Groups often at odds over health care reform — consumers, insurers, doctors, employers — reached a broad agreement Friday that could serve as a starting point for lawmakers trying to overhaul the system.
Although the long-awaited report of the Health Reform Dialogue avoided some of the most contentious issues, the agreement does have the kind of far-reaching support lawmakers will need to meet their goal of passing legislation this year.
"You can bet I'll be working closely with these groups," said Senate Finance Committee Chairman Max Baucus, D-Mont., who is trying to find consensus on Capitol Hill.
In their report, the groups said the uninsured should be covered through a mix of expanded government programs and subsidies to purchase private health coverage. They called for savings from making the health care system less wasteful and urged that prevention become the foundation for medical care. Many of their ideas are shared by President Barack Obama and influential lawmakers such as Baucus.
But the five-page proposal was thin on details, starting with how to pay for the plan. And the groups avoided such divisive issues as whether insurers should be forced to compete with a new government-sponsored insurance plan, as Obama has proposed.
The 18 groups met for six months. Along the way, two major unions pulled away, but other groups representing seniors, businesses, nurses, drug makers and patients kept talking.
"What the agreement tries to do is achieve a balance for coverage expansion through the two key pillars of health care today," said Ron Pollack, executive director of Families USA, a liberal advocacy group that stayed in the talks. "One is employer-sponsored private coverage and the other is safety-net coverage."
Other participants included the National Federation of Independent Business and the health insurance industry, who were instrumental in sinking the last attempt at a health care overhaul in the 1990s. Also in the talks were staunch supporters of guaranteed coverage for all, such as AARP and the American Cancer Society Cancer Action Network.
The Service Employees International Union and the American Federation of State, County and Municipal Employees took part but didn't sign on to the agreement because some of their concerns could not be satisfied. That underscored the difficulty of getting a health care compromise.
The groups all but endorsed a requirement that every American obtain health insurance. While their agreement avoided the politically loaded term "individual mandate," it said Congress should "enact reforms necessary so that all individuals will purchase or obtain quality, affordable health insurance." They avoided the issue of requiring employers to help pay premiums.
The agreement called for a two-prong strategy to cover the estimated 48 million uninsured. First, the Medicaid program should be expanded to cover all adults earning up to the federal poverty level, about $22,000 for a family of four. Then, subsidies or tax credits should be offered to help the middle class.
"I think what this document represents are some tough choices and some very tough consensus," said Mary Grealy, president of the Healthcare Leadership Council, which represents the medical industry. "It tells Congress: here are some very important components for health care reform that you can now be assured have widespread agreement."
The groups decided to sidestep the issue of whether to create a government insurance plan to compete with private companies. Many Democrats see that as an essential element of any final compromise. The insurance industry considers it a deal breaker.
The agreement also failed to spell out how to pay for expanded coverage in what is already the world's costliest health care system. The options lawmakers are considering include taxing some health insurance benefits and limiting tax deductions for high earners, both seen as highly controversial. Independent estimates of the costs range as high as $1.5 trillion over 10 years.
But the agreement did acknowledge that hospitals, doctors, drug companies, insurers and other major elements of the health care system must become more efficient and less wasteful.
The groups will continue to meet as Congress moves ahead on legislation. Their support could prove decisive if a viable compromise does emerge, much as AARP's backing helped ensure passage of the Medicare prescription drug benefit.
Source: AP Features