Stakeholders Moving Toward Agreement on Health Care Reform
Business groups, insurers, consumer advocates, physicians, hospitals and drugmakers have been among those holding private meetings on health care reform with the staff of Sen. Edward Kennedy (D-Mass.) and "appear to be inching toward a consensus that could reshape the debate," the New York Times reports.
The parties attending the meetings have not reached a complete agreement over whether all U.S. residents should be required to obtain health coverage. However, according to the Times, they have begun to "tackle the next steps," including:
- How such a requirement would be enforced,
- How to make insurance more affordable; and
- Whether employers should be required to provide coverage for workers.
Meeting participants said a sense of "urgency" has been added to the discussions because Kennedy, who is chair of the Senate Health, Education, Pensions and Labor Committee, has brain cancer, the Times reports.
In a memorandum, aides to Kennedy wrote, "While there was some diversity of views, the sense of the room is that an individual obligation to purchase insurance should be part of reform if that obligation is coupled with effective mechanisms to make coverage meaningful and affordable."
Insurers have expressed willingness to cover individuals with pre-existing conditions, as long as all people are required to obtain coverage.
In discussing how to make coverage affordable to everyone, participants have considered the separate possibilities of offering subsidies for private coverage based on income and expanding public insurance programs.
The memorandum also stated that participants in the talks mostly agree that eligibility levels for Medicaid should be increased.
Points of Disagreement Remain
Although a "fragile consensus is slowly emerging" on the issue, some contention exists, according to the Times.
For example, the Business Roundtable is pushing for an individual mandate and for the government to offer subsidies to help low-income people afford coverage.
However, U.S. Chamber of Commerce Senior Manager of Health Policy James Gelfand said, "Forcing individuals to purchase insurance in the current market would be a disaster. Before we even have that discussion, we need to make health care more affordable and improve its quality."
In addition, in a summary of recent discussions, Kennedy's office said, "There was little consensus on the employers' role."
Administration, Republican Involvement
President Obama is not directly represented in the talks, but his administration has been kept informed about the meetings.
Republicans have not participated in the talks because they believe they "would be relegated to a secondary role," the Times reports.
A business lobbyist involved in the discussions said, "The lack of acrimony, the air of cooperation toward a common end, is quite refreshing. If the Republicans were a party to these intense discussions, that would ease the path to enacting health care reform" (Pear, New York Times, 2/20).
On Thursday, KCRW's "To The Point" reported on the talks as part of a segment covering Obama's trip to Canada. According to the segment, those participating in the meetings have agreed that a single-payer system is "off the table."
Guests on the program include:
- Los Angeles Times reporter Noam Levey;
- Alan Cassels, a health policy researcher at the University of Victoria in Canada; and
- David Gratzer, a physician and senior fellow at the Manhattan Institute ("To The Point," KCRW, 2/19).