Baucus says health-care plan should be bipartisan

Sen. Max Baucus, D-Mont., pointed to rising costs as the real driver behind health-care reform and said his bipartisan approach is most likely to achieve a solution.

During a visit with the Inter Lake's editorial board Tuesday, Baucus referred to Medicare, Medicaid and the Children's Health Insurance Program as the fastest growing component of the federal deficit. He quoted Peter Orzak, director of the Office of Management and Budget.

"The road to economic recovery runs through health-care reform."

Baucus, as chairman of the Senate Finance Committee, is playing a pivotal role in sculpting one of the bills responding to President Barack Obama's call for health-care reform, and said he believes his bipartisan approach is essential. The House of Representatives has another bill and the Senate Health Committee voted to approve a third, but neither of those bills got any Republican support in committee.

None of the three bills has come to a full vote of the House or Senate. All have different provisions with none finalized, leading to confusion and growing angst among the public.

"There is no single bill and that has given the opposition a field day," Baucus said.

He said his office has received a flood of calls from the left demanding a single-payer system as well as calls from the right demanding other changes. Baucus said a lot of the nasty calls came from out-of-state, but acknowledged that the volume of calls and e-mails reflects deep concern in the public about health-care reform.

"They only call when they don't like what you're doing," he said.

Baucus said he has met with two single-payer groups, "tea party folks' in Helena, and also attended a conference in Bozeman in the past week. He said he tried to talk with people protesting outside the conference, but said they would not let him speak.

A staff member told Baucus that one person demonstrating said they were bused in from Texas. He said they spoke with a drawl and did not exhibit Montanan civility.

"These people were not civil," he said. "This was the closest thing to a mob that I've ever experienced in my life. But it was fine - it goes with the territory."

The senator said he hopes to have the finance committee bill passed out of committee with bipartisan support by late fall. He said that he and five other senators - three Democrats and three Republicans - "meet daily" to educate themselves on health care and to find common ground.

Baucus also noted that he spent a large part of 2008 holding hearings on health-care reform and educating himself for the coming battle. He held a one-day summit and 10 meetings around the state in preparation.

"This group of six 'senators' knows the health-care system really well," he said. "No other group back there has spent as much time on this as we have."

Baucus said he wanted to knock down incorrect perceptions about his committee's health-care reform bill. He said the bill will not cover illegal aliens, will not put bureaucrats in charge of health care decisions for patients, will not make cuts in Medicare benefits and will not add to the federal deficit.

"It doesn't add one thin dime to the national deficit," he said. "It's fully paid for over a 10-year period."

He compared it to a business plan with debt in the early years but becoming profitable later. Baucus termed it "a serious effort to bend the cost curve" of health-care cost increases.

He said single payer, like Canada's system, was not the way to control costs. Baucus called getting rid of waste "the basic fundamental way" to stop the spiraling costs.

The senator said cost savings in paying for government health care like Medicare would come through paying for quality instead of quantity.

"We have a pay system that encourages providers to order more services, more tests, more MRIs," he said. "If you improve quality, you reduce costs."

As examples, he cited the Mayo Clinic and other health-care institutions with integrated systems in which doctors, pharmacists and others in the health-care equation communicate and focus on patient outcomes.

He related a story of a Denver institution where cardiac patients were not improving but reported they were taking their medications. But checks with the pharmacists found they were not refilling their prescriptions, pinpointing the problem.

"That's one small example," Baucus said.

He described measuring quality as in its infancy and said the field has a long way to go. Baucus said major business leaders such as the CEOs of companies like GE and REI agree this is the path to curbing costs.

Baucus included reducing over-utilization of medical services as "a game changing, transformative" aspect of the finance committee bill. He said this doesn't translate to rationing, adding the bill has nothing limiting the care a person can receive.

"It's working to pay doctors for the quality they do - they're making all the decisions." he said. "No bureaucrat is deciding if you get health care or not."

Baucus allowed that some over-prescribing of tests relates to fear of lawsuits by doctors and others in the health-care system. He said that malpractice tort reform would help alleviate over-use.

"I think that should be on the table," he said, but he said he was also realistic about the possible outcome. "I don't know how likely it is that tort reform would pass this Congress or this president."

The senator said the bill that will come out of his committee won't cut benefits for Medicare but does include some reduction in the rate of increase of provider payments.

"It's hospitals and providers that are not going to get as much," he said. "But they make it up in volume (from more insured people)."

According to Baucus, the Finance Committee bill will reform the insurance industry by eliminating "the outrage" of health insurance companies denying coverage because of pre-existing conditions and charging some people "a lot more" than others.

"We're talking about individual and small group markets," he said.

To develop an affordable insurance option, Baucus said his committee is working on a health-care exchange concept similar to what he and other federal employees have where they choose coverage once a year during open season.

He envisions a one-page application and options to pay a higher premium for more benefits.

"It's got to be quality health insurance," Baucus said.

Asked if he would support a bill with a public option added before a final floor vote, Baucus said that his goal is to get health-care reform that bends the cost curve of spending, gets people covered and gets 60 votes in the Senate.

"We have no choice but to try and do the best we can," he said.

According to Baucus, medical inflation climbs at a rate 3 to 4 percentage points higher than the Consumer Price Index. He said spending on health care for some has gone up at a higher rate, with premiums up 80 percent in recent years.

The senator said that the United States spends twice as much on health care as the next most expensive country but Americans aren't twice as healthy. He said the Medicare Trust Fund would go "belly up in eight years' without health-care reform.

Baucus said he spends a lot of time trying to get these points across.

"It's not easy," he said. "This is the most difficult legislative challenge I've ever faced in my life."

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com