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Source: Lena M. Chen, Ashish K. Jha, Stuart Guterman, Abigail B. Ridgway, E. John Orav, Arnold M. Epstein, Archives of Internal Medicine, Vol. 170 no. 4, 2010
(subscription required)

From the abstract:
Background: Hospitals face increasing pressure to lower cost of care while improving quality of care. It is unclear if efforts to reduce hospital cost of care will adversely affect quality of care or increase downstream inpatient cost of care.

Conclusions: The associations are inconsistent between hospitals' cost of care and quality of care and between hospitals' cost of care and mortality rates. Most evidence did not support the "penny wise and pound foolish" hypothesis that low-cost hospitals discharge patients earlier but have higher readmission rates and greater downstream inpatient cost of care.
See also:
Decreasing Hospital Costs While Maintaining Quality: Can It Be Done?

Source: Karen Davis, Kristof Stremikis, Commonwealth Fund Blog, December 21, 2009

The U.S. Congress is on the threshold of historic change that will usher in a new era in American health care. In the last 50 years, three presidents--Nixon, Carter, and Clinton--have made a serious effort to enact reform and failed. The nation simply can not afford to fail again--too much is at stake for those Americans who fail to get the life-saving care they need and for those who pay the bills of ever-rising cost of health care. History makes clear that failing to act on health reform has serious and far-reaching economic ramifications. An examination of trends in health spending over the past 50 years shows that if health reform measures proposed by previous presidents had been enacted and slowed the growth in spending by as little as 1.0 or 1.5 percentage points annually, spending trends in the U.S. would have been closer to those seen in other major industrialized countries and fewer adverse health consequences and economic burdens would have been borne by American families, businesses, and government.
See also:
Chartpack

Source: Matthew Buettgens and Linda J. Blumberg, Urban Institute, February 2010

From a Robert Wood Johnson Foundation summary:
Many low-income workers would be prevented from accessing subsidies under current health reform proposals if they are offered employer-sponsored health insurance (ESI). Thus, some low-income families would not benefit from the reforms as much as others.

Source: Ken Jacobs, William H. Dow, Dave Graham-Squire and Laurel Tan, Center for Labor Research and Education at UC Berkeley, Issue Brief, February 2010

This report examines the impact that the proposed Senate excise tax on high-cost employer health plans would have on union and non-union workers. The report finds that the vast majority of workers that would be affected by a tax on health benefits that cost above a certain threshold are not covered by a union contract. Non-union workers would receive a much larger share of the savings from the reduced excise tax that was negotiated between the White House and labor leaders in January.

Source: Howard Gleckman, Commonwealth Fund, Volume 1368, February 17, 2010

From the summary:
Broad health care reform legislation being considered by Congress would effect a major change in the way the United States finances long-term care. This paper reviews the experiences of France, Germany, Japan, the Netherlands, and the United Kingdom, and highlights some of the lessons the United States can learn from each.

Source: Stephen Blakely, Employee Benefit Research Institute, EBRI Issue Brief no. 339, February 2010

Since the vast majority of Americans who have health coverage get it through their jobs, one obvious question raised by the health reform legislation pending in Congress is: How might it affect the U.S. employment-based health benefits system? At a recent day-long conference sponsored by EBRI, more than a dozen experts from a wide range of specialties found consensus on one point: Imposing a tax on health benefits (such as the proposed tax on so-called "Cadillac" health plans) is likely to cause major cuts in health benefits and might result in structural changes in the employment-based benefits system.
See also:
Press release

Source: Paul N. Van de Water, Center on Budget and Policy Priorities, February 3, 2010

From the summary:
Because rising health care costs represent the single largest cause of the federal government's long-term budget problems, fundamental health reform must be part of any budget solution.

Source: Capitol Ideas, Vol. 53 no. 1, January/February 2010
(scroll down)

States will undoubtedly face some major hurdles with reform of the nation's health care system.

Articles include:
- Hot Topic
The impact of health care reform on states will be more than just money.
- 10 Questions
Kathleen Sebelius talks about health care reform, Medicaid and children's insurance programs, and H1N1 preparedness.
- Timeline of Reform
States have taken action to supplement federal efforts at health care reform.
- Case Study
Four states have found ways to deal with coverage and care issues.
- Health Care Cost Drivers
Chronic disease and technology contribute to the rising cost of health care.
- Focus on Prevention
Various state programs focus on keeping people healthy.
- The Language of Reform
Dr. Frank Luntz shares insights into the debate about reform.
- Health Information Technology
Recovery Act dollars will help states incentivize progress in health IT.
- Straight Talk
Stakeholders share their opinions on important issues in reform.

Source: Jon R. Gabel, Commonwealth Fund, Issue Brief, January 2010

From the summary:
This study examines Congressional Budget Office scoring of three pieces of major reform legislation enacted during each of the past three decades, and finds that, CBO, in all three cases, substantially underestimated savings from these reform measures.

Source: Jennifer L. Nicholson and Sara R. Collins, Commonwealth Fund, Issue Brief, Vol. 73, December 18, 2009

From the summary:
This analysis of Commonwealth Fund survey data finds almost half of young adults, the largest uninsured population, are without insurance at some time during the year. An overwhelming majority of young adults think it is important for Congress and the President to pass health reform legislation. Provisions in the Congressional health reform bills could help young adults obtain and keep affordable, comprehensive coverage through transitions from school to work and from job to job.
See also:
Chartpack

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Union Strategies for Hard Times
by Bill Barry



What can unions do as the Great Recession ravages workers and their unions and threatens to destroy decades of collective bargaining gains? What must local union leaders do to help their laid-off members, protect those still working, and prevent the gutting of their hard-fought contracts – and their very unions themselves? How, in fact, can local union leaders seize the time and turn crisis into opportunity?



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