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WASHINGTON – After agreeing tentatively to jettison a key liberal priority — a full-blown government-run insurance option — Senate Democrats woke up Wednesday to some positive signs for the fragile coalition backing President Barack Obama's health care bill.

A much-courted moderate — Connecticut independent Sen. Joe Lieberman — signaled he might be able to live with a compromise to offer private insurance plans under the auspices of the federal employee health program while also allowing middle-aged people to buy into Medicare. Liberal Democrats also spoke out in favor of the idea.

"I am encouraged by the progress toward a consensus," Lieberman said in a statement that also underscored his opposition to any new government insurance plan that would compete with private carriers.

Meanwhile, former presidential candidate and one-time Vermont Gov. Howard Dean said the Medicare option for people age 55 to 64 was "a positive step forward."

Dean, a physician, has been one of the most vocal supporters of the idea that the government should get into the health insurance market. But as it became increasingly clear in recent weeks that a new government insurance plan did not command the necessary votes in the Senate, Dean contacted Majority Leader Harry Reid and Sen. Charles Schumer, D-N.Y., to offer the Medicare expansion as a way forward.

"Using Medicare makes more sense than reinventing more bureaucracy," Dean said Wednesday on CBS' "The Early Show."

Rep. Anthony Weiner, a vocal New York liberal who has strongly supported a public insurance option, issued a statement calling the Medicare expansion "one idea I like a lot."

However, as the Senate continued to debate, the American Hospital Association and the American Medical Association — both groups that have been generally supportive of Congress' health overhaul efforts thus far — raised red flags. Both groups are concerned about adding more patients to Medicare, because the program pays providers significantly lower rates than private insurers do.

"The AMA has long-standing policy opposing the expansion of Medicare given the fiscal projections for the future," said the group's president, Dr. James Rohack. "We believe a health insurance exchange without an expansion of Medicare will provide more affordable choices and better access to care for Americans ages 55-64."

A powerful small business group also swung into opposition. The National Federation of Independent Business, which was instrumental in defeating then-President Bill Clinton's health care bill in the 1990s, said the Democratic bill would raise costs and make it harder to create jobs.

"Despite the inclusion of insurance market reforms in the small-group and individual marketplaces, the savings that may materialize are too small for too few and the increases in premium costs are too great for too many," NFIB vice president Susan Eckerly said in a letter to Senate leaders.

Nonetheless Reid, D-Nev., was upbeat about the bill's prospects.

"We've overcome a real problem that we had," Reid said in announcing what he called a "broad agreement" Tuesday night.

Officials said it included nonprofit national health plans administered by the Office of Personnel Management, which runs the popular federal employees' health plan, as well as the idea of opening Medicare to uninsured Americans beginning at age 55, effective in 2011.

Greater government involvement would potentially kick in if private insurance companies declined to participate in the nationwide plan. If they didn't, one possibility was for the personnel office to set up a government-run plan, either national in scope or on a state-by-state basis.

"I think when people see this they'll really like what we've done," said Sen. Mark Pryor, D-Ark., who was among five moderate senators who spent several days negotiating with five liberals led by Schumer. Reid planned to describe the plan in greater detail after getting a cost analysis from the Congressional Budget Office.

White House spokesman Reid Cherlin said, "Senators are making great progress, and we're pleased that they're working together to find common ground toward options that increase choice and competition."

The Senate is in its second week of debate on the 10-year, nearly $1 trillion legislation that would dramatically remake the U.S. health care system and extend coverage to millions of the uninsured, with a new requirement for nearly everyone to purchase insurance. New purchasing marketplaces called exchanges would make it easier for small businesses and people without government or employer coverage to shop for health insurance, and unpopular insurance company practices such as denying coverage to people with pre-existing medical conditions would be banned.

The deal reached Tuesday would put even more requirements on insurers by requiring that 90 percent of premium dollars be spent on medical benefits, as opposed to administrative costs, officials said. The officials who described the details of the closed-door negotiations did so on condition of anonymity, saying they were not authorized to discuss them publicly.

Reid wants action on the health bill by Christmas, but more challenges lie ahead. On Wednesday, senators began debating an amendment by Sen. Byron Dorgan, D-N.D., to legalize the importation of prescription drugs from Canada and several other countries as a way of holding down consumer costs. The idea enjoys widespread support but is opposed by the pharmaceutical industry, which has worked closely with the administration on health care and has spent millions of dollars on television advertisements in support of legislation.

The Food and Drug Administration issued a letter saying it would be "logistically challenging" to assure the safety of imported drugs, raising concerns without stating outright opposition.

Underscoring the heated emotions surrounding the government insurance plan, Reid refused to acknowledge its demise, contending that reports it was gone were "not true."

In a statement, Reid said the emerging compromise "includes a public option and will help ensure the American people win in two ways: one, insurance companies will face more competition, and two, the American people will have more choices."

SirNitram wrote: Expecting the Senate not to eviscerate any good bill is like expecting Magi to devote himself to a life of pacifism above all else. 'Supposed to'? It means nothing with the reality of the situation.

SirNitram wrote:I have no interest in having a Public Option that crippled, weak, and pathetic, just to appease the promise of two words slapped on. Expecting the Senate not to eviscerate any good bill is like expecting Magi to devote himself to a life of pacifism above all else. 'Supposed to'? It means nothing with the reality of the situation.

The Cleric wrote:Insurance, at it's core, is a risk spreading operation. I am low risk, and don't really enjoy being forced to shoulder the burden of high risk individuals :/.

The Cleric wrote:If I'm not able to afford the basic medical costs of living, then there is only a VERY slim percentage of the US population that is.

Medical problems caused 62% of all personal bankruptcies filed in the U.S. in 2007, according to a study by Harvard researchers. And in a finding that surprised even the researchers, 78% of those filers had medical insurance at the start of their illness, including 60.3% who had private coverage, not Medicare or Medicaid.

Medically related bankruptcies have been rising steadily for decades. In 1981, only 8% of families filing for bankruptcy cited a serious medical problem as the reason, while a 2001 study of bankruptcies in five states by the same researchers found that illness or medical bills contributed to 50% of all filings. This newest, nationwide study, conducted before the start of the current recession by Drs. David Himmelstein and Steffie Woolhandler of Harvard Medical School, Elizabeth Warren of Harvard Law School, and Deborah Thorne, a sociology professor at Ohio University, found that the filers were for the most part solidly middle class before medical disaster hit. Two-thirds owned their home and three-fifths had gone to college.

But medically bankrupt families with private insurance reported average out-of pocket medical bills of $17,749, while the uninsured's bills averaged $26,971. Of the families who started out with insurance but lost it during the course of their illness, medical bills averaged $22,658. "For middle-class Americans, health insurance offers little protection. Most of us have policies with so many loopholes, co-payments, and deductibles that illness can put you in the poorhouse," said lead author Himmelstein. "Unless you're Warren Buffett, your family is just one serious illness away from bankruptcy."

The study underscores President Barack Obama's arguments in calling for health-care reform legislation this year. In a letter to Democratic Senate leaders this week, the President said: "Health-care reform is not a luxury. It's a necessity we cannot defer. Soaring health-care costs make our current course unsustainable. It is unsustainable for our families, whose spiraling premiums and out-of-pocket expenses are pushing them into bankruptcy and forcing them to go without the checkups and prescriptions they need."
Highest Costs for Diabetes, Neurological Illness

The study was funded by the Robert Wood Johnson Foundation and published online June 4 by the American Journal of Medicine. It will appear in the Journal's August print edition. The researchers examined the court records of a random sample of 2,314 bankruptcy filings across the nation during early 2007, and also contacted those filers for written explanations. The researchers then followed up with extensive phone interviews of 1,032 of those filers.

They found that a number of medical factors contributed to a family's financial disaster. More than 90% of medically related bankruptcies were caused by high medical bills directly or medical costs that were so high the family was forced to mortgage their home. The remaining 8% went bankrupt because a medical problem caused them to lose income. The authors were not able to track credit-card defaults caused by medical bills, but a 2007 study found that, of low- and middle-income households with credit-card debt, 29% used their plastic to pay off medical expenses.

Individuals with diabetes, one of the most common chronic diseases in the U.S., and those with neurological illnesses such as multiple sclerosis had the highest costs, an average of $26,971 and $34,167, respectively. Hospital bills were the largest single expense for half of all medically bankrupt families.

Dr. Woolhandler, an advocate of a single-payer health-care system, said lawmakers in Washington should reconsider health-care reform in light of the study. "Covering the uninsured isn't enough," she said. "Reform also needs to help families who already have insurance by upgrading their coverage and assuring that they never lose it."

frigidmagi wrote:I'll back this, but I would like to note I am getting damned tired of being told to take one for the team. In fact I'm starting to wonder if anyone else besides me and mine are gonna take one.