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Baucus Bill Summary



September 24, 2009 – Comments (2)

As part of its Perspective pieces, the New England Journal of Medicine published a review of the Baucus bill on healthcare reform.  The summary is well prepared and can be found here:


Baucus's Bill and the Long Road to Reform

"In an effort to attract Republican support, Senator Max Baucus (D-MT), chair of the Senate Finance Committee, stripped his health care reform proposal of some of its most contentious elements — the creation of a public insurance option, the imposition of an employer mandate, and the provision of physician payments for counseling Medicare beneficiaries about end-of-life care. But when Baucus unveiled his bill on September 16, he did so without any Republican support, in the face of wariness from some Democrats, and with more than 500 proposed amendments that his committee will consider when it begins to mark up the measure on September 22."


So the puplic plan is off the table for now, and likely to stay off in my opinion.  We'll see regarding the employer mandate, though there are provisions to 'encourage' insurance be provided at the employer level.  Again, my opinion is that having health insurance so tightly tied to employment is a problem that needs to be addressed but isn't getting much attention.  Denial of coverage / pre-existing conditions will likely be gone with the universal mandate, which helps, but doesn't really end the cycle of 'get sick, lose job, lose insurance'.

"The weakest element of all the bills may well be their failure to propose more sweeping change in the organization and incentives that drive health care delivery and financing."


This is a shame, but I guess one step at a time.  Also in this NEJM issue is a commentary on integrated payment solutions.  This is a positive paradigm change that will likely become more pronounced in my opinion.

21st-Century Health Care — The Case for Integrated Delivery Systems


There were also opinion pieces in the issue.  One in favor of the public plan option which is out of the Baucus bill and one on issues with the payment models (but more on the issues than suggestions IMO).  The links are below for the curious.

Poor Substitutes — Why Cooperatives and Triggers Can't Achieve the Goals of a Public Option

Putting U.S. Health Care on the Right Track


There was a round table discussion as well which I'll link later (like after I actually listen to it).



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2 Comments – Post Your Own

#1) On September 24, 2009 at 12:24 PM, edwjm (99.90) wrote:

The Baucus Bill, as it now stands, is worse than nothing.  If I were a senator, I would vote "NO."

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#2) On September 24, 2009 at 1:58 PM, Alex1963 (27.87) wrote:

I think you'll see the public option resurrected as the process unfolds. Especially if Republicans continue to completely resist. There is then really little incentive to water the bill down. I think the blue dogs will realize they are basically hanging out in the wrong camp and won't want to be responsible for sinking a sound bill.

But that aside I'm still interested in the Wyden bill too. To address your point it has the compelling feature of allowing employees to cash out of their employers coverage and take that amount and use it to shop in an exchange. Despite such a "free market" mechanism naturally no Republicans supported this bill either :) But I think that is also a route to explore. I think too that the Wyden bill also kicks in sooner whereas even the best public option bills don't kick in til 2013 and make the public option unavailable to folks getting their coverage thru work. 2 serious flaws in my book.

I've been following this very closely for months and I'm quite honestly burning out. I don't know how the rest of the country feels but I just wish they'd get a frickin bill together so we can all see what's what! There are so many "moving parts" in this that IMO no one feature is a deal breaker to me. You have to see the whole package and since their is no leadership or "must haves" (only 'must not haves' from the right) it's impossible to say what a final House or Senate bill will look like much less the reconciled one between the two. My take on the whole process is that this is legislation by opinion poll and it is pathetic & excruciating. Let's get this done already and move on to Financial Reform and Afghanistan and Job creation and, and, and.

Good post and links, thank you-rec



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