WASHINGTON — The Obama administration’s public health plan proposal and federal health cost-effectiveness board proposal could derail health reform efforts, a think tank analyst warned today.
Stuart Butler, a vice president at the Heritage Foundation, Washington, dissected the proposals at a roundtable on health care delivery reform that was convened by the Senate Finance Committee.
The proposals “are like nuclear land mines on the road to broad agreement,” he said. ‘They could be lethal to the prospects for consensus and even to the passage of any significant legislation.”
Even if the government simply sponsors a public plan that competes with private plans through an exchange, “there can be little doubt that the rules and regulations promulgated by Washington will favor the government-sponsored plan,” Butler said. “A ‘competing’ public plan as a choice will inevitably become a public plan for all, and unacceptable.”
Creating a federal health board that would decide whether particular medical treatments were cheaper or more effective than others also could undo any consensus, Butler said.
“It’s one thing to have a body to spur and distribute cost-effectiveness research,” he said. “It’s quite another to have a board, as others have urged, that is not really answerable to anyone and starts to determine how medical care can be provided.”
Another panelist, Karen Ignagni, president of America’s Health Insurance Plans, Washington, said a new public plan “is not necessary to achieve successful health care reform.”
It is important for policymakers to “consider the unintended consequences that could result from establishing a public plan to compete against existing private insurance plans” in a reformed health care system, Ignagni said.
“To illustrate our concerns about how we move toward an integrated, high-quality, health care delivery system under a public plan option, the committee should consider the success of the private market in offering innovative care management programs, and the difficulty associated with achieving similar results in a new government plan,” she said.
Scott Serota, president of the Blue Cross and Blue Shield Association, Chicago, said insurers should team with the government to ensure that everyone has coverage.
The government can help by expanding existing government programs, and by assuring that everyone ineligible for existing government programs can afford private coverage, Serota said.
One way to ensure access to private coverage is to build on the employer-based system, and another is to provide more support for individuals who must buy individual coverage but have difficulty affording it, Serota said.
The government also should ensure that everyone can buy health coverage, regardless of health status, with no variation in premiums based on health status, and it should simplify the process of shopping for coverage, by supporting state-run, Web-based health insurance supermarket programs, Serota said.
The roundtable was the second held by the Senate Finance Committee.
Sen. Max Baucus, D-Mont., chairman of the committee, said the third roundtable, on financing health reform, will take place next week. The committee then will develop a mock “mark-up” of health reform legislation.
The committee will start drafting the real health reform legislation in June, Baucus said.
The Senate Finance Committee then will hold discussions with the Senate Health, Education, Labor and Pension Committee, which is drafting its own legislation.
The committees hope to get consensus legislation ready for consideration by the full Senate before the August recess, Baucus said.