In a letter to Senators Ted Kennedy and Max Baucus that the White House just released this afternoon, President Obama spelled out his vision for health care reform, making it clear that he wants a public sector alternative to private insurance: “operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.” (Hat Tip to Jonathan Cohn, over at The Treatment for calling attention to this letter.
So much for speculation that the administration would back down on this issue.
The President also is “putting another $200 to $300 billion on the table,” Cohn notes, “proposing to extract that money from savings in Medicare and Medicaid.” He pairs the offer with a proposal he talked about yesterday that would give the Medicare Payment Advisory Commission (MedPac) the power to implement its recommendations for Medicare reform. (MedPac is an independent panel that advises Congress on Medicare Spending and under legislation sponsored by Senator Jay Rockefeller, MedPac would have authority to set fee schedules for both hospitals and doctors.)
I have written extensively about MedPac’s recommendations on HealthBeat and I’m now writing a post fleshing our precisely how MedPac would squeeze waste out of Medicare spending, while lifting the quality of care. )
In his letter, the President also stressed that “reform cannot mean focusing on expanded coverage alone. Indeed, without a serious, sustained effort to reduce the growth rate of health care costs, affordable health care coverage will remain out of reach. So we must attack the root causes of the inflation in health care.” He then points to the large multi-specialty medical centers, where doctors work on salary, that HealthBeat has pointed to as models for learning how to provide more effective care at a lower cost: “ That means promoting the best practices, not simply the most expensive. We should ask why places like the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions can offer the highest quality care at costs well below the national norm. We need to learn from their successes and replicate those best practices across our country. That's how we can achieve reform that preserves and strengthens what's best about our health care system, while fixing what is broken.”
I’ll post more about the role MedPac would play in reform later this evening.