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FROM SENATOR BAUCUS'S PRESS CONFERENCE.
Here are the quotes I took down from his comments. Everything is on-the-fly transcription, so there may be a word or two wrong.
When everyone is covered, premiums will be more affordable. Insurance markets will work better because costs will be shared by more healthy americans. Insurance companies will be able to reduce costs because everyone will get the care they need.We've gotta do this right. We need reform in our system. Really, it's not even a system. It's a hodgepodge. We don't have a health care system. But whatever it is we do have is clearly broken. Health care costs are rising too fast for individuals and companies, if you look at the medicare portion of our budget, we have to act.
Looking back at 1994, there were a few mistakes. The health care proposal was too top-down and they waited too long to offer it. And they came to Congress and basically said, this is it. It makes far more sense for Congress to have a more prominent role as the primary legislative body. Inaction is much more expensive than acting. I also will tell you that when i talk to senators, Republicans and Democrats both, we all know what needs to be done. We all know we have to move. The devil is in the details, clearly, but there's a much greater sense of momentum and movement than before.
I don't think a single payer health care system makes sense in this country. We are america, we will come up with a uniquely american health care system that's a combination of public and private.
We need to train more primary care doctors. I heard only 2 percent of last year's doctors were primary care, because the money wasn't there. We need more medical homes, a more holistic approach to care. There must be a greater role for primary care then there is in America today, and this bill has incentives to do that.
My main goal is a holistic system where all Americans are covered. Once we have accomplished that, I think we can more easily deal with some of these individual points of reform. The time has passed for us to nickel and dime this system, to tamp down on trouble over here so it bubbles up somewhere else. The goal here is to set up a comprehensive, holistic system.
i do believe we should not scrap the employer based system. We should maintain it. We should build upon it. but the current vision of the tax code has certain inefficiencies that I believe we can address while still building on the employer-based system.
How long will this take? It will take time. At least three years. But some features can come in earlier, like medicaid and medicare eligibility changes.
The cost of the economic bailout is not $700 billion. It's quite a bit less. I believe we have to be honest and creative in working with CBO. Mr. Orszag and I are going to have a lot of conversations about how to score some of these provisions.
COMMENTS (11)
Isn't it nice how he (and other politicians) can simply say stuff like "Well, we need more primary physicians"? Well, duh - but how are you going to create that situation?
Although I would honestly prefer single-payer, Baucus is right in that we don't necessarily need to go down that road. Europe, for example, has several different styles of health care systems (ranging from Britain's NHS, to France's single-payer, the Germany's weird system which I have a hard time describing) that work pretty well.
I do wish we'd get rid of the idiotic employer-covered system. It's a boondoggle on American companies from a period when there was virtually no challenge to American companies from abroad.
Posted by: Brett | November 12, 2008 1:20 PM
"The health care proposal was too top-down and they waited too long to offer it. And they came to Congress and basically said, this is it. It makes far more sense for Congress to have a more prominent role as the primary legislative body."
Yeah. The Bush Administration had so much trouble pushing The PATRIOT Act and the war in Iraq because it was too top down and they didn't give congress enough time to really think about it.
Posted by: Jeremy | November 12, 2008 1:24 PM
brett, the other problem with the employer covered system is that full time workers are an increasingly small portion of the labor force: WalMart, Pizza Hut, to name just a couple, seem to have tried to convert as much of their workforce to under 40 hrs. a week as they can. Some means of covering the 'parttime' must be found.
Posted by: MR Bill | November 12, 2008 1:34 PM
At least 3 years? Is that the fastest this could realistically get done, Ezra?
Posted by: Michael Feldstein | November 12, 2008 2:03 PM
....When everyone is covered, premiums will be more affordable....
That sounds like the mandate that Obama and you rejected.
...Looking back at 1994, there were a few mistakes...
Yes, not preparing for a drumbeat of industry attacks that caused the Democratic Congress to fail to support universal health care was a fatal error.
...I don't think a single payer health care system makes sense in this country...
Gee, Medicare, Medicaid and S-Chip don't make sense in this country. Who knew?
..We need to train more primary care doctors...
Pay them well and they will come; stint Medicare payments and they will go.
...The goal here is to set up a comprehensive, holistic system..
Damn that infernal candidate, Clinton. Curse her for daring to propose something that clashed with The One.
i do believe we should not scrap the employer based system.
And how do you propose to extend it to all? What will you propose when employers stop offering coverage?
Posted by: Mike | November 12, 2008 2:12 PM
The cost of the economic bailout is not $700 billion. It's quite a bit less.
Why did he say that? I can discern no connection between these statements and the rest of his remarks.
Posted by: Herschel | November 12, 2008 2:20 PM
You would think that Baucus was just elected president on this site...
Posted by: Joe | November 12, 2008 2:37 PM
I'm having trouble reconciling what Paul Krugman seems to think about the choice of Baucus vs. what Petey told us all during the primaries and the GE. Hmm. Who should I believe. I'm really torn over this one.
Do I go with the douchebag or the Nobel laureate?
Posted by: Jake | November 12, 2008 3:00 PM
Isn't it nice how he (and other politicians) can simply say stuff like "Well, we need more primary physicians"? Well, duh - but how are you going to create that situation?
I know the answer to that question. Stop training so many specialists. The people who don't get specialist training are the generalists. It helps if you also don't create a situation where an extra 2 or 3 years of training results in a doubled income.
I lurk on a diabetes forum. It's easy to tell the British from the Americans. The Brits refer to their docs as "my GP" while the Americans mostly refer to "my endo". You don't need endocrinologists to treat the 1/3 of the population that has type II diabetes. However, if an American diabetic has a complication (and sooner or later most of them have a complication), then they can turn around and sue their GP for "failure to refer in a timely manner" (which is one of the top reasons for malpractice lawsuits). Fix the overproduction of specialists (easy), fix the overpayment of specialists (a little harder), and fix the malpractice problem (much harder) and you'll have substantially cheaper medical care.
Posted by: J Bean | November 12, 2008 3:30 PM
Isn't it nice how he (and other politicians) can simply say stuff like "Well, we need more primary physicians"? Well, duh - but how are you going to create that situation?
This isn't something that's overly complex, conceptually. I don't think Baucus needs to spell out at this very instant how we would go about producing more PCPs. It would obviously involve using taxpayer money to train more such doctors, perhaps in return for a legal commitment to practice primary medicine for a given amount of time.
Posted by: Jasper | November 12, 2008 3:33 PM
Sorry, but until we separate health care coverage from employment, things aren't really going to get better. I have been stuck in a ridiculous employment bind my entire adult life, taking jobs that don't enable me to pay down my already existing medical debt just to keep my minimal health insurance in the hope of not losing my home along with my shirt. I'm sick of it and I'm not the only American whose career options have been curtailed by our stupid employer-based health insurance system. I have lived and worked in both England and Germany and my health care options were no more limited than they are here. Sorry, but anything connected to employment isn't a solution.
Posted by: Laurie | November 12, 2008 7:38 PM