Congress Looking at 3 Plans

[Herbert Hoover]

Report: Senators mull 3 health-insurance plans
Finance Committee expected to consider controversial proposals next week


WASHINGTON - Senators are considering three different designs for a new government health-insurance plan that middle-income Americans could buy into for the first time, congressional officials said Friday.

Officials familiar with the proposals said senators plan to debate them in a closed meeting next week. The officials spoke on condition of anonymity because details of the controversial plans have not been released.

Creating a public plan is one of the most contentious ideas in the debate over how to overhaul the nation's health-care system to cover the uninsured and try to restrain costs.

President Barack Obama and many Democrats say a government option would serve as a check to keep the private insurance industry honest.

Insurers fear the government would use its power to drive them out of business. And Republicans call a public plan in the legislation a deal-breaker, dashing hopes for bipartisan legislation for overhauling the health insurance system. Employer groups are also opposed.

The three approaches being discussed are:

• Create a plan that resembles Medicare, administered by the Health and Human Services department.
• Adopt a Medicare-like plan, but pick an outside party to run it. That way government officials would not directly control the day-to-day operations.
• Leave it up to individual states to set up a public insurance plan for their residents.

But many key details would still have to be fleshed out.

Among them is whether the public plan would be open to everyone, or be limited to small businesses and individuals purchasing coverage on their own.

Also, would the plan reimburse medical providers at discounted Medicare rates or the higher fees that private insurers pay? And would it be financed by tax dollars, or entirely from premiums?

Closed-door session
Senators on the Finance Committee will consider the proposals during a closed-door session scheduled for late next week. Committee leaders want to bring a bill to the Senate floor this summer. It's unclear whether a public plan in any form will emerge from Congress.

Citing surveys that show most seniors are happy with Medicare, Democrats say they believe that a public plan would be a political winner. But Republicans counter that it would be a step toward a government-run system in which medical services sooner or later would be rationed.

The majority of Americans now get health insurance through private insurers, about 170 million people in all. Most of them are enrolled in employer-sponsored plans.

A recent report by the Lewin Group, a numbers-crunching firm that serves government and private clients, found that a new government plan could radically alter that landscape — or maybe not.

It depends on the design.

If the public plan were open to all employers and individuals — and if it paid doctors and hospitals the same as Medicare — it would quickly grow to 131 million members, while enrollment in private insurance plans would plummet, the study found.

By paying Medicare rates the government plan would be able to set premiums well below what private plans charge. Employers and individuals would rush to sign up.

But the results would be far different if the government plan was limited to small employers, individuals and the self-employed.

In that smaller-scale scenario, the public plan would get from 17 million to 43 million members, the study said. It found that a government plan could be effective in reducing number of uninsured.

Lewin is a subsidiary of UnitedHealthcare, the nation's largest health insurer. The consulting firm says it makes its own judgments, however. Its work is used by groups on all sides of the health care debate, including supporters of a public plan.

http://www.msnbc.msn.com/id/30648497/

[MarsLasar]

That's interesting. And it looks like there is lobbyist pressure on the Montana senator...

SIIA Gets Attention of Key Senator on Health Care Reform


As reported previously, one of the biggest concerns regarding expected federal health care proposals is that the government will set up its own health insurance company to “compete” with the private sector. Steve Forbes writes about how such an initiative will lead us down the road to national health care in the May 11 edition of Forbes. You can access this article on-line through the following link.

http://www.forbes.com/forbes/2009/05...?partner=email

In closely related news, SIIA has met multiple times with Senate Finance Committee Chairman Max Baucus and his key staff to educate them on the success and importance of self-insured health plans as part of the overall U.S. health care system. It is widely acknowledged that Senator Baucus is the most important member of Congress with regard to health care reform legislation due to committee jurisdictional issues and his role as a leading “moderate” Democrat.

This groundwork appears to be having some positive impact based on comments that Senator Baucus made to reporters on Friday, as detailed in the article below excerpted from Congressional Quarterly.

While comments are positive, the debate over health care reform is expected to intensify in the coming months and SIIA needs the continuing financial support of the self-insurance/ART industry to make sure we have the resources necessary to ensure a positive outcome.

For information on how you can help, please go to the SIIA web site at www.siia.org and click on “War Chest” and “Self-Insurance PAC.”

Congressional Quarterly 4/24/09
At a meeting with reporters on Friday, Senate Finance Committee Chair Max Baucus (D-Mont.) said he will temporarily set aside talks on a new public insurance option to focus on maintaining employer self-insurance plans, CQ Today reports. Self-insured companies qualify for tax exemptions through the Employee Retirement Income Security Act. The federal law allows firms to create their own tax-exempt insurance plan -- a means of cutting costs by taking on the risks themselves -- as long as the plans meet federal standards laid out by ERISA. Firms contract with private insurers to administer the plans. Baucus said he would aim to preserve this self-insurance system while expanding private coverage and public programs such as Medicaid. He said, "We'll end up with more private insurance and more public insurance" (Armstrong, CQ Today, 4/24).

As for the creation of a new public insurance option, Baucus said that it is "on the table," adding that it "might be to the side a little bit, ... but it's still on the table." He added, "We're trying to get momentum going. We'll get to the public option a little later. Let's not forget: There's an awful lot more here than the public option" (Young, The Hill, 4/24).

Baucus said he would support a "system similar to Massachusetts," which allows residents to buy coverage through a "connector" offering plans that meet government-established benefit minimums. He also said, "I think the whole system should be more national, and the benefits have to be more national. You can't have benefits be one level in one state, and another level in other states." However, he said his goal is not to disrupt employer-sponsored plans. According to Baucus, "The system I envision is where self-insured companies, ERISA companies, can keep their own plans and manage health insurance in the way that they have. We're not going to change the ways self-insured companies handle health care for employees." As for workers at smaller firms that do not offer insurance and other people buying insurance on their own, Baucus said they could purchase insurance through the exchange that would be similar to the Federal Employees Health Benefits Program. He also said, "We have to reform the health insurance market" by guaranteeing that people are able to purchase insurance (CQ Today, 4/24).

[T-roy Boy]

I will be optimistic. If providers collect more, ie less bad debt, then the private plans' prices can come down making them somewhat competitive with the gov plan. Maybe.

[T-roy Boy]

Supposedly Obama is announcing something today (5/11) about the reform. Stay tuned...

http://www.ahiphiwire.org/HealthInsu...?doc_id=305373

[FormLetter]

I hope it is decided to leave it to the states.

[Heathen]

I wonder if the poll cited in the OP includes MC members that can't find doctors taking new MC patients.

I also wonder if the poll was taken before or after CMS anounced 20% cuts to providers.

[T-roy Boy]

http://www.politico.com/news/stories...404_Page2.html

We have to wait more. Till June 1 now. But, the article implies that a public plan looks like it can be avoided if all parties come to an agreeable crossroad.

[Herbert Hoover]

Originally Posted by MarsLasar's Article

In closely related news, SIIA has met multiple times with Senate Finance Committee Chairman Max Baucus and his key staff to educate them on the success and importance of self-insured health plans as part of the overall U.S. health care system. It is widely acknowledged that Senator Baucus is the most important member of Congress with regard to health care reform legislation due to committee jurisdictional issues and his role as a leading “moderate” Democrat.

This groundwork appears to be having some positive impact based on comments that Senator Baucus made to reporters on Friday, as detailed in the article below excerpted from Congressional Quarterly.
...

Single payer advocates are not happy with Baucus right now.

Barack Obama appeared this week with health-industry bigwigs, proclaiming light at the end of the health-care tunnel. Among those gathered were executives from HMO giants Kaiser Foundation Health Plan and Health Net Inc., and the health-insurance lobbying group America’s Health Insurance Plans; from the American Hospital Association and the American Medical Association; from medical-device companies; and from the pharmaceutical industry, including the president and CEO of Merck and former Rep. Billy Tauzin, now president and CEO of PhRMA, the massive industry lobbying group. They have pledged to voluntarily shave some $2 trillion off of U.S. health-care costs over 10 years. But these groups, which are heavily invested in the U.S. health-care status quo, have little incentive to actually make good on their promises.

This is beginning to look like a replay of the failed 1993 health-care reform efforts led by then-first lady Hillary Rodham Clinton. Back then, the business interests took a hard line and waged a PR campaign, headlined by a fictitious middle-class couple, Harry and Louise, who feared a government-run health-care bureaucracy.

Still absent from the debate are advocates for single-payer, often referred to as the “Canadian-style” health care. Single-payer health care is not “socialized medicine.” According to Physicians for a National Health Program, single-payer means “the government pays for care that is delivered in the private (mostly not-for-profit) sector.”

A February CBS News poll found that 59 percent in the U.S. say the government should provide national health insurance.

Single-payer advocates have been protesting in Senate Finance Committee hearings, chaired by Democratic Montana Sen. Max Baucus. Last week, at a committee hearing with 15 industry speakers, not one represented the single-payer perspective. A group of single-payer advocates, including doctors and lawyers, filled the hearing room and, one by one, interrupted the proceedings.

Protester Adam Schneider yelled: “We need to have single-payer at the table. I have friends who have died, who don’t have health care, whose health care did not withstand their personal health emergencies. ... Single-payer now!”

Baucus gaveled for order, guffawing, “We need more police.” The single-payer movement has taken his words as a rallying cry. At a hearing Tuesday, five more were arrested. They call themselves the “Baucus 13.”

One of the Baucus 13, Kevin Zeese, recently summarized Baucus’ career campaign contributions:

From the

• insurance industry: $1,170,313;
• health professionals: $1,016,276;
• pharmaceuticals/health-products industry: $734,605;
• hospitals/nursing homes: $541,891;
• health services/HMOs: $439,700.

That’s almost $4 million from the very industries that have the most to gain or lose from health-care reform.

Another of the Baucus 13, Russell Mokhiber, co-founder of SinglePayerAction.org, has been charged with “disruption of Congress.”

He was quick to respond: “I charge Baucus with disrupting Congress. It once was a democratic institution; now it’s corrupt, because of people like him. He takes money from the industry and does their bidding. He won’t even diffuse the situation by seating a single-payer advocate at the table.”

As I traveled through Montana recently, from Missoula to Helena to Bozeman, health-care activists kept referring to Baucus as the “money man.” Montana state Sen. Christine Kaufmann sponsored an amendment to the Montana Constitution, granting everyone in Montana “the right to quality health care regardless of ability to pay,” or health care as a human right. It died in committee.

Wisconsin Sen. Russ Feingold, a single-payer advocate, said his position will not likely prevail in Washington: “I don’t think there’s any possibility that that will come out of this Congress.” That’s if things remain business as usual.

Mario Savio led the Free Speech Movement on the UC Berkeley campus. In 1964, he said: “There comes a time when the operation of the machine becomes so odious, makes you so sick at heart, that you can’t take part, you can’t even passively take part, and you’ve got to put your bodies upon the gears and upon the wheels, upon all the apparatus, and you’ve got to make it stop. And you’ve got to indicate to the people who run it, the people who own it, that unless you’re free, the machine will be prevented from working at all.”

“Unless you’re free,” the Baucus 13 might add, “to speak.” The current official debate has locked single-payer options out of the discussion, but also escalated the movement—from Healthcare-NOW! to Single Payer Action—to shut down the orderly functioning of the debate, until single-payer gets a seat at the table.

[Herbert Hoover]

More Democratic nervousness over Baucus...

Dems unclear where Baucus will side on health care reform
TAGS: Max Baucus, Health Care Reform, Democrats, Senate Finance Committee
By CARRIE BUDOFF BROWN | 5/18/09 4:16 AM EDT Text Size:


The fate of health care reform this year rests in the hands of a stoic Montana senator with a reputation for confounding his party and a zeal for bipartisanship that many in his caucus don’t share.
Photo: AP


The fate of health care reform this year rests in the hands of a stoic Montana senator with a reputation for confounding his party and a zeal for bipartisanship that many in his caucus don’t share.

To put it bluntly, Finance Committee Chairman Max Baucus makes the liberal wing of the Democratic Party nervous — because they don’t know which Baucus will show up in the clutch.

Will it be the senator who infuriated his party in 2003 by working with Republicans on a Medicare prescription drug program even after they excluded the Democratic leadership from the final negotiations? Or the one whom Democrats credit with eviscerating former President George W. Bush’s plans to privatize Social Security?

“Sen. Baucus really understands the historic significance of this issue. At the same time, he has an orientation toward doing bipartisan work. And at some point, those two different tendencies are going to collide,” said Richard Kirsch, campaign manager for Health Care for America Now, a coalition of liberal organizations. “Because in order to change the health care system, we have to make the big changes that do not lend themselves to bipartisanship if Republicans are going to take traditional ideological or industry-centered views.”

The personal balance that Baucus strikes could go a long way toward determining the health care fix that Americans see. Democrats have waited a long time to get within reach of passing health care reform — and now, the senator in charge isn’t someone they have always trusted. Baucus puts a premium on bipartisanship, and if he insists on winning more than a handful of Republican votes, the final product could look vastly different than a bill passed through the Senate with only a simple majority.
Low-key and unpredictable, Baucus has erased some doubts by completely — obsessively, according to those close to him — committing himself to passing a bill this year.

He wasn’t expected to do this. He is an expert on trade and global finance, not health care. And despite the power of his committee, Baucus certainly would have shared the stage with Sen. Ted Kennedy (D-Mass.), had he not fallen ill with cancer.

But this is no rerun of Moynihan-Clinton, circa 1993-94, when Finance Committee Chairman Pat Moynihan (D-N.Y.) disagreed with President Bill Clinton’s approach to health reform and helped kill the effort. Baucus started developing a health care strategy more than a year ago, and he has ruled the process with a firm hand, demanding discipline from the interest groups that want to keep a seat at his table and steering the Senate into the most promising position in 15 years to fix the system.

“The way the chairman has managed the calendar, boxed the lobbyists and stolen all the thunder from the House has been politically masterful,” said Ben Sasse, a former assistant secretary of Health and Human Services in the Bush administration. “Still, at some point, real policy choices are going to need to be made.”

Democrats are loath to give any hint of dissension, but tensions lie just below the surface. Subtly and cautiously, some are trying to convince Baucus that a good Democratic bill is better than the 60- or 70-vote bipartisan scenario he touts. Sen. Bernie Sanders (I-Vt.) gave one of the rare public critiques of the Baucus strategy this month, saying Congress needed to be more concerned about “doing something real.”

Baucus stiffened his back when asked to respond to Sanders.

“Well, the definition of ‘good’ is in the eye of the beholder,” Baucus said. “I am very confident that a very large majority of senators and House members are going to vote for a good bill — a bill that is good. Not everyone is going to vote for it. But the vast majority will.”

If Republicans balk, Baucus said he will not rule out using reconciliation, a budgetary maneuver that allows passage of a bill with 51 votes rather than a filibuster-proof 60 votes. But he maintains that the way to achieve “sustainable” reform is through broad buy-in from both parties.

http://www.politico.com/news/stories...xzz0Ft4fRZJq&B

[Herbert Hoover]

http://www.huffingtonpost.com/2009/0..._n_209865.html

Anger mounting against Baucus.

Sen. Max Baucus got some not-so friendly advice from his Montana constituents last week as he works to reform the health care system: You're doing it all wrong.

Baucus, the chair of the Finance Committee and the leader of reform efforts in the Senate, scheduled 20 town hall meetings with constituents across the state to talk about the future of health care. The Senate was out of session, but Baucus, a Democrat, didn't personally attend. Instead, he sent staff and a video-recorded message.

"I really want to hear from all of you," Baucus said on the video, according to local media. "You're my employers. You're my bosses. You're the people I work for. I'm just the hired hand. I want to hear what you want to see in any legislation we pass in Washington, D.C."

He got what he asked for.

Five separate accounts of the meetings, published in four different local papers, show Montana voters were downright hostile to Baucus' reform proposal. Baucus has been a staunch opponent of single-payer health care, a system in which the government would provide universal coverage.

Baucus has kept single-payer advocates out of negotiations and has yet to endorse a compromise proposal by Sen. Charles Schumer (D-N.Y.) that would give Americans the option of buying into a publicly run plan that would compete with private insurers.

That stance put his staffers up against a wall, facing angry constituents fed up by what they viewed as a lack of courage in Washington.

"Majority wants single-payer health care," headlined an account in the Helena Independent Record.

At several of the events, Montanans' ire was directed at Baucus chief of staff Jon Selib, who defended the employer-based coverage system that he estimated covers 150 million Americans. Story continues below

"A lot of people like that," Selib said.

When the time came for questions, [self-employed consultant Steve] McArthur stood up and asked a simple question. Looking across a standing-room-only crowd of about 275, he asked how many were happy with their employer-based health insurance.

Fewer than 10 people raised their hands.

"The [argument] is bogus," McArthur said. "It's not working for 95 percent of us."

In fact, any mention of single-payer health care insurance brought raucous cheers and clapping. Any other solution to health care reform - including Baucus' "balanced" plan that would create a mix of public and private plans - was received more coolly.

The bitter questioning led Selib to break some news at the meeting.

"If you think your insurance company is screwing you ... then you'd have the option of going to the public plan," Selib said. "Senator Baucus is fighting tooth and nail to include that in any final deal."

Then he asked the standing-room-only audiences for comments -- and got an earful, mostly on the whys, hows and whats of national health insurance as the preferred option.

Baucus' staff repeatedly argued that 60 votes are needed to move a bill through the Senate and that single-payer, or an otherwise bold reform, simply wouldn't pass. That wasn't what they wanted to hear, said a story in the Missoulian, "Single-payer health care: Baucus keeps getting an earful."

PABLO - Sen. Max Baucus' insistence that consideration of a national single-payer health plan at this point will squander a golden opportunity for health care reform in the United States continues to be met with stiff resistance from many of his constituents.
"The word 'insurance' does not equal health care," Janelle Kuechle of Polson said at a meeting here Thursday. "If I have to pay a $900 premium to have health insurance with a $10,000 deductible, that is not health care."

"Congress ought to be representing us instead of the insurance lobby," said retired school teacher John Oberlitner of Polson. "Max Baucus has stated it's not feasible to pass a single-payer health plan, but one year ago people were saying it was not feasible that Obama could be elected our president."

Voters in Livingston weren't much warmer, recorded the Bozeman Daily Chronicle.

But many in the audience grilled a Baucus staffer on why they wouldn't allow single-payer advocates to participate in roundtables held to form his plan. Several doctors were arrested for protesting that point in Washington two weeks ago during a Baucus-led discussion.
Judy Moor of Bozeman asked whether the big campaign dollars Baucus has received from the insurance industry was reason for suspicion.


"Single-payer advocates not giving up the fight," observed the Great Falls Tribune.

Proponents of single-payer showed up en masse at the most well-attended meetings in Missoula, Hamilton, Anaconda, Dillon and Livingston to urge Baucus -- the chairman of the Senate Finance Committee -- to consider single-payer universal health care. Single payer -- a system in which the government provides health insurance to all Americans -- has been declared "off the table" by Baucus, Congress' leading man on heath care reform.
Baucus isn't pushing hard enough, said a Helena business owner, summing up the statewide wisdom. "Max is really making me mad now because he's not really trying to change the system, he's just trying to tweak it."