The following post is from Robert Polzoni.

Much like the Central Valley in August, the debate over health care reform will continue to heat up through the summer months.  Every special interest group – from the insurance industry and the American Medical Association to the AARP and the pharmaceutical and hospital industries will have their say and stake out their position.

The question is who will speak the loudest so their messages cut through the cacophony of advertisements, press conferences and media blitzes?  Will those that speak the loudest be the victors and leave the others to divide up the spoils?

We all remember those “Harry and Louise” ads the health insurance industry ran against the Clinton health care plan in 1993.  Those ads were credited with helping to sink “HillaryCare,” which was pronounced dead on arrival in the Senate by November 1994.

Harry and Louise are back but this time their singing a different tune.  They’re asking Congress and the President to put health care reform at the top of their agenda.

Harry and Louise won’t be the only ones making their voices heard.  Unlike 1993 there are many different venues to make the case for or against any health care reform package that comes out of Congress and the White House.  We have the 24-hour cable channels, the Internet and social networking sites.

You can expect that President Obama will use all of those venues to make his case for health care reform.   He’ll use the powerful presidential bully pulpit and his immense popularity in town hall meetings and long interviews with network and cable news outlets.   The Obama Administration also will use the Internet and social networking sites to reach out to the millions of supporters from the presidential campaign.

Hospitals, drug makers, insurers and doctors all want to make sure their voices are heard in the debate too.  What they lack in media savvy, they make up with money.

To improve the likelihood of being heard, the health-care industry has hired more than 350 former government staff and members of Congress to lobby on their behalf, according to an examination of disclosure records by the Washington Post.

Spending a lot of money lobbying in Washington is nothing new for groups like the pharmaceutical industry. But many health-care stakeholders are spending even more now: The health-care industry as a whole is spending more than $1.4 million on lobbying, according to the Post.

So it seems that the battle lines are drawn.  I expect it’s going to be a long, hot, loud and very, very expensive summer.

The following post is from Robert Polzoni.

This KCET video explores the financial pressures on emergency rooms in the Southern California area due to low reimbursements rates from Medi-Cal (Medicaid) and uncompensated care. Several ERs have closed, putting added pressures on those that remain open.

Emergency rooms throughout California will begin to feel even more pressure due to the state’s ongoing budget mess and the first eight Medi-Cal services slated for elimination.

The services set for elimination, the first of many cuts to be felt by Medi-Cal enrollees, include dental, podiatry, optometry and five other services the federal government does not require state Medicaid programs to provide.

Dr. Carla Docharthy, representing the California Podiatric Association, warned Tuesday at a rally in front of the state capitol of impending increases in emergency room visits as enrollees have no where else to turn for care.

The following post is from Robert Polzoni.

Hospitals, who always seem to get a black eye when it comes to media coverage of health care, are faring no better as the debate over health care reform heats up.

Critics of the nation’s broken health care system rank hospitals right up there with insurance companies as one of the villains.

The lead in a story on health care reform in this week’s Time Magazine reads:

“To get a sense of just how dysfunctional American health care is, members of Congress don’t need to look further than their local emergency department (ED). The overcrowding in EDs is so bad these days that patients who walk in with “immediate” needs, meaning the most severe on a clinical scale, wait an average of 28 minutes to see a doctor, according to a Government Accountability Office report released in May. That’s 27 minutes more than the recommended wait time for such conditions. Between 1996 and 2006, even as some 200 EDs shut down completely, visits nationwide increased from 90 million to 119 million, according to the Centers for Disease Control and Prevention. EDs are so packed that an ambulance is turned away and sent to one farther away every minute.”

It doesn’t get any better in the blogosphere – in fact it gets downright nasty – especially since the American Hospital Association and the American Medical Association (many link doctors and hospitals together) expressed misgivings about the President’s health care reform proposals.

Here is what Mark Rubi writes in an open letter to President Obama on his examiner.com blog:

“NPR reported on June 18th that AHA President and CEO Rich Umbdenstock discussed the association’s deep concern with the president’s proposal to cut an additional $220 billion in hospital payments over 10 years to help pay for health care reform. How much money do you think these people will spend to save that $220 billion?”

“The New York Times reports that the American Medical Association is letting Congress know that it will oppose creation of a government-sponsored insurance plan, which President Obama and many other Democrats see as an essential element of legislation to remake the health care system.  The only reform these guys (and the hospitals) want is to limit their liability when their mistakes maim or kill their patients. As you pointed out in your speech to the AMA, they do this about 100,000 times a year. Using the government to limit liability would be so much cheaper than the current legal expenses.”

Expect that it will be a long, hot summer as the health care reform debate rages on.

In his Weekly Address, President Obama explains how he will cover the upfront costs of health care reform by eliminating overpayments to Medicaid and Medicare and driving down costs contributing to government health care expenditures across the board.