    Donny Shaw of OpenCongress.Org has posted a story about the four amendments to the health care reform bill being considered by the Senate today. The Amendments are not online, but Shaw provides links to the websites of the four Senators who are offering the amendments. Details below.
    Senator Barbara Mikulski (D-MD) is offering an amendment that by its terms would expand coverage for preventive health services for women from those recommended by the United States Preventive Services Task Force (USPSTF) to those also recommended for women in comprehensive guidelines of the Health Resources and Services Administration. In a previous post I discussed how the USPSTF had decided not to automatically recommend mammograms for women until after the age of 50, and then only on a biennial basis. Mikulski issued a statement saying that under her amendment,
Services that would be covered under the Mikulski Amendment are likely to include cervical cancer screenings for a broad group of women; annual mammograms for women under 50; pregnancy and postpartum depression screenings; screenings for domestic violence; and annual womenâs health screenings, which would include testing for diseases that are leading causes of death for women such as heart disease and diabetes.
    Senator Lisa Murkowski (R-AK) is concerned about the same problem but offers a different solution. Instead of expanding preventive services to include those recommended by another agency, Murkowski would simply delete the reference to requiring coverage mandated by the USPSTF and would prohibit the government from using the recommendations of the Task Force to deny coverage. In her statement she says:
The Democratsâ health care bill under debate in the Senate would tie preventive care services offered by health insurance companies to the recommendations of the USPSTF. Murkowskiâs amendment would delete this provision from the bill and would prohibit the Secretary of Health and Human Services from using task force recommendations to deny coverage of preventive services, including mammograms and cervical cancer screening.
    (As I suggested in the previous posting, who was the genius at USPSTF who thought that this was a good time to issue the guideline cutting back on mammograms? On the other hand, that's what our advisors are supposed to do – tell us what we don't want to hear!)
    Michael Bennett (D-CO) has offered an amendment that makes no substantive change to the health care reform bill, but merely states that it does not reduce services for seniors under Medicare. In his statement he says:
The amendment states that nothing in the Patient Protection and Affordability Act will result in a reduction of guaranteed Medicare benefits. This amendment ensures that improvements to Medicare are made in the Senate health reform bill and extends the solvency of the program, lowering premium costs and improving care for seniors.
    (In other words, "We Democrats may be dumb but we're not stoooooopid!")
    John McCain wants to eliminate the cost-saving measures under Medicare and Medicare Advantage from the bill. In his statement he says:
"Today I introduced my amendment to address the Democrats' drastic and dramatic cuts to the Medicare program under their so-called 'health care reform' legislation," said Senator John McCain. "My amendment would send this legislation back to the Finance Committee with instructions to report the bill to the Senate without these irresponsible cuts. Slashing Medicare by nearly $500 billion, one-half a trillion dollars, to create a new federal health care entitlement is not health care reform," McCain continued. "These reductions include $120 billion to the Medicare Advantage program, $150 billion to providers including hospitals, hospice, and nursing homes, and $23 billion in unspecified decreases to be determined by an 'Independent Medicare Advisory board.' Simply put, these Medicare cuts will impacts senior's access to quality care. This is a price that American's should not be asked to pay."
    I discussed the elimination of the 14% premium for Medicare Advantage in this post from November 23. Many experts regard this premium as a boondoggle for insurance companies that does little for patients.  In this report "Bending the Curve: Effective Steps to Address Long-Term Health Care Spending Growth," published in August of 2009, the Brookings Institute recommends instituting competitive bidding for Medicare Advantage. I agree with the Institute and do not agree with Senator McCain. We can squeeze the waste out of Medicare without reducing services.
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In other words, "We Democrats may be dumb but we're not stoooooopid!"
Quotable quote, Professor Huhn!
Your coverage on the health care debate is amazing. Once exams are over, I look forward to reading them thoroughly, versus the brief glance I have time for now.
Thanks!
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