September 22, 2009
By DAVID D. KIRKPATRICK
WASHINGTON — The Nevada Cancer Institute
, in Las Vegas, may not have a national reputation as a clinic or a research facility. But it does have the ear of its state’s senior senator, Harry Reid, the Democratic leader. And that is why the four-year-old institute could reap a big gain in federal reimbursements as part of the health care overhaul.
After months of noisy public debates over big policy ideas like universal coverage and a public insurance option, the health care legislation is getting down to the fine print. This is the time when powerful members of Congress customarily tuck in their pet projects, either to please their constituencies or as sweeteners to win the votes of lawmakers who may be sitting on the fence.
Senator Blanche Lincoln of Arkansas, a wavering Democrat on the Senate Finance Committee, has proposed expanding Medicare coverage of home infusion therapy, a form of treatment for a variety of purposes that is championed by a medical entrepreneur in her state. Senator Orrin G. Hatch, a Utah Republican on the panel, is seeking a health care tax break for any state that “begins with the letter U.”
But few proposed amendments to the health care bill now before the Finance Committee better exemplify the process than one that would help out the Nevada Cancer Institute. Known in Congressional parlance as a “rifle shot” — the narrowly focused tax or policy equivalent of a spending earmark — the proposal would provide more favorable Medicare payment rates to just a handful of specific medical facilities.