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Dem Platform Seeks Healthcare 'Watchdogs'

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Calls by writers of the Democratic healthcare platform for Democratic presidential candidate Sen. Barack Obama, D-Ill., to create “watchdog” groups to monitor health insurance companies if he is elected president has industry lobbyists scrambling to clarify exactly what the party has in mind.

“Yes, we think this is important,” said John Greene, vice president of congressional affairs for the National Association of Health Underwriters, which represents more than 20,000 health insurance agents. “We are in touch with Democratic campaign officials because we are trying to assess exactly what he means here.”

Clearly, he added, “We think it is worth clarifying what Sen. Obama means.”

The Democrats’ intentions were stated at the party’s convention by Norman Solomon, a national board member with Progressive Democrats for America and an electedObama delegate from California’s 6th Congressional District, as stated in Congress Daily, an industry publication.

“Private insurance companies are antithetical to truly guaranteeing healthcare for all with a single standard of care,” Solomon was quoted as saying. “They’re inthe business of limiting and denying health care, while maximizing profits.”

Ira Loss, who covers healthcare regulatory issues for Washington Analysis, said he believes the term “watchdog” means enactment of legislation creating a Patient Bill of Rights, or, in the alternative, imposing regulations that do so. He said this proposal is supported by both presidential candidates, and is designed to protect consumers when insurers deny coverage.

“It sounds like they want to keep the pressure on insurers to provide coverage at the lowest possible rates,” he said. “It is an issue of deep concern to many American voters.”

But, he cautioned, putting something in a platform and having it enacted are two different things. “Healthcare is an issue that Congress must tackle, and it is unclear at this time what Congress will impose.”

But Greene said that the Democrats haven’t used the term, “patients’ bill of rights.” He said he believes they are thinking of programs first proposed by first lady Hillary Clinton in 1993 and 1994, ideas rejected by the voters at the polls in 1994.

Specifically, Greene said, he believes the concepts would include community ratings, and prepares a guarantee that an insurer has to provide coverage.

“Guaranteed coverage means that coverage has to be provided, and community ratings necessarily imply high costs because people would be allowed to wait until they need it to seek it,” he said.

Then, he said, patients “will know they will benefit because the benefits will outweigh the cost.”

The problem with those approaches, he said, is that “they belie the entire concept of insurance. For example, you don’t wait before your home burns down to get homeowners’ insurance; you are expected to get it when you purchase the house,” he explained.

Robert Zirkelbach, director of strategic communications for America’s Health Insurance Plans, said a number of organizations are lobbying for more oversight of health insurance plans “but it is too early to tell what Congress will ultimately do to deal with the issue.”

He said that as a group, AHIP recognizes “that the current healthcare system is not working for everybody.”

Specifically, he said the complaints that have been voiced include the fact that some individuals “are falling through the cracks, and the fact that small businesses are struggling to provide healthcare coverage.”

Zirkelbach said that “is why we have put forth a series of healthcare proposals, designed to cover the uninsured, to improve quality and to reduce healthcare costs.”

He said the “question here is, basically, Where are the Democrats going to come out for healthcare reform next year?”

As for AHIP, Zirkelbach said, “We have been active on healthcare reform, and we want the next president to make healthcare reform a priority. It is going to take cooperation between all stakeholders to make healthcare reform a reality.”


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