Traditionally, New York's representatives in Congress are the standard-bearers of teaching hospitals and their various causes, which include pleading for more Medicare dollars. That's not surprising, considering that New York boasts one of the highest concentrations of teaching hospitals in the nation.
What is surprising is that the Association of American Medical Colleges is steering clear of its old allies from New York and finding new advocates in Congress.
The association credited Illinois teaching hospitals, particularly the University of Chicago Hospitals, with stirring up the congressional support.
But some say first lady Hillary Rodham Clinton's expected bid for a Senate seat in New York is behind the switch.
Clinton began sympathizing with teaching hospitals after her "listening tour" of New York several months ago. On Oct. 14, she addressed the Healthcare Association of New York State's annual conference and talked about the impact of the Balanced Budget Act of 1997.
That, in turn, has raised the ire of some congressional Republicans, who suspect that giving teaching hospitals a financial break will give Hillary a political break.
So teaching hospitals have recruited a number of Illinois members of Congress to speak on their behalf, including Reps. Danny Davis and Janice Schakowsky and Sen. Richard Durbin, all Democrats. And let's not forget that House Speaker J. Dennis Hastert, a Republican, hails from Illinois.
Race matters. Most African-Americans are unaware that blacks fare worse than whites in important health benchmarks, such as infant mortality and life expectancy, a new national survey shows.
But majorities of both whites (55%) and blacks (58%) surveyed did not know that infant mortality rates are higher for blacks than for whites, according to a new survey by the Menlo Park, Calif.-based Henry J. Kaiser Family Foundation.
While most African-Americans believe there are racial disparities in access to healthcare, 67% of whites believe African-Americans are "just as well or better off than the average white person."
Credibility gap. A month after Sen. Charles Grassley (R-Iowa) called it on the carpet for making bogus claims about nursing homes being persecuted by government inspectors over minor infractions, the American Health Care Association seems intent on running what's left of its credibility into the ground.
In a recent release condemning Medicare cuts, the nursing home trade group said those cuts "have already thrown a large number of skilled-nursing facilities-from national companies to independent, nonprofit and faith-based facilities-into bankruptcy."
Recent bankruptcy filings by Vencor, Sun Healthcare and other for-profit chains aside, Outliers was not aware of mass filings among not-for-profit facilities. Neither was the Catholic Health Association or the American Association of Homes and Services for the Aging, which represents not-for-profits. Asked for a list to back up their claims, a spokeswoman said no such list existed, nor could one be produced.
Stark humor. Give the staff of Rep. Fortney "Pete" Stark (D-Calif.) credit for creativity. The latest missive from the office of the senior Democrat on the House Ways and Means health subcommittee spoofs industry-financed advertisements opposing President Clinton's plan to include prescription drugs in the Medicare benefit package.
The industry-funded TV advertisements by the Citizens for Better Medicare feature a friendly-but-firm beneficiary named Flo who doesn't want Medicare in her medicine cabinet.
Stark's spoof ads, funded by the satirical "Corporations for Beaucoup Margins," begins, "Hi, I'm Flora. Maybe you've seen my commercials. They are paid for by drug companies that make lots and lots of money selling you overpriced prescriptions. How else do you think these companies can afford all the silly ads that don't have a clear message?"
The "advertisement" goes on to criticize the drug benefit called for under the plan drafted by the National Bipartisan Commission on the Future of Medicare as being "the most profitable Medicare reforms for drug companies."
Define "no way." President Clinton quibbled with investigators in the impeachment proceedings over the meaning of "is." House Ways and Means Committee Democrats now are sparring with their Republican counterparts over the meaning of "should" and "shall."
The issue arose during the Ways and Means health subcommittee's hearing to pass a bill that will roll back payment restraints imposed under the Balanced Budget Act of 1997.
At the same time, subcommittee Chairman William Thomas (R-Calif.) is pushing the Clinton administration to make regulatory changes that will ease the spending curbs. He included language in the legislation saying HCFA "should" make certain regulatory changes, but doesn't order those changes by saying "shall."
There's a point to the madness. Ordering HCFA to do it by using the word "shall" would force the Congressional Budget Office, the official arbiter in fiscal disputes, to estimate a spending increase and make Congress look like spendthrifts. But if HCFA, responding to the "shoulds" contained in the legislation, eases cost caps, the increased spending doesn't count for the CBO's purposes, and Congress comes away looking better.
Quotables. "I love it that he came in as the radical and I get to be the conservative."-HHS Secretary Donna Shalala, speaking to the U.S. Chamber of Commerce, on a proposal by Rep. William Thomas to eliminate employer-based health coverage and give individuals the tax deductions that employers enjoy for covering employees.
* "I see the world now not so much from the viewpoint of an academic but from someone who has to deal with 107 managed-care bills in the California Legislature."-Walter Zelman, a Harvard School of Public Health instructor who last year became president and chief executive officer of the California Association of Health Plans, at this month's Harvard Conference on Strategic Alliances in Healthcare in Boston.