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Health reform – when will the next shoe drop?

There are few Americans angrier or more frustrated than House and Senate liberals. They’ve made concession after concession on issues as dear to them as abortion, single payer, the public option, taxes on high income earners, and tougher regulation of insurers. And for what?
A bill widely applauded by Wall Street for it’s promise of millions more customers for the private insurers liberals believe are the problem, not the solution to our health care mess.
For now there us precious little the liberals can do about this. For now.
Later may well be a different story. I’d expect we have not seen the last of their efforts to alter the landscape, in fact the liberals will have learned their lessons well. The most important will be to avoid having to placate Nelson and Lieberman and Landrieu; if the Senate only needed 51 votes we’d have a very different health reform bill.
The obvious route is to use the reconciliation process to push thru legislation that wouldn’t survive the 60 vote test. I’d look for a requirement that the Feds negotiate drug prices for Medicare and lower payments for Medicare Advantage plans to start. These are both well within the boundaries of the reconciliation process and therefore will not need the support of any of the afore-mentioned Senators.
And it won’t stop there. There is a large and growing concern about the cost of entitlemt programs and Part D is particularly problematic. By attacking drug costs and thereby reducing Medicare’s future liability, liberal Democrats will make it very tough for their opponents to use the ‘big spender’ attack angle in November.

Joe Paduda is the principal of Health Strategy Associates




A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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