After months of negotiations, hours of committee meetings and hundreds of amendments, the Senate Finance Committee has voted to move its health care reform bill out of the committee phase thus moving health care reform efforts closer to the finish line.

The vote was 14-9 with Senator Olympia Snowe (R-ME) as the sole Republican vote for the bill.  Snowe said in her remarks that she will vote “yes” today, but that did not mean that she will vote “yes” in the future.  Iowa Senator Charles Grassley (R) voted “no” stating in his remarks, “This bill is already moving on a slippery slope toward more government control of health care.”

The committee’s move completes the committee phase on health care reform, as the other four Congressional committees (1 Senate, 3 House) have completed work.  The Finance bill will now be melded with the Senate Health, Education, Labor and Pensions bill before moving to the Senate floor for a vote.  Meanwhile, the House continues to wait and see what results in the Senate before taking its bill to the floor for a full House vote.

Many are speculating that the health care reform debate will continue, and some are questioning whether or not a bill will make it to the president’s desk before the Congressional Thanksgiving recess in November. 

Senate Finance Committee Chairman Max Baucus (D-MT) has released a document outlining a framework for health care reform which is likely to set the stage for draft legislation for committee consideration perhaps even yet this week.

The framework lays out several key priorities and is the result of ongoing negotiations in the Senate by the “Gang of Six” (key Democratic and Republican negotiators including Iowa Senator Charles Grassley) that has been working toward a bipartisan agreement. 

One major development in the Senate’s version is that instead of a government-run public insurance option as found in the House bill, the framework rather creates a network of nonprofit cooperatives that would be charged with pooling individuals and negotiating with insurance companies and providers.

Other initiatives include the establishment of health insurance exchanges in 2010 and requiring health plans to report the amount of money they spend on items other than health care and require insurers to cover pre-existing medical conditions.

The report is broken down into seven sections:

• Immediate Relief For Families And Small Businesses
• Ensuring Affordable Health Coverage
• Promoting Disease Prevention And Wellness
• Improving The Quality And Efficiency Of Health Care
• Transparency And Program Integrity
• Fraud, Waste, And Abuse
• Revenue Provisions

Baucus is also proposing tax credits to help individuals who earn up to 300 percent of the federal poverty level, or $66,000 for a family of four, to purchase health care coverage. In addition, individuals who earn between 300 percent and 400 percent of the federal poverty level would be eligible for a premium credit as a flat percent of income.

The Finance Committee is continuing negotiations and several concepts from the framework are expected to be included in the bill draft the committee will mark-up in the coming weeks.

Click here to read the framework document.

Iowa Senator Charles Grassley heard a clear, unified message from the state’s hospital leaders at a meeting in Des Moines this week:  stay at the health care reform negotiation table and fight to fix geographic variation in Medicare payment.  Grassley, who is one of six key Senators negotiating language for that chamber’s reform bill, said he is committed to including that fix in the final bill and will “be at the table until I am pushed away.”

At the same meeting, the American Hospital Association (AHA) backed the IHA-formulated plan to address Medicare geographic variation through value-based purchasing.

Meeting with more than 30 hospital CEOs and other executives at Des Moines University, Grassley told the group he wants to understand the priorities of Iowa hospitals.  “I appreciate the help we get from AHA and the work they do, but I am much more interested in how you folks see it,” Grassley said.  “I want to be able to gauge the progress of addressing your ideas.”

Over the course of the hour-long discussion, Grassley heard several concerns related to health care reform and its impact on Iowa hospitals, including the need to address Medicare payment issues for “tweener” hospitals through a low-volume adjustment and reauthorization of the Medicare Dependent Hospital program.  Grassley said Iowa hospitals have done a great job of keeping the “tweener” issue in the forefront, noting that he now had the names of the impacted hospitals memorized.

The meeting with IHA members was one of the last for Grassley before he returns to Washington, D.C. to resume work on the health care reform legislation.  Having spent most of August hearing the concerns of Iowans at well-attended town-hall meetings, Grassley said his faith in grass-roots democracy has been revived.  He also noted he consistently heard from hospital representatives at those forums.

“For the most part, Iowans can be proud of how they conducted themselves at those meetings,” Grassley said.  “A lot of what we saw on the media didn’t reflect what I saw here in Iowa.”

Developing more specific proposals and finalizing legislation will be difficult over the next three months, said Grassley, who reiterated his commitment to a bipartisan bill.  “There are a lot of unknowns out there,” he said.  “Maybe we’ll know after the president speaks next week,” he added, referring to President Obama’s speech on health reform before a joint session of Congress on September 9.

The last time a president addressed a joint session of Congress that wasn’t a State of the Union or the traditional first address by a new president was when President George W. Bush spoke about the war on terrorism following the 9/11 attacks.

Have thoughts about the health care reform debate and how it is impacting Iowa?  Leave your comments below.

As the health care reform debate continues, it is critical that Iowa’s Congressional Delegation hear from hospital leaders on the issues, especially in light of the announced cuts to hospital payments.  Over the next few weeks, Iowa Senators Tom Harkin and Chuck Grassley and their staffs will be traveling across Iowa holding listening posts and town hall meetings on health care reform.  Hospital leaders are encouraged to attend these meetings and take the opportunity to address concerns about health care reform.

It is very important for hospital leaders to attend these forums to address concerns and share ideas.  IHA has produced talking points for hospital advocates to use while addressing Iowa’s congressional delegation in these meetings.  Our health care reform hospital talking points have been updated to include the recent announcements of major cuts to Medicare.

Events hosted by Senator Grassley

Grassley is the ranking member on the Senate Finance Committee that oversees the Medicare program and other health care finance related issues.  He is not holding specific hospital meetings, but will be holding the following events:

June 30 8:15-9:15 a.m. Allamakee County Town Meeting Farmers & Merchants Savings Bank Community Room 201 West Main Street, Waukon	July 3 7:30-8:30 a.m. Marion County Town Meeting Pella Community Services Building 712 Union Street, Pella
10:45-11:45 a.m. Clayton County Town Meeting Elkader City Hall Lower Level 207 North Main Street, Elkader	10:00-11:00 a.m. Poweshiek County Town Meeting Brooklyn Public Library 306 Jackson Street, Brooklyn
1:45-2:45 p.m. Dubuque County Town Meeting Dupaco Community Credit Union 5865 Saratoga Road, Asbury	12:00-1:00 p.m. Tama County Town Meeting Renig Toledo Civic Center 1007 South Prospect Drive, Toledo

Events hosted by Senator Harkin

Harkin chairs the Health, Education, Labor and Pensions Committee’s Prevention and Public Health Working Group charged with crafting the prevention and public health components of the health reform bill. Notice time change for Cedar Rapids.

June 29 9:00-10:00 a.m. Linn Community Health Center Medical Plaza Building- Lower Level 855 A Avenue NE, Cedar Rapids	June 30 9:30-10:30 a.m. Adair County Memorial Hospital 609 Se Kent St., Greenfield	July 1 9:00-10:00 a.m. Winneshiek Medical Center Conference Room B 901 Montgomery Street, Decorah
10:30- 11:30 a.m. (corrected) St. Luke’s Hospital 1026 A Avenue NE, Cedar Rapids	11 a.m.-noon Regional Health Services Of Howard County 235 8th Avenue West, Cresco	10:00-11:00 a.m. Denison Community Room 111 N. Main Street, Denison
12:30-1:30 p.m. (corrected) Mercy Medical Center 701 10th Street SE, Cedar Rapids	1:30- 2:30 p.m. Guthrie County Hospital Todd/ Neff Conference Room 710 N 12th Street, Guthrie Center	11:30-12:30 p.m. Crawford County Senior Center 201 S. Main Street, Denison
	2:45-3:45 p.m. Mercy Medical Center- New Hampton Health Education Center 308 N. Maple Avenue, New Hampton	11 a.m.-noon Veterans Memorial Hospital Lower Level Large Conference Room 9 40 First Street SE, Waukon
	4:00-5:00 p.m. Grape Community Hospital Cafeteria 2959 State Highway 275, Hamburg	2:00-3:00 p.m. Burgess Health Center Boardroom 1600 Diamond Street, Onawa

Attending an event? Send us your feedback

If you attend any of these events, feel free to send us your notes or feedback about what was discussed. We’d love to continue these conversations on our blog.

Content can be forwarded to Dan Royer.

The 2008 presidential campaign introduced mainstream America to the power of social media and online communication in a way it had never experienced before.  People organized events, made donations and contacted supporters like they have always done, but the amplification for their messages that social technology provided enabled them to reach more people more quickly.  As people began realizing how impactful this technology could be when used in the right way, more organizations and political groups began integrating it into their communications strategies.

Social media penetrates politics and the public

This leads us to today, when individuals, groups and companies are using freely available technology to engage loyal supporters and introduce their messages to people who may never have heard them before.  Aside from consumers and private-sector organizations, these users also include members of local, state and federal government.

What was once often only discussed behind closed doors or in whispers between party members is now made available to consume in the public forum.  This new age of transparency and interaction allows people to make opinions and thoughts known before they have the chance to pass through political filters or press secretaries.

Be ready for real-time feedback and responses

A recent example includes several messages sourced from Senator Chuck Grassley (R-IA) illustrating his frustration with President Obama, who was making a stop in Europe last week.  There is nothing new about Senators and politicians having disagreements with the president, but the channel through which Grassley’s views were presented and the public availability of said comments would have been unheard of just a few years earlier.

Grassley posted several messages on his Twitter account, a microblogging social network where users can exchange short messages with friends, addressing his concerns with the president:

“Pres Obama you got nerve while u sightseeing in Paris to tell us ‘time to deliver’ on health care.  We still on skedul/even workinWKEND.”

“Pres Obama while u sightseeing in Paris u said ‘time to delivr on healthcare’ When you are a ‘hammer’ u think evrything is NAIL I’m no NAIL.”

These messages from Senator Grassley were seen by at least 11,000 people who follow the senator’s messages (tweets) directly, while hundreds and perhaps thousands more read them as the media caught wind of the story.  There is nothing inherently wrong with what Grassley posted (and they are still available to see at http://twitter.com/chuckgrassley), but the message and the lesson are that we need to be aware of the tools that surround us and know how best to use them.

People are out there talking; are you ready to listen?

Conversations are taking place all over the world about the topics, issues and concerns of everyone, just as they always have.  The new problem is understanding how those messages can spread and what role we play in addressing or interacting with them.

IHA has taken a strong stance in the realm of social media – this interactive, participatory two-way type of dialogue – by establishing our own grounds online and staking claim to the issues most important to Iowa’s community hospitals.  As the voice of hospitals and health care in Iowa, it is IHA’s responsibility to be represented wherever discussions are happening, be it on Capitol Hill or Facebook.

Apart from the IHA Web site, the blog acts as IHA’s authoritative clearinghouse for contact via social media with the public and beyond.  All of our interactive actions direct back to this home base in an effort to clarify IHA’s mission, vision and values.

As IHA continues along this path into the future of communication and dialogue, it will adapt to change, but the core existence and purpose will remain:  supporting the missions of Iowa’s hospitals.

Looking to learn more about how IHA is engaging individuals and influencers by using these social technologies? Keep reading our blog and see the about page for more details.

What questions do you have? How are you using these techologies to impact your goals?