Politico.com this past weekend included news of what it described as Senator Ted Kennedy’s
reemergence in the health care reform debate, with proposals “distinctly
to the left” of those of Senate Finance Committee Chairman Max Baucus.
It also included the staff
working paper being circulated among members of Kennedy’s
Senate Health, Education, Labor, and Pensions Committee, and which presumably
reflects Kennedy’s positions.
The Politico report and a parallel piece in the New York
Times both claimed significant policy differences
between Kennedy and Baucus, reflecting Kennedy’s liberalism and Baucus’
more moderate (or conservative, depending on one’s politics) views.
The New York Times focused on the public plan issue as a defining difference
between the two senators, and noted Baucus’ efforts to develop compromises
with Republicans as potentially moving a Senate Finance reform bill
further to the right. So, what’s the truth?
Comparison of Finance Committee comments
with those of the HELP Committee working paper does show differences,
but in most cases ones of nuance. The working paper is often vague
on details (What are “reasonable limits” for premium variations?
is there any real evidence of the effectiveness of “medical homes”?)
but it is also quite comprehensive in scope, including a major section
on long-term care, something that has been almost totally ignored in
the reform debate. Other than the long-term care issue, though, there
is little in the HELP paper that is truly at odds with the Finance Committee’s
own policy outline—the November 2008 White Paper.
While the HELP paper does call—as
reported by Politico and the Times—for creation of a public plan,
no specifics are provided, and the words used could be as applicable
to the “weak” models suggested by Senator Charles Schumer and the
New America Foundation’s Len Nichols as to the “strong” Medicare-based
models suggested by liberals.
The conclusion: obviously there are
differences between Senators Kennedy and Baucus and between their respective
committees, (notwithstanding the two senators’ latest joint announcement ) but there is no deal-breaker. Yet.
Roger Collier was formerly
CEO of a national health care consulting firm. His experience includes
the design and implementation of innovative health care programs for
HMOs, health insurers, and state and federal agencies.
He is editor of Health
Care REFORM UPDATE.