Sen. Schumer kills reform
Schumer Offers Middle Ground on Health Care
By Robert Pear
The New York Times
May 5, 2009
In an effort to defuse the most explosive issue in the debate over comprehensive health care legislation, a top Senate Democrat has proposed that any new government-run insurance program comply with all the rules and standards that apply to private insurance.
The proposal was made Monday by Senator Charles E. Schumer of New York, the third-ranking member of the Senate Democratic leadership, in a bid to address fears that a public program would drive private insurers from the market.
Democrats in Congress hope to shift the debate from the question of whether to create a public health insurance plan to the question of how it would work.
“The public plan,” Mr. Schumer said Monday, “must be subject to the same regulations and requirements as all other plans” in the insurance market.
The chairman of the Senate Finance Committee, Max Baucus, Democrat of Montana, asked Mr. Schumer to seek a solution. In his response, Mr. Schumer set forth these principles:
- The public plan must be self-sustaining. It should pay claims with money raised from premiums and co-payments. It should not receive tax revenue or appropriations from the government.
- The public plan should pay doctors and hospitals more than what Medicare pays. Medicare rates, set by law and regulation, are often lower than what private insurers pay.
- The government should not compel doctors and hospitals to participate in a public plan just because they participate in Medicare.
- To prevent the government from serving as both “player and umpire,” the officials who manage a public plan should be different from those who regulate the insurance market.
In addition, Mr. Schumer said, the public plan should be required to establish a reserve fund, just as private insurers must maintain reserves for the payment of anticipated claims. And he said the public plan should be required to provide the same minimum benefits as private insurers.
Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group, said, “We are very, very grateful that members of Congress have been thoughtfully looking at our concerns.” But she said she still saw no need for a public plan “if you have much more aggressive regulation of insurance,” which the industry has agreed to support.
http://www.nytimes.com/2009/05/05/health/policy/05health.html?ref=politics
Comment:
By Don McCanne, MD
The success of the effort to reform health care seemed to be threatened by the disagreement over whether or not a public insurance option should be offered to compete with private health plans. All Republicans have expressed opposition to the public option, indicating that it would be a deal breaker if included. The Progressive Caucus in the House, which actually wants single payer, has taken a position that leaving the public option out of the reform legislation would be a deal breaker.
To prevent gridlock, Sen. Charles Schumer offers the simple solution of “public option light” so that it would not be a deal breaker for either side. The progressives would have a government-sponsored plan in the mix of private plans, and the Republicans would have government-sponsored plan that is indistinguishable from private plans, creating a level playing field. Thus each side could move forward with reform without having to implement their deal-breaking rhetoric.
This is not simply Sen. Schumer’s personal effort defuse this bomb. His public option compromise was prepared at the request of Sen. Max Baucus who has been working closely with Sen. Charles Grassley to craft truly bipartisan reform legislation. In fact, at yesterday’s Senate Finance Committee hearing on expanding health care coverage, in addition to the fifteen scheduled witnesses, Sen. Baucus called on committee member Schumer to present the public option compromise.
Look at the history of what has happened here. The progressives were told by the moderates that the votes for single payer were not there. So negotiations began from a position that single payer was off the table. The progressive community then decided to concede that the Republicans and the insurance industry could have their market of private plans, and that the compromise position that all could accept would be the addition of a public insurance option.
In the compromise process, the Republicans and the insurance industry finally made their move. That was, “drop dead.” The Progressive Caucus responded with, “we’ve already come more than half way, so now you drop dead.” So now we have the Schumer compromise of public option light, which now has been blessed as the current, official Democratic position, even though it moves even closer to the Republican position.
What have the Republicans conceded so far? Nothing. What is the insurance industry’s position on a competing public plan that looks just like their private plans? Karen Ignagni of AHIP says that she still sees “no need for a public plan.” No concession.
The Democrats have already conceded on an effective public plan option. They have conceded that universal coverage is not possible so we should merely “aim for universal.” They have admitted that they have not figured out a way to pay for plans with adequate benefits for working families. They have abandoned support of policies that would improve value while controlling costs.
The Democrats have already given away all major policies for reform, and the Republicans haven’t had to budge the least. Why should they when the Democrats are rushing in their direction?
It is ironic that yesterday, at the Senate Finance hearing, one by one, eight individuals, including physicians from PNHP, stood up and offered to present policies that would work.
One of them stated, “… single payer national health care; we want a seat at the table.”
Sen. Baucus responded, “We want police,” and he got them. Each was arrested in turn.
That allowed enough time for Sen. Baucus to add Sen. Schumer as an additional pseudo-witness so that they could kill the last, but all-too-feeble effort at real reform - the public option.