A look at the Baucus Bill

9/23/2009

Here’s a rundown of some of the highlights discussed yesterday in the conference call between senior health care legislative aides in the office of Sen. Harry Reid, and five blog publishers, including myself.

You can read the entire bipartisan bill that came out of the Senate Finance Committee this week -- also called the Baucus Bill -- at: http://finance.senate.gov/sitepages/leg/LEG%202009/091609%20Americas_Healthy_Future_Act.pdf

This is the long-awaited bill that is supposed to keep the costs within the framework mandated by President Obama, and be acceptable to both sides of the aisle, while keeping the spirit of reform.

Note: It does NOT include a public option. In other words, it’s a compromise, from the start.

Since the Baucus Bill was published over the weekend for Mark Up, nearly 600 amendments have been proposed. The amended version of the bill should be available for study in a few days. I’ll put up a link when I have one.

During the conference call, we focused on priorities for seniors, and how the bill will affect Medicare recipients. Here are a few highlights:

--This bill contains no benefit cuts to seniors on Medicare. NONE.

--Those enrolled in a drug benefit plan will get a 50% discount on brand name drugs while they are in the so-called donut hole. That discount will not affect their ability to reach the next level in the drug program, however, because they will be credited for 100% of the cost of the drugs they buy at a discount.

--Senior Medicare recipients will get a free annual physical. This is something new.

--All prevention testing and immunization will be free. This will include flu shots, mammograms, colonoscopies and the like. One amendment under consideration would add bone-density testing to the list.

--Physicians treating Medicare patients will get a 5 % increase in reimbursements beginning 2010, instead of the scheduled 21% payment cut. This should make it more likely that physicians will open their doors to new Medicare patients.

I asked what the catch was for all this “free” stuff. After all, we know there’s no such thing as a free lunch.

We were told money would be raised to pay for new benefits through revenue provisions (taxes and fees?), as well as by cracking down on waste, fraud and abuse. The Baucus Bill gives the Secretary of DHHS, FBI and Department of Justice new tools to monitor and increase penalties for fraud.

One aide said we already spend billions every year on health care in this country that do not improve health one iota. For instance, a large part of the health care dollar goes to pay for consumer marketing and direct advertising by insurance and drug companies, or is lost to fraud or waste.

All bloggers were urged to encourage their readers to voice opinions on this bill and other health care reform proposals through emails or calls to elected officials, or through blogs like our own.

For more information, be sure to read the blogposts by the other bloggers on the call:
George Phenix at Blog of Ages
Nancy Belle at The Tempered Optimist
Jan Adams at Happening Here
Ronnie Bennett at Time Goes By

Here’s a handy form Ronnie Bennett put together:

Contact your senators and representative here.

Nancy Pelosi
Email form
Phone 202.225.0100

Harry Reid
Email form
Phone 202.224.3542

3 Comments

Larry

9/23/2009 11:42:02 pm

I agree with Kathleen in Texas who suggests that every US citizen should have access to a uniform system of affordable health care.

Perhaps that is why I have a hard time understanding the widely divergent opinions held by Americans on the subject. I can only assume that there are those who have terrific insurance coverage (or think they do); those who have terrible insurance coverage or none; those who fall somewhere in between those two extremes; and of course those without insurance who don't think they need it/don't want to pay for it (heaven help them if they get sick).

As far as the government insurance option is concerned, I am not sure I understand how a government-run plan would be an unfair competitor. Blue Cross/Blue Shield is the largest health insurer in Iowa (operating under the name Wellmark here), and it is a "not-for-profit" corporation. Now if for-profit companies can compete against BCBS, why wouldn't they be able to compete against a government-run plan? As for the suggested buying coops, I heard on NPR a few weeks ago an interview with an executive of such an organization in Seattle. She told the reporter that it took her group literally years to get up and running and it still isn't a stellar performer. Can we afford to experiment with creating such groups all across the nation?

I also am puzzled that there is so little public discussion of the vast differences in available private insurance plans. As Kathleen noted, the largest employers (including many governmental units) are able to negotiate excellent insurance plans at "reasonable" costs for them and/or their employees. Small businesses and individuals are hard pressed to obtain even decent insurance at an affordable cost. That to me is very unfair.

And the uninsured apparently are also subject to outrageous add-ons by health care providers. I read this week in the Des Moines Register, published in Des Moines, Iowa, that a recent study showed hospitals in Maine were charging uninsured patients vastly higher amounts for a colonoscopy than they were charging insured patients. That is inexcusable and unacceptable.

The existing health care system is a real mess. But, will a majority of Americans ever agree to support any given legislative proposal? Seniors are afraid of any change in Medicare, yet how can we (I am one) justify continuation of Medicare Advantage Plans (I don't have one) when the federal government is subsidizing every insurer that offers them? Organized labor has been very vocal about protecting the insurance plans it has negotiated on behalf of its members. Is it fair, however, that organized labor or large corporations or governmental units can negotiate and offer "Cadillac" insurance plans that simply aren't available to Americans who own their own businesses or who are otherwise employed or are unemployed? Should insurers have the right to dictate which doctors their policy holders can or cannot use? Should health care practitioners continue to be reimbursed on a fee-for-service basis? Should insurer/insured disputes over acceptable medication, such as that noted by Sarah in Massachusetts, be resolved before an "independent" agency rather than through repeated appeals within the insurance company?

I believe that unless and until the members of Congress and the rest of us begin to debate and resolve these kinds of tough issues, we Americans will never achieve meaningful health care reform. What we clearly do not need is a massive piece of costly legislation that masks the symptoms or creates even more, but does nothing to cure the disease. What we clearly cannot afford is to put off making these decisions another two or five or ten years or more.

Kathleen Scott link

9/24/2009 01:23:09 am

Thanks, Paula, for the links and highlights. I'm sending a link to this blog post to every one in my family.

Joan

9/24/2009 10:44:49 am

My comments re healthcare are simple. We need it and we need it now. I would prefer single payer, but realize we have to "break the ice" so to speak and work towards it. A Public Option is a nice start. I would love to see the insurance companies held to task also. Good health is NOT a privilege it is a human RIGHT. I know that is a hackneyed phrase...but if it tells the truth, so be it.