The first salvo in the legislative fight for the next Congress has just been fired. Max Baucus (D â€“ Montana) is the chair of the Senate Finance Committee, and given that this committee controls the money coming into the government and half of the money going out gives him enormous control over social policy. The fight over healthcare will happen there, so itâ€™s well worth reading Ezra Kleinâ€™s profile of Baucus
in general, but especially if you want to get into the nuts and bolts of healthcare.
In general Baucus hasnâ€™t been an especially inspiring Democrat, but he really seems to have his game face on here. Heâ€™s been holding public hearings (9 of them at last count) and has been meeting privately with Kennedey and others. And to formally kick of the policy fight, and more importantly frame the debate, Baucus has released a white paper laying out his positions
Thereâ€™s a lot of the Obama plan in there, though he adds quite a bit including an individual mandate. The plan runs just shy of 100 pages, and I donâ€™tâ€™ think anyone has read the whole thing yet, but the quick and dirty summary paragraphs from the executive summary are:
Like a sturdy stool, the Call to Action has three equally important legs: (1) a policy that ensures meaningful coverage and care to all Americans; (2) an insistence that any such expansion be coupled with an emphasis on higher quality, greater value, and â€” over time â€” less costly care; and (3) an absolute commitment to weed out waste, eliminate overpayments, and design a sustainable financing system that works for taxpayers as well as for the nationâ€™s recipients and providers of health care.
Beyond measures to refocus the system on primary care, reward quality care, and invest in critical research and technology, the Baucus plan would endorse direct steps in five additional areas to curb excess health care spending. The plan would invest more to detect and eliminate fraud, waste, and abuse in public programs. The plan would address overpayments to private insurers in the Medicare Advantage program. The plan would increase transparency of cost and quality information and would require disclosure of
payments and incentives to providers by drug or device makers that may lead to biased
decision-making. The plan also considers careful reforms of medical malpractice laws that could lower administrative costs and health spending throughout the system, while ensuring that injured patients are compensated fairly for their losses.
The full executive summary follows below. There's a lot of good stuff here, though right off the bat I'm somewhat dubious about any talk of malpractice lawsuit reform (though it's certainly debatable). The points about reducing cost either seem glossed over or of questionable value, which I think could be a big issue both legislatively and with the real world application. Besides making it palatable, we do need to rein in costs and improve care, and ramping up access, though important, is only a first step.