Senator Max Baucus (D-MT) issued a “Call to Action” on health care reform this week, unveiling what he calls a “blueprint” for ensuring all Americans have “quality, affordable health care.” (Here’s the official press release and executive summary from Sen. Baucus’s office.)

Sen. Baucus’s proposal has drawn both praise and criticism, but more importantly, it has stimulated a great deal of substantive discussion about our health care system, the need for reform, and potential solutions.

On her blog, Health Beat, Maggie Mahar called the white paper “shockingly honest”:

In his clear-eyed summary of the problems in our health care system — and his candid description of the obstacles — Baucus makes it clear that overhauling the system, and providing healthcare for all will probably require more than one piece of legislation. As he puts it, “The solution will demand time and attention to make sure that we get it right.”

Wall Street Journal health blogger Jacob Goldstein pointed out similarities and differences between the Baucus and Obama health plans:

[The Baucus plan] has a lot in common with Barack Obama’s plan, and at least one major difference: It would require everyone to buy health insurance… Obama says all children should be required to have health insurance, but has not supported a mandate for adults.

Both the Obama and Baucus plans would offer government-backed plans to more citizens, and would bar insurers from denying coverage for people with pre-existing conditions.

Over on his New York Times blog, Paul Krugman hailed Sen. Baucus’s move as “big news” signaling a “reasonable chance” for universal health care to be enacted in 2009:

One of the key questions about the new Democratic majority was whether Congress would try to play it safe, backing down on big ideas about reform, especially on health care…

But now Max Baucus — Max Baucus! — is leading the charge on a health care plan that, at least at first read, is more like Hillary Clinton’s than Barack Obama’s; that is, it looks like an attempt at full universality.

On Daily Kos, in agreement with Krugman, mcjoan commented:

That this is coming from cautious, conservative, DLCish Max Baucus does indeed mean, as Krugman says, that it’s looking much more likely that we have universal health care enacted in the next year.

At The American Prospect, Ezra Klein analyzed the political implications of Sen. Baucus’s plan:

[Baucus] just moved from Possible Player to Player. He’s first out of the gate with a health reform plan. His position as chair of the Senate Finance Committee means his priorities are more than mere preference or moral exhortation: They are actionable. He controls the relevant committee, and if he decides it’s doing health care, then it’s doing health care. That’s not to say he won’t come to some sort of accommodation with Obama’s preferences on sequencing, but it will be an accommodation that recognizes Baucus’s agenda, too.

On Obsidian Wings, publius expressed excitement about Sen. Baucus’s aggressive proposal, and said the major health care reform push that has now begun is “a testament to the Democratic primary — and to John Edwards in particular”:

Edwards forced the major candidates to spend a lot of time on health care, and forced them to think bigger and move left.

Today, we can see the benefits more clearly. Because Obama had to hone his arguments and sharpen his policy… to talk about health care so early and often, his mandate now includes major health care reform… [Edwards] opened the political space. And if reform passes, he deserves a lot of credit.

Regarding implications for primary care physicians, KevinMD reacted with “cautious optimism”:

There is acknowledgment that any changes will spread the wealth are “budget neutral,” meaning that there will be significant resistance from the AMA and specialist organizations…

Also important is that the approach is explicitly not single-payer or Medicare for all…

If this plan is the foundation for future legislation, it is reassuring to know that primary care will be the centerpiece of reform.

Robert Laszewski said that the lack of details in Sen. Baucus’s proposal is evidence that there is no consensus in Congress on important health reform issues:

If you read just the executive summary you might see proof of consensus on what health reform might look like.

If you read all 98 pages it is clear there is no consensus on many of the key details, what health reform would cost, the timetable for implementation, or the source for paying for it.

On Say Anything, Rob offered an alternative solution to Sen. Baucus’s “mandated health insurance” plan:

Why don’t we look at ways to empower individuals to pay for their own health care? Because the problem with our health care system is a lack of choice, not a lack of availability. If we made individuals responsible for their own health care, and did away with the system where they were dependent on an employer or the government to pay for it, we’d not only see health care prices go down we’d also see more hospitals and clinics pop up to provide more choice.

Finally, on Huffington Post and his own blog, The Sentinel Effect, RJ Eskow noted that while some are calling the white paper “the Baucus ‘plan,’” Sen. Baucus “disagrees with that label,” and so does Eskow:

It’s a statement of positions of key health policy issues, and overall it’s a compendium of some of the best “center-to-moderate-left” thinking on those issues. That means it’s politically achievable, and would be a significant improvement over what we have today. The Baucus paper may represent grounds for a new bipartisan consensus, and therefore may give a glimpse of what we can expect to see proposed in 2009.

Some background:

The health care system described in Sen. Baucus’s proposal would incorporate currently existing private and public health care plans (including Medicare, Medicaid, SCHIP, and those offered by employers). Other highlights from Sen. Baucus’s 98-page white paper:

- A mandate requiring everyone to purchase health insurance;
- A mandate requiring employers (with exceptions for very small businesses) to offer health insurance plans or pay into a government fund to cover the uninsured;
- An Insurance Exchange system, from which small businesses and individuals may buy coverage plans (Sen. Baucus expects it to take two to three years to set this up); the health plans offered through the Exchange would have meet certain coverage requirements “established by a new Independent Health Coverage Council”;
- Offering those in the 55-64 age bracket the option of buying in to Medicare, until the Insurance Exchange system is operational;
- Regulations to prevent insurers from denying coverage or charging more because of pre-existing conditions;
- Tax credits to subsidize premium costs for those below 400 percent of the Federal poverty line who are unable to afford coverage, and to help small businesses offer health plans for employees (health plan affordability would be determined by the Insurance Exchange Board);
- Establishing caps on on “the amount of health care benefits that can be excluded from workers’ taxable income… based on the value of the benefits, or… based on a person’s income — or both.”;
- Expanding Medicaid, and SCHIP, to cover all uninsured below 100 percent of the poverty line, and 250 percent of the poverty line, respectively;
- After the Exchange system is operational, a government-run health plan option for those under 65;
- Measures for increasing pricing pransparency, preventative care, chronic disease management, and health IT.

Related posts:

1. Women’s Empowerment: a Call to Action
2. Reactions from the Web: Tom Daschle for HHS and Health Reform
3. Reactions to the Congressional Budget Office Reports
4. Reactions to President-Elect Obama’s Staff Selections
5. Missed Opportunities and the Mandate Dilemma

This entry was posted on Friday, November 14th, 2008 at 5:49 pm and is filed under Policy. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.