Baucus Bill Summary
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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