Video: What’s next for anti-trust?

  1. Closed captioning of: What’s next for anti-trust?

    >> now, florida democratic congresswoman debbie schultz , and connecticut governor richard bloomenthal, a leading advocate for health care reform and the establishment of competition and choice for all americans, which we've all been deprived of, even if we didn't realize it, in many cases, going back to 1945 . thank you for making the time for us.

    >> you're welcome.

    >> what happens next?

    >> i think it's interesting to note that in the judiciary committee yesterday in the house, which as you noted, is extremely partisan normally, the three republicans that voted for the repeal of the anti-trust exemption for the insurance industry run the gamut of the philosophical spectrum. it's really emblematic of the widespread support there is for repealing the exemption, but also the fact that it's really hard to say that price fixing and collusion is something that a member supports. we need to make sure that he we get this done.

    >> i see this as indicative of some bigger issues, whether we talk about the banks, health care , it's clear there are policies in place that are unfair and anti-competitive in this country. this, perhaps, being the most ovs one. but, again, if you look at the lack of choice for employer health care , all the loop holes to put all those on an exchange. we're not saying don't do it. people are saying why don't you want to do it in public? why is it so difficult to get our government to simply nand t demand restoration of democracy? so that secret dealings can't put us to the brink of disaster. why is this so difficult, i guess, is my question?

    >> the insurance industry is a very powerful lobby. they have a stranglehold on the process in a lot of places and they've had this exemption for a long time. it's interesting that their defense is that we're not engaged in anti-competitive behavior, so this is a solution that's seeking a problem, nothing could be further from the truth. when you look at the statistic that senator schumer threw out yesterday where 40 states have only two insurance companies that control more than 50% of their market. market share control, price fixing and when we pass health care reform , we're going to create an exchange that allows for the true free market to fully engage and bring prices and more choice to consumers.

    >> right. the problem, of course, right now is that that exchange is only accessible to 10% of the population. what kind of a market is it if you make it illegal for most people to go there?

    >> no, no. the exchange will be available to for more than 10% of the people.

    >> no, that's not true.

    >> it is true.

    >> look at 85% of the people, right? go ahead, i'm sorry.

    >> no, that is true. we are -- our goal is to make sure that everyone gets coverage. again if you like the coverage you have now, if your employer is providing you with that coverage, then in the house bill you can keep that coverage.

    >> but i can't switch. but i can't switch. i can keep it and i appreciate that opportunity but right now i'm a ge paying for a fen om nolly expensive plan. i can't do that under this current reform.

    >> what will happen is that the same reforms that we're passing in the house bill will apply to those insurance policies . so, they can't be dropped for having a pre-existing condition. the coverage becomes portable. they can't charge premiums based on your gender or where you live. there will be significant reforms put in place that even those policies, prices will begin to come down and the choices will be more competitive.

    >> i compliment you on all of that.

    >> thank you.

    >> i would encourage the exchange to be available to everybody as opposed to a select few. richard bloomenthal, attorney general

updated 10/22/2009 1:21:55 PM ET 2009-10-22T17:21:55

House Democrats have reached a deal on Medicare payments that will secure critical support from heartland and Pacific Coast lawmakers for President Barack Obama's goal of revamping health care.

The agreement announced Thursday holds the promise of changing the way Medicare pays hospitals and doctors, to reward quality care instead of the sheer volume of tests and procedures. It also would address geographic disparities that lawmakers say penalize hospitals and doctors in certain areas. With hundreds of billions of dollars at stake, it would rely on recommendations from neutral experts to drive sweeping changes.

The announcement came as House Speaker Nancy Pelosi, D-Calif., is putting the finishing touches on a revised health care bill to cover the uninsured and try to rein in medical costs, delivering on Obama's top priority. The Medicare agreement is incorporated in the legislation.

"There is nothing tougher to deal with in Congress than a formula fight. This has been a strategy to avoid that kind of fight," said Rep. Dave Obey, D-Wis. "The end result is that Medicare will reimburse on the basis of quality, not on the basis of how many votes each faction has."

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At issue is an old problem with the government's health care program for seniors and disabled people. In some states, Medicare recipients get quality care at lower cost than in many other places. But hospitals and doctors in frugal states aren't rewarded. Instead, they make less money per patient than providers in higher-cost areas where the medical care is no better, and sometimes worse.

The deal with Pelosi attempts to address the disparities without busting the budget.

Video: Are women making themselves sick? It calls for two expert studies on changing how Medicare pays hospitals and doctors. One would address geographic differences in payment. A second — and more crucial one — would reset how Medicare pays hospitals and doctors to reward quality, not just volume. The studies would be carried out by the Institute of Medicine, which is affiliated with the National Academies of Science.

The institute's recommendations could not lead to an increase in total Medicare spending. They would be carried out unless Congress objects.

The deal was announced by 15 lawmakers representing states from Michigan to Washington. They called it essential to their support for a health care overhaul, and one warned the Senate that it must be included in any final legislation.

The lawmakers said they had been concerned that a government-run insurance plan called for in the House bill would only make matters worse. In the House bill, the public plan's payments to hospitals and doctors would be based on existing Medicare rates. Without any changes, the lawmakers worried that low reimbursement levels could force some hospitals in their districts to shut down.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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