Weekly Newsletter: April 27, 2009
A Victory for Patients’ Rights; How Long Will It Last?
Last week, an overwhelming majority of the Senate voted to preserve Americans’ right to keep their doctor and health plan—only for the Democrat Congressional leadership to ignore the bipartisan will of the Senate. On Thursday, the Senate by a 79-14 vote approved a motion to instruct budget conferees intended to prevent the Senate from considering “legislation that eliminates the ability of Americans to keep their health plan and eliminates the ability of Americans to choose their doctor.” Clear majorities in both parties supported the motion, including Budget Committee Chairman Conrad, Finance Committee Chairman Baucus, and Majority Leader Reid.
It remains unclear whether this bipartisan Senate provision will remain in the budget conference report that the House and Senate may consider later this week. However, some Members may be concerned that the Democrat leadership will attempt to strip the provision, in order to further the creation of a government-run health plan that will cause as many as 120 million Americans to lose their current health coverage. Some Members may also be concerned that any refusal by the Democrat majority to guarantee that patients retain the ability to keep their current doctor and health plan, coupled with Health and Human Services Secretary-designee Kathleen Sebelius’ repeated refusal to state that government cost-effectiveness research will not be used to determine reimbursement levels, may be the first steps in creating a health system where Washington bureaucrats, not doctors and patients, determine appropriate levels of care.
Survey Says…
Last week, two online surveys about health reform provided some insight as to Americans’ views on the upcoming debate. A Kaiser Family Foundation survey conducted in March included some important revelations:
- More than seven in ten Americans (72%) believe that scientific evidence between two treatment options “is not always clear”—suggesting that Americans would be highly skeptical of attempts by bureaucrats arbitrarily to restrict access to certain treatments or therapies.
- Support for an outside group to evaluate treatment options plummets among Americans of all parties when the group is “appointed by the federal government”—further evidence of Americans’ opposition to a bureaucrat-run health plan.
- More than nine in ten Americans with health coverage believe their plan is “good” (51%) or “adequate” (41%)—meaning plans to create a government-run health plan causing as many as 120 million Americans to lose their current plan may spark significant public outcry.
- More than one-third (34%) of the uninsured would not be willing to pay $100 per month to buy health insurance, and more than two-thirds (67%) would not be willing to pay $200 monthly—suggesting a significant segment of the uninsured may be choosing not to buy health insurance, and that a mandate might not be able to persuade Americans who apparently find health coverage of little value.
On Tuesday, the online edition of the journal Health Affairs released a new analysis of data from a poll taken in February 2008. The poll found that an individual mandate to purchase health insurance lacked support of a majority of Americans. And while support for a brief “shared responsibility” proposal exceeded that for a stand-alone individual mandate proposal, few demographic groups offered a whole-hearted endorsement. Support for the “shared responsibility” approach remained below 60% for most groups, including independents, even though the poll mentioned none of the potential downsides to some of the Democrat plans currently being considered—tax increases on individuals and businesses, a government-run plan leading to Americans losing their current coverage, and delays and difficulties accessing treatments as a result of interference by Washington bureaucrats Americans’ personal health decisions.
Taken together, some Members may believe the poll results offer a cautionary note to Democrats as they weigh the option of using budget reconciliation legislation to advance health reform. At a time when most Americans with coverage value their current plan—as well as their choice of doctor—and a public consensus on health reform has yet to emerge, some Members may believe that proceeding with the creation of a government-run health plan would represent bad policy resulting in a health system many Americans may not want and some Americans would resent.
Subcommittee Hearing Exposes Democrat Disagreements
An Education and Labor Subcommittee hearing on health reform last Thursday exposed fissures in the Democrat agenda for health reform, with some Democrats arguing for a single-payer system that would abolish private insurance entirely. Press reports indicate that Rep. John Tierney, one single-payer advocate, argued for imposing de facto price controls on insurance companies, regulating the percentage of premiums which carriers must pay out in medical benefits.
Some Members may be concerned that imposing such arbitrary price controls on health insurance companies could well discourage new entrants that would detract from market competition, while also suppressing attempts by carriers to manage disease through chronic care and other administrative initiatives that may actually reduce the total amount of medical benefits paid. Some Members may therefore question whether imposing price controls on insurance companies would have many of the same unintended and adverse consequences that have resulted from past attempts at government price fixing, such as the stagflation associated with price controls during the 1970s.