Sens. Baucus, Kennedy Write Letter to President Obama Confirming Plans To Deliver Final Health Reform Bill by Summer
In a letter to President Obama on Monday, Senate Finance Committee Chair Max Baucus (D-Mont.) and Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) confirmed their respective panels' plans to mark up separate health care overhaul bills in June, CQ HealthBeat reports (Reichard, CQ HealthBeat, 4/20). The letter stated, "Our intention is for the legislation to be very similar, and to reflect a shared approach to reform, so that the measures that our two committees report can be quickly merged into a single bill for consideration on the Senate floor" (CongressDaily, 4/20). The senators wrote, "We have a moral duty to ensure that every American can get quality health care," adding, "We must act to contain the growth of health care costs to ensure our economic stability; to help American businesses deal with the health care challenge; and to make sure that we are getting our money's worth" (CQ HealthBeat, 4/20).
Baucus on Tuesday will hold the first of three roundtable discussions that will focus on issues such as changing health care payment systems, increasing the role of primary and preventive care, and better managing chronic diseases (Ochs, Long Island Newsday, 4/21). The first meeting will cover ways to improve health care delivery (Budoff Brown, Politico, 4/21). House leaders sent a letter to Obama last week stating their intention to have a single House overhaul bill ready for a vote by August (Long Island Newsday, 4/21).
Liberal interest groups and lawmakers are expressing concerns that Obama has shown willingness to compromise on the issue of creating a public health insurance option as part of a potential health care overhaul, the Washington Post reports. Obama spokesperson Linda Douglass on Monday said, "The administration is open to all ideas for achieving" the president's health care goals. Len Nichols, health policy director at the New America Foundation, said, "That's what got the left nervous. I took that as a signal to" Sen. Chuck Grassley (R-Iowa) that Obama might offer a compromise regarding a public plan. Last week, White House Office of Health Reform Director Nancy-Ann DeParle said that there "are many different breeds of public plans that could be part of this." According to the Post, discussions of such a compromise "shine a light on the intraparty fissures that may prove more problematic than any partisan brawl" (Connolly, Washington Post, 4/21).
Employer Tax Exemption
Discussions of changing the tax exemption for employer-sponsored health coverage is an "emerging flashpoint" in the debate over how to pay for a proposed health care overhaul, the Wall Street Journal reports. Possible changes include placing a dollar limit on health benefits that can be excluded from taxable income; eliminating the exemption for people above a certain income limit; and allowing tax-exempt benefits to the lowest-income U.S. residents but taxing benefits on a sliding scale based on income. Baucus has expressed support for taxing only those over a certain income. Another possibility would be to tax benefits depending on where the worker live, as health care costs vary widely across states.
AFL-CIO health care lobbyist JoAnn Volk said, "If you had to choose, an income threshold would be better," but "anything that might undermine the place where most workers get coverage is a concern." However, Republicans and like-minded groups believe this method would in effect be placing a new tax on higher-income individuals. Douglas Holtz-Eakin, the former senior policy adviser for the presidential campaign of Sen. John McCain (R-Ariz.) and former Congressional Budget Office director, said, "It just seems completely wrongheaded from a tax policy point of view, and it doesn't accomplish anything from a health policy point of view." Republicans also say placing a cap on the exemption could "put downward pressure" on health costs, according to the Journal. Nichols said the scope and depth of any tax changes will be determined by how much funding is needed for an overhaul. He said, "The reality is, we don't have enough money to pay for health reform without changes to the tax expenditure. How much will depend on what we can generate from other sources, such as making the delivery system more efficient" (Vaughan, Wall Street Journal, 4/21).
The Los Angeles Times on Tuesday examined how the Obama administration is "unapologetic about seeking so many big changes at the same time," but "for all the talk of sweeping change," Obama "is not really a radical." According to the Times, "He hasn't proposed replacing private health insurers with a government plan; instead, he talks of making the insurance industry a cornerstone of his new system." An Obama aide said of the administration's priorities, "Passage of health care in some form, progress on energy, and a sense by the end of the year that the economy is turning the corner -- that what has been put in place is starting to work" (McManus, Los Angeles Times, 4/21).
Providence Journal: As the "battle lines are forming" over a public option in comprehensive health care reform legislation, "the details of the public option will matter a great deal" as they will in "all aspects of the health care puzzle," a Providence Journal editorial states. The editorial continues, "We are concerned about the fees that a public plan would pay to doctors and hospitals" because we "want the medical profession to remain well paid and attractive to the best and the brightest." The editorial adds, "At the same time, good comprehensive reform should save doctors money," noting that physicians "make handsome livings in most every country, including those with government-run health programs." The Providence Journal concludes that the "details will determine whether the proposed public option would preserve quality of care as well as curb the relentless increases in the cost of medicine. Let's approach this with open minds" (Providence Journal, 4/21).
- Washington Times: "It doesn't matter what your doctor says: the Obama administration plans to decide" what care a patient will receive, a Washington Times editorial states. The editorial notes that Lawrence Summers, Obama's chief economic adviser, in an appearance on "Meet the Press" on Sunday said that the country could reduce health care spending by $700 billion annually by employing cost-effectiveness analyses. The editorial states, "Let's be clear -- Mr. Summers is talking about rationing" health care. According to the Washington Times, "Rationing is inevitable under" a universal health care plan because "[n]ationalized health care puts bureaucrats -- not doctors -- in charge of deciding who needs what medical treatment." The editorial concludes, "That's one reason Mr. Obama's universal health care plans must be stopped" (Washington Times, 4/21).
- Fred Barnes, New York Post: While preventing government intervention in physicians' treatment decisions "won't make Republicans more popular, ... at least they'll be heroes in the cause of defending private health care and preserving individual freedom," Weekly Standard columnist Barnes writes in a New York Post opinion piece. According to Barnes, "Obama and other Dems now talk about health care in a more appealing fashion" than their counterparts during the Clinton administration's failed overhaul efforts. Democrats say that "rather than replace employer-purchased insurance, the 'public' plan would merely 'compete' with it," Barnes writes. He adds that, in reality, "By offering cut-rate fees and drug prices -- it wouldn't need to make a profit -- it would soon clear the field of competitors." Barnes concludes, "It's up to Republicans to rally a well-financed army of relentless opposition ... for the good of the country" (Barnes, New York Post, 4/21).
- Stan Collender, Roll Call: "[W]hen it comes to health care, reconciliation shouldn't be an issue at all" because "health care reform will have a substantial impact on federal finances," and it "can't be said to be unrelated to the budget, which is one of the critical criteria for using reconciliation," Collender, a partner at Qorvis Communications, writes in a Roll Call opinion piece. He adds, "[G]iven that at least two of the largest mandatory federal spending programs -- Medicare and Medicaid -- are health care programs, health care reform and reconciliation would seem to be a perfect fit." He writes that "including [health care] in reconciliation does not prevent the committees with jurisdiction from producing a bill outside the reconciliation process," and it "may very well provide a strong incentive for these committees to produce a bill on their own" (Collender, Roll Call, 4/21).
- Wendy Everett, Boston Globe: As federal lawmakers develop the new comparative effectiveness research program for determining the best medical treatments, "they must do so while recognizing that health care cannot work without innovation," Everett, president of the New England Healthcare Institute, writes in a Globe opinion piece. Everett writes that "in winnowing out some interventions even as it promotes others, comparative research will inevitably have an impact on innovation." In order to ensure comparative studies do not halt innovation, Everett suggests that the program "avoid focusing solely on medical technologies such as drugs and devices." She adds that "Congress and the administration should make a commitment to fund and develop new ways of conducting comparative research." In addition, Everett writes that "the program must ensure that the findings actually reach patients and physicians in order to make a difference in practice." Everett concludes, "Designed wisely, comparative effectiveness research can achieve the best of both worlds: vast improvements in the health care evidence base along with sustained development and adoption of valuable innovation throughout the health care system" (Everett, Boston Globe, 4/21).
- Jason Fodeman, Salt Lake City Deseret News: A "dysfunctional approach" to health care financing in the U.S. "encourages excess utilization of medical services and drives up medical costs at the same time it prices insurance beyond the means of many families," Fodeman, a health policy fellow at the Heritage Foundation and a fourth-year medical student at the Albert Einstein College of Medicine, writes in a Deseret News opinion piece. "The way to fix the financing is not to have government pick up an even larger share of the tab," but rather "to give individuals more control over how their health care dollars are spent," he writes. Fodeman continues that letting people have control over spending "includes letting them decide what kind of insurance coverage they want." Fodeman says, "For this to happen, Washington will have to change the tax code so it no longer penalizes individuals and families for getting insurance outside of the workplace," which "means establishing a national market for health insurance." Fodeman concludes, "The far superior alternative for expanding coverage and controlling costs is to inject real consumer choice and robust competition into the health care sector" (Fodeman, Salt Lake City Deseret News, 4/20).
- Scott Huennekens, Washington Times: "It may not be the most popular opinion to have in our industry," but with health care spending increasing, the U.S. "must invest in research to find faster, less expensive solutions to common medical problems without creating more regulatory and reimbursement hurdles that often slow adoption," Huennekens, president and CEO of the medical device maker Volcano, writes in a Washington Times opinion piece. Huennekens continues that Obama's proposal for "comparative effectiveness research will illuminate the positive impact these technologies will have on health care spending." He adds, "Increasing reimbursement for [such] technologies ... may cost a couple hundred million dollars now, but it will save the health care system billions down the road" (Huennekens, Washington Times, 4/20).
- The Rev. Jesse Jackson, Chicago Sun-Times: The budget resolution conference committee, which is scheduled to meet this week, "may well decide the fate of President Obama's health care reform," Jackson, president of the Rainbow/PUSH Coalition, writes in a Sun-Times opinion piece. Jackson writes, "Against the power of the Big Pharma, the drug company lobby and the health insurance lobby, it will take a pitched battle to get significant reform with 50 votes," adding, "If it requires 60, it isn't likely to happen." According to Jackson, "The health insurance and drug industries have a multibillion-dollar stake in limiting reform," but U.S. residents have "a direct personal interest in comprehensive reform that helps get costs under control." He concludes, "The insurance company lobbies are laying siege to the Senate now," adding, "The question is whether the senators will hear from the rest of us" (Jackson, Chicago Sun-Times, 4/21).
- Peter Pitts, San Jose Mercury News: As health care reform legislation progresses, lawmakers "must be aware of the facts" and "they must be clear on the precise causes of America's health care woes," Pitts, president of the Center for Medicine in the Public Interest and a former FDA associate commissioner, writes in a Mercury News opinion piece. According to Pitts, "Of the $2.2 trillion America spends each year on health care, 75% of that money goes to fighting chronic diseases, many of which are preventable." He continues that "it stands to reason that any meaningful plan to make health care more affordable in this country must start with reducing the prevalence of chronic diseases." According to Pitts, better medical education can produce "huge strides" in reducing health care spending. He concludes that if President Obama "wants to ensure that all Americans have access to affordable, high-quality health care, he needs to address the growing threat of chronic illnesses" (Pitts, San Jose Mercury News, 4/20).
NPR's "Morning Edition" on Tuesday reported on a health care reform proposal developed jointly by Families USA and the Pharmaceutical Research and Manufacturers of America -- "[t]wo longtime adversaries in health care." The segment includes comments from Families USA Executive Director Ron Pollack and PhRMA President and CEO Billy Tauzin (Rovner, "Morning Edition," NPR, 4/21).