If Republicans and moderate Democrats in the Senate decide they want to spend hundreds of billions on a health-industry reform proposal (and that is a big and unpleasant “if”), then it’s going to be more or less the Baucus plan they sign on to.
You can find an 18-page summary outline of the plan here, courtesy of Politico. An informal straw poll concluded that the average, reasonably intelligent person’s eyes glaze over at about page 12. Try it for yourself!
Seriously, though, Max Baucus is probably the senator with the best grasp of the health-care industries and the flaws of the current system. He has been conducting Finance Committee hearings on the matter, preparing for this endgame, since what seems like the dawn of time (see the Columbia Journalism Review’s 13-part “Baucus Watch”). His plan consequently has a great deal of oomph and a pleasing number of specifics.
There’s plenty to discuss, but a few things that stand out are efforts to:
* Liberalize the sale of insurance. The bill allows the interstate sale of insurance plans. No doubt this would add flexibility for consumers. It would be contingent on states’ compact-making with one another, which might prevent a more raucous national system of the type that has led Delaware and South Dakota to be leaders in credit and banking. The plan would also create “exchanges” in each state that would make it easier for consumers to know just what is on offer in their states and to purchase their desired plan.
* Mandate health insurance for everyone. Subject to penalty, individuals must buy some plan that covers at least 65 percent of medical costs. The only exception is young adults, who could buy a plan without “catastrophic” coverage. There is no out-and-out employer mandate, and so individuals would really be the focal point of this requirement.
* Implement Co-ops. The plan hopes to allay fears of both Left and Right by mandating that 1) no company in the health-insurance business as of today can form a co-op, and 2) that no form of government, federal, state, or local, can be involved in running a co-op. They’d have to be financially self-sufficient after the first year of operation — that is, after they receive a huge chunk of government money.
* Emphasize prevention and wellness. This approach to cost-saving has long been Max Baucus’s hobbyhorse, and a Bozeman conference on preventive medicine and incentivizing healthy lifestyles was the most notable item on Baucus’s calendar while he was at home in Montana during the August recess. Among other mandates, Medicaid and Medicare could no longer exclude subsidies for patches and medicines to encourage smokers to quit, and enrollees of government plans would receive some sort of incentive for staying healthy.
Despite his chronic inability to comport himself with grace in front of cameras, Baucus shows impeccable political timing, as ever. Here he is, on the eve of Obama’s get-’er-done harangue to Congress, vertically inserting a detailed point-by-point into a Senate hungry for a moderate path. If liberal Democrats insist on a public option that is not a co-op, I bet they’ll take their battle to the conference committee.
–Travis Kavulla is a former associate editor of National Review and author of a profile of Sen. Max Baucus (D., Mont.) that appeared in the Sept. 7 issue.






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