As a statement of principle rather than as a legislative proposal, the white paper released today by Max Baucus, Senate Finance Committee chair, will spark serious discussion and comment (see (eugene's diary, and TomP's as well as mcjoan's post.)
Some things to consider in our discussions:
- Having a debate about health reform front and center is a terrific thing. This can't wait, and having it proposed by the Senate Finance Chair makes it real. If you want to see why it can't wait, go here (hint: we cannot afford to wait.)
- This is bad news for incrementalists (who prefer to think of themselves as sequentialists - this is all comers, not kids followed by adults.)
- There is a public piece in this, so there would be competition between public and private entities. That's very important. If a government option is superior, it will win.
- The issue of mandates is not settled, but they are implied. That will make some people unhappy, and convince others of the seriousness of the proposal. It will also remind people of Hillary's 2008 health proposals, as well as John Edwards'.
- This is not single payer and leaves private insurance intact, for now, along with employer-based health care (which was threatened by McCain.) However, from Baucus' executive summary: Private insurers offering coverage through the Exchange would be precluded from discrimination based on pre-existing conditions. That's huge.
- Taxing health benefits (also proposed by McCain) is not off the table. Details still unclear (at least to me.) [More here].
- None of this is detailed enough to be a legislative proposal. That will be difficult to craft, with all the players from each chamber wanting to influence the final outcome.
- Whatever the final piece, it will need to be passed. Something that cannot pass is useless.
- Along those "has to pass" lines, pay-go rules may need to be suspended.
- Elections have consequences. Do they ever.
Reaction from some of the players:
Conservative National Center for Policy Analysis (which favors "market-driven solutions") doesn't like this proposal. Their president is John Goodman, McCain's health care advisor, who famously said a couple months ago that everyone in America is insured because we can all just go to the emergency room.
"The end result of Baucus' plan would destroy any choices that consumers have to select health coverage that meets their individual needs," said Herrick. "We would be stuck with a government-designed and regulated health plan that will drive up costs and limit access for too many consumers."
AHIP (the insurance lobby) is taking a "wait and see" approach.
Now is the time for health care reform. We commend Senator Baucus for putting forth a comprehensive reform proposal that addresses the key health care challenges facing the nation. We look forward to reading the plan and participating in the discussion to ensure all Americans have access to high-quality, affordable health care coverage.
Health Care for America Now says this in supporting the initiative.
Health Care for America Now (HCAN) applauds Senator Baucus for coming up with a comprehensive health care plan that is a blueprint for enacting quality, affordable health care for everyone in 2009 and is generally consistent with our principles – the principles also supported by President-elect Obama and more than 150 members of the 111th Congress who have already signed on to HCAN’s Statement of Common Purpose.
We also welcome Senator Baucus’ support for regulating the private insurance industry and offering Americans the choice of public as well as private insurance.
Physicians for a National health Plan (PNHP) says this in qualified support (w/caveats).
There are many valuable recommendations in this report. Some of them should be enacted soon as possible as urgent measures to hold us over while we are pressing forward with comprehensive reform. Others can be enacted independently of the comprehensive legislative package. But some represent flawed policy concepts and should never be enacted.
Sen. Ron Wyden:
"I couldn’t be happier than to see Chairman Baucus make health care such a priority for the next Congress. Two years ago, when Senator Bennett and I started sitting down with our colleagues to talk about the Healthy Americans Act and the steps we need to take to reform the nation’s health care system, I said that half the battle would be getting Senators and Members of Congress on board with the idea of health reform. I could not have imagined then, that less than two years later we would be looking forward to the 111th Congress with such momentum. I am very glad that Chairman Baucus’s proposal reflects a lot of the features that have gained such bipartisan support as part of the Healthy Americans Act and I look forward to working with him and his staff as well as Senator Kennedy, President-Elect Obama and the co-sponsors of the Healthy Americans Act to finally make meaningful health care a reality for all Americans."
Sen. Ted Kennedy:
Baucus told reporters that he talked to Kennedy this morning, and while he wouldn't disclose the conversation, he suggested they are on the same page.
For links to previous discussions of health reform, see DemFromCT's Health Care Discussion Links.