Secretary Thompson, Lawmakers Address Range of Health Care Issues in Roll Call

In a Roll Call policy briefing on health care today, HHS Secretary Tommy Thompson addressed patients' rights, Medicare reform and other health care issues. Answering questions from Roll Call Executive Editor Morton Kondrake, Thompson "made it clear he's a Bush [administration] team player. But he's also a man with his own convictions." Some highlights from the interview appear below.

• Patients' rights: Thompson said that while President Bush supports legislation that would provide "a right to a legal and arbitration process, and if that doesn't work, then to some sort of litigation," Bush "doesn't want to encourage litigation. Discussing the McCain-Kennedy-Edwards patients' rights bill, Thompson said that the legislation would encourage litigation "[m]uch more so than the President and I feel comfortable with," which could "put a damper" on employers offering health insurance. He added that Bush "doesn't want to usurp states from supervising health insurance programs and policies" when they "measure up or come close to measuring up" to federal standards. "I think that's going to be left up to this department -- I suppose me in the long run -- to determine who's going to be able to supervise these health insurance policies," Thompson said.
• Medicare reform: Thompson said that Medicare "needs a lot of repair and modernization," calling Breaux-Frist II "a starting point" for reform. Responding to criticism that the bill would force "old people into HMOs," Thompson said, "[T]he truth is, what ... we're going to attempt to do is not force people into managed care but give them a choice," adding the Federal Employee Health Benefit Plan will serve as "a basic building block" for reform. He also said that he would "argue against" enacting a prescription drug benefit without broader Medicare reform, calling pharmaceutical coverage the "honey" that will allow lawmakers to revamp the program. "I mean, prescription drugs is what everyone wants. If you pass that, what's the incentive for any Member of Congress to come back next year to fix Medicare? It needs fixing now. Prescription drugs is politically popular. But we need Medicare reform," Thompson said, predicting that legislation would reach the House floor by September or October this year.
• HCFA reform: Thompson said that "Congress has put a lot more additional responsibilities onto HCFA over the years and given it fewer resources," such as employees and updated computer systems. In addition, he said that he hopes to "simplify" the agency's "complex" rules and regulations, which often encourages "costly" mistakes, and issue rules and regulations on a set -- not "willy-nilly" -- time period. Thompson also hopes to educate providers "better" and offer "more detailed advice ... so you don't turn individuals into criminals just because they make mistakes." Still, he said, "HCFA's great. HCFA needs to be reformed, but HCFA's gotten a lot more criticism than it deserves. I'm coming to its defense, even though I probably was one of the biggest critics of HCFA in the years past when I was governor."
• The uninsured: To help provide coverage for more Americans, Thompson said that the "smartest thing that we can do is find ways to expand CHIP," which would allow the uninsured and "working poor" to "buy into our Medicaid systems across America." He added that he hopes to "start working on some sort of flexible" CHIP program that Bush would support and Congress would "hopefully and enthusiastically buy into."
• Stem cell research: Thompson said that the Bush administration would decide whether the government should fund embryonic stem-cell research "sometime this year," adding that he "feel[s] strongly about" allowing federal funding of stem cell research.

Debate Rages On
In addition to Thompson's interview, the Roll Call health care policy briefing features opinion pieces on several key issues, including patients' rights, Medicare reform, a prescription drug benefit and patient privacy regulations. Excerpts appear below.

• Patients' rights: Backing the Breaux-Frist patents' rights bill, measure co-sponsor Sen. Jim Jeffords (R-Vt.) argues that the legislation would provide "meaningful protections" for all Americans without prompting employers to drop health insurance coverage or "significantly" increasing the cost of health coverage. Sen. Ted Kennedy (D-Mass.) defends the rival McCain-Kennedy-Edwards patients' rights bill, arguing that the measure would "guarantee Americans the rights that every respected insurance company already grants, along with providing an effective, timely means to enforce these rights";
• Medicare reform: Rep. Nancy Johnson (R-Conn.) calls Medicare "antiquated" and argues that lawmakers must "modernize and improve the Medicare program so that it can fulfill its promise of providing accessible, affordable health care." However, while Rep. Pete Stark (D-Calif.) admits that "we need to modernize Medicare," he argues against the Breaux-Frist proposals championed by some Republicans, calling the plans "little more than thinly veiled attempts to privatize Medicare and reduce the government's contribution to health care for some of our most vulnerable citizens."
• Prescription drug benefit: Touting the Breaux-Frist Medicare reform package "the best of what the government does" and the "best of what the private sector does," bill co-sponsor Sen. John Breaux (D-La.) argues that lawmakers have a "prime opportunity" for adding a prescription drug benefit to Medicare. Rep. Bernie Sanders (I-Vt.), criticizing pharmaceutical companies for charging "outrageously high" drug prices, advocates a separate plan that would require seniors to pay only 20% out-of-pocket and never more than $2,000 per year for pharmaceuticals.
• Patient privacy regulations: Rep. Jim Greenwood (R-Pa.) argues that until "market-based initiatives are ready to ensure consumer privacy and protection," government may "need to fill the void. Touting the "need for strong federal privacy laws," Rep. Jim McDermott (D-Wash.) adds "If individuals doubt their information will be kept private, they will either delay treatment or be less forthcoming with their physicians" (Roll Call, 3/26).