Pearlstein: "The chairman of the Senate Finance Committee has put the reform back in health reform."

[jefferson_dem]

Obviously, the Finance Committee Mark-Up will not be perfect. But the more "reform-oriented" it is, the better the baseline we will be working from when it's folded into the HELP Committee bill and then debated on the floor and in Conference.

Health-Insurance Difference Without a Distinction

By Steven Pearlstein
Friday, September 25, 2009

My hat is off to Max Baucus. He's produced a credible plan to make health care both a right and a responsibility of all Americans while beginning to rein in health spending in a way that is politically acceptable to a majority of Americans. In many ways it is the most robust proposal so far because of its emphasis on changing the way health care is organized, delivered and paid for. The chairman of the Senate Finance Committee has put the reform back in health reform.

During the first two days of committee action on his bill, Baucus, a Democrat from Montana, beat back repeated attempts by most of the committee's Republicans to gut provisions that would slow runaway growth in Medicare spending. Republicans want us to believe that they care deeply about the federal deficit and about keeping Medicare from going broke, while at the same time demanding that there should be no cuts in benefits, no cuts in payments to insurers or providers, and no reduction in the utilization of medical services. It was the most craven, cynical, hypocritical performance by a group of elected officials that I can remember, and a good measure of the political, intellectual and moral bankruptcy of the Republican leadership in Congress.

There is, however, one feature of all the Democratic health proposals -- including Baucus's -- that's been bothering me for a while, and it has drawn little attention. That's the two-tiered structure of the health-insurance market that the proposals envision.

<SNIP>

As a practical matter, it's probably a good idea to get the exchanges up and running by limiting them initially to individuals and small businesses that now have the hardest time finding affordable insurance. But if they prove to be efficient and effective at spreading risk and offering a wide choice of plans at competitive prices, there's no reason why they shouldn't be quickly opened to all workers and all companies, as Sens. Ron Wyden (D-Ore.) and Olympia J. Snowe (R-Maine) have proposed. Under the pressure of competition -- and with some tweaks in the regulations and the structure of the subsidies -- the distinctions between the two markets could fade away.

It's all a bit wonky, I realize, but it sure beats the shouting matches over death panels and government takeovers.

http://www.washingtonpost.com/wp-dyn/content/article/2009/09/24/AR2009092404607_pf.html

[Captain Hilts]

1. I read this, this morning and I'm still digesting it. The bit about businesses

still paying for health ins. if their employees opt for a govt.-sponsored plan is something I did not know.