# Public Health Insurance Option

House health care bill will change Medicare reimbursements

The offices of Congressmen Bruce Braley (IA-01), Dave Loebsack (IA-02) and Leonard Boswell (IA-03) announced big news on Friday afternoon:

Boswell, Loebsack, and Braley helped negotiate a compromise adding language to the healthcare reform bill changing Medicare to a quality-based payment system in two years.  Specifically, the compromise would (1) require Medicare to conduct a two-year study on a value-based system, and (2) at the end of the two year study period, Medicare would switch to a quality-based system unless Congress specifically cast a vote to disallow that change. […]

Medicare currently operates under a fee-for-service system, basing payments to doctors and hospitals on the amount of procedures completed and the number of patients seen.  This system creates a financial incentive to order more and more procedures.  Ironically, according to many studies, this increased number of procedures does not result in better outcomes for patients.

Boswell, Loebsack, and Braley have strongly advocated a switch to a Medicare payment system based on value and quality, which determines payments based on procedures’ effect on patient health.  In June, Rep. Braley introduced the Medicare Payment Improvement Act with Rep. Ron Kind (D-WI).  Reps. Boswell and Loebsack are co-sponsors of the legislation.  The bill would have required Medicare to switch to a quality-based payment system, outlining specific details on how to measure quality and value.

If Congress adopts a health care bill containing this provision, it will be very good news for Iowa health care providers, who are reimbursed by Medicare at much lower rates than in some other parts of the country. I’ve posted the whole press release from Braley’s, Loebsack’s and Boswell’s offices after the jump.

On a related note, Iowans who support a strong public health insurance option should contact Boswell’s office. There is some confusion surrounding his position on this issue. He expressed support for a public option in June. In early July he signed a good letter from a group of Blue Dogs and New Democrats advocating for a public option. However, when confronted on camera this week, Boswell said he wasn’t against a public option and wants to see the final version of the health care bill before making a decision.

A public option could provide coverage and competition in the majority of U.S. markets that are currently dominated by one or two private health insurance providers. It also could save hundreds of billions of dollars. Supporters of the public option can Stand With Dr. Dean here. Please also consider signing up with Health Care for America Now. Senators Richard Durbin, Patrick Leahy and Chuck Schumer set up this online petition supporting a public option as well.

In other health care reform news, Senator Tom Harkin is rightly frustrated that the Congressional Budget Office scoring of the Senate Health, Education, Labor and Pensions Committee bill didn’t include any cost savings from the prevention measures Harkin fought to have included. He’s concerned that the language on prevention might not survive Senate negotiations:

“We got a lot of savings out of it. But they just don’t score it that way. And I’ve got to fight like the dickens to make sure we keep it in there,” he added. “Otherwise, people will say, ‘We’ve got some costs here. But we don’t have any savings, and since we have costs, not savings, we’ll throw that overboard.’ “

Thanks for fighting the good fight, Senator Harkin. Private sector companies that have focused on prevention have reduced costs for treating some chronic conditions.

UPDATE: Boswell’s official website explains his position on health care. He seems focused on whether the public option will be “self-sustaining and deficit neutral,” as opposed to whether it will provide competition or coverage to his constituents who are badly served by the status quo.

Funny, I don’t ever remember Boswell insisting that other government spending (like agriculture subsidies) need to be self-sustaining or deficit neutral. If universal health care isn’t worth spending public money on, what is?

Continue Reading...