An overlooked piece of the U.S. health care reform debate is a side agreement in the works to reduce wasteful medical spending and promote more equal Medicare payments to doctors and hospitals in Washington state.
U.S. Rep. Jay Inslee, a Bainbridge Island Democrat from Washington’s 1st Congressional District, told The Olympian’s editorial board Wednesday that he helped negotiate the agreement at House Leader Nancy Pelosi’s request between House leaders and seven lawmakers from both high-reimbursement and low-reimbursement states on the Commerce Committee.
“This is a major improvement to the bill that we have,” Inslee told the board. “Nobody has written on this yet.”
He added that the agreement on Medicare still needs to be attached to House Resolution 3200, the major U.S. House reform measure on the House floor later this year, “but barring some changes that deal has been made.”
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Inslee’s stop at the newspaper came at the end of an August recess that saw him hold three town hall meetings, which he saw as constructive.
On Tuesday, he and other members of Congress return to work on the controversial health reforms that caused quite a bit of tumult in some town halls.
Locally, U.S. Rep. Brian Baird said he also thought his town hall in Olympia on Monday and another last week in Cowlitz County were a model for good discussions.
But back in the other Washington, it is unclear what reforms will pass. Inslee said H.R. 3200 overall is on the right track, because it provides greater access to quality care, bends down “the cost curve” of rising health care spending, and increases choices for consumers by giving a “public” insurance option.
He predicted the House would pass a bill similar to what has emerged from committee – but with his Medicare agreement added on the floor. That House bill then could meld with any Senate bill and go to President Barack Obama early next year.
Under the agreement Inslee helped broker with Rep. Charles Rangel of New York and others, the Institute of Medicine would study and recommend ways of improving care and changing the Medicare payment system to encourage better medical care.
This is meant to end incentives for doctors to order more tests and surgeries than needed simply because it’s profitable. This also would reward doctors for use of good treatments, Inslee said.
The Institute of Medicine is part of the National Academy of Sciences and has played a role in promoting quality improvements in medicine nationally.
Inslee’s negotiated agreement also calls on the secretary of the Department of Health and Human Services to revise the Medicare payment system to get rid of geographic inequalities that hurt doctors and hospitals in Washington.
Inslee said the state has been a leader in delivering higher-quality health care at lower costs, which has led to lower reimbursements than in other parts of the country.
For instance, Medicare spends about $16,300 a year on average to treat patients in Miami, double the $7,000 cost in Seattle, Inslee said. He pointed to a June 1 article in The New Yorker magazine that explored how the current reimbursement system has led to abuse in McAllen, Texas, where doctors order up many more tests and surgeries that often lead to worse outcomes than in other parts of the country.
Inslee said that without reform there already is a “hidden tax” of $1,300 a year on everyone who buys insurance. That tax is the cost shift from hospitals and doctors passing on costs of treating people who lack insurance or don’t pay bills.
On other topics, Inslee:
• Described passage of a climate-change and energy bill as key to keeping the U.S. competitive in a global race to create clean-energy jobs building electric cars, solar energy and wind generators, and development of lithium-ion batteries. He played a role in shaping the bill that passed the House earlier in the summer and could get consideration late in the month in the U.S. Senate.
“We are now engaged in a great race with the world to capture the economic growth potential associated with the new energy future,” he said. “This bill is essentially the starter pistol to get us started in that race. We do not have a month or two to waste in getting the U.S. started in this international race for these jobs of the future.”
Some business groups and Republicans have criticized the bill as a new tax and a drag on the economy, but Inslee said polls show the public supports the limits on pollution, making polluters pay and investing in high technology. Also, energy-intensive industries would get free permits that shelter them from costs under what he called the Inslee-Doyle amendment.
“I do not want to trade an addiction to Saudi Arabian oil for an addiction to Chinese lithium-ion batteries. That is the risk we face if we do not act,” he said. “If we miss this opportunity, China will not.”
• He said he is not planning another run for governor, but didn’t rule it out. He lost in the 1996 primary and said he would “consider” a run if Gov. Chris Gregoire decides not to seek another term.
Gregoire spokesman Pearse Edwards said Gregoire has filed papers to raise money for a third-term campaign, “holding her options open.” But she has not made any decision, he said.