Keeping healthcare reform on track

KEEPING HEALTHCARE REFORM ON TRACK…. There’s been ample speculation as to whether the Obama administration will pursue healthcare reform this year, but as the White House budget comes together, the issue remains very much on the frontburner.

“The budget will kick off or facilitate a focus on getting health care done this year,” the senior official said, adding that the White House is planning a health care summit. The event has been delayed by former senator Thomas A. Daschle’s decision to withdraw from consideration as health secretary because of tax problems, a move that left Obama without a key member of his health team.

Administration officials and outside experts say the most likely path to revamping the health system is to begin with Medicare, the federal program for retirees and people with disabilities, and Medicaid, which serves the poor. Together, the two programs cover about 100 million people at a cost of $561 billion in 2007. Making policy changes in those programs — such as rewarding physicians who computerize their medical records or paying doctors for results rather than procedures — could improve care while generating long-term savings, experts say.

Obama’s budget request would create “running room for health reform,” the official said, by reducing spending on some health programs so the administration would have money to devote to initiatives to expand coverage. The biggest target is bonus payments to insurance companies that run managed-care programs under Medicare, known as Medicare Advantage.

The Bush-era program has attracted nearly a quarter of Medicare beneficiaries to private health insurance plans that cover a package of services such as doctor visits, prescription drugs and eyeglasses. But the government pays the plans 13 to 17 percent more than it pays for traditional fee-for-service coverage, according to the Medicare Payment Advisory Commission, which advises Congress on Medicare financing issues.

On a related note, the Politico reported that the White House is “considering dumping its newly created Office of Health Reform,” which Tom Daschle was slated to lead. Does that mean Obama’s team is backing off on the broader initiative? Ezra Klein explains that just the opposite appears to be true. The Office of Health Reform was going to be Daschle’s baby and “filling that spot with someone else would actually undermine the original intent of the office.”

Ezra concluded, “If they decide to dump the Office of Health Reform, it’s not because they’ve abandoned health care reform. It’s because they haven’t, and they’re building a post-Daschle strategy.”

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