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 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.
