It's a pundit's dream to win the president's ear. The Atlantic's own Ron
Brownstein, in a 2,600-word Saturday post on health care reform,
did just that, attracting the attention of the nation's most influential reader, President Obama. Brownstein wrote
that the Senate bill on health care reform is a "milestone" for its measures to control costs:
Both the Senate bill's priority on controlling long-term health care
costs, and its strategy for doing so, represents a validation for
Senate Finance Committee chairman Max Baucus (D-MT). When Baucus
released his health reform proposal last September, after finally
terminating months of fruitless negotiations with committee
Republicans, Democratic liberals excoriated his plan as a dead end. And
on several important fronts--such as subsidies for the uninsured, the
role of a public competitor to private insurance companies, and the
contribution required from employers who don't insure their
workers--[Senate Majority Leader Harry] Reid moved his product away from Baucus toward approaches
preferred by liberals.
But the Reid bill's fiscal strategy, and its vision of how to "bend the
curve," almost completely follows Baucus' path from September. Baucus'
bill was the first to establish the principle that Congress could
expand coverage while reducing the federal deficit; now that's the
standard not only for the Senate but also the House reform legislation.
And, perhaps even more importantly, the Reid bill maintains virtually
all of Baucus ideas' for shifting the medical payment system away from
today's fee-for-service model toward an approach that more closely
links compensation for providers to results for patients. In the Reid
bill, there is some backtracking from Baucus' most aggressive reform
proposals, but not much. [...]
The attempt in all these ideas to nudge the medical system away from
fee-for-service medicine toward an approach that ties compensation more
closely to results captures how much the health care debate has shifted
toward cost-control. So far, the rise in health care spending has
proven almost invulnerable to every previous attempt to tame it, like
the managed care revolution in the 1990s. Even if Obama signs into law
a final bill embodying all these reform proposals, many skeptics wonder
if they can bend, much less break, the seemingly inexorable increase in
health care spending. [Former CBO
director Robert] Reischauer understands that skepticism, but isn't
able to entirely suppress a kernel of optimism that this latest reform
agenda may prove more effective than its predecessors. "One never knows
whether we're turning the corner or if this is just playing the same
old game for another inning," he says. "But I sense there's something
different out there. I think the medical profession and its leaders
have read the handwriting on the wall and are trying to evolve." If so,
the ideas the Senate will begin voting on tonight could mark a
milestone in that journey.
that Obama "declared" that Brownstein's post "was mandatory reading for all senior staff
and that everyone involved in, or covering, the health care debate
should see the piece." Talking Points Memo adds
that White House Chief of Staff Rahm Emanuel told senior staff "not to
come back to the next day's meeting if they hadn't read the article."
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