Private Health Care Joins Obama
The claim:
http://news.yahoo.com/s/ap/us_health_overhaul_savings
WASHINGTON – President Barack Obama on Monday portrayed the health care industry's promise to cut $2 trillion in costs over 10 years as "a watershed event" in the long search for a solution to the millions of uninsured.Whether that is true won't be readily known as debate begins in Congress over sweeping health care legislation. What is known now is that the move puts the industry groups involved firmly inside the process of expanding coverage, with the hope they can steer the final product toward something that doesn't restrict their profitability.
"I will not rest until the dream of health care reform is achieved in the United States of America," Obama declared in the White House's State Dining Room as he announced the voluntary offer made to the White House Monday by a consortium of hospitals, insurance companies, drug makers and doctors.
They told Obama they would slow rate increases by 1.5 percentage points a year by improving coordination, focusing on efficiency and embracing better technology and regulatory reform.
Government economists say the shaved costs would create breathing room to help provide health insurance to an estimated 50 million Americans who now do not have it.
It's a substantial change from the time in the early 1990s when President Bill Clinton took on health care reform, only to see industry leaders fight back hard, ultimately killing the White House proposal before it could gain any traction.
Still, even Obama acknowledged that the step announced Monday would be meaningful into the future only if it is not a singular event, but part of a larger and successful effort toward universal health care coverage for Americans. He said the country "can, will and must" accomplish this goal by the end of the year.
"There's so much more to do," he said.
"We can't continue down the same dangerous road we've been traveling for so many years," Obama said. "Reform is not a luxury that can be postponed, but a necessity that cannot wait."
He indirectly criticized some of the groups at his side for killing the effort last time.
"All too often, efforts at reform have fallen victim to special interest lobbying aimed at keeping things the way they are, to political point-scoring that sees health care not as a moral issue or an economic issue, but as a wedge issue, and to a failure on all sides to come together on behalf of the American people," the president said.
The industry letter said "these and other reforms will make our health care system stronger and more sustainable."
Although the offer from the industry groups doesn't resolve thorny details of a new health care system, it does offer the prospect of freeing a large chunk of money to help pay for coverage. And it puts the private-sector groups in a good position to influence the bill Congress is writing.
The industry groups are trying to get on the administration bandwagon for expanded coverage now in the hope they can steer Congress away from legislation that would restrict their profitability in future years.
Insurers, for example, want to avoid the creation of a government health plan that would directly compete with them to enroll middle-class workers and their families. Drug makers worry that in the future, new medications might have to pass a cost-benefit test before they can win approval. And hospitals and doctors are concerned the government could dictate what they get paid to care for any patient, not only the elderly and the poor.
It's unclear whether the proposed savings will prove decisive in pushing a health care overhaul through Congress. There's no detail on how the savings pledge would be enforced. And, critically, the promised savings in private health care costs would accrue to society as a whole, not just the federal government. That's a crucial distinction because specific federal savings are needed to help pay for the cost of expanding coverage.
Costs have emerged as the most serious obstacle to Obama's plan. The estimated federal costs range from $1.2 trillion to $1.5 trillion over 10 years, and so far Obama has only spelled out how to get about half of that.
A few less optimistic notes:
http://news.yahoo.com/s/ap/us_health_overhaul_analysis
WASHINGTON – The White House trumpeted the news: health care providers taking a $2 trillion scalpel to their costs and pushing the U.S. toward Barack Obama's vision of health coverage for all. But don't line up yet for those insurance cards.First, a reality check for the nation's 50 million uninsured.
Pledging restraint on costs Monday at the White House were groups representing hospitals, doctors, drug makers, medical device manufacturers and a major health care labor union _a Who's Who of health care interests. The president posed proudly with them and called it "a watershed event."
But none of the groups can actually dictate to their members. Doctors in New York or hospitals in Los Angeles are free to charge what they please.
Also, medical providers have a long track record of avoiding fiscal constraints, as witnessed by the government's efforts to tamp down Medicare costs.
And there's one more catch: Even if every penny of the promised savings shows up, not all of it would be used to help cover uninsured Americans. Actual savings to the government are all that can be counted as Congress tries to pay for subsidies that will be needed to help make health insurance affordable for everyone.
The medical groups' pledge is "a very hopeful sign," said economist Robert Reischauer, head of the Urban Institute. "But when we get down to hammering out the details, health care reform remains both complex and philosophically and politically difficult to accomplish."
Costs could still turn out to be the greatest obstacle to Obama's health care plan.
Outside experts estimate the taxpayers' tab could total between $1.2 trillion and $1.5 trillion over 10 years. Some go as high as $1.7 trillion. Obama's budget proposal includes a down payment that may cover less than half the bill.
The president wants to build on the current system in which most people get coverage through private insurers. But he wants to change the rules so the sick can't be turned down. And he wants to provide subsidies to help low-wage workers and even some in the middle class afford their premiums.
House Republican leader John Boehner of Ohio isn't impressed. "Today's announcement promises savings with no concrete plan to achieve them and no enforcement mechanism if they don't," he said Monday.
Indeed, it's too early to tell whether Monday's White House meeting will be remembered as a turning point or as a political mirage. The administration is projecting an image of a new coalition for health care, with Obama and most of the health care industry and consumer interest groups claiming the political center.
Left out, for now, are conservative Republicans, who oppose Obama's direction but have yet to articulate their own vision, and liberal Democrats who have been hoping to move toward a nationalized system like Medicare for all. As the debate heats up, the voices from both ends of the political divide will get louder — and the pressure on the center will increase.
Still, the sight of health care industry leaders volunteering to hold back spending is still pretty unusual.
By joining Obama, providers are acknowledging at least some responsibility for a bloated and dysfunctional system that economists say is unaffordable.
In the 1990s, when President Bill Clinton attempted to overhaul health care, the battle lines quickly hardened. Obama, who has gone out of his way to woo the interest groups, praised their willingness to sacrifice on Monday.
The groups don't just have the national interest in mind. Industry is worried that Congress will create a government health plan to compete with private insurers. Such a plan would quickly become the biggest in the country and could use its power to set lower payment rates, driving costs down on the backs of medical providers.
"I think the reason all these groups want to actively participate in the process is they don't want to see a blunt instrument used to get spending down," said Mark McClellan, who ran Medicare for President George W. Bush. "This is an opportunity to get everyone behind a better approach to improve the way health care works."
That's just what the groups say they want to do. Their proposals include coordinating care for people with chronic illnesses, rewarding quality not quantity, and using technology to root out waste and prevent errors that get patients sicker.
But it's hard to put numbers next to any of those ideas. For example, what if better care for chronically ill patients turns out to increase costs? None of the groups has set a target for how much its members should have to pony up.
Congress is going to need hard numbers to pass Obama's plan this year.
Robert Laszewski, a former health insurance executive turned policy consultant, said he's betting the consensus won't last.
"When Congress comes up with mechanisms to reduce costs that actually take money out of the hands of doctors, hospitals and insurance companies, that's when we're going to find out if things are really different this time," he said.
Basically the private health insurance providers have said they're willing to work with the government to restructure the system and Obama is implying the he wants to steer away from a nationalized system. At the same time critics say that Obama hasn't explained where funding will come from at this point and that there's no way to be sure either side will see this any farther than this.