by Kent Garber
Editorial Cartoon by David Horsey
Obama insists that healthcare reform must include a public option
Around 7 a.m. last Wednesday, Sen. Chris Dodd got a call from Sen. Ted Kennedy. Dodd, a Connecticut Democrat, was scheduled to kick off debate in the Senate health committee on Kennedy's healthcare overhaul bill, and the Massachusetts Democrat was phoning to wish him luck.
"He's dedicated virtually all of his public life to this issue," Dodd said of Kennedy, who is battling brain cancer. "He wanted to warn all of us that he's watching" on TV.
Kennedy couldn't have been pleased with what he saw later that morning. Dodd had barely begun opening remarks when a peeved Sen. John McCain interrupted and denounced the bill as incomplete.
"How can we possibly, reasonably address the trillions of dollars of spending associated with this bill without accounting for some way to pay for it?" the Arizona Republican queried.
McCain was not the only one in Washington asking that question last week. New government figures on the potential costs of healthcare legislation put Democrats on the defensive, having to rethink not only their proposals but also their hope of having a bill ready for President Obama's signature by October.
The inciting spark was the Congressional Budget Office's released of preliminary estimates on the costs of the two main Senate bills.
Kennedy's was tagged at $1 trillion. The other, being developed by Finance Committee Chairman Max Baucus, would cost $1.6 trillion.
Those numbers -- especially the latter figure -- thundered through Washington, partly because of their sheer magnitude and partly because of the CBO's nonpartisan reputation. In response, Baucus, a Montana Democrat, announced that he would not unveil his bill last week as planned but will "slow things down" and look for ways to cut more than $600 billion from the cost.
The White House has tried not to flinch.
Kathleen Sebelius, the secretary of health and human services, said late last week that the president would not be "distracted by the chatter" and asked Congress to ignore day-to-day reports of impending defeat or failure.
President Obama himself is now talking.
In a news conference Tuesday, he insisted that reform must include a government-run insurance option. His position has been buoyed by a new poll this week, conducted by CBS and the New York Times, showing that 72 percent of Americans support a public option.
"Reform is not a luxury, it's a necessity," Obama said.
But Baucus's move will have real consequences.
Senate Democrats plan to weave the Baucus and Kennedy bills together into a single text. Delaying Baucus's bill could slow the whole process. (In the House, Rep. Charles Rangel, who chairs the Ways and Means Committee, released draft bill last Friday.)
Amid all the caterwauling, there was some good news for Obama.
His remarks to the American Medical Association last week apparently scored points, because the group rejected a resolution officially opposing his public insurance plan. On the other hand, that's far from an endorsement.
Senators from both parties have hailed a new report from former Sens. Bob Dole and Tom Daschle, founders of the Bipartisan Policy Center, as offering a "road map" for healthcare reform. But limited bipartisanship has been in evidence in the marble-walled Senate hearing room that is now overflowing with paper drafts of proposed amendments.
Dodd says he hopes to fill in the gaps in Kennedy's bill, including costs, by the end of this week. Republicans warn those moves could add another trillion in red ink.
Day of Reckoning at Hand for Health Insurers
by Robyn Blumner
President Obama and the Democratically-led Congress are rolling up their sleeves, sharpening pencils and trying to deliver health-care changes that cover many more people, provide a safety net for the rest of us and won't bankrupt our nation the way the current system most assuredly will
America's Hospitals Can't Afford Healthcare Cuts
by Rich Umbdenstock
Rich Umbdenstock is president and CEO of the American Hospital Association. We must not lose sight of the fact that we will need good healthcare policy changes -- not just payment cuts -- if we hope to find long-term solutions to the healthcare challenges vexing America: 46 million uninsured, an aging population, an epidemic of obesity and chronic disease and the need for a more coordinated system of care.
Uwe Reinhardt: Plain Talk on Healthcare Reform
by Bernadine Healy M.D.
If there were a Straight Talk Express for health economists, Princeton professor Uwe Reinhardt would be the engineer. Born in Germany and raised in Canada, Professor Reinhardt has personally experienced medical systems in different countries. Over the past 25 years, he has become a critical voice in the debate about reforming America's healthcare system.
Employers to Make Deeper Cuts in 2010 Health Coverage
by Martha Lynn Carver
Look for employers to cut more deeply than ever into health care coverage for their workers in 2010. Companies are getting walloped by higher than expected costs just when they can least afford it.
When Healthcare Reform Hits Grandma
by Bernadine Healy M.D.
Obama has laid the groundwork for a massive overhaul of America's healthcare system into a more publicly managed, cost-conscious enterprise that focuses more on wellness than sickness. Driving most government outlays, however, are the many millions of Americans, particularly the elderly, with extremely resource-intensive chronic diseases.
However, what's tried and true, is the government's power to restrict reimbursement and change medical behavior. Medicare, which covers virtually all of the elderly, can say "No" to expensive treatments. That's great if the care is unnecessary. But you can't always tell if you're not at the bedside.
Government-run Healthcare Insurance-Program Sure to Backfire
by Phil Gingrey, M.D.
My fear is that creating a government-run health insurance plan wouldn't guarantee quality care by physicians -- in fact, it will not guarantee care at all. The quality of care in a government-run health plan may seem irrelevant to those individuals who are happy with the coverage they currently have -- after all, President Obama promised during his campaign that, "If you like the plan you have, you can keep it." But most individuals don't really have their own health coverage -- they get it from their employers.
Obama's Uphill Battle to Reform Healthcare
by Kent Garber
President Obama stood at a podium flanked by six healthcare leaders and announced what he called "a watershed event in the long and elusive quest for healthcare reform." Obama, by almost any account, had just scored what appeared to be a major concession from several of the country's biggest healthcare players.
Obama's Hidden Business Tax Increase
by Matthew Bandyk
Obama's proposal would require companies to account for their inventories on a first-in-first-out (FIFO) basis rather than a last-in-first-out (LIFO) one -- an eye-glazing change that's highly significant. In an era of rising costs, to assume that you're selling your oldest inventory rather than your newest increases reported profits and thus taxes, even though nothing real has changed. If inflation turns worse, as many analysts predict, FIFO would force companies to pay real taxes on phantom profits as the value of goods gets inflated while they sit in inventory.
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