White House advisers: Senate reform bill controls health costs

Nov 26 2009

In a pre-Thanksgiving conference call with reporters, senior Obama administration officials praised cost controls in the Senate health reform bill.

The New York Times: "Two of President Obama's senior health care advisers said Wednesday that a proposed tax on high-cost insurance plans and a new commission to control Medicare spending were among 'four pillars' essential to major health care legislation. Their remarks firmly aligned the White House with the Senate on two major disagreements facing Democratic Congressional leaders trying to pass a bill."

"The health care legislation that the House adopted on Nov. 7 did not include the excise tax on the so-called Cadillac insurance plans. But the Senate majority leader, Harry Reid of Nevada, included the levy in the bill that the Senate will begin debating in earnest next week, and many health economists say it is vital to slowing long-term costs" (Herszenhorn, 11/25).

The Washington Post: "White House budget director Peter Orszag told reporters via conference call that the $848 billion bill pending before the Senate contains important cost-cutting tools. He added, however, that further adjustments could be made through amendments to the legislation, saying: 'We're not at the end of the process.' On the same conference call, White House health-care adviser Nancy-Ann DeParle said the administration was pleased with the House bill and the one emerging in the Senate. She described the Medicare savings in both bills -- about $500 billion under the Senate approach and $400 billion in the House version -- as the first serious effort to restrain the entitlement program's growth since the 1997 Balanced Budget Act" (Murray, 11/26).

Christian Science Monitor reports that Orszag "said the legislation is expected to incorporate most of the major cost-control ideas that have emerged in recent years. Those include:
• Moving toward a 'bundled-payment' system in which providers are paid for overall care - not for each test or procedure they perform.
• Starting to track what treatments work better than others (which could nudge hospitals toward more efficient care).
• Digitizing medical records to improve efficiency.
• Forming a Medicare commission to curb rising costs in the program that covers older Americans - and that accounts for a large share of expected federal budget deficits in the future.
The pre-Thanksgiving healthcare push comes at an important moment. The Senate is about to dig into the details of its bill, polls suggest that voters are wary about the prospect that costs will go up rather than down, and the calendar is ticking quickly toward an election year in which a voter focus on the economy could undercut momentum for healthcare reform" (Trumbull, 11/25).

NPR: "DeParle said the effect of changes laid out in the Senate bill, for instance, 'will be broader and deeper than what the Congressional Budget Office and even our colleagues at (the White House Office of Management and Budget) are anticipating.' And the White House has company, DeParle and OMB Director Peter Orszag pointed out, citing a recent letter sent to Obama by a couple of dozen leading health economists, including former CBO chiefs Alice Rivlin and Robert Reischauer, and former Bush administration health honchos Mark McClellan and Katherine Baicker" (Rovner, 11/25).

The Hill: "Orszag on Wednesday took aim at 'loosey goosey' criticisms of the Democratic healthcare bill's ability to contain costs. Orszag ... contrasted suggestions that the bill will lead to more federal debt with recent reports in The Atlantic and The New York Times that found that economists who have looked closely at the bill support many of its features. 'The folks who have done that kind of reporting come to a much different conclusion instead of a kind of 'loosey goosey, let's talk about things in the air instead of what's in the legislation,'" Orszag said. Republicans in Congress have long said that the House and Senate healthcare bills will not bring down the rising cost of healthcare services and insurance premiums" (Fabian and Alarkon, 11/25).

Meanwhile, The Associated Press reports that "President Barack Obama's top aides met frequently with lobbyists and health care industry heavyweights as his administration pieced together a national health care overhaul, according to White House visitor records obtained Wednesday by The Associated Press. The records disclose visits by a broad cross-section of the people most involved in the health care debate, weighted heavily toward those who want to overhaul the system. The list includes George Halvorson, chairman and CEO of Kaiser Health Plans; Scott Serota, president and CEO of the Blue Cross and Blue Shield Association; Kenneth Kies, a Washington lobbyist who represents Blue Cross/Blue Shield, among other clients; Billy Tauzin, head of PhRMA, the drug industry lobby; Richard Umbdenstock, chief of the American Hospital Association, and numerous lobbyists" (Theimer and Davis, 11/25).