La reforma de salud versión edulcorada
El plan no incluye la controvertida opción de seguro “público”, a la que se oponen los republicanos, pero sí la creación de cooperativas sin fines de lucro para crear competencia en el mercado asegurador. La semana próxima lo trata el Senado.
El presidente del Comité de Finanzas del Senado estadounidense, Max Baucus, presentó ayer una nueva versión del plan de reforma sanitaria que prevé excluir la “opción pública” –como se conoce a la propuesta de un seguro estatal impulsado por los demócratas más progresistas– y supondrá un gasto inferior. La Casa Blanca ya dejó en claro que la opción de seguro público no será un punto que frene la aprobación de la norma.
El proyecto reduce ligeramente el costo total de la reforma propuesto inicialmente por el presidente Barack Obama y garantiza que los 856.000 millones de dólares durante los próximos 10 años saldrán íntegramente de reducciones en el despilfarro actual (507.000 millones de dólares) y de nuevos impuestos, especialmente a las compañías de seguros (349.000 millones de dólares). “El costo del quebrado sistema sanitario estadounidense exige demasiado de las familias, negocios y la economía durante mucho tiempo”, afirmó Baucus durante una introducción al plan. “Para mucha gente, una sanidad costeable y de calidad simplemente está fuera de su alcance”, subrayó.
Actualmente, unos 46 millones de personas en Estados Unidos –casi un sexto de la población– no cuentan con un seguro sanitario. De acuerdo con esta ley, todos los ciudadanos norteamericanos estarán obligados a tener un seguro. Aquellos que no puedan pagar una cobertura adecuada contarán con subvenciones del Estado. Los empresarios no tienen que ofrecer obligatoriamente protección sanitaria a sus empleados, pero las compañías con más de 50 trabajadores tendrán que pagar una tasa por cada uno de ellos que necesite subvención pública para su seguro de salud.
La propuesta no incluye la controvertida opción de seguro “público” –planteada por Obama y a la que se oponen los republicanos– e incluye la creación de cooperativas sin fines de lucro para crear competencia en el mercado asegurador y reducir así los costos del sistema. Las compañías de seguros no podrán, como hacen frecuentemente ahora, rechazar a un cliente por condiciones médicas previas ni expulsarlo posteriormente por el agravamiento o la prolongación de su enfermedad.
Esta iniciativa es la más moderada sobre el tema presentada hasta ahora en el Congreso, frente a proyectos aprobados por tres comisiones en la Cámara de Representantes y el panel de salud del Senado. El texto será sometido a la primera prueba sobre sus posibilidades de ser aprobado la próxima semana, cuando sea votado dentro del propio comité.
Los republicanos que lo integran no han dado aún su apoyo al plan, aunque uno de ellos, la senadora Olympia Snowe, ha manifestado que podría hacerlo en los próximos días. Por su parte, entre los demócratas, uno de los senadores más implicados en esta iniciativa y que con más pasión ha defendido la opción pública, Jay Rockefeller, ha advertido que no respaldará el proyecto en su redacción actual. El jefe del grupo demócrata, el senador Harry Reid, ha anunciado una reunión, mañana, para coordinar la estrategia y tratar de mantener una unidad que resulta imprescindible para sacar adelante la ley.
El plan Baucus es considerado como el que, tras las esperadas modificaciones y recortes, tiene la mayor posibilidad de convertirse en la base de un proyecto de ley en el Senado. Porque, además, en esa cámara hay mayoría de demócratas más conservadores. Pero la idea de renunciar al seguro público quizá sea más decisiva en la Cámara de Representantes, donde el grupo de demócratas más a la izquierda es suficiente como para restar al proyecto los votos necesarios para su aprobación. Por otra parte, la sustitución de esa “opción pública” por un sistema de cooperativas sin fines de lucro podría favorecer el apoyo de algunos republicanos más moderados.
El plan no incluye la controvertida opción de seguro “público”, a la que se oponen los republicanos, pero sí la creación de cooperativas sin fines de lucro para crear competencia en el mercado asegurador. La semana próxima lo trata el Senado.
El presidente del Comité de Finanzas del Senado estadounidense, Max Baucus, presentó ayer una nueva versión del plan de reforma sanitaria que prevé excluir la “opción pública” –como se conoce a la propuesta de un seguro estatal impulsado por los demócratas más progresistas– y supondrá un gasto inferior. La Casa Blanca ya dejó en claro que la opción de seguro público no será un punto que frene la aprobación de la norma.
El proyecto reduce ligeramente el costo total de la reforma propuesto inicialmente por el presidente Barack Obama y garantiza que los 856.000 millones de dólares durante los próximos 10 años saldrán íntegramente de reducciones en el despilfarro actual (507.000 millones de dólares) y de nuevos impuestos, especialmente a las compañías de seguros (349.000 millones de dólares). “El costo del quebrado sistema sanitario estadounidense exige demasiado de las familias, negocios y la economía durante mucho tiempo”, afirmó Baucus durante una introducción al plan. “Para mucha gente, una sanidad costeable y de calidad simplemente está fuera de su alcance”, subrayó.
Actualmente, unos 46 millones de personas en Estados Unidos –casi un sexto de la población– no cuentan con un seguro sanitario. De acuerdo con esta ley, todos los ciudadanos norteamericanos estarán obligados a tener un seguro. Aquellos que no puedan pagar una cobertura adecuada contarán con subvenciones del Estado. Los empresarios no tienen que ofrecer obligatoriamente protección sanitaria a sus empleados, pero las compañías con más de 50 trabajadores tendrán que pagar una tasa por cada uno de ellos que necesite subvención pública para su seguro de salud.
La propuesta no incluye la controvertida opción de seguro “público” –planteada por Obama y a la que se oponen los republicanos– e incluye la creación de cooperativas sin fines de lucro para crear competencia en el mercado asegurador y reducir así los costos del sistema. Las compañías de seguros no podrán, como hacen frecuentemente ahora, rechazar a un cliente por condiciones médicas previas ni expulsarlo posteriormente por el agravamiento o la prolongación de su enfermedad.
Esta iniciativa es la más moderada sobre el tema presentada hasta ahora en el Congreso, frente a proyectos aprobados por tres comisiones en la Cámara de Representantes y el panel de salud del Senado. El texto será sometido a la primera prueba sobre sus posibilidades de ser aprobado la próxima semana, cuando sea votado dentro del propio comité.
Los republicanos que lo integran no han dado aún su apoyo al plan, aunque uno de ellos, la senadora Olympia Snowe, ha manifestado que podría hacerlo en los próximos días. Por su parte, entre los demócratas, uno de los senadores más implicados en esta iniciativa y que con más pasión ha defendido la opción pública, Jay Rockefeller, ha advertido que no respaldará el proyecto en su redacción actual. El jefe del grupo demócrata, el senador Harry Reid, ha anunciado una reunión, mañana, para coordinar la estrategia y tratar de mantener una unidad que resulta imprescindible para sacar adelante la ley.
El plan Baucus es considerado como el que, tras las esperadas modificaciones y recortes, tiene la mayor posibilidad de convertirse en la base de un proyecto de ley en el Senado. Porque, además, en esa cámara hay mayoría de demócratas más conservadores. Pero la idea de renunciar al seguro público quizá sea más decisiva en la Cámara de Representantes, donde el grupo de demócratas más a la izquierda es suficiente como para restar al proyecto los votos necesarios para su aprobación. Por otra parte, la sustitución de esa “opción pública” por un sistema de cooperativas sin fines de lucro podría favorecer el apoyo de algunos republicanos más moderados.
New health proposal is industry's favorite so far
By JULIE HIRSCHFELD DAVIS, Associated Press Writer Julie Hirschfeld Davis, Associated Press Writer – Thu Sep 17, 6:43 am ET
WASHINGTON – The latest health overhaul plan circulating on Capitol Hill gives health insurers, drug makers and large employers reasons to heave sighs of relief, sparing them the higher costs and more burdensome rules included in other Democratic-written alternatives.
Industry players that have already struck bargains with President Barack Obama's administration and leading Democrats to help pay for revamping the health system saw most of those deals left intact — and in some cases sweetened — in the $856 billion proposal unveiled Wednesday by Sen. Max Baucus, D-Mont., the Finance Committee chairman.
You won't hear any of them cheering publicly about what they would get out of the measure, because many are still hoping for a better deal before Congress takes final action on revamping the health care system. But don't expect to hear them coming out in opposition, since they know Baucus' plan is the lesser of many evils being considered.
Take the health insurance industry.
It would score a new, taxpayer-subsidized customer base of millions who don't currently have insurance, thanks to a mandate that everyone purchase coverage — backed up by steep penalties on people who don't. And it wouldn't have to compete with the government to cover people, unlike in the four other health overhaul plans approved this year by Democratic-dominated congressional committees.
Nor would the nonprofit so-called "co-ops" designed to provide consumers with an alternative to private health insurance pose any real threat to their business, according to a nonpartisan analysis released Wednesday. The Congressional Budget Office said those plans "seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments."
Insurers would also take a smaller hit to the payments they get for offering private plans under Medicare — some $110 to $120 billion, estimated one industry source, compared with the $175 billion that Obama initially proposed this year.
In exchange, insurers had already agreed to stop denying coverage to people with serious health conditions and help cover the cost of the transition to the new system. They're still fighting hard against two other aspects of the measure that would slice into their potential profits: a new 35 percent excise tax on high-cost plans and $60 billion in fees, both of which insurers warn would be passed on to consumers.
"We have some significant concerns, particularly the new taxes that are going to make health insurance less affordable," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans. He rejected the notion put forth by many liberal and labor groups that the measure amounts to a gift to private insurers, arguing that the companies are covering more than one-quarter of its pricetag, a level disproportionate with the industry's share of health care costs.
But health insurance stocks jumped Wednesday at the news of Baucus' public option-free measure. And privately, industry lobbyists acknowledged that the plan is far more to their liking than any of the other measures currently under discussion, and expressed confidence that it would improve further as senators and Obama's team continued to haggle over its details as it approaches a Senate vote.
Meanwhile progressives called the measure an industry giveaway — "like a dream come true" for insurers, said Justin Ruben of MoveOn.org — and labor leaders said Baucus had compromised too much and produced a bill that would force people to buy health coverage they couldn't afford.
"We think the plan the way it is structured incentivizes employers to offer bare-bones plans," said Chuck Loveless, the legislative director of the American Federation of State County and Municipal Employees. As for the co-ops, he said they were "designed to fail, and it's a great boondoggle for the insurance companies. We don't think it's going to increase competition or bring down costs."
Big employers would dodge what many of them considered the most costly bullet among Democrats' health care proposals — a mandate to offer health insurance — although they would have to pay a modest fee if the government ended up subsidizing employees' coverage.
The Business Roundtable, which represents corporate executives, cheered Baucus' proposal in a statement from Eastman Kodak CEO Antonio M. Perez that called it "bold" and "a step in the right direction."
Drug makers who had previously cut a deal with Obama and Baucus to kick in $80 billion to help pay for the overhaul would see that agreement preserved, while rival proposals in the House that would force them to cover more drug costs for elderly people would cost them considerably more, as much as $140 billion.
The Pharmaceutical Research and Manufacturers of America, which plans to spend tens of millions on an ad campaign promoting a health overhaul, stayed relatively quiet, issuing only a brief statement that said it was reviewing Baucus' plan.
Ken Johnson, PhRMA's spokesman, said the industry would "continue to be a constructive partner" in the effort to enact health reforms.
Some businesses would see increased costs under Baucus' plan, and they were pushing hard to avoid them. Medical device makers would have to pay fees amounting to $40 billion while clinical laboratories would pay $7.5 billion.
The Next Steps for Kennedy's Cause: Healthcare Reform
By Kent Garber Kent Garber – Mon Aug 31, 5:07 pm ET
Sen. Ted Kennedy was out of sight this summer, fighting the brain cancer that finally claimed his life last week, but up until his last days he was still at work, following C-SPAN's healthcare reform coverage and calling his Washington colleagues. Earlier this month, he phoned Connecticut Sen. Chris Dodd, a close friend, to offer advice. "He was just as courageous as he could be," Dodd said last Wednesday, the morning after Kennedy's death. "Less than two weeks ago, when he called, it was like he had never been sick. He was down with the details on how to deal with costs--literally, two weeks ago."
Though Kennedy is gone, the cause of his career--universal health coverage--is simmering at the forefront of national politics, much as it was in the early 1970s and again in the 1990s. Congress won't return from its recess until September 8, yet much of what has gone on this year, and much of what is still to come, reflect the shifting nature of the reins of power that Kennedy held for so long.
Kennedy was the country's dominant healthcare figure for much of his career. Even after his cancer diagnosis forced him to leave Washington last year, he ranked as the sixth-most-powerful healthcare player in the country, according to a survey by the trade magazine Modern Healthcare. This year, because of his deteriorating health, he didn't crack the top 100, but senators like Dodd say he still held a powerful place in the debate. He was replaced on the list by two colleagues, Montana Sen. Max Baucus, a Democrat, and Iowa Sen. Chuck Grassley, a Republican. They now lead the Senate Finance Committee's "Gang of Six," which has positioned itself at the center of the reform debate in Kennedy's absence.
Baucus says the Gang of Six is working on a healthcare bill that will win bipartisan support. But amid August's wild town halls and the new concerns among liberals that a public health insurance option will be dropped from the bill, many Democrats have grown restless with its promises.
Some, like New York Sen. Chuck Schumer, say that if Democrats want to get something done, they are going to have to do it alone. But Kennedy's death may make that more difficult. Democrats have only 59 votes in the Senate now, one short of the 60 needed to block a filibuster. (Unless Massachusetts law is changed, the state won't hold a special election to replace Kennedy until at least January.) One option that's sure to make news in coming weeks will be a legislative maneuver known as reconciliation, which would allow Democrats to pass a healthcare bill with only 51 votes. But some on Capitol Hill say that would be unwise.
Had Kennedy been present, experts say, this summer's debate might have been more civil and reasoned, not just because of the deep respect he commanded from members of both parties but also because of his ability to talk in compelling and clear terms about healthcare. "We have been lacking articulation," says Yale University's Ted Marmor, a health policy expert and former senior policy adviser to Walter Mondale. "Kennedy would have been early and earnest in attending to the justification for why we are going about things in a certain way."
Yet Marmor and others also say that Kennedy, who remained a life-long idealist on large issues like national healthcare insurance, could only have done so much, given the partisan nature of the debate. "There is no doubt he would have been the most eloquent voice there could be for the cause of universal health insurance," says Jonathan Oberlander, a health policy expert and professor at the University of North Carolina. "But John McCain wasn't going to vote for this if Kennedy was there. Orrin Hatch wasn't going to vote for this if Kennedy was there. There is an ideological divide."
Perhaps the biggest impact of Kennedy's absence has yet to be felt. Assuming that a bill does pass the Senate, members of both chambers will have to get together in a conference committee to merge their competing versions. Those negotiations may prove just as difficult as what has happened this summer. "Had he been well, Kennedy might have been the figure in the conference committee who held on to some principles more vigorously" than other Democrats, says Marmor. That duty will now most likely be split between Baucus and whoever fills Kennedy's giant shoes on the Senate Health Committee.
