Published: November 2008

Call to Action: Health Care Reform 2009

Senator Max Baucus (D-MT), chair of the key U.S. Senate Committee on Finance, has issued a detailed "white paper" on insurance-based health care reform. It includes public and private plan options and directives to limit "out of pocket" costs for patients.

Montana Democratic Senator Max Baucus's "white paper" on health care reform is a proposal to provide all U.S. residents with health care coverage. Senator Baucus led the U.S. Senate Committee on Finance in holding nine hearings on health care reform this year, and hosted a day-long health summit in June 2008 to explore in greater depth the problems plaguing our health system.

The white paper is an open and inclusive process. Senator Baucus's staff welcomes advice and suggestions as the process toward creating legislation moves forward.

According to Baucus, the “Call to Action” aims to do three things:

  • get everyone in America covered with decent health insurance
  • reduce health care costs so that everyone can afford the care they need, even if the insurance is basic
  • make America healthier with better quality care and more preventive care.

The plan would cover the uninsured by strengthening the employer-based system, by targeted expansions in public programs, and by creating a new arrangement called the the Health Insurance Exchange where individuals and small businesses would go to get affordable coverage.

The plan calls for everyone to have health coverage—and creates an individual responsibility to do it. It would require most employers to either provide coverage or to contribute toward covering the uninsured.

Everyone would be expected to be part of the system and all stakeholders would have a responsibility to improve the quality of care.

The plan suggests improving the quality of health care by strengthening the primary care system. Baucus has said that primary care providers, including community health centers, "watch over a patient’s whole medical history and keep them healthier all their lives."

Primary care would be rewarded by increasing reimbursement for primary care services, providing additional payments for primary care doctors to improve care coordination, and encouraging more medical students to choose a career in primary care.

The plan proposes to pay providers for the quality of care they give patients. Today's system pays doctors, hospitals and other providers based on the amount of care they deliver—not for the quality of care patients receive. It would establish a pay-for-performance program in Medicare that will reward hospitals that provide the highest quality care, creating new policies that penalize hospitals with high re-admission rates, and testing models to “bundle” or combine hospital and physician payments in an effort to encourage them to work together to provide quality care and reduce costs.

The Call to Action would invest in "comparative effectiveness" research to give providers unbiased and actionable information about what treatments, technologies, and procedures work best for patients, and health IT that will reduce medical errors immediately, and over time would allow providers to share patient information and connect with colleagues to more effectively manage care.

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Call to Action: Health Care Reform 2009


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