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House Republicans Prepare to Slash Spending in Budget Showdown

With Social Security and Medicare off the table, conservatives are focusing on a wide range of smaller programs as a clash with President Biden and Democrats looms.

Salon.com

After staying away during pandemic, doctors return to lobby Congress

Over 300 physicians lobbied Congress in hopes of increasing Medicaid pay for doctors

Salon.com

White House says GOP bill would force "one of the biggest Medicare benefit cuts" in US history

"House Republicans are trying to slash lifelines for middle-class families on behalf of rich special interests"

Longreads

Your Next Hospital Bed Might Be at Home

We think of being in the hospital as enduring isolation in a clinical setting, cut off from normal life. But what if being hospitalized meant something different? What if you could be receive hospital-quality care in your own home? Helen Ouyang profiles a movement of health care providers who, propelled by a range of factors, not least among them the COVID-19 pandemic, are working to redefine what hospitalization in America might look like:

Other countries, including Australia, Canada and several in Europe, had already been experimenting with this practice, some of them extensively. In Australia, which has been running home-hospitals for decades, these services provided in Victoria alone are the equivalent of what a 500-bed facility could offer in one year. Overall, the patients treated in this way do just as well, if not better, in their homes.

The obstacles impeding Leff and other hospital-at-home advocates in the United States were bound up with America’s labyrinthine health care system and particular medical culture. The Centers for Medicare and Medicaid Services (C.M.S.), which is the largest payer of hospitalizations, has required that nurses must be on site 24 hours a day, seven days a week, effectively keeping patients within the hospital walls. This matches how American society has come to regard hospitalization, too — nurses at the bedside, doctors making their rounds, in elaborate facilities pulsating with machines.

But Americans didn’t always convalesce in hospitals. Before the 20th century, treatment at home was the norm. “Only the most crowded and filthy dwellings were inferior to the hospital’s impersonal ward,” the historian Charles E. Rosenberg writes in his 1987 book “The Care of Strangers: The Rise of America’s Hospital System.” “Ordinarily, home atmosphere and the nursing of family members provided the ideal conditions for restoring health.” As Rosenberg puts it, “Much of household medicine was, in fact, identical with hospital treatment.” As health care became more specialized and high-tech, however, diagnosis and treatment gradually moved into hospitals, and they evolved into institutions of science and technology.