Despite long odds and a collective thumbs down from the hospital industry lobby and other interest groups, a proposed healthcare bill sent from the White House to Capitol Hill two weeks ago could inch forward with a push from lawmakers, though the path would admittedly be tough.
Some policy analysts and Capitol Hill sources said that the negative initial reaction from the industry may be misguided, and cited certain provisions in the billincluding premium adjustments in Medicares prescription drug program and provisions to encourage adoption of health information technologyas being viable components of the legislation.
People need to take a look at this and realize that in the near future Social Security, Medicare and Medicaid will almost completely consume the federal budget, said Tory Mazzola, a spokesman for Sen. John Ensign (R-Nev.), who has introduced legislation that has closely mirrored the Bush administrations proposal. If we wait on this, it will cost us more money.
Ensigns support could prove pivotal in the Democratic-led Congress. The Republican senator is a member of the Senate finance and budget committees, which have oversight of the Medicare and Medicaid programs as well as general spending, and his support of the legislation could sway other lawmakersespecially over parts of the bill that have narrowly stalled in the past.
Were certainly hopeful, Mazzola said, touting Ensigns assignment to the Senate Finance Committee in 2007. Hes in a much better position to help put Medicare on stronger financial ground.
The bill, hammered out by the Bush administration and sent to Congress Feb. 15, would use a three-pronged approach of value-based purchasing, malpractice reform and higher Medicare prescription drug premiums to help lower overall spending within the Medicare program.
At the outset, the legislation would require HHS to publicly post cost, price and quality information as a means to help Medicare beneficiaries make the best choices among providers, plans and treatments. The bill would also require HHS to have in place quality measures for at least 50% of the care provided under Medicare by 2013. In addition, beneficiaries would be rewarded for choosing the most efficient and highest quality path of care.
Under provisions meant to revise current medical malpractice lawsuits, the bill establishes a three-year statute of limitations in which a person can bring a claim, and caps noneconomic and punitive damages at $250,000, with some exceptions. The bill also prohibits punitive damages in a product liability lawsuit against medical-device manufacturers.
Other provisions would require HHS to make personal health records available to Medicare beneficiaries, and give the department the authority to release physician-specific quality and efficiency data. Additionally, the legislative package would increase Medicare Part D premiums for single beneficiaries with incomes greater than $82,000 and married couples with incomes greater than $164,000.
The legislative blueprint comes in response to exploding healthcare costs and was required under a provision in a densely packed 2003 Medicare bill. In a letter sent to House Speaker Nancy Pelosi (D-Calif.), HHS Secretary Mike Leavitt said that the billespecially if enacted with the reforms outlined in the presidents budgetwould help put the Medicare program on firmer financial ground. Perhaps more importantly, it would begin to address the long-term challenge and lay the foundation for the comprehensive Medicare reforms that are necessary to strengthen and improve the program for future generations, Leavitt stated in the letter.
But with a Democratic-led Congress and interest groups who quickly aligned in opposition of the bill, any movement on Capitol Hill would be met with a tough fight.
Kirsten Sloan, director of federal health and long-term-care issues at the AARP, focused on the higher premium rates for some seniors in Part D, saying that the provision misses the target when it comes to driving down healthcare costs. If were talking about trying to tackle Medicare spending, shifting more costs on to the beneficiary isnt the answer, she said. The American Hospital Association railed against the very provision that created the bill in the first placethe so-called 45% triggercalling it arbitrary and saying that it will strike a devastating blow to Medicare and its beneficiaries.
The Medicare funding warning was triggered when the Medicare trustees determined, for two consecutive years, that general revenue makes up 45% of total Medicare spending.
Many House Democrats took turns knocking down the legislation as well.
But Senate Finance Committee Chairman Max Baucus (D-Mont.) signaled that some parts of the bill could gain traction, though most likely in a separate Medicare bill. There is room to work together, he said in a written statement. Value-based purchasing and health information technology are both smart targets for reforms in Medicare right now.
Other parts of it, like the presidents outline for medical liability reform, would be buried, he said. Sue Steinman, director of policy at the American Association for Justice, formerly the Association of Trial Lawyers of America, said she agrees and that the group supports nothing in the section of the bill that would restrict liability lawsuits.