The Kennedy Plan

Roger collier

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
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


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The Esquire
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All that aside, why does Edward (“Silver Spoon” aka “Chappaquiddick”) Kennedy continue to be elected?
Term limits for everyone!


““Over the last several months, HELP [Committee] Democrats have been working non-stop to develop a health reform bill that reduces cost, protects individual choices and assures affordable, high-quality healthcare for every American,” Kennedy spokesman Anthony Coley said in a statement.” Anyone that knows history should be running for the hills. How bad does Kennedy have to screw up American Healhcare before he loses his seat at the table? Other steller Kennedy Health Reform circa 1978; “”The current revival of the HMO movement should come as no surprise. HMOs have proven themselves again and again to be effective and efficient mechanisms… Read more »


For an excellent summary of the reasons why a public plan option is not desirable, I strongly recommend Victor Fuch’s article in a recent issue of the New England Journal of Medicine. It is a devastating argument.