Insuring Resources Commentary:
See this for a quick summary: http://prescriptions.blogs.nytimes.com/2010/02/25/video-the-health-care-session-in-4-minutes/
Philosophical differences between the Democrats and Republicans ruled the day.
Mitch McConnell (Rep- KY) argued for starting over one step at a time starting with a blank page. Sen. LaMar Thompson (R-Tenn) argued, "We don't do comprehensive well."
Sen. Tom Harkin (Dem- Iowa) argued that a comprehensive bill is necessary because its all intertwined. He's right and here's why.
1. Everyone agrees we need to eliminate pre-existing conditions. Slam dunk.
2. The first item however requires the implementation of an individual mandate or else people will wait to purchase health insurance until they get sick. If we allow that prices will be much higher because of the risk associated with insuring those individuals.
3. #2 requires the implementation of health insurance exchanges to cover individuals and small businesses to pool the risk and put millions of people in to groups to spread the risk. If we require individuals to purchase their own insurance premiums will be astronomical.... but that is what Cong. Paul Ryan (Rep- Wisconsin) wants to do by providing individuals a $2500 tax credit. That would buy about two- three months of health insurance if we have people do it on their own.
The Republicans oppose both # 2 and # 3.
Here's more from Paul Ryan- fact checking provided by Politico.com
Ryan overhypes Medicare Advantage hit
Rep. Paul Ryan (R-Wis.) claimed that under the Democrats’ plan, millions of seniors will lose their Medicare Advantage plans.
Not quite.
According to health policy experts, it’s fair to say that if the Democrats have their way, the benefits provided by Medicare Advantage will be reduced — which means that a number of seniors might choose not to enroll in the program in the future. That doesn’t mean people are going to “lose” their plans, exactly — just that fewer are likely to enroll. Seniors would still be guaranteed their traditional Medicare benefits.
Then I saw former Senator Bill Frist on MSNBC this morning and he talked about cost and changing how health care is performed and financed. He talked aboput more efficient and quality care through provider incentives. He gets it and a lot of Republicans do as well. I don't get why the Democrats still don't get this point because it could be the bridge to a major compromise..... as I've said here since August. Senator Kohl (D- Wisconsin) offered an amendment to the Senate Bill on Dec. 14th to take a huge step toward this but the amendment FAILED. At the time the Democrats had a 60-40 advantage in the Senate, and yes the amendment offered by a Democratic Senator from a blue state, FAILED.
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Link to a 4 minute video summary
http://prescriptions.blogs.nytimes.com/2010/02/25/video-the-health-care-session-in-4-minutes/
Showing posts with label exchange. Show all posts
Showing posts with label exchange. Show all posts
Friday, February 26, 2010
Saturday, January 23, 2010
What a Bipartisan Bill May Look Like.... if we get one at all
Insuring Resources Commentary:
Below is a link to a New York Times article depicting possible items included in a health care reform package. In this NY Times reporter's analysis of conversations with lawmakers, aides and health care policy experts he compiled these items as still doable in the post Super-majority Democratic Senate health care reform era. His list is similar to the blog post I provided a few days ago so you get the benefit of my analysis of what's possible again.
Here's my further analysis of these items:
-No pre-x for children makes sense, this probably has 85-90% support in both houses and would be agreed to easily in any health care bill.
-Dependent coverage up to age 25 is also a given. Wisconsin just approved this in 2009, effective 1/1/2010 for ages up to 27. This too would have substantial bi-partisan support.
-Grants to establish state-based health insurance exchanges for individuals and small businesses. This probably would pass both houses as it would most likely not be mandated for businesses or individuals. This could help alleviate some cost pressures for these groups. If a wide range of coverage options were offered through the Exchanges and states were encouraged to be innovative this could be very positive.
-The fed. gov't offer financial incentives for state Medicaid expansion to cover childless adults and parents. Wisconsin, with its BadgerCare program and other states who have already done this, would not be happy about this measure. In those cases perhaps there can be adjustments or bonuses to state's who go above and beyond the minimum or who have already accomplished it. This too has broad bipartisan support as long as Nebraska doesn't get its Cornhusker Kickback. Special deals cannot be a part of a compromise bill at this point. The public backlash would be too enormous.
-Tax credits for small business purchase of health insurance-- This is very bi-partisan friendly as most GOP health care proposals, including those offered by Rep. Paul Ryan (R-Janesville) and Sen. John McCain (R-Arizona), were centered on tax credit use to purchase health insurance.
This would perhaps get more GOP than Dems supporting it and would pass both houses.
For a lengthy analysis I authored of the Paul Ryan proposal for WPRI
2 years ago go to the web link at the upper left hand sidebar.
-The package could also include changes in Medicare, to reduce the growth in payments to doctors and hospitals while rewarding providers of high-quality, lower-cost care. To help older Americans, it could narrow a gap in Medicare coverage of prescription drugs, sometimes known as a doughnut hole. I don't understand why again the incentives only apply to Medicare for high quality, more efficient care. I just don't get why Congress is so reluctant to address the whole system rather than just Medicare. If they're going to make regulatory changes why sell it short and stop only at Medicare rather than addressing the whole system and the whole cost problem.
See link below to read the whole article
---------------------
From the New York Times article
"A New Search for Consensus on Health Care Bill"
The entire article linked: http://www.nytimes.com/2010/01/22/health/policy/22health.html?ref=todayspaper
By ROBERT PEAR and DAVID M. HERSZENHORN
Published: January 21, 2010
Below is a link to a New York Times article depicting possible items included in a health care reform package. In this NY Times reporter's analysis of conversations with lawmakers, aides and health care policy experts he compiled these items as still doable in the post Super-majority Democratic Senate health care reform era. His list is similar to the blog post I provided a few days ago so you get the benefit of my analysis of what's possible again.
Here's my further analysis of these items:
-No pre-x for children makes sense, this probably has 85-90% support in both houses and would be agreed to easily in any health care bill.
-Dependent coverage up to age 25 is also a given. Wisconsin just approved this in 2009, effective 1/1/2010 for ages up to 27. This too would have substantial bi-partisan support.
-Grants to establish state-based health insurance exchanges for individuals and small businesses. This probably would pass both houses as it would most likely not be mandated for businesses or individuals. This could help alleviate some cost pressures for these groups. If a wide range of coverage options were offered through the Exchanges and states were encouraged to be innovative this could be very positive.
-The fed. gov't offer financial incentives for state Medicaid expansion to cover childless adults and parents. Wisconsin, with its BadgerCare program and other states who have already done this, would not be happy about this measure. In those cases perhaps there can be adjustments or bonuses to state's who go above and beyond the minimum or who have already accomplished it. This too has broad bipartisan support as long as Nebraska doesn't get its Cornhusker Kickback. Special deals cannot be a part of a compromise bill at this point. The public backlash would be too enormous.
-Tax credits for small business purchase of health insurance-- This is very bi-partisan friendly as most GOP health care proposals, including those offered by Rep. Paul Ryan (R-Janesville) and Sen. John McCain (R-Arizona), were centered on tax credit use to purchase health insurance.
This would perhaps get more GOP than Dems supporting it and would pass both houses.
For a lengthy analysis I authored of the Paul Ryan proposal for WPRI
2 years ago go to the web link at the upper left hand sidebar.
-The package could also include changes in Medicare, to reduce the growth in payments to doctors and hospitals while rewarding providers of high-quality, lower-cost care. To help older Americans, it could narrow a gap in Medicare coverage of prescription drugs, sometimes known as a doughnut hole. I don't understand why again the incentives only apply to Medicare for high quality, more efficient care. I just don't get why Congress is so reluctant to address the whole system rather than just Medicare. If they're going to make regulatory changes why sell it short and stop only at Medicare rather than addressing the whole system and the whole cost problem.
See link below to read the whole article
---------------------
From the New York Times article
"A New Search for Consensus on Health Care Bill"
The entire article linked: http://www.nytimes.com/2010/01/22/health/policy/22health.html?ref=todayspaper
By ROBERT PEAR and DAVID M. HERSZENHORN
Published: January 21, 2010
Friday, September 25, 2009
Overhaul Divides Business and Its Traditional GOP Allies
The Business Roundtable, the US Chamber of Commerce and others are telling the GOP they must have health insurance reform. This may get even more interesting once we start hearing from more businesses who see health insurance at a crisis point.
In particular business groups like the Baucus plan because they see its attempts to control skyrocketing medical costs. Business appears to understand this much better than most of Congress. Now that we have had public town hall forums with citizens, perhaps congressional decision-makeers will start to listen to employers who actually provide 60% of insurance coverage in the US.
The Baucus plan is by no means perfect but it does attempt to control costs and does establish a health insurance exchange for small businesses.
---------------- ------------------ ---------------
From the Wall Street Journal- Setp. 25th
By NEIL KING JR.
WASHINGTON -- Business is parting from its traditional allies in the Republican Party on health care as companies and big corporate lobbyists lend tentative support to a congressional overhaul that conservative lawmakers staunchly oppose.
The rift mirrors a similar divide on other issues, including immigration and climate change, where many companies have backed legislative action that Republican lawmakers oppose.
But the health-care debate, in particular, casts a spotlight on the split in the longstanding alliance between economic conservatives and the business community. Republican lawmakers are digging in to oppose the overhaul effort as a big-spending government intrusion. Many companies, on the other hand, cite soaring costs to explain why they continue to back the congressional work under way to revamp the health-care system, despite misgivings over a range of provisions.
"We are now at a crisis point," said Joe Olivo, who has struggled to keep up with rising health costs as the president of Perfect Printing Inc., a 40-employee printing company in Moorestown, N.J.
Mr. Olivo is apprehensive about many proposed Democratic fixes, above all the push to create a government-run insurance program. But he said he was also "disappointed that the Republicans don't seem to be at the table at all."
The business world this summer largely recoiled from legislation put forward in the House, which would mandate that employers provide employee coverage and would create a public insurance option.
But companies have been far more receptive to the plan released last week by Senate Finance Committee Chairman Max Baucus. The Baucus bill, which the committee is now busy amending, wouldn't include an employer mandate. It proposes a national exchange where individuals and small businesses could purchase insurance.
Just as Sen. Baucus was preparing to unveil his plan, the Business Roundtable, a lobbying group that represents major U.S. multinationals, released a study arguing that congressional inaction was not an option.
The study found that without any changes to the current system, the cost to insure a single employee, including the person's own out-of-pocket expenses, would jump to more than $28,000 a year by 2019, from around $11,000 a year now.
"The status quo is a prescription for failure," said Eastman Kodak Co. Chief Executive Antonio Perez, who heads the group's health initiative, in a statement endorsing the study. Mr. Perez, who declined to comment further, gave a plug in his statement for the Baucus bill, calling it "a bold framework...that builds on what works and improves what doesn't."
The U.S. Chamber of Commerce, which represents about three million businesses of all sizes, has run television ads opposing the Democratic-led health-care push. And the chamber, like many other big business groups in Washington, has many concerns about the Baucus bill, particularly the taxes it proposes to help pay for its $774 billion Congressional Budget Office price tag over 10 years.
But the chamber applauded much of the Baucus bill as the first proposal "that will actually...get health-care costs under control." "The reality with the business community is that we want reform, while some Republicans want to stop this train and start over," said Bruce Josten, the chamber's chief lobbyist. "That is just not going to happen."
Republican lawmakers predicted that businesses would soon sour on the Senate health-care package as Democrats heap on various amendments.
"I wouldn't confuse pleasant noises about the Baucus bill with an endorsement," said Republican Rep. David Camp of Michigan. "If this bill tacks left, which it is already doing, business won't support it."
Tennessee Republican Sen. Lamar Alexander said he wasn't disturbed by the interest shown by business groups in the Baucus bill. "They've got a right to say what they think," he said.
Sen. Alexander noted that "one of the ironies" in the debate was that while President Barack Obama often promises to reduce the role of special interests in policy-making, "most of the special interests are for the bill." He pointed specifically to drug makers.
Republicans have been particularly furious at the pharmaceutical industry, whose early willingness to cooperate with the White House and with Sen. Baucus proved crucial in keeping the push for an overhaul alive this summer. In June, the drug makers' lobbying group, PhRMA, cut a surprise deal with Mr. Baucus, offering to slash $80 billion in drug costs in exchange for a range of protections from the government.
That deal was shortly followed by the announcement of $150 billion in concessions by the hospital industry.
House Republican leader John Boehner blasted the PhRMA deal in a letter to the group's president, Billy Tauzin, a former Republican lawmaker.
"We have been criticized by people from both ends of the political spectrum, but we remain convinced that we are doing the right thing," said PhRMA spokesman Ken Johnson. "If health-care reform is going to be successful, it will require a shared sacrifice -- and, in our case, a stiff upper lip."
In particular business groups like the Baucus plan because they see its attempts to control skyrocketing medical costs. Business appears to understand this much better than most of Congress. Now that we have had public town hall forums with citizens, perhaps congressional decision-makeers will start to listen to employers who actually provide 60% of insurance coverage in the US.
The Baucus plan is by no means perfect but it does attempt to control costs and does establish a health insurance exchange for small businesses.
---------------- ------------------ ---------------
From the Wall Street Journal- Setp. 25th
By NEIL KING JR.
WASHINGTON -- Business is parting from its traditional allies in the Republican Party on health care as companies and big corporate lobbyists lend tentative support to a congressional overhaul that conservative lawmakers staunchly oppose.
The rift mirrors a similar divide on other issues, including immigration and climate change, where many companies have backed legislative action that Republican lawmakers oppose.
But the health-care debate, in particular, casts a spotlight on the split in the longstanding alliance between economic conservatives and the business community. Republican lawmakers are digging in to oppose the overhaul effort as a big-spending government intrusion. Many companies, on the other hand, cite soaring costs to explain why they continue to back the congressional work under way to revamp the health-care system, despite misgivings over a range of provisions.
"We are now at a crisis point," said Joe Olivo, who has struggled to keep up with rising health costs as the president of Perfect Printing Inc., a 40-employee printing company in Moorestown, N.J.
Mr. Olivo is apprehensive about many proposed Democratic fixes, above all the push to create a government-run insurance program. But he said he was also "disappointed that the Republicans don't seem to be at the table at all."
The business world this summer largely recoiled from legislation put forward in the House, which would mandate that employers provide employee coverage and would create a public insurance option.
But companies have been far more receptive to the plan released last week by Senate Finance Committee Chairman Max Baucus. The Baucus bill, which the committee is now busy amending, wouldn't include an employer mandate. It proposes a national exchange where individuals and small businesses could purchase insurance.
Just as Sen. Baucus was preparing to unveil his plan, the Business Roundtable, a lobbying group that represents major U.S. multinationals, released a study arguing that congressional inaction was not an option.
The study found that without any changes to the current system, the cost to insure a single employee, including the person's own out-of-pocket expenses, would jump to more than $28,000 a year by 2019, from around $11,000 a year now.
"The status quo is a prescription for failure," said Eastman Kodak Co. Chief Executive Antonio Perez, who heads the group's health initiative, in a statement endorsing the study. Mr. Perez, who declined to comment further, gave a plug in his statement for the Baucus bill, calling it "a bold framework...that builds on what works and improves what doesn't."
The U.S. Chamber of Commerce, which represents about three million businesses of all sizes, has run television ads opposing the Democratic-led health-care push. And the chamber, like many other big business groups in Washington, has many concerns about the Baucus bill, particularly the taxes it proposes to help pay for its $774 billion Congressional Budget Office price tag over 10 years.
But the chamber applauded much of the Baucus bill as the first proposal "that will actually...get health-care costs under control." "The reality with the business community is that we want reform, while some Republicans want to stop this train and start over," said Bruce Josten, the chamber's chief lobbyist. "That is just not going to happen."
Republican lawmakers predicted that businesses would soon sour on the Senate health-care package as Democrats heap on various amendments.
"I wouldn't confuse pleasant noises about the Baucus bill with an endorsement," said Republican Rep. David Camp of Michigan. "If this bill tacks left, which it is already doing, business won't support it."
Tennessee Republican Sen. Lamar Alexander said he wasn't disturbed by the interest shown by business groups in the Baucus bill. "They've got a right to say what they think," he said.
Sen. Alexander noted that "one of the ironies" in the debate was that while President Barack Obama often promises to reduce the role of special interests in policy-making, "most of the special interests are for the bill." He pointed specifically to drug makers.
Republicans have been particularly furious at the pharmaceutical industry, whose early willingness to cooperate with the White House and with Sen. Baucus proved crucial in keeping the push for an overhaul alive this summer. In June, the drug makers' lobbying group, PhRMA, cut a surprise deal with Mr. Baucus, offering to slash $80 billion in drug costs in exchange for a range of protections from the government.
That deal was shortly followed by the announcement of $150 billion in concessions by the hospital industry.
House Republican leader John Boehner blasted the PhRMA deal in a letter to the group's president, Billy Tauzin, a former Republican lawmaker.
"We have been criticized by people from both ends of the political spectrum, but we remain convinced that we are doing the right thing," said PhRMA spokesman Ken Johnson. "If health-care reform is going to be successful, it will require a shared sacrifice -- and, in our case, a stiff upper lip."
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