Smith wants more savings in health bill

BRAD SHANNON; The Olympian | • Published September 11, 2009

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U.S. Rep. Adam Smith said President Barack Obama did a good job of talking about those who have health insurance and are at risk of losing coverage during his speech Wednesday night.

But the Tacoma-based Democrat, who serves Washington’s 9th Congressional District, told The Olympian’s Editorial Board on Thursday he thinks the House reform as written in House Resolution 3200 is a “failure” and “deeply flawed.”

“It simply doesn’t do enough on the cost-control side,’’ Smith said, speaking by telephone from Washington, D.C.

Smith said the reforms need to shift the focus of payment in Medicare and Medicaid away from fee-for-services “and start actually paying based on the quality of the service instead of the quantity.”

Smith, who supports a government-run or public option, for those who cannot find insurance on the private market, said he expects a “Plan B” to emerge in the next couple of weeks that is more acceptable and said he expects a House vote on reform in October.

He cited Group Health among organizations that have made that kind of switch, which lowers costs and improves the quality of care, he said.

“We are not going to be able to provide universal access in any meaningful way unless we change those perverse incentives,” Smith said.

He gave the example of a man with breathing problems that led to $35,000 in tests that could have been avoided if the primary-care doctor had had more time to talk to the patient and learn of an environmental trigger behind the illness.

Smith said he also was impressed when Obama talked about making sure that if cost savings don’t materialize, spending cuts will be made.

Smith sounded receptive to a few ideas that minority Republicans have advanced. He said people need to be able to buy insurance policies issued across state lines and that he welcomes a look at medical malpractice, which he sees as a contributor to defensive medical costs. U.S. Rep. Brian Baird, D-Vancouver, said during an Olympia forum recently that he also wants to look at easing the purchase of policies from other states.

Smith’s overall praise echoed the comments of several Northwest Democrats in Congress after Obama’s speech. Republicans were more guarded, including U.S. Rep. Dave Reichert of Auburn, who faulted Obama for not saying more about how he would pay for the reform, which Obama estimated will cost $900 billion over 10 years.

“I’m pleased the president focused on the need for access to affordable health care for all Americans, especially those looking to purchase care outside of what their employers or the government provides,” Reichert said in a statement, adding, “I am also pleased the president answered the call for medical malpractice reform.”

Smith repeated his call from August for Obama to lay out his own reform legislation. Smith said he puts more faith in the White House than in congressional leaders to get the needed changes.

Smith said efforts by fellow Rep. Jay Inslee, D-Bainbridge Island, offer hope of containing health care costs but don’t go far enough. Inslee negotiated an agreement with seven other lawmakers at the request of Speaker Nancy Pelosi for reforming the way health care is paid for.

One piece, if adopted as an amendment to the reform bill, orders a national advisory group, the Institute of Medicine, to develop a different payment model and recommend changes to Obama’s secretary of human services in two years. Smith said the flaw is that the agreement does not require the new payment system to take effect, and he fears it could be dropped if the secretary of human services finds that the recommended changes are too politically hot.

A second major piece of Inslee’s agreement, which Smith supports, would fix the historic disparity in federal health care payments to providers in low-cost states such as Washington that get far less for the same medical work as high-cost states such as Florida or New York.

Brad Shannon: 360-753-1688

bshannon@theolympian.com

www.theolympian.com/politicsblog

‘Tea Party’ rally set for Saturday

Another “Tea Party” rally is set for noon Saturday on the state Capitol steps. It will target President Barack Obama and majority Democrats’ health reforms.

Sponsor Ken Morse of Olympia said he wants to do more educating than protesting this time.

“We’re actually trying to offer some positive alternatives,’’ Morse said Thursday, citing his interest in limits on tort claims to reduce the costs of defending medical-malpractice claims.

His Web site, www.olympiateaparty.com, also mentions health-savings accounts and freeing consumers to buy insurance policies from out of state.

It’s the third “Taxed Enough Already” rally at the Capitol since April 15, and one of as many as a dozen statewide Saturday; others will be in Anacortes, the Tri-Cities, Burlington, Okanogan, Vancouver and Monroe. Olympia’s will feature a talk by Dr. Roger Stark, who opposes the public option that Obama and other Democrats want for those who can’t get insurance.

Morse declined to predict the size of his event but said he’ll be “happy as a clam” if it draws 500 people.