Posts Tagged ‘healthcare reform debate’

The UK: American Healthcare Reform’s Mirror Image

Wednesday, July 25th, 2012

If you want to see a twin of our healthcare reform battle, try the other side of the Atlantic: England is undertaking the biggest reform of its government healthcare program, the National Health Service, as part of its massive 5-year austerity program. “After a year in parliament, more scrutiny than any bill in living memory, and more than 1,000 amendments in the House of Commons and the House of Lords,” as the Guardian newspaper put it, “MPs cast their final vote for the (reform) bill.” At its heart are plans which will give primary care providers more sway over the NHS’s £106 billion annual budget, and introduce more private competition. British reform moves quicker than ours — the program takes effect over the next 12 months. A major plank of the reform is the NHS Mandate, under which the government will set targets for improvement in 60 areas of care, such as patients surviving after cancer treatment, and medical errors. The goals? Reduce administration costs by one third.

And, in another instance of seeing double, we’re watching the other side working hard to repeal it and vowing to do so on Day One if they win the next election. “The government’s reforms to the NHS in England have undermined the service and opened the door to privatization,” said (opposition) shadow health secretary Andy Burnham, who championed Labour’s motion, which claims that treatments and services are being rationed in the NHS. In an opposition-led debate on the NHS on 16 July 2012, Mr. Burnham said: “We will repeal the bill; it is a defective, sub-optimal piece of legislation that is saddling the NHS with a complicated mess.” But (government) Health Minister, Simon Burns said: “Far from the meltdown that some gleefully predicted, we have seen a robust and resilient NHS delivering better care for patients. Waiting times remain low and stable, in fact below where they were at the last general election.”

So, just to recap, here we have the conservatives championing reform and austerity and the liberals pleading for repeal in opposition to a privatized system and rationing.  All of this, of course, is part of the cost-cutting program that some say caused Britain to fall back into a double-dip recession. After the 2010 general election, Prime Minister David Cameron, leader of a coalition of the Conservatives and the Liberal Democrats, initially said that the austerity program would finish by 2015. During this period, more than £80 billion would be raised by spending cuts and tax rises. However, the program was extended to 2017 last fall with further savings £30 billion hoped for.

Alan Frumin Is Playing an Important Role in the Healthcare Reform Debate

Thursday, April 8th, 2010

A little-known star in achieving healthcare reform is Alan Frumin, the Senate’s Parliamentarian, who wields as much power over the debate as President Barack Obama.  A scholar of Senate procedure, Frumin is one of the few people who fully comprehend the arcane rules that govern a piece of legislation’s progress on the Senate floor. Though Frumin is technically an advisor to the Democratic majority – who gave him the job — Senators can rule on procedures as he recommends or ignore him and act as they please.Senate Parliamentarian Alan Frumin is in the healthcare reform hot seat.

Frumin is in the spotlight because of the possible use of reconciliation, the parliamentary shortcut that lets the Senate pass legislation with a 51-vote majority instead of the usual 60. According to the Byrd rule of 1985 – named for its author, Senator Robert Byrd (D-WV) – reconciliation is intended to be used only with budget-related items.  In keeping with that, Frumin has said that reconciliation must be related to existing law.  Frumin’s ruling is that the House of Representatives must pass the Senate healthcare plan, send it to President Obama for his signature, and then vote to pass the “fixes” proposed by the president.

Once the vote reached the Senate, Frumin found two errors in the legislation, which meant that the bill had to go back to the House after Senators voted to approve by a 56-43 margin.  The House voted its final approval in a 220 – 207 vote and was sent back to President Obama’s desk for his final signature.

The parliamentarian’s advice is not set in stone.  Vice President Joseph Biden, in his role as Senate president, can overturn the parliamentarian’s ruling.  “This is probably the most difficult situation for any Senate parliamentarian in my memory,” said Robert Dove, who previously held the position.  “I was never under the pressure that Alan Frumin is under right now.”