Yesterday’s revelation of a compromise on health reform by two key Senators – a Republican and a Democrat – was the first public statement of the long-simmering plan to significantly change physician reimbursement.
It wasn’t much to start – a call to increase reimbursement for primary care services by 5% along with bumps in payments to rural physicians. But is also noted a decrease in reimbursement for other specialists. And that’s where things are going to get very contentious.
The proposal by Senators Max Baucus (D-Mont.) and Charles E. Grassley (R-Iowa) indicates there’s been significant progress between the two parties on health reform; according to the LATimes, “the senior members of the Senate Finance Committee have reached some bipartisan agreement about how the federal government should pay providers through its Medicare program.”
This bipartisan agreement, coupled with the earlier announcement of Sen Arlen Specter’s move to the Democratic party and the decision by Democrats to subject health reform to the reconciliation process (where it can pass the Senate with a simple majority) may well kick health reform into high gear. Politically, more Republicans may be realizing that a continued policy of pure obstruction will not help turn around the fortunes of the party.
With health reform a highly visible issue, at least some members of the minority party may have decided to try to steer the bus instead of continuing to lie down in front of it. Politico reported late yesterday that Rahm Emanuel met with Senate Minority Leader Mitch McConnell yesterday to discuss health reform – a meeting that may well indicate the GOP leader is willing to engage.
I’d expect there is some serious horse-trading going on in the back offices, and one of the chips is very likely the public plan option. If the Rs can keep that off the table in return for their acceptance of other health reform provisions, we just may see reform this year. As I’ve noted repeatedly, the protests over the public option are generally overblown. Be that as it may, killing the public option would enable Rs to claim a significant victory and retain some political capital amongst their core supporters.
What does this mean for you?
Watch what key Democrats say about the public option; a cooling of enthusiasm may well indicate a compromise is in the offing and reform may actually happen.
Apr
30
I can think of one key Democrat whose enthusiasm for the public plan has not cooled — Barack Obama. He mentions it every time healthcare comes up. He even brought it up, unprompted, at his press conference with that new Democrat, Arlen Specter.
Of course, this may just be part of his game, maintaining the perceived value of that bargaining chip so that some true concessions on other points may be gained. If so, he is playing this very, very well.
Joe, This compromising in my view shows that the Dems will not be able to force all the reform they had hoped in this year. As to Arlene Specter’s departure from the GOP, well that is something that has needed to be done for a long while. I applaud his finally mustering the cajone’s to make the move. The only pity here is that he did not take some of the other RINO’s with him (i.e. Chuck Schumer). Perhaps in this season of change we will find more people like Sen. Specter who re-align to their “true” beliefs.
Dorrence – Chuck Schumer is and has always been a Democrat.
I believe the country needs (at least) two strong parties. At this rate the Rs will not be one of them as they are increasingly shrinking due to slavish devotion to some R’s commitment to ideological purity. The strength of any entity is not in its single-mindedness, but rather in welcoming dissension and respecting diverse views.
Paduda