View Full Version : U.S. Issues Dem Leader Harry Reid's Idea Of Health Care Cost-Savings

09-22-2009, 08:37 AM
WASHINGTON — The Nevada Cancer Institute, in Las Vegas, may not have a national reputation as a clinic or a research facility. But it does have the ear of its state’s senior senator, Harry Reid, the Democratic leader. And that is why the four-year-old institute could reap a big gain in federal reimbursements as part of the health care overhaul.

After months of noisy public debates over big policy ideas like universal coverage and a public insurance option, the health care legislation is getting down to the fine print. This is the time when powerful members of Congress customarily tuck in their pet projects, either to please their constituencies or as sweeteners to win the votes of lawmakers who may be sitting on the fence.

Senator Blanche Lincoln of Arkansas, a wavering Democrat on the Senate Finance Committee, has proposed expanding Medicare coverage of home infusion therapy, a form of treatment for a variety of purposes that is championed by a medical entrepreneur in her state. Senator Orrin G. Hatch, a Utah Republican on the panel, is seeking a health care tax break for any state that “begins with the letter U.”

But few proposed amendments to the health care bill now before the Finance Committee better exemplify the process than one that would help out the Nevada Cancer Institute. Known in Congressional parlance as a “rifle shot” — the narrowly focused tax or policy equivalent of a spending earmark — the proposal would provide more favorable Medicare payment rates to just a handful of specific medical facilities.

Three of them — a hospital under construction in Cleveland, a venerable center in Detroit and, apparently, another in New Jersey — are among some 40 “comprehensive cancer centers” that have received grants with that designation from the government’s National Cancer Institute. The young Nevada institute has not earned that status. It aspires to it, though, its Web site says.

In addition to the favor of the top Senate Democrat, the amendment has the sponsorship of two other members of the party leadership, Senators Debbie Stabenow of Michigan and Robert Menendez of New Jersey, suggesting it is a rifle shot with some velocity. A spokesman for Ms. Stabenow called the provision a “typical rifle shot.”

The identities of the beneficiaries are hard to determine on first reading. The text of the amendment describes its purpose only as ensuring “access to high quality cancer care.”

Then, in classic rifle-shot style, the text masks the names of the beneficiaries by using, in a kind of code, the dates they first received “comprehensive cancer center” grants from the National Cancer Institute. The amendment would cover “certain hospitals” if they “received N.C.I. comprehensive cancer care designation on July 27, 1978, February 17, 1998, June 13, 2000.”

The first date turns out to refer to the Karmanos Cancer Center in Detroit. A government relations official there said the hospital had been seeking such an exemption for about six years through Senator Stabenow and its local congressman, Representative Sander M. Levin. Mr. Levin, a Democratic member of the House Ways and Means Committee, is among the outspoken supporters of a public insurance plan whom the president and Senate leaders may try to woo to a compromise.

The second date refers to University Hospitals in Cleveland, which is building a new cancer hospital and has lobbied hard for such treatment. (One of Ohio’s senators, Sherrod Brown, a Democrat, helped write the public insurance option in the Senate health committee’s bill.)

The third date is more of a mystery, or perhaps a result of a drafting error. A spokeswoman for the National Cancer Institute could find no record of a hospital that received a “comprehensive cancer center” grant on June 13, 2000. But the date appears intended to refer to the Cancer Institute of New Jersey and an affiliate, Robert Wood Johnson Medical School.

A spokesman for the institute’s congressman, Representative Frank Pallone Jr., a Democrat who heads the House Energy and Commerce Subcommittee on Health, said he believed the Stabenow-Menendez amendment covered that cancer center. Mr. Pallone has long tried to win such treatment for the center, to help it compete with regional rivals.

The amendment also covers one more cancer center, in similar code: “designated on June 10, 2003, as the official cancer institute of its state.” That is the date the Nevada Legislature voted to assign that title to the Nevada Cancer Institute, which was then still under construction.

The substance of the amendment would exempt each of the centers from the Medicare “prospective payments” system, which compensates hospitals on the basis of diagnoses rather than treatments they actually provide. The exemptions would add to these centers’ income and the cost to taxpayers, although, in an apparent nod to the narrow scope of the amendment, the authors note that it would be unlikely to add much to that cost, because it “is unlikely to affect a large number of hospitals.”

Hospital officials pushing for the exemption argue that the prospective payments system is inadequate to cover the high costs of cancer treatment. They note that about 10 of the 40 comprehensive cancer centers already have exemptions, giving them a competitive advantage.

The Nevada Cancer Institute has spent about $115,000 on federal lobbying fees this year. Jennifer McDonnell, a spokeswoman there, said the institute could not have sought the exemption in any way other than Congressional action, because at present that is the only way for a hospital to attain it.

As for the majority leader, his spokesman, Jim Manley, said only, “Senator Reid has supported efforts in the past to help the Nevada Cancer Institute and will continue to do so in the future.”

09-22-2009, 08:55 AM



09-22-2009, 08:56 AM
This is one reason why you don't want politicians controlling the system...

09-22-2009, 08:58 AM
Frankly, I'm shocked that a Dem politician facing an uphill battle for reelection took this opportunity to feather his nest.