Last Thursday, the Republicans filibustered Finance Committee Chairman Max Baucus’s Medicare Improvements for Patients and Providers Act of 2008. Among other things, the bill would prevent a 10% cut in Medicare payments to doctors that will otherwise take effect in July. Why does this matter?
The 10.6 percent pay cut — the result of a Medicare formula set up several years ago to limit payments to physicians — originally had been scheduled to take effect at the beginning of this year, but Congress agreed in December to temporarily delay it until July 1 while lawmakers searched for ways to pay for eliminating the cut.
Doctors have repeatedly warned that if the cuts take place, many of them will refuse to accept new Medicare patients.
Congress could agree to simply extend the delay on the pay cuts, but that would mean Medicare’s 44 million beneficiaries would pay higher premiums next year to help finance the higher-than-scheduled payments to doctors this year.
The key to any medical reform in this country runs right through Max Baucus’s Finance Committee and the Senate Republican’s filibuster. The Finance Committee is one of the elite committees in the Senate. No one from the Class of ’06 has yet earned a seat on the committee. The most junior member is Ken Salazar of Colorado, who is hardly a liberal. I’ve long despaired at the makeup of the Finance Committee because it is so conservative that I assume it will never consider a truly universal system of health care. Even if we elect 10 or more new senators this fall, it’s unlikely that any of them will win a seat on Finance until at least two years later. That’s why I was so encouraged by something I saw on CSPAN last night. It turns out that Senator Baucus, who professes to watch very little television, just happened across the recent Frontline documentary on universal health care called Sick Around the World. Baucus was so impressed by the documentary that he decided to invite the creator to present the film at his Senate Finance Committee 2008 Health Reform Summit yesterday. Here’s a snippet about the film:
In Sick Around the World, FRONTLINE teams up with veteran Washington Post foreign correspondent T.R. Reid to find out how five other capitalist democracies — the United Kingdom, Japan, Germany, Taiwan and Switzerland — deliver health care, and what the United States might learn from their successes and their failures.
T.R. Reid visits the five countries in turn, and explores the strengths and weaknesses of each health care system. He finishes in Switzerland.
Reid’s last stop is Switzerland, a country which, like Taiwan, set out to reform a system that did not cover all its citizens. In 1994, a national referendum approved a law called LAMal (“the sickness”), which set up a universal health care system that, among other things, restricted insurance companies from making a profit on basic medical care. The Swiss example shows health care reform is possible, even in a highly capitalist country with powerful insurance and pharmaceutical companies.
What’s impressive here is that Max Baucus did not recoil in horror at the idea of cutting the insurance and pharmaceutical companies out of the profits from basic health care but, rather, was so enthused about the idea that he made the entire Finance Committee watch the documentary. That’s a very positive sign because nothing can get done on health care reform unless Sen. Baucus signs off on it.
Now, Barack Obama is not running on a truly universal system for the simple reason that it is not politically possible to get a truly universal system passed. Obama proposed a plan that would result in everyone that wants it having health insurance. That’s quite distinct from having health coverage. You can call them both ‘universal’ but it’s a sleight of hand. The question is, though, what if the Democrats pick up 10 or more senate seats this fall and win the White House? That will change what is politically possible because it will eliminate the Republican filibuster. If the Democrats find themselves with that large of a majority they could rework Obama’s proposal into a truly universal system like the ones portrayed in Sick Around the World. Until I saw that Baucus was enthusiastic about the documentary I considered him the biggest obstacle to single-payer health care. Now, I’m not so sure.
