Are We Going Far Enough, Fast Enough?

In an effort to stay ahead of the curve, I literally waded through the 263-page Chairman’s mark-up from the Senate Finance Committee. Although, I did not literally read every page, my intent – like “War and Peace” – is to do so some day.  It is quite a tome, and the policy wonks, lobbyists, and independent analysts are all offering their filters on the language of the mark-up and reactions are beginning to percolate.  I must say that compared to Harrison’s Principles of Internal Medicine [the textbook of basic medicine], the Committee’s report is complex stuff!
 
As the week wore on, the stances of various healthcare sectors also became increasingly clear.  First, the insurance industry weighed in with Karen Ignagni, President of America’s Health Insurance Plans, suggesting the Senate Finance proposal “will fail the test of affordability for individuals.” Second, the American Medical Association expressed its concern because the Baucus Bill does not include $200 billion in promised higher Medicare payments for doctors – something we reported last week.  And, the gathering storm was heightened when Chip Kahn, President of the Federation of American Hospitals, noted “the Senate has a ways to go to meet our deal.”  He was referencing the fact that the hospitals agreed to a $155 billion haircut in Medicare payments last summer in return for getting the number of uninsured – both legal and illegal – to less than 6 percent of the population.  As the bill stands, 9 percent of the population will remain uninsured.  In an effort to calm the discussions, the White House emphasized that the whole legislative discussion in both the Senate and the House was a “work in progress.”  The long and short – to sooth the insurance companies, the doctors, and the hospitals – the issue of more, not less, money for the proposed healthcare reform effort is on the table – despite the caution expressed by others over the cost of the plan(s).   So, the pull and tug of reform continues unabated.

At the same time, many people I talk with are increasingly concerned that the discussion has become a fiscal and insurance-based debate and not a healthcare reform debate.  Are we going far enough?  Fast enough?  Many people on both sides of the aisle agree our healthcare system needs to be fixed, and the time is now.  In an effort orchestrated by the White House, a chorus of current and former Republican leaders spoke out in support of healthcare reform this past week, including: former Majority Leaders and Senators Robert Dole and William Frist (a transplant surgeon from Tennessee), Governor Arnold Schwarzenegger of California, two former Secretaries of Health and Human Services, Louis Sullivan, MD and Tommy Thompson (also, a former Governor of Wisconsin), the former Bush Medicare chief Mark McClellan, and the Republican-turned-Independent New York City Mayor, Michael Bloomberg. 

The mobilization of the chorus was yet another move in the intricate chess game of healthcare reform aimed at capturing swing votes like that of Senator Olympia Snowe (R-ME).  But even though there was bi-partisan endorsement of the healthcare reform efforts, the details of the GOP support were conditional on the shape of the final bill.  As an example, while throwing support for healthcare reform on the table, both former HHS Secretary Tommy Thompson and former Senate Majority Leader Bill Frist echoed the familiar concern about cost.  Though they both admitted the Senate Finance Committee’s bill would impose new taxes, both expressed optimism that a final plan that would help the American people, in fact, would pass Congress.  Their concern on overall costs resonates with many healthcare analysts – again, on both sides of the aisle – that simply insuring more people without fixing the system is a hazardous road on which to venture.  But, to quote the venerable Yogi Berra, “the game’s not over till it’s over.”

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Services or its affiliates.