President Barack Obama now has his team to help him achieve
health care reform, one of his biggest goals. At press time, Kansas
Gov. Kathleen Sebelius was going through confirmation to be
Secretary of the Department of Health and Human Services. Nancy-Ann
DeParle, a top official in the Clinton administration, has been
named White House Director of the Office of Health Reform.
Obama's 2010 budget proposes to spend $634 billion over the next
10 years for a new approach to reducing the cost and improving the
quality of care while extending insurance coverage to millions more
Americans. The money would be raised by increasing taxes on couples
earning $250,000 or more a year and individuals earning $200,000 or
more, while also cutting or changing Medicare and Medicaid payments
to insurers, hospitals, drug companies, home health agencies and
other health providers. The budget includes eight general
principles Obama wants Congress to follow as it drafts health care
reform; he may not propose anything more specific.
This does not mean that after having laid out its funding plan
the new administration will step aside and let others develop new
policies. Instead, the administration has mounted a huge political
and public relations campaign to persuade Congress, the public and
various segments of the health care industry to buy into the plan
as the details develop.
You already see lawmakers and certain advocacy groups supporting
Obama's efforts by publicizing the shortcomings of the current
system. The White House brought together the largest interests in
health care for a “Health Summit” in early March, and
followed that with a series of regional meetings around the country
to discuss health reform.
The President has described health care reform as a
“fiscal imperative,” and said “the status quo is
the one option that is not on the table.” At the same time,
Congressional leaders scheduled a series of hearings this spring on
health reform in the House and Senate.
At the Health Summit, top Democrats promised to try and have
House and Senate bills pass before the August recess. In Congress,
however, multiple committee share jurisdiction over this issue. In
the House there are three committees whose leaders generally share
similar visions on health care reform: Energy and Commerce chaired
by Henry Waxman, D-Calif.; Ways and Means chaired by Charlie
Rangel, D-N.Y.; and Education and Labor chaired by George Miller,
D-Calif. House leaders have predicted they may be able to pass a
bill this summer.
Not so in the Senate, where political leadership on the issue is
less unified. Two committees in the Senate have jurisdiction:
Finance, chaired by Max Baucus, D-Mont., and Health, Education,
Labor and Pensions, chaired by Ted Kennedy D-Mass. Sens. Kennedy
and Baucus do not necessarily share a common vision for health care
reform.
Stating the obvious, the health care reform issue is huge and
complex, and clearly a uniformly supported plan does not exist. One
major issue already looming is whether to create a government-run
health plan, such as Medicare, that would be open to all Americans
and would compete with private insurance companies. Many Democrats
support the idea; many Republicans oppose it.
There are hundreds, perhaps thousands, of policy decisions
implicated in health reform. If the President achieves his goal of
enacting a major health reform package this year, it will surely be
a herculean task.
So where do we as an industry stand in the mix? With all the
activity on health reform, we must be vigilant, persistent and
vocal in extolling the trifecta of home health care:
patient-preferred, cost-effective and better outcomes.
In addition, we need to make sure that our issues are at the
forefront of lawmakers' minds. We are pursuing parallel goals of
working to enact legislation that meaningfully addresses fraud and
abuse, permanently suspends the “competitive” bidding
program, fixes the post-36 month payment issues for oxygen therapy
and repeals the 9.5 percent payment cut for complex rehab.
A busy agenda indeed.
A specialist in health care legislation, regulations and
government relations, Cara C. Bachenheimer is vice president,
government relations, for
target="_blank">Invacare Corp., Elyria, Ohio. Bachenheimer
previously worked at the law firm of Epstein, Becker & Green in
Washington, D.C., and at the American Association for Homecare and
the Health Industry Distributors Association. You can reach her at
440/329-6226 or cbachenheimer@invacare.com.
