Sunday, February 22, 2009

Health care industry in talks to shape U.S. policy

It appears universal health care is going to happen, with a mandate that everyone be covered (something more akin to Hillary's plan). Only with everyone being required to have health coverage can the insurance companies expect to make any money off this, especially since they'll have to cover people with "pre-existing conditions," i.e., sick people. See full story here.

Since last fall, many of the leading figures in the nation's long-running health care debate have been meeting secretly in a Senate hearing room. Now, with the blessing of the Senate's leading proponent of universal health insurance, Edward Kennedy, they appear to be inching toward a consensus that could reshape the debate.

Many of the parties, from big insurance companies to lobbyists for consumers, doctors, hospitals and pharmaceutical companies, are embracing the idea that comprehensive health care legislation should include a requirement that every American carry insurance.

While not all industry groups are in complete agreement, there is enough of a consensus, according to people who have attended the meetings, that they have begun to tackle the next steps: how to enforce the requirement for everyone to have health insurance; how to make insurance affordable to the uninsured; and whether to require employers to help buy coverage for their employees. . . .

While President Barack Obama is not directly represented in the talks, the White House has been kept informed and is encouraging the Senate effort as a way to get the ball rolling on health legislation. . . .

The ideas discussed include a proposal to penalize people who fail to comply with the "individual obligation" to have insurance. . . .

The proposal for an individual mandate was one of the few policy disagreements between Obama and Hillary Rodham Clinton in their fight for the Democratic presidential nomination. She wanted to require everyone to have and maintain insurance. He said he wanted to "ensure affordable coverage for all," but would initially apply the mandate only to children. . . .

Their motives vary. Some say the moment to overhaul the health care system has arrived because of a confluence of events, including Obama's election, the growing number of uninsured and the relentless increase in health costs. Some want to protect the interests of their members and could ultimately oppose the legislation, depending on its details. . . .

James Gelfand, senior manager of health policy at the United States Chamber of Commerce, said: "Forcing individuals to purchase insurance in the current market would be a disaster. Before we even have that discussion, we need to make health care more affordable and improve its quality."

The current efforts contrast with the Clinton administration's approach in 1993-4. The Clinton White House demonized health insurance companies, accusing them of "price gouging" and profiteering. Kennedy is trying to keep insurers and other stakeholders talking together in the same room. Getting affordable health insurance is now a top priority for small-business owners, who helped kill the Clinton plan. . . .

A business lobbyist involved in the talks said: "The lack of acrimony, the air of cooperation toward a common end, is quite refreshing. If the Republicans were a party to these intense discussions, that would ease the path to enacting health care reform." . . .

Many businesses, crushed by soaring health costs, say they now support changes in the health care system as a way to control their costs. But in its summary of the recent discussions, Kennedy's office said, "There was little consensus on the employers' role."

Many insurance executives say they are willing to accept stricter regulation, including a requirement to offer coverage to people with pre-existing medical conditions, if the federal government requires everyone to have coverage. . . .

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