Harry Reid: Public Option Is In The Eye Of The Beholder

By Justin Duckham-Talk Radio News Service

According to Senate Majority Leader Harry Reid (D-Nev.), health care reform legislation that includes the public option can pass through the Senate, although what form the public option will take remains to be seen.

“The public option is in the eye of the beholder. There are different types of public option. We’re going to look at all of them,” Reid stated during a press conference with Senate Democratic leaders Thursday.

The Senate Finance Committee is pursuing a non profit insurance co-op as an alternative to a public option styled after Medicare, a plan the Majority Leader finds acceptable.

“If we can come up with a [co-op] that... makes more competition and makes insurance companies honest, I think it will fill the bill,” said Reid.

The Majority Leader said he would like to have health care reform legislation reach the floor by the Thanksgiving recess, if not earlier.

GAO Gives Three Options For Cap-And-Trade Legislation

By Mariko Lamb-Talk Radio News Service

In a hearing with the Senate Finance Committee Tuesday, John Stephenson, Director of the Government Accountability Office (GAO) Environmental Protection Issues, Natural Resources and Environmental Team, outlined three options for the distribution of emission allowances for companies under a cap-and-trade program: auctioning revenue allowances, allocating free allowances to covered entities, or a combination of the two.

According to a preliminary report by the GAO, auctioning revenue allowances would enable the government to collect substantial revenues, create incentives for companies to lower emissions before the program starts, and level the playing field for covered entities. However, “auctioning does not by itself offer compensation to covered entities that could feel the greatest economic impact of the program,” Stephenson said.

The second option, allocating free allowances to covered entities, could “help build support for the program and ease the transition," he said, but added that it may also potentially dampen incentives to decrease electricity use by businesses and households.

The third option, a combination of auctioning and free allocation, “may help compensate energy intensive industries,” noted Stephenson. A study by the Congressional Budget Office suggests that a 6% and 21% free allocation of allowances would fully compensate these industries.

According to the American Clean Energy and Security Act, passed by the House in June, 85% of emission allowances would be allocated by the government for free. Chairman of the Senate Finance Committee Max Baucus said, “whatever the approach, we need to devise a system that both meets environmental goals and passes political muster. That won’t be easy. The close vote in the House tells us that.”

“Let’s see if we can figure out how to distribute emission allowances in a way that one might call ‘just.’ Let’s see if we can figure out how to give all Americans what they deserve,” Chairman Baucus said.

The GAO will release a final report to the Senate Finance Committee later this year in preparation for a markup on a climate change bill later this year.

Sen. Cornyn Criticizes Democrats' “Power Grab” In Health Care Debate

By Learned Foote- Talk Radio News Service

Sen. John Cornyn (R-Texas) harshly criticized the health care reform proposals put forward by the administration and Democratic congressmen.

“[There is a] continued power grab out of Washington, starting with the financial institutions, leading to car companies, and now to health care,” said Cornyn during a conference call with reporters Wednesday. He warned that the American government might take up policies practiced in England, the United Kingdom, and Canada, where “government ultimately makes a calculation on the value of individual lives" in rationing health care.

Cornyn, who serves on the Senate Finance Committee’s subcommittee on Health Care, said that reform should lower the costs of health care and make coverage accessible to more people, but argued that the proposals will not sufficiently address these needs. Instead, the Senator argued, they will “create a huge command-and-control infrastructure.”

Cornyn said that the government will undercut private insurance providers, and cited statistics from The Lewin Group, a health-care policy research firm. The groups’ report estimates that 119 million individuals, two-thirds of those currently privately-insured, will end up on a public plan.

Cornyn also criticized a proposal floated by some Democrats to tax health benefits, a practice he said Obama “derided” during the Presidential campaign.

Cornyn praised Senator Max Baucus (D-Mont.), the chairman of the Senate Finance Committee, for attempting to work in a bipartisan fashion, but said that Baucus is “being dictated to” by Senate Majority Leader Harry Reid (D-Nev.), who favors a public option.

“My hope is that common sense will prevail and that we will listen to the stake-holders, including the millions of Americans whose health care will be forever changed should some of these proposals pass without an opportunity for bipartisan input,” said Cornyn.

No Single Payer System For Healthcare

Coffee Brown, University of New Mexico, Talk Radio News


In what Chairman of the Senate Finance Committee Max Baucus (D-Mont.) called "an historic moment," the full Committee hearing on Comprehensive Health Care Reform held the first of several planned meetings Tuesday. Their task will be to figure out how to pay for universal access.

Sen. Jeff Bingaman (D-N.M.) wanted the Employer Exclusion of Contributions for Medical Insurance Premiums and Medical Care from employee income taxes on the table.

James Klein, president of the American Benefits Council, described it the Exclusion as progressive and too complex to tamper with.

Jonathan Gruber, professor of economics at the Massachusetts Institute of Technology, Cambridge, Mass., described the Exclusion as unequivocally regressive, amenable to modification, and a key revenue point.

John Sheils, senior vice president of the The Lewin Group, Falls Church, Va., believes that the Exclusion should be modified, but only after protections are put into place to prevent discrimination against the elderly and those with pre-existing conditions.

All of the panelists agreed that there was an enormous amount of potential revenue there. The Urban Institute calls it "the single largest tax expenditure in the federal budget ... worth $112 Billion.”
Gerald Shea, assistant to the president for governmental affairs at the AFL-CIO said, "That would be a radical change. If you're going to go that far, you might as well go to a single payer system. I'm flabbergasted that you would even consider it."

Baucus was clear that "We're not going to repeal the Employer Exclusion or go to universal single payer healthcare. We have to work with what we have. We can't turn on a dime. It's the devil you know vs the devil you don't know."

After Baucus finished speaking, protesters stood up and recited in favor of the single payer system. As each protestor was escorted out by Capitol Police,another stood including at least one physician.
Sen. Jim Bunning (R-Ky.) was concerned about a proposal to partially fund healthcare reform by raising taxes on alcohol. He said that thousands of jobs had been lost in the hospitality industry already, and that the last such hike had been followed by a drop in revenue. He asked whether lifestyle taxes couldn't be considered regressive.

Robert Greenstein, executive director of the Center on Budget and Policy Priorities responded that all industries have lost jobs, losses in the hospitality industry are not attributable to alcohol taxes, and
whether the tax put more money into healthcare, or resulted in diminished alcohol consumption, it would be a win-win strategy.
Other lifestyle taxes discussed included sugary soft drinks, tobacco and trans-fats.

Stuart Altman, professor of national health policy at the Heller School for Social Policy and Management, Brandeis University, Waltham, Mass., held that end-of-life care was a significant driver of cost in America vs. peer nations.

Gail Wilensky, Senior Fellow for Project HOPE, Bethesda, said that such costs have held at about 28 percent of lifetime healthcare expenses for 30 years.

Altman said, yes, but that's 28 percent for a growing demographic, as Americans age, and of a much larger absolute cost, as Healthcare costs have inflated much faster than the general economy.

Baucus concluded by saying, "I have a feeling this is not the last discussion on this we're all going to have on this."

The High Cost of Doing Nothing

Coffee Brown, MD, University of New Mexico, for Talk Radio News Service

For each increase of one percent in the unemployment rate, the number of medically uninsured goes up by approximately 1 million, according to Professor Jeanne Lambrew, Deputy Director of the new White House Office of Health Care Reform. Unemployment and medical debt in turn, increases foreclosures, she stated while addressing the National Health Policy Conference in Washington D.C., speaking at the National Health Policy Conference.
The coming spike in the uninsured will trigger a provision in the recovery act to subsidize 65 percent of cobra payments. When workers lose their jobs, they usually lose their insurance as well. By law, they can continue their former plan for six months by paying the entire premium plus two percent. This is about 80 percent of typical unemployment benefits, rendering it unaffordable for most. It may be wise to offer medicare as a less expensive, longer-lasting alternative, Lambrew said.
She also expressed concern over medical error rates that are higher in America than in peer nations. Health reform is needed to address these problems and the healthcare workforce shortage as well. This in turn will create lasting jobs, and cash flow within communities, she concluded.


Robert Berensen said that there is no longer any significant debate about the need for healthcare reform, now it’s about the form of the healthcare delivery system itself. The effort to reform the system has been gridlocked for 30 years, he said.
Paul Wallace, M.D., spoke for Kaiser Permanente and Glenn Steele, M.D., spoke for the Geisinger Health System. They described private sector innovations aimed at increasing efficiency, such as varying pay structures to improve healthcare benchmarks. The most important of these was getting caregivers to adopt electronic records. This measure speeds flow, reduces redundancy and reduces errors by making sure that the patient’s history is up-to-date at each visit, even when they cannot see their usual provider.
Both physicians emphasized the importance of a patient “care home”, a clinic and staff who know the patient well. This practice, the modern equivalent of the family doctor, is increasingly common as states experiment with ways to reduce costs and increase patient satisfaction. Results reported at several recent conferences have been very positive.

Sen. Max Baucus, D-Mont., at the National Health Policy Conference, said there are several good reasons for healthcare reform right now.
First, he said, the cost of doing nothing has become greater than the cost of doing something. Prices were rising faster than inflation even before the crash, he said. By 2014, half of U.S. households will be spending 45 percent of their total incomes on health insurance premiums.
Second, the current system is failing. Costs are higher and quality markers are lower than for other industrialized nations. Medical errors are killing tens of thousands of us a year, largely due to poor Health IT systems, which are now a major item in the recovery package.
Third, there is an unprecedented degree of bipartisan and even industry support.
Baucus concluded with the statement that the first priority has to be changes that create economic stimulus, and the second needs to be speed, while the momentum is favorable. The problem, he said, is that we also have an economic crisis, two wars, and an oil-dependence crisis competing for the attention of congress and the president.