Date: 3/27/2009
RICARDO ALONSO-ZALDIVAR
Associated Press Writer
WASHINGTON (AP) — Groups often at odds over health care reform — consumers, insurers, doctors, employers — reached a broad agreement Friday that could serve as a starting point for lawmakers trying to overhaul the system.
Although the long-awaited report of the Health Reform Dialogue avoided some of the most contentious issues, the agreement does have the kind of far-reaching support lawmakers will need to meet their goal of passing legislation this year.
“You can bet I’ll be working closely with these groups,” said Senate Finance Committee Chairman Max Baucus, D-Mont., who is trying to find consensus on Capitol Hill.
In their report, the groups said the uninsured should be covered through a mix of expanded government programs and subsidies to purchase private health coverage. They called for savings from making the health care system less wasteful and urged that prevention become the foundation for medical care. Many of their ideas are shared by President Barack Obama and influential lawmakers such as Baucus.
But the five-page proposal was thin on details, starting with how to pay for the plan. And the groups avoided such divisive issues as whether insurers should be forced to compete with a new government-sponsored insurance plan, as Obama has proposed.
Critics minimized the result. “They’ve moved the health care debate forward a few inches,” said Richard Kirsch, director of Health Care for America Now, a grassroots campaign backed by labor.
The 18 groups met for six months. Along the way, two major unions pulled away, but other groups representing seniors, businesses, nurses, drug makers and patients kept talking.
“What the agreement tries to do is achieve a balance for coverage expansion through the two key pillars of health care today,” said Ron Pollack, executive director of Families USA, a liberal advocacy group that stayed in the talks. “One is employer-sponsored private coverage and the other is safety-net coverage.”
Other participants included the National Federation of Independent Business and the health insurance industry, who were instrumental in sinking the last attempt at a health care overhaul in the 1990s. Also in the talks were staunch supporters of guaranteed coverage for all, such as AARP and the American Cancer Society Cancer Action Network.
The Service Employees International Union and the American Federation of State, County and Municipal Employees took part but didn’t sign on to the agreement because some of their concerns could not be satisfied. That underscored the difficulty of getting a health care compromise.
The groups all but endorsed a requirement that every American obtain health insurance. While their agreement avoided the politically loaded term “individual mandate,” it said Congress should “enact reforms necessary so that all individuals will purchase or obtain quality, affordable health insurance.” They avoided the issue of requiring employers to help pay premiums.
The agreement called for a two-prong strategy to cover the estimated 48 million uninsured. First, the Medicaid program should be expanded to cover all adults earning up to the federal poverty level, about $22,000 for a family of four. Then, subsidies or tax credits should be offered to help the middle class.
“I think what this document represents are some tough choices and some very tough consensus,” said Mary Grealy, president of the Healthcare Leadership Council, which represents the medical industry. “It tells Congress: here are some very important components for health care reform that you can now be assured have widespread agreement.”
The groups decided to sidestep the issue of whether to create a government insurance plan to compete with private companies. Many Democrats see that as an essential element of any final compromise. The insurance industry considers it a deal breaker.
The agreement also failed to spell out how to pay for expanded coverage in what is already the world’s costliest health care system. The options lawmakers are considering include taxing some health insurance benefits and limiting tax deductions for high earners, both seen as highly controversial. Independent estimates of the costs range as high as $1.5 trillion over 10 years.
But the agreement did acknowledge that hospitals, doctors, drug companies, insurers and other major elements of the health care system must become more efficient and less wasteful.
The groups will continue to meet as Congress moves ahead on legislation. Their support could prove decisive if a viable compromise does emerge, much as AARP’s backing helped ensure passage of the Medicare prescription drug benefit.
Copyright 2009 The Associated Press.
Health debate could spur malpractice changes
Date: 3/17/2009
By ERICA WERNER
Associated Press Writer
WASHINGTON (AP) — The Obama administration and key congressional Democrats are taking a hard look at the nation’s medical malpractice system as part of a broader health care overhaul.
“It’s an essential piece for there to be enduring reform, reform that will stick and will get a significant bipartisan vote in the United States Senate,” said Sen. Ron Wyden, D-Ore., who has a bipartisan health bill that includes incentives to get states to enact malpractice reforms.
Reviving the issue could provoke a fierce fight from trial lawyers, who, along with doctors, have the most at stake.
Already the trial lawyers’ lobby is preparing to distribute a brief on Capitol Hill casting medical malpractice as a small cost in the overall health system. The brief cites an Institute of Medicine finding that as many as 98,000 deaths in the U.S. each year result from medical error.
Trial lawyers and their Democratic Senate allies helped kill attempts under the Bush administration to cap punitive and pain and suffering payouts in malpractice lawsuits. The Congressional Budget Office says such caps could have saved the federal government $4.3 billion from 2010-2019.
Capping judgments likely remains a nonstarter.
John McDonough, a top health adviser to Sen. Edward Kennedy, D-Mass., told a conference of urologists this week that doctors must improve quality of care.
“The solution in terms of medical malpractice is not putting arbitrary caps on pain and suffering that discriminate against lower-income folks,” McDonough said.
The urologists responded with a chorus of “boos.”
But many top Democrats and administration officials say something must be done to curb medical malpractice costs to help pay for revamping the nation’s $2.4 trillion health system.
Obama himself told business leaders last week that ideas to save money like “medical liability issues — I think all those things have to be on the table.”
Senate Finance Committee Chairman Max Baucus, D-Mont., cites costs including fast-rising medical malpractice insurance premiums and so-called “defensive medicine” whereby doctors prescribe treatments that may be unnecessary to guard against getting sued if they fail to do so.
There’s agreement from some in the House including Rep. Rob Andrews, D-N.J., who chairs an Education and Labor health subcommittee.
“It’s hard for me to imagine a result that gets to the president’s desk that doesn’t deal with the medical malpractice issue in some way,” Andrews said in an interview Tuesday.
Proposed solutions include alternative dispute resolution, some similar to legislation that Obama co-sponsored with Hillary Rodham Clinton when both were in the Senate in 2005. Their bill would have created a program to allow patients to learn of medical errors and establish negotiated compensation with the offer of an apology.
Baucus has proposed giving states grants to develop alternate litigation, such as “health courts” whose judges have health care expertise.
Both lawyers and doctors say they’re open to alternative dispute ideas.
But “changing the legal system will not make anyone healthier or save one life,” said Linda Lipsen, senior vice president of public affairs at the American Association for Justice.
Meanwhile doctors are calling malpractice reform a top issue in the health reform debate.
“We need meaningful tort reform,” Nancy H. Nielsen, president of the American Medical Association, told Obama health adviser Ezekiel Emanuel at a recent conference.
“Stay tuned,” Emanuel told her.
Copyright 2009 The Associated Press.
By ERICA WERNER
Associated Press Writer
WASHINGTON (AP) — The Obama administration and key congressional Democrats are taking a hard look at the nation’s medical malpractice system as part of a broader health care overhaul.
“It’s an essential piece for there to be enduring reform, reform that will stick and will get a significant bipartisan vote in the United States Senate,” said Sen. Ron Wyden, D-Ore., who has a bipartisan health bill that includes incentives to get states to enact malpractice reforms.
Reviving the issue could provoke a fierce fight from trial lawyers, who, along with doctors, have the most at stake.
Already the trial lawyers’ lobby is preparing to distribute a brief on Capitol Hill casting medical malpractice as a small cost in the overall health system. The brief cites an Institute of Medicine finding that as many as 98,000 deaths in the U.S. each year result from medical error.
Trial lawyers and their Democratic Senate allies helped kill attempts under the Bush administration to cap punitive and pain and suffering payouts in malpractice lawsuits. The Congressional Budget Office says such caps could have saved the federal government $4.3 billion from 2010-2019.
Capping judgments likely remains a nonstarter.
John McDonough, a top health adviser to Sen. Edward Kennedy, D-Mass., told a conference of urologists this week that doctors must improve quality of care.
“The solution in terms of medical malpractice is not putting arbitrary caps on pain and suffering that discriminate against lower-income folks,” McDonough said.
The urologists responded with a chorus of “boos.”
But many top Democrats and administration officials say something must be done to curb medical malpractice costs to help pay for revamping the nation’s $2.4 trillion health system.
Obama himself told business leaders last week that ideas to save money like “medical liability issues — I think all those things have to be on the table.”
Senate Finance Committee Chairman Max Baucus, D-Mont., cites costs including fast-rising medical malpractice insurance premiums and so-called “defensive medicine” whereby doctors prescribe treatments that may be unnecessary to guard against getting sued if they fail to do so.
There’s agreement from some in the House including Rep. Rob Andrews, D-N.J., who chairs an Education and Labor health subcommittee.
“It’s hard for me to imagine a result that gets to the president’s desk that doesn’t deal with the medical malpractice issue in some way,” Andrews said in an interview Tuesday.
Proposed solutions include alternative dispute resolution, some similar to legislation that Obama co-sponsored with Hillary Rodham Clinton when both were in the Senate in 2005. Their bill would have created a program to allow patients to learn of medical errors and establish negotiated compensation with the offer of an apology.
Baucus has proposed giving states grants to develop alternate litigation, such as “health courts” whose judges have health care expertise.
Both lawyers and doctors say they’re open to alternative dispute ideas.
But “changing the legal system will not make anyone healthier or save one life,” said Linda Lipsen, senior vice president of public affairs at the American Association for Justice.
Meanwhile doctors are calling malpractice reform a top issue in the health reform debate.
“We need meaningful tort reform,” Nancy H. Nielsen, president of the American Medical Association, told Obama health adviser Ezekiel Emanuel at a recent conference.
“Stay tuned,” Emanuel told her.
Copyright 2009 The Associated Press.
Obama wants to overhaul health care; can he do it?
Date: 2/22/2009
By RICARDO ALONSO-ZALDIVAR
Associated Press Writer
WASHINGTON (AP) — Now for the hard part.
Even if the national credit card is maxed out and partisanship remains the rule for Washington’s political tribes, President Barack Obama and Congress are plunging ahead with a health care overhaul.
In the week ahead, Obama will start the dialogue on how to increase coverage, restrain costs and improve quality.
Whether a bill can get through Congress and to Obama this year is uncertain. For half a century, the track record on health care has been one of missed opportunities, spectacular failures and hard-won incremental gains.
Obama plans to stress the need for major changes in his address to Congress on Tuesday, administration officials say. He quickly will follow up with a budget that includes a commitment to expand coverage for the uninsured. A White House summit on health care is being planned in coming weeks.
“They don’t intend to blink. They intend to plow ahead,” said health economist Len Nichols of the nonpartisan New America Foundation. “Health reform is seen as essential to balancing the federal budget and economic recovery in the long run.”
People in the U.S. spend $2.4 trillion a year on health care, or about $7,900 per person. That’s more than twice as much per capita as in other advanced countries. But few would claim those dollars are buying good value. The costs are a staggering burden for taxpayers, employers and families, and the recession is leaving more people without insurance.
Yet even a self-described optimist such as Sen. Mike Enzi, R-Wyo., says he has doubts about prospects for overhauling health care. “It needs to be done up front and quickly,” said Enzi, the senior Republican on the Senate Health, Education, Labor and Pensions Committee. “I’m not so sure that we haven’t already lost that, with so many other things coming in and weighing us down.”
In the 1990s, President Bill Clinton took the better part of a year to deliver a 1,300-page health care bill to Congress and later waved his veto pen at lawmakers who might have given him half a loaf. He got nothing. Obama has shown a tendency to be more pragmatic.
Administration and congressional officials say Obama will lay out a vision and see if Congress can make the details work. The Senate has gotten an early start and is shaping up as the proving ground for legislation.
“The Obama administration has said they are going to give the Senate a very wide berth,” said Sen. Ron Wyden, D-Ore., who for years has tried to get Democrats and Republicans working together. “There are areas in which there is going to be spirited debate. But there are four or five major areas where there’s a lot of common ground.”
Polls show most people support coverage for all and believe government should help guarantee it. But what looks like consensus starts to break down once thorny details such as costs and the government’s influence on the doctor-patient relationship come into the picture.
Administration officials say Obama has made a down payment by expanding coverage for children of low-income working families and by providing subsidies to help people who lose their jobs keep health benefits.
As he moves forward, Obama will follow the plan laid out in his campaign.
It calls for government, employers, families and individuals to keep sharing financial responsibility for health care. The approach would overhaul the health insurance market, particularly for self-employed people and small businesses. It would set up a national insurance purchasing “exchange” through which people would be guaranteed access to private health insurance or the choice of a new public plan.
Obama sees coverage for all as a goal to be reached in steps. His plan would not require every individual to purchase insurance. The estimated cost is about $90 billion a year, to start with.
The plan might sound simple in a brief summary, but it’s not. Potential dealbreakers lurk at every turn.
Many liberals can’t get excited about doing battle for just a promise — not an immediate guarantee — of coverage for all.
Conservatives and insurance companies fear that a public plan offered to workers and their families could become the gateway for Canada-style government health care for all.
Employers, hospitals, doctors, and drug companies worry that the government’s already pervasive influence in health care will become stifling.
The initial work has fallen to the Senate, where Democratic Sens. Max Baucus of Montana and Edward Kennedy of Massachusetts want to present a bill by the summer.
Baucus is chairman of the Senate Finance Committee, which oversees Medicare and taxes. Kennedy, who is under treatment for brain cancer, leads the Senate health committee. He has pursued the goal of coverage for all his entire career and doesn’t want this opportunity to slip away.
Baucus has already outlined a plan that differs in some key details from Obama’s. For example, it contemplates taxing some health insurance benefits to raise money for expanded coverage. That’s an idea Obama has rejected but one that certain Republicans favor.
It takes 60 votes to get a bill through the Senate, and Democrats don’t have them.
In the House, the effort seems to be moving more slowly. Senior aides from leadership offices and committees are talking. Rep. Henry Waxman, D-Calif., chairman of the House Energy and Commerce Committee, is expected to take a leading role.
Some experts believe the issue is too complicated to try to accomplish in one year and one bill.
Watching and waiting are people such as Robyn Perry, 56, of Lake Worth, Fla., who recently lost a job with health benefits. She has struggled to find coverage now that she is self-employed. Private plans are either too expensive or won’t take her because she had a ministroke several years ago. A plan sponsored by local government accepted her, but won’t cover her outside her county.
“Something has to be done,” said Perry. “I work. I make decent money. But I still can’t get coverage. I would really like to find a normal health insurance plan that would cover me wherever I get sick, not just in Palm Beach county.”
___
On the Net:
White House: http://www.whitehouse.gov/agenda/health_care/
Copyright 2009 The Associated Press.
By RICARDO ALONSO-ZALDIVAR
Associated Press Writer
WASHINGTON (AP) — Now for the hard part.
Even if the national credit card is maxed out and partisanship remains the rule for Washington’s political tribes, President Barack Obama and Congress are plunging ahead with a health care overhaul.
In the week ahead, Obama will start the dialogue on how to increase coverage, restrain costs and improve quality.
Whether a bill can get through Congress and to Obama this year is uncertain. For half a century, the track record on health care has been one of missed opportunities, spectacular failures and hard-won incremental gains.
Obama plans to stress the need for major changes in his address to Congress on Tuesday, administration officials say. He quickly will follow up with a budget that includes a commitment to expand coverage for the uninsured. A White House summit on health care is being planned in coming weeks.
“They don’t intend to blink. They intend to plow ahead,” said health economist Len Nichols of the nonpartisan New America Foundation. “Health reform is seen as essential to balancing the federal budget and economic recovery in the long run.”
People in the U.S. spend $2.4 trillion a year on health care, or about $7,900 per person. That’s more than twice as much per capita as in other advanced countries. But few would claim those dollars are buying good value. The costs are a staggering burden for taxpayers, employers and families, and the recession is leaving more people without insurance.
Yet even a self-described optimist such as Sen. Mike Enzi, R-Wyo., says he has doubts about prospects for overhauling health care. “It needs to be done up front and quickly,” said Enzi, the senior Republican on the Senate Health, Education, Labor and Pensions Committee. “I’m not so sure that we haven’t already lost that, with so many other things coming in and weighing us down.”
In the 1990s, President Bill Clinton took the better part of a year to deliver a 1,300-page health care bill to Congress and later waved his veto pen at lawmakers who might have given him half a loaf. He got nothing. Obama has shown a tendency to be more pragmatic.
Administration and congressional officials say Obama will lay out a vision and see if Congress can make the details work. The Senate has gotten an early start and is shaping up as the proving ground for legislation.
“The Obama administration has said they are going to give the Senate a very wide berth,” said Sen. Ron Wyden, D-Ore., who for years has tried to get Democrats and Republicans working together. “There are areas in which there is going to be spirited debate. But there are four or five major areas where there’s a lot of common ground.”
Polls show most people support coverage for all and believe government should help guarantee it. But what looks like consensus starts to break down once thorny details such as costs and the government’s influence on the doctor-patient relationship come into the picture.
Administration officials say Obama has made a down payment by expanding coverage for children of low-income working families and by providing subsidies to help people who lose their jobs keep health benefits.
As he moves forward, Obama will follow the plan laid out in his campaign.
It calls for government, employers, families and individuals to keep sharing financial responsibility for health care. The approach would overhaul the health insurance market, particularly for self-employed people and small businesses. It would set up a national insurance purchasing “exchange” through which people would be guaranteed access to private health insurance or the choice of a new public plan.
Obama sees coverage for all as a goal to be reached in steps. His plan would not require every individual to purchase insurance. The estimated cost is about $90 billion a year, to start with.
The plan might sound simple in a brief summary, but it’s not. Potential dealbreakers lurk at every turn.
Many liberals can’t get excited about doing battle for just a promise — not an immediate guarantee — of coverage for all.
Conservatives and insurance companies fear that a public plan offered to workers and their families could become the gateway for Canada-style government health care for all.
Employers, hospitals, doctors, and drug companies worry that the government’s already pervasive influence in health care will become stifling.
The initial work has fallen to the Senate, where Democratic Sens. Max Baucus of Montana and Edward Kennedy of Massachusetts want to present a bill by the summer.
Baucus is chairman of the Senate Finance Committee, which oversees Medicare and taxes. Kennedy, who is under treatment for brain cancer, leads the Senate health committee. He has pursued the goal of coverage for all his entire career and doesn’t want this opportunity to slip away.
Baucus has already outlined a plan that differs in some key details from Obama’s. For example, it contemplates taxing some health insurance benefits to raise money for expanded coverage. That’s an idea Obama has rejected but one that certain Republicans favor.
It takes 60 votes to get a bill through the Senate, and Democrats don’t have them.
In the House, the effort seems to be moving more slowly. Senior aides from leadership offices and committees are talking. Rep. Henry Waxman, D-Calif., chairman of the House Energy and Commerce Committee, is expected to take a leading role.
Some experts believe the issue is too complicated to try to accomplish in one year and one bill.
Watching and waiting are people such as Robyn Perry, 56, of Lake Worth, Fla., who recently lost a job with health benefits. She has struggled to find coverage now that she is self-employed. Private plans are either too expensive or won’t take her because she had a ministroke several years ago. A plan sponsored by local government accepted her, but won’t cover her outside her county.
“Something has to be done,” said Perry. “I work. I make decent money. But I still can’t get coverage. I would really like to find a normal health insurance plan that would cover me wherever I get sick, not just in Palm Beach county.”
___
On the Net:
White House: http://www.whitehouse.gov/agenda/health_care/
Copyright 2009 The Associated Press.