The Blog

<i>In The Public Interest</i>: Senate Moderates Get it Right

Progressives continue to have real disputes with some of the Senate centrists. But some of those centrists' proffered amendments are serious attempts to hold down costs and they deserve support.
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As the health care reform debate moves toward an endgame in the U.S. Senate, it is no surprise that centrists of both parties remain opposed to the public option. The headline today is Senator Joe Lieberman's (D-CT) declaration of opposition to any form of a public plan or Medicare buy-in. But as the press has focused on the controversy around the new Medicare buy-in/FEHBP compromise, Lieberman has led a trio of Senate moderates to offer a delivery reform amendment that bucks powerful health industry lobbies and dramatically strengthens cost containment in the legislation.

Lieberman, Senator Susan Collins(R-ME) and Senator Arlen Specter (D-PA), a threesome most famous for dragging this year's recovery bill toward the right, put forward a remarkably constructive amendment that seriously advances cost containment.

This tri-partisan amendment establishes a new publicly available website called "Physician Compare" where individual consumers can see how physicians in their area perform according to a series of new quality measurements. The amendment also demands that insurance companies take the unprecedented step of disclosing their rate of coverage denials. And, it doubles penalties for bad-actor hospitals with high rates of re-admissions, attacking the current system that rewards hospitals for pushing out patients before they are ready.

Finally, the amendment delivers what progressive Senators and the administration together have yet to include in the bill: broad authority to expand successful cost-saving delivery and payment pilot programs nationwide. It is this authority that will allow the scaling up of the reforms that have made innovators like Mayo Clinic and Geisinger Health so successful. Years from now, historians might very well acclaim this one provision as critical to long-term cost containment and sustainability of health care reform.

Lieberman, Collins, and Specter are not the only centrists trying to find common ground on cost containment. Collins and Evan Bayh (D-IN) joined longtime health care champion Senator Ron Wyden (D-OR) on amendments to open the exchange to millions of Americans at large employers and to adjust a tax on insurance companies to reward plans that do the most to hold down costs.

First-year Senate moderates Senators Mark Warner (D-VA) and Mark Begich (D-AK) worked with everyone from progressive freshmen to the AARP to assemble an amendment package that will strengthen the Independent Medicare Advisory Board and ensure that administrative and delivery reforms can be extended beyond Medicare to lower costs in the private sector.

Progressives continue to have real disputes with some of the Senate centrists. But these amendments are serious attempts to hold down costs and they deserve support.

For their efforts, Collins, Lieberman and Specter have already earned the co-sponsorship of Rhode Island progressive Senator Sheldon Whitehouse. And many of the tripartisan amendment's provisions have long been championed by administration figures like White House Office of Management and Budget Director Peter Orzag.

But it remains to be seen whether enough Senators will resist industry pressure and take a stand for the public interest by insisting that the Lieberman/Collins/Specter amendment gets in the final bill.

Here's hoping that they do.