05 February 2009

Health Benefits For Unemployed Stripped From Stimulus.

Post: Huffington Post, February 4, 2009 05:28 PM

Reading even a single page of a Senate bill is often no simple task, with legislative-ese obscuring the purpose behind the language. Reading 736 pages of the stuff is like mountain climbing in a wheelchair.

So we outsourced the work to Huffington Post readers: 367 people responded to the call and signed up to read portions of the Senate stimulus bill, compare it to the House bill passed earlier, and look for anything else interesting or newsworthy in it. Hundreds more posted their finds in the comments section below the full text of the bill. Responses that came in earlier are featured here.

The readers who signed up brought varying degrees of expertise to the project. One reader, who wanted to stay anonymous, is a consultant who works with the Department of Defense doing facilities and infrastructure assessments to determine the need for just the kinds of projects included in the section of the bill he read. Another, Tim Dickinson, is a politics reporter for Rolling Stone. Dickinson quickly found that the Senate had increased funding for STD prevention to $400 million. (Senate Republicans found that appalling and have succeeded in stripping it from the bill.)

Citizen journalism is still in its infancy and there will be many more opportunities around budget time to dig through congressional and presidential products. If you were one of the hundreds of people who contributed -- or signed up to, but didn't end up having time - let us know where the kinks are. How could it have been smoother?

The sifters found some noteworthy nuggets in the bill. Combing through his section of the bill, law professor and health care author Timothy Jost noticed that the Senate had removed the House provision that would allow people 55 and over who are laid off to continue COBRA coverage at a subsidized rate until they're 65 and eligible for Medicare. The House version also made folks who were laid off temporarily eligible for Medicaid; the Senate version strips that out, Jost found. Every one percent increase in unemployment throws more than a million people into the ranks of the uninsured.

Our Pentagon consultant broke the spending differences into a spreadsheet and also found a nugget in the bill giving Filipino World War II veterans $198 million. His find highlights what citizen journalists are capable of. His item had yet to be reported when he e-mailed it Tuesday evening; between then and now, the L.A. Times broke the story. So we cost our guy a scoop. Our apologies. We'll get it next time.

Still, his analysis is worth sharing. He said that his "pork-o-meter went off" and he did some rough math. "For U.S. citizens, [the payment is] $15,000 a head and for non-citizens it's $9,000 a head. Considering that there are only 1.6 million Filipinos in the U.S. and only 30 percent of those are over the age of 55, and to qualify you would have to be at least 78 years old, the lion's share of this money would be going to non-citizens. This will not create jobs or stimulate the economy," he wrote.

Diane Szilagy, whose expertise is in the energy and information technology fields, broke her section into a comparison chart you can see here.

Jost, the law professor, noticed that a crucial word had been added to the Senate bill's health care section. The House had appropriated $700 million for health care "comparative effectiveness research." Finding what health care approaches are most cost effective is a key to reducing those costs, but opponents of such research see it is a first step toward rationing care -- not that we don't ration care already, in a different way -- and health care companies oppose it because it could cut into profits.

Jost noticed that the word "clinical" was inserted into the Senate package so that the money would only go to study the clinical effectiveness of treatment, not cost effectiveness.

The website Medical Devices Today, the voice of the medical device industry, had been pushing for the change. "We need a clear statement in the language of the bill that it would fund clinical comparative effectiveness, not cost comparative effectiveness, and that the studies will not be used for national coverage determinations," it quoted AdvaMed Senior Executive VP David Nexon as saying last week.

To join the team for the next round of research, sign up here.


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