CQ HEALTHBEAT NEWS
Feb. 25, 2009 – 5:27 p.m.
Billy and Ron’s Excellent Overhaul Adventure
By John Reichard, CQ HealthBeat Editor
Billy Tauzin, the drug industry’s top lobbyist, and Ron Pollack, one of the left’s leading advocates for universal coverage, enjoy an easy familiarity with each other, a vibe they’d like to see spread to erstwhile foes on Capitol Hill in the battle over how to revamp health care. In a meeting with CQ reporters and editors on Wednesday, the pair said the alliance of seemingly disparate groups is finding common ground, and they suggested a big announcement would be coming soon.
So far, the groups are finding consensus on universal coverage, preventive care and the importance of strengthening safety net programs such as Medicaid and the State Children’s Health Insurance Program (SCHIP), the two men said. They said their efforts should boost efforts in Congress to reach a deal this year on revamping health care.
Tauzin, former chairman of the House Energy and Commerce Committee, is the CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA) and Pollack is executive director of the left-leaning advocacy group Families USA.
The common ground in the group, called the “Healthcare Reform Dialogue,” goes only so far — “we’re dating, we’re not married,” Pollack quipped about his relationship with PhRMA. But any signs of progress right now would be happily welcomed by lawmakers and congressional aides worried about the slow start of the administration’s overhaul effort.
Continuing questions about who will lead the charge in the Senate and the increasingly troublesome absence of a new secretary to head the department of Health and Human Services (HHS) undercut the ringing declaration by President Obama in his address to Congress Tuesday night that a health overhaul will be accomplished this year.
While Senate Finance Committee Chairman Max Baucus , D-Mont., has begun a new series of hearings and meetings with industry groups, Senate Health, Education, Labor and Pensions Committee Chairman Edward M. Kennedy , D-Mass., has appeared rarely in Washington in recent weeks as he battles brain cancer.
And doubts about who would head HHS deepened at least temporarily Wednesday as speculation cooled that Kansas Gov. Kathleen Sebelius would be nominated by Obama to become HHS secretary. In town over the weekend for the winter meeting of the National Governors Association, Sebelius departed the capital with no announcement made.
Tauzin and Pollack emphasized the importance of the stakeholder agreements that coverage should be universal and that it should build on two of the pillars of U.S. health care, the employer-based health insurance system and safety net programs such as Medicaid and SCHIP.
“The safety net’s got some enormous holes in it,” Pollack said. “I think that’s a significant movement in terms of consensus.” In doing that, “we’ve actually not had any controversy on that issue among the 20 organizations.” That is a remarkable development in light of some of the past position of the groups, Pollack said, noting for example, the House of Delegates of the American Medical Association (AMA) produced a resolution years ago calling the elimination of Medicaid. “AMA is part of this consensus — that’s a huge change.”
Pollack said he would say to his friends on the left, “this consensus that’s being built about public programs is something they should cherish.”
Pollack also depicted changes in the tax treatment of employer-paid health insurance premiums as fertile ground for compromise and for revenues to subsidize coverage of the uninsured. Eliminating the exclusion of those revenues from individual income — in other words, taxing health insurance benefits — would raise huge revenues. Pollack said that’s not likely, but placing a cap who can exclude those premium dollars or on how many of those premium dollars can be excluded would raise significant revenue, he said. Although labor groups aren’t happy with the idea of those changes, Pollack said he thinks they can be structured in a way that do not harm the rank and file.
Tauzin emphasized that preventive care could reap big savings in the system despite the fact that the Congressional Budget Office does not now score big savings from preventive programs. Private sector programs demonstrate clear savings, he asserted, arguing also that tax breaks to employers and lower out-of-pocket charges to employees who get involved in weight reduction and other types of preventive care programs would be powerful incentives for change.
Pollack said the agreement to be announced by the 20 groups would go beyond the three elements of universal coverage, prevention and strengthening public programs.
But big gaps have yet to be bridged, including on the key question of how to finance subsidies. Tauzin appraised limits on the exclusion of employer-paid premiums from taxable income cautiously, suggesting that even limited caps rather than an outright elimination could disrupt the employer-sponsored health insurance system.
Pollack said that while the agreement would include some commentary on financing, “we won’t go chapter and verse” on the issue.
The pair also said there hasn’t been much discussion of financing in discussions so far. Pollack said it’s too early for that. “I don’t think the groups are prepared at this point to bargain against themselves” by making concessions on financing, he said.
But Pollack also noted that the clock is ticking on overhaul efforts because of a need to act while Obama still has political capital. “It’s gotta happen early,” Pollack said.
The 20 organizations in the Healthcare Reform Dialogue are AARP, the American College of Physicians, the American Cancer Society-Cancer Action Network, the American Federation of State, County and Municipal Employees, America’s Health Insurance Plans, the American Hospital Association, the AMA, the American Nurses Association, the American Public Health Association, AdvaMed, the BlueCross BlueShield Association, the Business Roundtable, the Catholic Health Association, Families USA, the Federation of American Hospitals, the Healthcare Leadership Council, the National Federation of Independent Business, the Pharmaceutical Research and Manufacturers of America, the Service Employees International Union and the U.S. Chamber of Commerce.




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