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Health Care Reform Coming Out of Senate Finance?

We’ve been getting lots of news these past few days leading to optimism that a bipartisan health care bill will soon emerge from discussions between the “Coalition of the Willing.” That term refers to the three Republicans and three Democrats trying to find common ground in the Senate Finance Committee.First, let me be clear that I have the greatest respect for Senators Baucus and Grassley and their four colleagues. Theirs is the kind of bipartisan approach that all of Washington, DC should be following on any number of issues.And, as I have posted here before, I am concerned that in their efforts to find compromise they are headed for a health care bill that is based on a formula of cost containment “lite,” minor paring of Medicare and Medicaid provider payments, and at least $500 billion in new taxes. I don’t see much changing fiscally if that is the final result in a health care system that is already unsustainable and on the way to spending upwards of $35 trillion to $40 trillion over the next ten years as it goes to 22% of GDP by 2018.From what we have heard, their bill would hardly "bend" any curves.

Yes, we could well cover tens of millions more people and that alone would be a noble accomplishment. But just loading all of these people onto a system that we can’t now afford seems to me to be ultimately a fool’s errand. The number of uninsured we have in this country isn’t the fundamental problem—it is the most aggravating symptom of our real problem, which is unsustainable cost.Being good guys and bipartisan doesn’t necessarily lead to the best policy!But I would also caution people watching this process not to be so certain that when the final Senate Finance product is unveiled—if it is ever reached—that we are on the fast track to legislation.We’ve literally had these Senators holed up in secret for a number of weeks engaged in a very complex group dynamic trading one policy and revenue concept for another that may be leading to a compromise that makes sense to them. But each trade-off they made, or are making, is something really important to someone outside their little group and maybe not something any one, or a group of, the other 529 members of Congress is willing to go along with.What we do know is that every time a new idea for controlling costs, getting a good CBO score, or raising money has hit the media it has about always come in for lots of criticism from one side or the other—or even both at times.For more than a year I have been telling readers of this blog that health care reform was going to be very, very difficult to do. That we really didn’t have the consensus in this country over just what the problems are and what we need to do about them, or the political will to make the tough calls we need to make. Many people have disagreed with that assessment. I may still turn out to be wrong about it being different this time—but not so far.I’d wait to see just what the “Coalition of the Willing” is able to put on the table before we go declaring any victories. If for no other reason, any product is going to have to lay on the table for all of August and that won’t be pretty.I will remind you that the last group to go off on their own and hatch a health care plan in secret didn’t do so well when it hit the light of day.Made sense to them at the time.

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Alex C.Dorothy HarrawayJoshuafreespiritkty Recent comment authors
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Alex C.
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Alex C.

No one is discussing the real problem with the med mal issue. Tort reform in the form of payment caps is not the answer. The real cost isn’t the malpractice premiums or the payouts. The real problem is a legal system that forces physicians to order so many test out of fear to protect themselves. The problem for doctors is that even if they follow the most up to date guidelines and studies they can still be sued for malpractice because there are no established legal standards of care. The “standard of care” is whatever any given attorney can convince… Read more »

Dorothy Harraway
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Dorothy Harraway

The Universal Health Care Reform 3200 is an insurance that is restrictive. I have read most of the bill and it gives government the access to your aocounts and they will review your ddual power of attorneys. Obama tells another verison (his own verison) that is different from the factual written reform. As for Canada the skier died because she had to be taken to a hospital far away.(No helicopter service). A friend has been waiting over a year for knee replacement and does not know when she will ever get it. (a senior)

Joshua
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Joshua

For all those people screaming just say NO!! Does this mean we should stop medicare and Medicaid so we can truly get government out of health insurance? What your saying is we have the best health care system in the world so why do we need any government intervention right? People on Medicare and Medicaid would be much better off with private health insurance right? So I will stand with that get rid of Medicare and Medicaid and the taxes I would save from helping fund them I’ll put toward a great private plan..well until I get sick and need… Read more »

freespirit
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freespirit

Facts!! We aren’t being given the facts. We are being brainwashed. No, the health care reform bill does not use the exact words “forced abortion” or “euthanasia” that they scream at us are not in the bill, but hidden in the ambiguous excessive wordage, these things, are a distinct possibility. It takes a sharp mind to detect it, but the scariest thing is the phrase that does hit one in the face over and over. “As determined by the Commissioner”. Those exact words are in the bill over and over. To further define what this administration is about one only… Read more »

kty
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now im not saying our country doesnt need serious reform. but has anyone taken time to look at the new healthcare bill? end of life counseling? seriously? requiring vaccines? it would actually save money if they allowed parents to opt out of getting their children certain vaccines, but that wont be allowed. mandates on state family planning services? isnt that where they do abortions? Section 1121 – all doctors will be paid the same no regards to specialty. say goodbye to your specialists everyone. the government will have access to ALL of our financial information? Section 58B- nonresident aliens exempt… Read more »

debt reduction
Guest

somone fix this health care problem

SPhelps
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SPhelps

Those of you who are blaming tort reform, i.e., law suits & medical malpractice for the rising health care costs, would do well to keep this statistic in mind. Medical malpractice costs only make up about 1-2% of the total cost of healthcare!!!! That’s not where our money is going, despite what the politicians (& some doctors) are trying to tell us! And while some specialties (OB, neurosurgeons, etc.) by their very nature are more prone to malpractice, not every physician has to carry such super high malpractice insurance! Even when you factor in the testing that doctors often do,… Read more »

tcoyote
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tcoyote

jd seems to forget that this year, our federal deficit equals 50% of total spending. That is, we’re borrowing HALF of the money were spending on federal programs this year, including Medicare. We are spending money, other peoples’ money, our childrens’ money, like drunken sailors. Letting cost containment wait three or four years until we’ve gotten all the new people enrolled in health insurance is not responsible social or economic policy. The first boomer arrives on Medicare in TWO YEARS, the advance guard of 76 million additional customers for a program that is already living beyond its means. Wake up,… Read more »

jd
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jd

Certainly it’s true that Robert Laszewski, like many of us, has been saying for a long time that health care reform that substantially improved the value equation (outcomes as function of cost) would be difficult and have to overcome entrenched and powerful opposition. However, Mr. Laszewski has also been a member of a rather large club of serious thinkers who heavily criticizes reform packages whenever they appear to have weak cost control measures built in. That is not the best attitude to take if you want to get real reform with real cost controls. Health care reform is a war,… Read more »

HealthReformWatch.com
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http://www.healthreformwatch.com/2009/07/30/dead-center/
Professor Tim Greaney, Saint Louis University School of Law posing a few rather pointed questions to the so called “centrists.” Prof Greaney is one of this country’s preeminent Health Law scholars. Bio: http://law.slu.edu/faculty/profiles/profile.asp?username=greanetl

individual medical insurance
Guest

I think everyone should be required to have medical insurance because all of us insureds pay for each and every one of the uninsured through our health premiums. Just like auto insurance…if you drive a car, you must carry the insurance. If you are a human being and breathe, then you must have health insurance.

medical insurance plans
Guest

Lawyers have a lot to answer for in the ever rising cost of health care. Tort reform is fundamental to keeping medical insurance costs at bay.

family medical insurance
Guest

Defensive medicine must be stopped at the root…skyrocketing costs of tests that are needlessly ordered increases everyone’s medical insurance

medical insurance
Guest

You must admit that this bill will be the closest bipartisan solution that we’ve had yet. Once the details emerge…it may not be as bipartisan as we once thought! A mandate that everyone must have medical insurance is a step in the right direction.

Jeff Goldsmith
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Jeff Goldsmith

The “debate” seems to be taking place on two levels. I think the PUBLIC has a very different idea of the health cost problem than the experts and Congress. To the public, 46 million of whom have 100% exposure to health costs, its the costs to THEM of healthcare use that is the # 1 concern. This concern has been massively aggravated by this recession, the terrible household liquidity crisis and by the steady twenty year accretion of deductible and copay exposure. To address this (which HR 3200 actually does by capping cost sharing), you’ve got to promise to reduce… Read more »