Senate support for a simple majority vote on healthcare reform is likely. Senator Jon Tester[ D-Mont.] says that reconciliation rules, which would allow Democrats to bypass a Republican filibuster, should be used for healthcare reform if Republicans resort to obstructionist tactics. Democrats appear to have the votes for a budget measure that would allow reform of the nation’s healthcare system with just 51 votes.
Medicare should become the test lab for making the entire healthcare system less wasteful, experts told a receptive Senate Finance Committee. Savings could be used to strengthen Medicare itself, or plowed into covering the uninsured. The new approach for seniors would stress close follow-up care by their family doctors and nurses. That’s aimed at keeping chronically ill patients from having to be hospitalized repeatedly. Primary care doctors, the generalists who care for patients day in and day out, would be paid more. Specialists, who tend to order more tests and procedures, would face closer scrutiny of their decisions. Hospitals could be penalized if patients don’t get adequate follow-up care and wind up being repeatedly readmitted for the same problems.
The government could run a public plan, in a manner similar to the way it runs Medicare, but without paying the exact same rates that Medicare does. The government could promise that the new public plan would pay better than Medicare, say by ten or fifteen percent on average. That should ease the concerns of insurers, providers, and other groups worried that a public plan wouldn’t pay sufficiently high rates.
Source: Campaign for America’s Future, April 22, 2009