Shared responsibility, Baucus mindset topics of journal
articles
Universal coverage costs can’t be dumped on
individuals, Americans say in survey; Baucus brings conservative values
to HCR debate.
The health policy literature is filled to the brim with health care
reform material these days, and two important articles have been
published this week. From the Project HOPE journal Health Affairs, a
study shows that Americans understand the need for universal health
coverage, but they believe that the government, employers, and insurers
should share responsibility with individuals. In this week’s
New England Journal of Medicine, the motivations and mindset of a
key legislator, Senate Finance Committee Chair Max Baucus (D–MT),
are explored in a Perspective article.
Spreading responsibility for achieving universal health coverage
among government, employers, insurers, and individuals was more popular
than a stand-alone mandate among all subgroups of respondents to a
national survey, and this shared-responsibility approach obtained 50%
support or better in each subgroup except Republicans (44%), according
to Health Affairs authors (doi: 10.1377/hlthaff.28.3.w501).
[EXTERNAL LINK TO
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.3.w501.
OPEN NEW PAGE FOR LINK.] In a telephone survey of 1,704 adults age 18
and older, 48% of respondents expressed support for an individual
mandate on its own. However, a shared-responsibility approach with an
individual mandate was considerably more popular than a stand-alone
mandate. Overall, 59% of the public supported this approach. The biggest
increases in support for a shared-responsibility approach, as compared
to a stand-alone individual mandate, were found among those making
$80,000 to $100,000 and among African Americans, reported study authors
Bob Blendon, professor of health policy and political analysis at the
Harvard School of Public Health, and colleagues.
Attempting to read the tea leaves regarding the prospects of health
care reform this year in Congress, New England Journal of
Medicine [EXTERNAL – NEW PAGE -- LINK TO:
http://content.nejm.org/cgi/content/extract/360/17/1693] national
correspondent John K. Iglehart provides these insights into the
thinking of Sen. Baucus: “Because he is generally careful
not to stray too far from the conservative views of many of his Montana
constituents, Baucus’s passionate pursuit of health care reform
has surprised some people. At a recent briefing, he said, ‘This is
the most difficult legislative challenge of my life, and I relish
it.’ Baucus has expressed a willingness to cap the tax-free amount
of employer-provided health benefits, whose deductibility currently
costs the federal treasury about $250 billion a year in forgone tax
revenue. (The administration has signaled a willingness to accept such a
measure even though during the presidential campaign Obama denounced a
similar proposal as ‘the largest middle-class tax increase in
history.’) Baucus also proposed accelerating the pursuit of fraud,
waste, and abuse in public programs; increasing the transparency of
physician–industry relationships and physicians’
self-referral of patients; and addressing professional-liability
issues.”
Related resources on www.pharmacist.com
L. Michael Posey, BPharm (mposey)
Posted April 24, 2009, 1:00 pm EDT
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