Kaiser Daily Health Policy Report Highlights Health Reform News
Several newspapers recently highlighted news about people involved in health care reform. Summaries appear below.
- Reps. Rob Andrews (D-N.J.), Frank Pallone (D-N.J.): Andrews and Pallone -- chairs of the House Education and Labor Health, Employment, Labor and Pensions Subcommittee, and House Energy and Commerce Health Subcommittee, respectively -- in separate interviews said the final House health reform bill likely will expand the employer-based insurance system and implement a "marketplace" where unemployed people or those without access to employer-based coverage can shop for competing private plans, the Newark Star-Ledger's "N.J. Voices" reports. Andrews and Pallone are among the six House committee and subcommittee chairs who will actually write the chamber's bill, a draft of which is expected to be complete by next month and a final version passed by the end of the year. They also said the bill likely will include financial incentives for employers to offer insurance, either through reductions in premiums or tax breaks, or both. However, they said lawmakers have not decided whether to penalize companies not offering insurance, whether to require that everyone have insurance or whether to include a public insurance option. Pallone said, "The committees and subcommittees won't be producing their own plans that have to be reconciled later" (Braun, Newark Star-Ledger, 4/12).
- Former Vermont Gov. Howard Dean (D): The Hill on Monday examined how Dean is using Democracy for America -- an organization that grew out of his 2000 presidential campaign -- "to build a 50-state strategy advocating for public health care." According to The Hill, DFA in recent years "has been little more than a campaign organization," but "with Dean back on board, ... the group intends to transform itself into what [DFA Executive Director Arshad Hasan] described as a single-issue advocacy organization." DFA says it has gathered more than 250,000 signatures for a petition through the Web site www.StandwithDrDean.com that will be delivered to Congress. The Hill reports that "Dean has effectively set himself up as an alternative to the White House, a position from which he could give liberals a voice to pressure Obama" (Wilson, The Hill, 4/13).
- Former House Majority Leader Dick Gephardt (D-Mo.): Gephardt has warned the Obama administration that it should enact cost-saving reforms before it attempts to pass universal or near-universal health coverage proposals, the New York Times reports. Gephardt, a "major figure in Democratic politics" during his years in office, said that any effort to enact sweeping health care reform could suffer the same fate as the Clinton administration's health care attempts in the early 1990s unless costs are addressed first. Gephardt said universal coverage "is absolutely imperative, and it needs to be dealt with," but "the way to get it is to show that we can deal with some of these problems first." According to the Times, Gephardt has said that small steps toward increasing coverage for low-income workers and children could be the most Congress can gain while achieving cost containment. Tom Buffenbarger, president of the machinists' union, linked Gephardt's assessment to the former governor's new lobbying career. "He's advising a lot of big corporations," Buffenbarger said, adding, "All he's hearing is costs" (Harwood, New York Times, 4/13).
- Sen. Chuck Grassley (R-Iowa): At a town-hall meeting in Mason City, Iowa, Grassley "struck a highly upbeat note" about prospects for a bipartisan health care overhaul bill, but "clarified that he will only go so far" in seeking compromise, CQ HealthBeat reports. Grassley said that Congress has a "great opportunity" to act on health care this year, but that the "true test of this bipartisan process will be how we handle the details." He expressed his opposition to a proposed public insurance option, as well as the use of the budget reconciliation process to pass overhaul legislation in the Senate. Grassley also said he would not support the creation of a national health care board. However, he said of his work with Senate Finance Committee Chair Max Baucus (D-Mont.) on passing a health care bill, "If we don't get it done this year, ... it ain't going to be done for four years. That's why Sen. Baucus and I are on an aggressive schedule." He added, "I think we have momentum right now. It can be done ... as long as we don't try to bite off more than we can chew and create new problems where none exist, it can be done." The meeting was organized by AARP and the Divided We Fail campaign (Norman, CQ HealthBeat, 4/13).
The AP/USA Today on Sunday examined how the lack of a unified voice representing the U.S.' uninsured "could have profound repercussions." Richard Kirsch, a campaign director for Health Care for America Now, said, "We would never want to organize the uninsured by themselves because Americans see the problem as affordability, and that is the key thing." Kirsch added that many uninsured are busy with trying to pay bills. "They may not have a lot of time to be activists," he said.
Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health, said that the uninsured "do not provide political benefit for the aid you give them," adding that the uninsured "are not likely to help members of Congress get re-elected." According to AP/USA Today, research has shown that almost 50% of those who lose coverage find other insurance in four months or less (Alonso-Zaldivar, AP/USA Today, 4/12).
New York Times: "There are reasons to be wary about resorting to" the budget reconciliation process in order to pass health care overhaul legislation by a majority vote, but "it is a weapon that the Democrats would be foolish to give up without evidence that Republicans will truly cooperate in fashioning meaningful reform," a Times editorial states. According to the editorial, "Other than dealing with the economic crisis, health care reform is the most essential item on the congressional agenda" because it "is imperative to lower the cost of health care, improve its quality and cover tens of millions of uninsured Americans." Endorsing reconciliation would "make it easier to adopt such important measures as a tightly regulated insurance exchange for those without group coverage, a new public plan to compete with private plans, and mandates that employers contribute to the cost of covering their employees," it adds. Although there are "dire warnings that resorting to reconciliation will poison the atmosphere for bipartisanship," most "Republicans have shown little appetite for cooperation on anything," the Times continues, concluding, "A bipartisan agreement would be nice, but what the country needs right now is effective health care reform" (New York Times, 4/12).
- Wall Street Journal: The public insurance option favored by Democratic lawmakers would represent a "new middle-class entitlement" and "the last stand for anything resembling private health insurance," according to a Journal editorial. President Obama has said the public plan would allow people to keep their private coverage if they prefer, but the "reality is far different," the Journal states, adding, "Not only will the new program become the default coverage for the uninsured, but Democrats intend to game the system to precipitate -- or if need be, coerce -- an exodus to government from private insurance." The editorial states, "A public program won't compete in a way that any normal business would recognize" because as "an entitlement, [the plan] will enjoy potentially unlimited access to the Treasury, without incurring the risks or hedging against losses that private carriers do." In addition, as "people gravitate to 'free' or heavily subsidized care, the inevitably explosive costs will be covered in part with increased outlays to keep premiums artificially low or even offer extra benefits," according to the Journal. Similar to Medicare, "overall spending in the public option will be controlled over time by paying less for medical services, drugs and technology," meaning that using the new plan's "monopsony purchasing power, below-market fees will be dictated on a take-it-or-leave-it basis -- an offer hospitals and physicians won't be able to refuse," the editorial states. In addition, "Congress will finish the job with regulatory changes," under which any "private plan will essentially become a public utility where government decides what products it must offer and how much it can charge," according to the Journal. The Journal states, "Democrats want to sell their 'public option' as a modest and affordable reform that won't affect anyone's private insurance. It isn't true" (Wall Street Journal, 4/13).
It is a "false comparison" to relate private insurance to public plans like Medicare when advocating for a government-run health insurance option because "[p]rivate insurance and public benefits are not in the same business," former acting CMS Administrator Kerry Weems and former HHS Assistant Secretary Benjamin Sasse write in a Journal opinion piece. "For all its warts, private insurance tries to manage care," while "Medicare is mostly about paying the bills presented to it," they write. Weems and Sasse add, "As the case of Medicare's anemic antifraud efforts painfully illustrates, less management and lower administrative costs do not necessarily mean the program is really less costly."
Weems and Sasse write that those who use the Medicare example when advocating for a government-run health care plan "are motivated by the naïve assumption that most of the health sector's ills could be cured if profit-seekers were excluded." They write, "As the Congress continues the health care debate ... there should be an honest discussion of administrative costs and their value." According to Weems and Sasse, "Those who believe that health care should have no profit should be open with their views and not hide behind the false economy of Medicare" (Weems/Sasse, Wall Street Journal, 4/14).