First published 7/17/11 on Kaiser Health News
Health reform raises central ideological questions about the size and scope of government, about progressive taxation, about the individual mandate and more. It’s easy to forget that cost control will be a huge challenge, no matter how these ideological matters are resolved, indeed under any health system. Finding the right combination of humanity and restraint will be particularly hard in addressing life-threatening or life-ending illness. Economic incentives, American culture, a changing doctor-patient relationship and fundamental uncertainties at the boundaries of clinical care conspire against our efforts to provide more humane, more financially prudent care.
First published 5/5/11 on Kaiser Health News
An excellent Chicago Tribune story by Rex Huppke details the impact of cuts to home and community-based services in Illinois. Huppke recounts the story of 81-year-old Lorraine Phifer, who cares for her son William, who has cerebral palsy. Phifer has a wheelchair van, but she can’t maneuver him into it by herself anymore. He has also required help with a wheelchair lift to get into and out of bed. Staff from the University of Illinois at Chicago Assistive Technology Unit have come out to the Phifer home and provided valuable help. That unit now faces a 70 percent budget cut.
UIC’s intellectual disabilities family clinics, which offer a range of services that are hard to access elsewhere, also face deep cuts. My intellectually disabled brother-in-law occasionally uses these facilities, too. I am not a disinterested observer.
Continue reading “The Real Impact of Cutting Medicaid Just When We Need It The Most”
Dr. Donald Berwick runs the Centers for Medicare & Medicaid Services. He now serves under a recess appointment that will expire at the end of this year. And, although the president could take the politically risky step of extending his tenure with another recess appointment, officially naming him to run the agency for the long haul would require Senate confirmation. News reports suggest that this won’t happen. Berwick may not even receive a hearing.
We can’t evaluate the backstage politics, but one thing is certain. Both Democrats and Republicans should be dismayed at the sight of a partisan campaign driving yet another distinguished figure out of American government.
Continue reading “The Donald Berwick Predicament”