The election for president hasn’t even been certified yet, and already the powerful chairman of the Senate Finance Committee, Max Baucus has issued his healthcare reform plan.
His plan tracks closely with the other plans that have been proposed including President Obama’s, with the exception that the Senator’s plan provides for healthcare coverage of all Americans. The other difference is that Baucus’s plan is significantly more flushed out (89 pages) versus the (9 page) Obama plan.
According to Senator Baucus, part of the reason for such an early release of his plan is that Senator Baucus wants to remain relevant in the debate, and does not want to repeat the mistakes of the past. According to the LA Times “The health proposal by the Clinton administration was too top-down," he said. "And, frankly, they waited a bit long before they sent it up to the Congress. Basically, they worked on their plan and said, 'OK, Congress, this is it.” This probably caught the Obama team off guard but this is simple positioning for the Senator saying: Hey, I am relevant and you have to work with me on this issue.
On the area of transparency the Senator tracks closely with the MedPAC recommendations:
Physician Industry Relationships, which will disclosure of gifts and other transfers of value made by drug and device companies to physicians and other healthcare professionals.
In justification for this he includes several sources including information from Harvard’s Eric Campbell, codes from AMA and PhRMA, and MedPAC.
The senator states that: Unfortunately, data collection alone may not prevent inappropriate relationships. However, once national, system-wide data is available, the extent of industry influence and the wasteful spending that it leads to can be better determined. With this information, stronger enforcement can be put into place, so that regardless of provider relationships, we can be sure physicians are recommending and performing medical care based on sound medical science rather than heavy-handed industry influence. And: Only with this information can potential bias be known, and the requirement to disclose may deter inappropriate behavior.
The use of the term heavy-handed industry influence is a very critical way to discuss the way industry and physicians work together. This tone, if continued could have huge implications as a vast majority of industry physician relationships are beneficial or benign towards patients.
Other areas of transparency that the Senator Address’s include: physician self referral and cost and quality measures.
Earlier this summer the Senator held a one day Healthcare Summit on the topic of healthcare reform where many of the ideas that he presented in his plan were developed.
The plan is not without opponents; one economist at the National Center for Policy Analysis called the plan a "blueprint for economic disaster in health care coverage for Americans." I doubt it will be a disaster but like all plans they change once the debate gets under way. Senator Grassley cautions that “we're heading toward a deficit that's 10 percent of the economy. So, paying for health care reform needs to be done in an intellectually honest way for the fiscal health of our country, and the broader the support for any health policy changes, the more durable and effective they will be.”
Senator Baucus has been gracious to recognize that the fact that he has proposed this plan is a next step in the healthcare debate and is not intended to be a legislative proposal, rather that it details his vision for healthcare reform.
Key Resources
Baucus Call to Action Healthcare Reform 2009
Baucus Press Release on Call to Action
Grassley Press Release on Healthcare Reform
Market Watch: Baucus Health Plan is Fatally Flawed