The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Baucus Health Care Reform Plan an Interesting Start

Posted by Alan on November 17, 2008

Comprehensive national health care reform is coming. The only question is when and what wil it look like. There will be many reform plans put forward during this process. Some will have more substance than others. Some will be more credible than others. Some may even be practical. And a few might make America’s health care system better, not worse, than it is today.

One thing we know pretty much for certain is that a true single payer system is not coming any time soon. President-elect Barack Obama made comprehensive health care reform a central theme to his campaign. it clear throughout his campaign that he saw an important role for the private sector in the country’s future health care system. The Democratic National Platform made this approach explicit. (Irrelevant factoid: this post could well be the one and only time you ever read anyone referring to a party platform — until 2012).

What’s less certain is whether health care reform will be taken up by the Obama White House and/or Congress in the first few months of the new Administration. There are certainly a lot of influential lawmakers seeking to make health care reform an initial priority, including Senator Max Baucus, Chair of the Senate Finance Committee, and Senator Ted Kennedy, Chair of the Senate’s Health, Education, Labor and Pensions Committee. There’s more already entered in this particular derby and many more to come.

Senator Baucus’ health care reform plan is interesting for several reasons. First, any reform package will need to pass through his Finance Committee. Whether it’s his bill or another’s, Senator Baucus will have the ability to influence the final package. Understanding his starting point, consequently, takes on special significance.

Second, Senator Baucus’ plan, which he notes is not intended to be a legislative proposal, but rather a blueprint describing his vision for health care reform, devotes considerable attention to the need to reduce the underlying cost of medical care at great length. Even his discussion of wellness, preventive care, transparency, and reducing waste — standard components of any credible reform plan — goes well beyond the normal discussion. Most significantly, he goes beyond the low hanging fruit to address more controversial approaches. For example, he calls for financial incentives for primary care providers in the Medicare system and suggests funding them by reducing payments to specialists. He also endorses using medicare to test other primary care models especially those that “promote comprehensive care management and coordination, particularly for the chronically ill.”

Third, while the market reforms included in Senator Baucus’ plan should be no surprise to anyone who listened to Senator Obama during the presidential campaign, it does provide more specificity than was offered during the election. So while it contains the expected laundry list of proposals (tax credits, guarantee issue, etc.) it’s the additional details he provides that are significant.

For example, most insurance agents who read this blog will want to know what role, if any, they will have in the government-run Health Insurance Exchange Senator Baucus would create to compete with private sector offerings. A hint is all he provides, but it’s an encouraging one. In the discussion of the proposed purchasing pool, the document states “Plans participating in the Exchange would be subject to oversight by states with regard to consumer protections (e.g., grievance procedures, external review, oversight of agent practices and training, market conduct). ” italics added.

States are to regulate agent practices in connection with the pool. That must mean Senator Baucus envisions some role for agents in connection with the pool. As noted, it’s only a hint, but it’s a welcome one.

During the debate over Assembly Bill X1-1 earlier this year, carriers and agents were able to insert language in the legislation to allow, but not require, agents to sell products offered through the purchasing pool it would have created. Whether agents can educate lawmakers at the national level that the services we provide are worth including and protecting in whatever reforms eventually emerge will be challenging. But it appears Senator Baucus, at least, is open to the idea. And the experience agents have gained in California and elsewhere should aid in this effort.

No one, not even Senator Baucus, assumes his blueprint will be adopted as is. There will be a long and contentious health care reform debate before any kind of consensus emerges. Senator Baucus’ proposal is an important contribution to the stew of ideas that is simmering in the nation’s Capital. It’s an interesting start. But only a start.


5 Responses to “Baucus Health Care Reform Plan an Interesting Start”

  1. Arnett Satterla said

    National Health care sounds good but it isnt. Do you want the federal government to have your medical records. Right now the do not have direct access to you records.

  2. Rick said

    Requiring Americans to do anything was against the Constitution in the founding fathers minds. Sure the gov should provide insurance for any and all but never add to the IRS requirement to file a tax return to the requirement of insurance. Where will it end? It will end with more and more requirements and a total loss of freedom which is the best gift the fathers gave us. A highly socialized system will fail and ruin the US for certain because people will not adhere to the mandates and we cannot even close the border or assure the safety of food for goodness sake!

  3. Lauren Serven said

    Six months from now, more Americans will not have health coverage because they will have lost their jobs and can no longer afford to pay their premiums. Universal health coverage is coming regardless of the clout of Senator Baucus. Move out of the way and let this happen. You and your special interest agents are contributing to the problem. If businesses were freed up from providing health coverage from health coverage profiteers such as yourseleves they would be relieved from an expensive financial burden that would let them, gee, maybe hire a few more people. Of course, healthcare needs to be paid for, but I’d rather pay into a system that doesn’t pad the backside of health care insurance industry executives and the agents that lick the spit off their faces.

  4. John said

    Heath care is a Right…not a privilege….Health care should be a public trust like firefighting…not a commodity like soybeans to make money from. We are just ahead of Slovenia in overall health and we’re sinking….States like Florida and Texas have a whopping one-fourth of their citizens without health coverage. We need reform now!

  5. Ron Masters said

    Thank you once again for your timely heads-up. As usual, your command of the health care system shines through once again. Clearly, President-Elect Obama was given a mandate to make many changes and health care reform was the one most often mentioned with passion. Americans listened and the political reality (perception) was believed be a commitment of action to be taken. However, the real world reality will require answers that will work to some basic questions of; with what mechanism(s), with which current stake holders, what is the real cost and who really pays. Notably, health care reform elevates the significance of the phrase “the devil is in the details”. As for the agent role, as far back as 1987 Sen. Kennedy acknowledged their importance. Not by specific reference of inclusion, but thankfully without exclusion. Will his point of reference of 20 years ago for agent value be carried forward? We will need to wait for that answer. Sen. Backus, on the other hand, appears to concede an agent role, at this time. However, in my opinion, agents should avoid being lulled into contentment that their role is secure. Why? As easily as those few words referencing the agent were placed in this “trial balloon”, they can be replaced by _ _ _ _ _ _ _ _ _ _ (fill in the blank) federal agency employee. To be sure, there are no guarantees. But as agents we can use what we know, and that it is, how to sell. It is the mission of the agents who deliver health care plans to America’s families, trade associations who represent their interests and even the constituencies (clients) who they serve, to educate Congress and the public of their indispensable role today and in the future. Agents know how to sell products, sell their service and demonstrate their value added. This time, the sales calls have a new type of prospect,,,,,,,,,,,,,,,,,,,,,,,,Congress!

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