When the Senate used a procedural vote earlier this month to kill a Democratic managed-care-regulation measure, four Republicans crossed party lines to vote with Senate Democrats in what was otherwise a straight party-line vote.
Besides voting with the Democrats, all four of the Republicans-Christopher Bond (Mo.), Alphonse D'Amato (N.Y.), Lauch Faircloth (N.C.) and Arlen Specter (Pa.)-have something in common. They are all running for re-election in November.
Several sources close to the vote absolved Specter, who is one of the Senate's most renowned mavericks, of any political motive. He is not in a close race and has long supported the patient-rights measure.
The other three did not draw the same reaction. They may have used the tried-and-true congressional maneuver: As long as the party has enough votes to win, a member can go against his or her natural leanings so as not to hand an opponent a weapon.
Go figure. Baffling how two surveys that purport to measure the same thing over the same period of time can reach disparate conclusions.
Earlier this month, the Medical Group Management Association released its annual Physician Compensation and Production Survey. Its news release, titled "Physician compensation stays flat for second straight year," noted that while primary-care compensation increased less than 1% last year, to $135,891, specialists saw a half-percent drop in pay, to $220,476.
Four days later, the American Medical Group Association released its 1998 Medical Group Compensation & Productivity Survey. The AMGA's take: "Physician compensation and productivity increase for most specialties."
AMGA spokeswoman Laura Johnson chalks it up to sampling differences: "My sense it that most of the folks who responded to our survey are from large multispecialty groups and MGMA's tend to be smaller, so that kind of accounts for it."
The brick wall moves. He's one of the people whom ambitious healthcare dealmakers in California dread crossing. Now James Schwartz is switching sides.
Schwartz, 52, the deputy state attorney general who successfully blocked such healthcare mergers as the Columbia/HCA Healthcare Corp.-Sharp HealthCare deal, is taking a new job as a partner in the Los Angeles law firm of Manatt Phelps.
The move is a dramatic change for Schwartz, a direct but soft-spoken type who has been with the attorney general's office for his entire 27-year legal career. He had had offers from the private sector in the past but always turned them down. "This one was the right opportunity," he says, adding that his focus at Manatt Phelps would be national healthcare alliances and mergers.
Politics also plays a role in Schwartz's departure: His boss, California Attorney General Dan Lungren, is the Republican candidate for governor, so there will be a new attorney general.
Fruitful experiment. Suffer a long wait to see a doctor at Medford (Ore.) Clinic, and you're in for a treat.
About a month ago, the 85-member multispecialty group opened a $15,000 account with locally based food mail-order company Harry and David and empowered all its employees to send "recovery baskets" of nuts, candies and fruit to patients who receive poor service.
To pay for it, the group cut money from its promotions and advertising budget based on the belief that positive word of mouth is more effective.
"It's up to staff to use their best discretion and judgment as to when someone should receive one," says clinic Chief Executive Officer John Ness. So far about 50 baskets have been sent, Ness says. "Patients can't believe it," he says. "They call me. Usually they get ahold of my secretary and they say, `Thank you very much for noticing.' "
Harmony behind closed doors. How did Congress approve a massive expansion of health insurance for children in 1997 but fail to pass a nationwide healthcare reform package in 1994?
Asked that question at a recent conference of the Alliance for Health Reform, Sen. Jay Rockefeller (D-W.Va.), a healthcare reform advocate and the alliance's chairman, partly blamed the media.
The media treatment of President Clinton's healthcare reform package in 1994 was largely over the politics surrounding it rather than the issues driving Clinton's call for change, Rockefeller said. "Let's see what the Clintons are like" was the typical tone of healthcare reform coverage in 1994, largely driven by the president's enemies, he said.
But to pass the Children's Health Insurance Program as part of the Balanced Budget Act of 1997, members of the Senate Finance Committee, on which Rockefeller sits, met behind closed doors and cut the deals necessary, he said.
Sen. Orrin Hatch (R-Utah), ordinarily no friend to Clinton or to liberal causes, "was so into it that he got to his feet and demanded that extra money be put into children's health insurance," Rockefeller said.
Musical patients. Hurricane Georges threw more than a scare into New Orleans late last month; it forced local hospitals into a tizzy as they moved patients, staff and materials from one hospital to another.
On Sept. 26, about 2,500 staff, physicians and family members crashed in the unused clinic portion of Tulane Hospital and Clinic; patient care on the hospital side was uninterrupted. "It was a controlled madhouse," says Tom Davis, a manager of food and linen services at the hospital, 80% owned by Columbia/HCA Healthcare Corp.
Meanwhile, Lakeland Medical Center, a Columbia-owned facility situated 2 feet above sea level in downtown New Orleans, closed up shop, sending 60 patients, along with staff, beds, food and linens, to Tulane.
Three hours after the last Lakeland hospital patient had been moved to Tulane, the Orleans Parish office of emergency preparedness asked Lakeland to reopen and take in 98 residents of two nearby nursing homes, says Christine Gilbert, media coordinator for the hospital. Staff, linens, food and beds were relocated as well. Meanwhile, 100 family members joined 80 inpatients at the DePaul-Tulane Behavioral Health Center; also swelling the ranks were 20 psychiatric patients and attendant staff from rival River Oaks Hospital in nearby Harrahan.