March 2009 Archives

What must happen for employer mandates to be enacted?

Employer mandates, a staple of Democratic health care reform proposals, require employers to either offer insurance or pay into a fund for worker coverage. But some stakeholders and Republicans fear that the mandates give government too much power to increase the burden on employers later on, and leverage low prices from doctors and hospitals that make it hard for private plans to compete.

What is the biggest mistake that policy makers could make when it comes to employer mandates? What have we learned from the employer mandates in Massachusetts, and what could make these mandates a deal-breaker for reform?

-- Marilyn Werber Serafini, NationalJournal.com

10 responses: Newt Gingrich, Dan Danner, Len Nichols, John Sheils, Karen Davis, Marilyn Werber Serafini, Jason Rosenbaum, Denis Cortese, John C. Goodman, James P. Gelfand

Can Congress fashion a public health plan option so that it does not blow up health care reform this year?

Nearly all Democratic health reform proposals would create a public health plan that would compete alongside private insurers. The idea is for uninsured people to gain access to a variety of health plans, including one public plan option.

Many Democrats argue that a public plan would ensure that sick people have access to insurance, while Republicans and some interest groups counter that the public plan is a back door to single-payer, government-run health care. Republicans worry it would have an unfair advantage by price-setting.

Which is the truth, and is there an acceptable way to fashion a public plan? Why not do away with the idea?

-- Marilyn Werber Serafini, NationalJournal.com

17 responses: Scott P. Serota, Len Nichols, James P. Gelfand, Billy Tauzin, John C. Goodman, Jason Rosenbaum, Marian Wright Edelman, Denis Cortese, John Sheils, Karen Davis, Uwe Reinhardt, Stuart Butler, Celinda Lake, Grace-Marie Turner, Paul B. Ginsburg, Len Nichols, Karen Ignagni

Should the federal government tackle major Medicare reform this year, separate from the general health care reform legislation Congress is working on?

Partly due to the recession, insolvency of the Medicare trust fund may be only five years away, economists say. Medicare trustees will deliver their annual state-of-Medicare report shortly, and the numbers are expected to be sobering.

How serious are Medicare's financial problems? Can they easily be solved without jeopardizing the fundamental integrity of the program? What are the best and worst possible responses?

-- Marilyn Werber Serafini, NationalJournal.com

13 responses: Billy Tauzin, James P. Gelfand, Jason Rosenbaum, Nancy H. Nielsen, John C. Goodman, Karen Davis, Leonard D. Schaeffer, Drew Altman, Stuart Butler, Kerry Weems, Uwe Reinhardt, Len Nichols, John Rother

Ten years from now, what health care issue will you look back on and really wish we had paid more attention to in 2009? Childhood obesity? Medicare and other entitlement spending? Mike Leavitt, former Health and Human Services secretary, recently spoke about health entitlements with National Journal; watch his comments below.

-- Marilyn Werber Serafini, NationalJournal.com

8 responses: Drew Altman, Christine Ferguson, John C. Goodman, Uwe Reinhardt, Raymond C. Scheppach, Karen Davis, Jane L. Delgado, Gail Wilensky

What specifically do you like -- and dislike -- about the health components of the budget proposal that President Obama unveiled last week? Are certain provisions so controversial that they put bipartisan health reform efforts that have been blooming at risk?

Does the $634 billion funding figure represent a responsible offset for health care reform? (In his budget, Obama said that $630 billion is "not sufficient to fully fund comprehensive reform," and called it a "first crucial step").

The proposal raises some of the money by:

1. Reducing payments to Medicare Advantage insurance plans.

2. Requiring drug companies to increase rebates to Medicaid.

3. Give hospitals bundled payments so that those with high readmission rates will be paid less.

4. Reducing the itemized deduction rate for families with incomes over $250,000.

(We'll be discussing these issues Thursday at National Journal's Health Care Policy Breakfast, where Ron Brownstein and I will be interviewing a panel of experts, including Sen. Bob Bennett, expert blogger Karen Ignagni of America's Health Insurance Plans, and SEIU's Andy Stern. If you're interested in attending, you can register online.)

-- Marilyn Werber Serafini, NationalJournal.com

Updated at 3:31 p.m. on March 3.

7 responses: Jack Lewin, Sen. Max Baucus, D-Mont., Nancy H. Nielsen, Karen Davis, Leonard D. Schaeffer, John C. Goodman, Tom Miller