If healthcare interests want more pork-barrel provisions in the federal budget next year, they need to see their senators.
According to several House aides, the Senate is responsible for generating most of the pork fattening up the recently signed revisions to the Balanced Budget Act of 1997. The changes give back billions of dollars to providers stung by the Medicare reductions in the 1997 law. But numerous provisions helped individual hospitals in states represented by such key members of the Senate as Majority Leader Trent Lott (R-Miss.) and Sen. James Jeffords (R-Vt.), chairman of the Health, Education, Labor and Pensions Committee.
Sources say Rep. William Thomas (R-Calif.), chairman of the House Ways and Means health subcommittee, was the key to keeping pork out of the House version of the bill. The House compromised with the Senate to come up with the final version of the bill, which President Clinton signed on Nov. 29.
"If you look at the House bill, it was clean," says a Ways and Means spokesman, who asked not to be identified. "Mr. Thomas was very adamant about that. When you're dealing with a finite amount of money, you want to make sure you keep it national in scope and balance the playing field out."
Buy low, but after the settlement. When looking for investment opportunities, it pays to search out growing companies and to shy away from ones under investigation by the feds, right?
Not necessarily, according to the January issue of SmartMoney, a personal finance magazine published by the Wall Street Journal.
Two for-profit hospital companies-one of them in trouble with the feds and the other less known to many investors-made the magazine's list of top 12 stock picks for 2000.
One of them, Nashville-based Columbia/HCA Healthcare Corp., still has a federal whistleblower investigation hanging over its head and boasted declining profits and revenues in the quarter ended Sept. 30, 1999.
But Columbia, with a price-to-earnings ratio of 19, should be able to boost earnings by 15% per year, according to the SmartMoney prognosis. And as for the federal investigation, well, not a problem, evidently.
If investigators had much to go on, they'd have nailed the company by now, SmartMoney quotes Peter Costa, a healthcare analyst from ABN Amro, as saying.
Also making the list as a runner-up is rural hospital company Health Management Associates, Naples, Fla., which has a price-to-earnings ratio of 15 based on fiscal 2001 earnings projections. The company is an attractive investment because it is often the only game in town in its rural markets, according to the report.
Just say no. When the American Medical Association's House of Delegates voted last month to support the distribution of condoms in schools, it raised the ire of at least one physician in Congress.
So much so that the physician, Rep. Tom Coburn (R-Okla.), released a statement Dec. 14 that chastises the AMA and sent association President Thomas Reardon, M.D., a letter blasting the group's decision. Coburn, a family physician with an obstetric practice, favors advocating abstinence over handing out condoms.
"The AMA resolution. . .endorses a `risk reduction' rather than a `risk avoidance' strategy in addressing the problems of adolescent pregnancy and sexually transmitted diseases," the statement said.
Coburn argues that neither research nor experience supports the AMA's position. He hasn't been happy with the association's agenda in general lately. The AMA endorsed an aggressive managed-care bill competing with Coburn's own proposal. The AMA-backed bill, co-sponsored by Reps. Charlie Norwood (R-Ga.) and John Dingell (D-Mich.), passed the House in October.
Tough talk. Normally, the American Medical Group Association doesn't like to pick fights. It usually leaves that kind of dirty work to the AMA, which readily tangles with payers of any stripe.
But in a sign of just how dire the financial situation of the nation's preeminent physician organizations has become, Alexandria, Va.-based AMGA last month announced a campaign to "retake control" of the nation's healthcare system from for-profit insurers.
The association, which represents some of the nation's largest and best-known medical groups, such as Mayo Clinic and Henry Ford Medical Group, intends to develop a "war plan" at its national conference in March. It has asked members to create a list of demands to use in negotiations with health plans.
"I'm sure we'll have some members who think we're being much too militant, much too aggressive," says AMGA Chief Executive Officer Donald Fisher. "But I think the window of opportunity for physicians to regain their rightful place in healthcare decisions is short."
We're not alone.If the Institute of Medicine's November report on medical errors shook American hospitals, imagine how the Australian healthcare sector feels.
The Associated Press reports that the government is being accused of being too slow to tackle a poor hospital safety record after new research showed mistakes were killing or injuring patients at up to three times the rate in the U.S.
The IOM report was based on a government-commissioned study by Harvard University experts that found adverse events, mostly attributable to human error, were associated with 3.2% of admissions in two U.S. states. In Australian hospitals the rate was 10.6%. The study, reported in The Australian newspaper, found such events included medical and surgical mistakes, abnormal reactions to procedures and adverse reactions to drugs.
Quotable. "The University of California-San Francisco is hiring the Hunter Group again to bring UCSF back into shape, which is like hiring Dracula to dress your neck wound."-Charles Idelson, spokesman for the California Nurses Association. The Hunter Group was brought in at UCSF-Stanford Health Care before its merger fell apart.