BREAKING! SURGEON GENERAL NOMINEE REGINA BENJAMIN CONFIRMED BY SENATE TONIGHT BY VOICE VOTE!
We have been asking for weeks now, why don't we have a Surgeon General? Rachel Maddowstarted up the quest again on her show on Monday night, October 26, and Dr. Nancy Snyderman of MSNBC continued it on her show Thursday October 29th.
The answers to the delay have been varied, contradictory, and byzantine. Apparently it's not because of Dr. Regina Benjamin herself, say the Republicans. They think she's qualified (more or less -- not all will state their position). And she is, indeed, anamazingly qualified family physician who practices in rural Alabama. And apparently there is NO secret hold on her nomination.
So what are the reasons? If I had a lifetime, I probably could not explain that exactly, but I"ll give it a try.
Initially, the story was that Senator Mike Enziof Wyoming and seven Republican colleagues (McConnell, Kyl, Grassley, Cornyn, Alexander, Murkowski and Thune), had written a letter on September 24th stating that they would not support ANY of the nominees for health positions, including Dr. Benjamin, until certain issues were resolved with HHS and CMS. So the Republicans set up a procedural delay on the Surgeon General nomination that effectively has kept the vote from coming to the floor of the Senate.
This has been done despite the fact that Dr. Benjamin received a unanimous vote of approval from the Senate HELP committee -- from both Republicans and Democrats -- when she was vetted by them earlier in September. So what changed?
What changed was that Medicarehad issued a "letter of warning" or whatever you want to call it, to health insurance companies including Humana, regarding communications they had been sending their Medicare beneficiaries about "possible" changes to the Medicare Advantage program. Medicare routinely regulates what health plans can tell members about their benefits. That is not new.
Dawn Teo in a Huffington Post piece, explained this kerfuffle in detail.
According to a source with inside knowledge of the way CMS regulates marketing guidelines, Medicare providers are only allowed to communicate with plan members about the benefits they have now, not about possible changes to benefits. They are also not allowed to use plan-related communications to lobby for policies or legislation.
This seems to be the essence of the dispute that is holding up the Surgeon General's nomination and many others -- what can the government tell health plans about their communications with members? The action by HHS enraged Humana, headquartered in Kentucky and supporter of Senator Mitch McConnell and other Senators as well. After some back and forth in the last month to which I am not privy, HHS has apparently backed off and has ended up only requiring that Medicare beneficiaries be allowed to "opt out" of receiving these communications.
Did that solve the problem? It did not. The Republican Senators who sent the letter now declare that the issue is bigger than this -- it is an issue of freedom of speech, constitutionality, etc. that all companies be allowed to communicate freely with their members about things that might happen as a result of legislation that hasn't happened yet.
Are you with me so far?
In conversations with staffers of Senators Enzi, McConnell and Reid in the past few days, I have learned that there is a lot of finger pointing going on, the procedural issues are truly complicated, that there is NO "secret hold" on the nomination -- it's pretty public by now -- but the bottom line is that the Humana "thing" is still an issue, and therefore the Republicans will not lift their delaying tactics until it is resolved to their satisfaction.
That means that Dr. Benjamin and many other nominees for HHS positions will remain in limbo while this fight plays out. When I asked the Republican staffers why they couldn't resolve this problem outside of the nomination process -- that is, figure out another way to do it other than holding nominees hostage, they had no answer.
On the MSNBC Nancy Snyderman show today, I had 2 minutes to try to explain this and the best I could do was to say it's "complicated". And complicated it is. But for the average person, it remains puzzling and irritating that at a time when we need the voice of our nation's doctor, the Surgeon General, explaining flu vaccine, shortages, protection measures, etc., we do not have a Surgeon General to deliver that message. It's a real shame.
cross posted on: http://www.huffingtonpost.com/...