points to share?