Healthcare reform updates

It looks like there are now sixty votes in the Senate for passing healthcare reform legislation as Senator Ben Nelson has agreed to a compromise on abortion funding:

Under Mr. Reid’s amendment, states would have the authority to bar coverage for abortions by new government-approved health insurance plans.

A section of the bill titled “state opt-out of abortion coverage” explains how this would work: “A state may elect to prohibit abortion coverage in qualified health plans offered through an exchange in such state if such state enacts a law to provide for such prohibition.”

Some health plans receiving federal subsidies could offer coverage for abortion, but they could not use federal money to pay for the procedure. They would have to use money taken from premiums paid by subscribers and would have to keep it separate from federal money.

The government would subsidize premiums for many low- and moderate-income people. Under Mr. Reid’s amendment, some health plans receiving federal subsidies could offer coverage for abortion, but they could not use federal money to pay for the procedure. They would have to use money taken from premiums paid by subscribers and would have to keep it separate from federal money. State insurance commissioners would police the “segregation of funds.”

There's still a long ways to go because House Democrats have to remain onboard since the Senate bill lacks features like a public option that House members voted for. (A comparison of the bills here.)

Jon Podesta from the Center for American Progress has posted his top ten reasons for supporting the Senate bill.

And I received this email from Senate Majority Leader Harry Reid today:

Dear Fellow Nevadan,

This morning I released the details of the final version of the health insurance reform bill. The bill will reduce the deficit by roughly $1.4 trillion over the next 20 years – more than twice the previous estimate – due to modifications we made over the past week. We strengthen patient protections, lowered consumer costs, improved our short-and long-term economic health and protected seniors by extending the solvency of Medicare by a decade and closing the “doughnut hole.”

Every day, nearly 200 people in Nevada lose their health insurance each day and too many file bankruptcy because of health care costs. Nevadans with health insurance will see their premiums decrease by up to $1,600 per year because of this bill. I am confident that this bill will be really good for Nevadans.

Every part of this long process – from passing two carefully crafted bills in committee, to merging them into one comprehensive bill, to reaching a final consensus – has been an enormous undertaking. From the very beginning, we knew the end result had to be a bill that saves lives, saves money and saves Medicare.

We knew that we had to stabilize insurance for everyone who has it and help secure it for millions who don’t. We had to lower the cost of staying healthy and reduce the national deficit. And we had to stop insurance companies from denying health care to the sick.

The bill we proposed a few weeks ago does every one of these things – and the revisions being read right now on the Senate floor are even stronger. The newest elements:

• Create new programs to further rein in health care costs;


• Give small businesses tax credits that will immediately go into effect


• Demand even greater accountability from insurance companies


• Create more choice and competition for consumers.

All of these things will help lower costs for Americans, and will finally level the playing field between American families and insurance companies.

Some on the left think this bill doesn’t go far enough, and that it should be stopped. While I, too, strongly prefer a public option, I also believe this bill, which will make millions of Americans’ lives better, is worth supporting.

Some on the right think this bill goes too far, and that it should be stopped. To them I say that the broken system cannot and will not continue. When President Obama signs this bill into law, we will officially end the era in which insurance companies win only when patients lose.

This bill is about improving patients’ health, protecting consumers’ rights, keeping insurance companies honest, strengthening our economy, and making the hard choices necessary to do what is right.

I hope that you will read this update and visit my website for more information.

HARRY REID
United States Senator for Nevada

(Video link)

Finally, Ezra Klein has several items on his blog today including a summary of some other changes in Reid's "manager's amendment" to the current Senate legislation and a summary of the latest report from the Congressional Budget Office.

Jennifer goes green

My friend Jennifer recently won first place in a video contest sponsored by Nevada Federal Credit Union. Here is her winning entry, "Furry Friends Go Green." Love it! And she loves the giant $1000 check they gave her! :-)

(Video link)

Domestic partnerships arrive in Nevada

Nevada's Domestic Partner Registry Act goes into effect today, allowing lesbians and gay men in the state to register their relationships with the state. From The Center in Las Vegas:

According to the Nevada Secretary of State's office, nearly 700 couples pre-registered their partnerships in the month-long pre-registration period ending September 24th in order to receive their certificates today. Many more couples are expected to file their forms today.

For GLBT couples, this opportunity represents the equalizing effect that state recognition offers for our relationships. We now enjoy many of the same rights and responsibilities in Nevada that opposite-sex couples enjoy when they choose to marry and share their lives together.

The Center sponsored multiple workshops to educate couples about their rights and responsibilities under the law—with hundreds of couples attending the seminars to be better informed about their choices and obligations. 27 couples registered one night, on September 14th at a Center sponsored seminar.

A special thanks to Senator David Parks for his hard work in sponsoring this monumental legislation and Secretary of State Ross Miller and his office for their commitment to making the process simple and accessible.

Thank you to all those community members and organizations, who organized, educated, lobbied and worked to make this law a reality.

And the Las Vegas Sun has an article about two women who worked to get this law passed:

Why do they love each other?

Carline, who is now 37: “She has the biggest heart I’ve ever met. I don’t know anyone who would take on all of that responsibility when she did. She was 18, she could have gone to college and only had one job. But she took three jobs and was with us. She’s always provided for us, making sure we have what we need. She’s always been there for us. She’s been really good to me and really good to the kids. She’s funny. She’s smart.”

Jodie, who is now 27: “She’s always there to talk to. We work well as a team. We get things done.”

Carline: “She’s a woman of few words.”

And then the whole scene dissolves in blushes and hugs....

Last spring Nevada’s Legislature debated a bill introduced by state Sen. David Parks, D-Las Vegas. It wouldn’t overturn Nevada’s ban and make us one of the four states with same-sex marriage. It wouldn’t provide federal recognition for same-sex couples. But it would make Nevada the 10th state with either domestic partnerships or civil unions. It would be a legal piece of paper for couples to show doctors and bosses.

Carline and Jodie consider themselves active in the gay community, but they don’t think of themselves as activists. As Carline says, “I’m a lesbian but that’s not the only hat I wear. I’m a mom, I’m active at my kids’ school.”

They also were among the couples who traveled to Carson City in April to lobby legislators to pass the bill.

Quality of life at the end of life

I heard the first half of Terry Gross' interview with Dr. Robert Martensen on Fresh Air today. Martensen's new book, A Life Worth Living, examines the peculiarities of healthcare in America that lead to difficult choices for families when a love one is near death. The program is definitely worth a listen.

I've been thinking for awhile that I needed to update my healthcare durable power-of-attorney and living will since moving to Nevada, and I did so as soon as I got home. (Nevada residents can do this online here and file a copy with the state of Nevada here.)

The U.S. healthcare system's default stance is to prolong life whenever possible, regardless of the quality of the life that the patient is experiencing. One impact is that end of life healthcare costs shoot up (especially in the four months before death) as seen in this graph from "Longevity and Healthcare Expenditures," an article in The Journals of Gerontology:

Dr. Martensen noted on the program that if a physician spends an hour or so talking to an elderly patient and his or her family about what is important to the person and their desires with regard to end-of-life treatment, Medicare will reimburse the doctor $18! But if the doctor spends 15 minutes with the patient and then orders a bunch of tests, the doctor receives a lot more compensation. The incentives for doctors are all screwed up in our current system... one more reason we need healthcare reform!

Nevada looks at cashing in on its sunshine

The Las Vegas Sun looks at the potential for solar energy to bring jobs and potentially tax revenues to the state.

News on Yucca Mountain and America's energy supply

From Senate Majority Leader Harry Reid's office:

Today, President Obama, with help from Senator Reid, released an outline for the 2010 federal budget, which will drastically scale back funding for ongoing efforts to license the dump.

“President Obama yesterday took a critical first step toward fulfilling his promise to end the Yucca Mountain project, and I could not be happier for the people of Nevada,” Reid said. “Make no mistake: this represents our most significant victory to date in our battle to protect Nevada from becoming the country’s toxic wasteland. I have worked for more than two decades with help from our state’s leaders and thousands of Nevadans to stop Yucca Mountain. President Obama recognizes that the proposed dump threatens the health and safety of Nevadans, and millions of Americans. His commitment to stop this terrible project could not be clearer.”

Pres. Obama’s budget also reveals plans to consider alternatives to the dump. The outline says the administration will devise “a new strategy toward nuclear waste disposal,” something long called for by Nevadans.

While Senator Reid has been working with Pres. Obama to kill the Yucca Mountain dump, he also secured $100 million for Nevada in an omnibus bill the Senate will consider next week. The bill includes $18.7 million for roads and transportation, nearly $15 million for energy projects, $5.4 million for schools and $4.6 million for health care – funds that are badly needed in Nevada during this budget crisis.

Meanwhile, Reid has continued his crusade to make Nevada a renewable energy pioneer. This week, Reid announced he would be presenting a major energy transmission bill in the Senate that would make it easier to carry renewable energy from often remote locations to urban centers in need of power.

(Video link)

The August 2008 meeting that Reid mentions in the video was the National Clean Energy Summit.

REID WAS ALSO ON KNPR's State of Nevada program today talking about Yucca Mountain and Nevada's share of the economic stimulus package.

Debbie Harry

A really poor quality photo of Debbie Harry toward the end of Blondie's awesome concert at Buffalo Bill's in Primm last night.

Me and Deborah Harry's shoe!

Illegible

But it says "BLONDIE." And we're waiting them to start the concert!

Franch dressing is available...

At Buffalo Bill's in Primm, Nevada.

Speaking against Nevada's higher education budget cuts

Following on a big rally at UNLV last month, students will be traveling to Carson City to protest the severe budget cuts that Governor Jim Gibbons supports:

On February 25-27, eight students (two from each of Southern Nevada’s student leadership institutions, including both undergraduate and graduate student body leaders) will travel to Carson City to lobby on behalf of Nevada’s students.

On Wednesday evening, they will attend a legislative dinner and meet with state leaders that evening as well as Thursday afternoon to discuss student interests and needs in relation to budget cuts.

This event is being co-hosted and organized by the student governments of the University of Nevada, Las Vegas (UNLV), College of Southern Nevada (CSN), and Nevada State College (NSC).

Seriously, how is this state ever going to become something more than a place driven by gambling and tourism if we don't invest in the education of our citizens?

More information on how Nevada's higher education institutions are responding to the cuts here; you can voice your opinion with our sorry excuse for a governor here.

The Nevada living will lockbox

The state of Nevada has an electronic lockbox where you can file your living will or advance directive to ensure that your wishes are carried out in the event that you become seriously ill or incapacitated. Nevada residents, check it out here.

"Less steak, more beans"

Nevada has the unfortunate distinction of being the state hardest hit by the economic downturn.

I just heard State Treasurer Kate Marshall being interviewed on NPR. When asked how the state would handle further revenue declines (a special session was held over the summer to reduce spending in the current budget), Marshall replied, "Less steak, more beans."

And her response to a question about what she was most concerned about in these tough times left me scratching my head.

Her answer: "My employees."

How about the citizens of Nevada?

FDIC takes over Nevada bank

No cause for alarm, they say.

Energy and global warming

Yawn. I saw lots of headlines today about the leaders of the G-8 nations deciding to cut global emissions of greenhouse gases in half by 2050.

If only it wasn't so much hot air (are G-8 proclamations themselves a greenhouse gas????).

The problems with their declaration are many:

• They only offered to cut the G-8 nations' emissions if other nations, including developing nations like China and India, also cut their emissions by 50%. Since this has been a sticking issue for several years already, yesterday's announcement was simply the status quo.
• When they met last year, the talk was about reducing emissions 50% from 1990 levels. One year later, they're now talking about reducing emissions 50% from today's levels. And since G-8 emissions have increased around 16% since 1990, the new proposal is significantly less aggressive than what was discussed just last year.
• They didn't propose a roadmap for getting to a 50% reduction by 2050. That's 42 years away... and a huge decrease in emissions. Pronouncements like this tend to be meaningless.
• My understanding is that they weren't that specific about which greenhouse gases they're talking about. CO2, presumably. Methane as well?

So another year passes, and another twelve months of lost opportunity pass us by. Now that's leadership.

I SAW T. BOONE PICKENS' ENERGY AD on television yesterday.

Pickens is an old oil man but he's now got a plan that's at least moving in the right direction. He calls the U.S. the "Saudi Arabia of wind energy" and wants us to invest aggressively in harnessing it to cut our dependency on oil.

He also talks about relying more on natural gas, especially for transportation. I'm a bit more dubious about this... we've got more domestic reserves of natural gas than oil, but it's still a dwindling resource. Perhaps it'll act as a bridge to the future, but we've got to keep the focus on the sustainable sources of energy.

NPR HAD A STORY TODAY ABOUT SOLAR ENERGY and it focused on company here in Nevada named Ausra. They're building solar collectors that don't rely on photovoltaic technology to generate electricity. Instead they concentrate the sun's heat, boil steam, and use it to spin turbines to drive electrical generators. It's similar to the way we currently produce our electricity, the only difference is the source of the heat.

Best of all, water holds heat well, so Ausra's system can be used to generate electricity even after the sun goes down.

Now we just need to get the Bureau of Land Management to fast-track the environmental impact studies for some of the proposed solar plants here in Nevada. Right now they've put a nearly two year moratorium in place. I've been a lifelong proponent of protecting the environment, but I recognize that the environment is being impacted now. Global warming is affecting people, animals, and plants around the world. Moving to energy sources that don't increase global warming any further is a moral imperative... and we can no longer afford to move slowly.

HERE'S ONE BILL that seems to be moving in the right direction: HR 2809. Check it out on OpenCongress.

Oil at record highs... hey, let's put the brakes on solar!

You'd think with soaring fuel prices that the government would be doing everything possible to speed the development of alternative energy sources.

The Bureau of Land Management claims to be doing that, but it's approach is to put a 22-month moratorium on new solar projects on the land it controls (which includes 67% of Nevada).

While I understand that it's necessary to ensure that these projects don't harm vulnerable arid and semi-arid areas of the southwest, it's also disappointing that the BLM's move comes now. There are 125 pending applications for solar projects on Federal lands, some of which are over three years old.

From the Las Vegas Sun:

“[The moratorium] immediately is going to slow the momentum of a growing economy of solar business in the state of Nevada,” said Chris Brooks, director of the renewable energy division of Bombard Electric, which installed solar panels at Nellis Air Force Base. “Twenty-two months will drive businesses out of existence.”

Brooks and other solar energy insiders said the moratorium, especially coupled with uncertainty in Congress over long-term tax credits for solar development, would discourage solar manufacturers from locating in the Southwest.

Of the 125 pending applications, 23 are for Nevada, and they have the potential to produce a huge amount of electricity:

The Nevada applications, 11 in Nye County and 12 in Clark County, would involve 211,000 acres of federal land and could produce 15,000 megawatts, more than twice the peak summer load in Southern Nevada. The 125 applications nationwide, if approved, would power 20 million American homes, according to the BLM.