Baucus Bill Passes 14-9 -- payment reform MIA

Now this and other bills will be negotiated into one final bill to be debated in the house and Senate probably in early November for a vote in mid November.

I am a member of the Wisconsin Insurance Commissioner's Health Insurance Advisory Council and at today's (link to the agenda) (http://www.oci.wi.gov/advcoun/hl_not20091013.pdf ) public meeting we heard from the Natl Assooc of Insurance Commissioners. They provided an analysis of the current issues in the Health Insurance Reform debate and particularly on the Baucus Bill.

I asked the presenter if my reading of the Baucus bill and the othewrs is correct- i.e. there are no comprehensive provisions that get at health CARE reform and particularly payment reform through episodes of care reimbursement structures, quality outcome incentives or waste elimination. He agreed with my analysis. He agreed that nothing comprehensive exists in any of the bills... only small voluntary Medicare demonstrations and pilots on those issues. Furthermore, he saw little chance of payment reform being added during the final debates.

Once again our congressional leaders don't understand what they're doing and are not addressing the key issues. They are getting this wrong, the results could be catastrophic.


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Below are the opinions of two Republicans. I happen to agree with the comments from Sen. Ensign.

Sen. John Ensign, R-Nev., complained about the lack of a CBO estimate of the effects of the AHFA proposal on overall health care costs. "We haven't brought health care costs down with this bill," he said.

Sen. Michael Enzi, R-Wyo., praised Baucus's work on the bill but noted that many of his constituents find the bill confusing, partly because detailed legislative language is not yet available.

Many people on Medicare, for example, wonder why Congress seems to be shifting Medicare funding to other uses while at the same time creating a commission that will look at ways to save Medicare from insolvency, Enzi said.

Doctors want to know why the Medicare commission will be looking at their reimbursement rates but not at hospitals' reimbursement rates, and they also want to know what Congress will do about the medical malpractice issue, Enzi said.

"They're really not seeing us doing anything about tort reform," Enzi said.