Enzi health care proposal likely to enter national dialogue

Wednesday, August 01, 2007

By Ben Cannon

A major healthcare reform proposal introduced by Wyoming U.S. Senator Mike Enzi is likely to gain a momentum in a national debate as the country focuses on a flawed healthcare system and moves toward an upcoming presidential election.

In mid-July, Enzi, the state’s senior Republican senator, unveiled “10 Steps to Transform Health Care in America,” a measure that, if passed in totality, would massively reform healthcare coverage and enable new insurance opportunities for many of the nation’s estimated 46 million uninsured people. 

“I’ve studied … other proposals very carefully and you will see I’ve included many of the key concepts of those other proposals in the Ten Steps,” Enzi said on the Senate floor during the proposal’s announcement speech.

Enzi – formerly chair of the Senate’s Health, Education, Labor, and Pensions (HELP) and now a ranking minority member – is, along with Sen. Ted Kennedy (D-Mass.), perhaps one of the most influential lawmakers in the realm of healthcare, an issue that polls show Americans are increasingly concerned about and one that presidential candidates will have to address seriously as January’s Iowa Caucus approaches.

The Enzi plan, currently the only major introduced healthcare reform proposal floating around Capital Hill, is unique in that, unlike the failed immigration reform act, the “Ten Steps” can be voted on and adopted individually.

“This is not an all-or-nothing plan,” said Enzi spokesperson Elly Pickett. “They can be passed altogether as one big package or on a step-by-step basis.”

The Enzi plan can be characterized by its emphasis on routine care as preventative treatment, its approach to allow broader, market-based insurance pooling across state lines, and its tax treatment equalization that would allow more options for people to put credits where they choose, even away from Medicare and Medicaid and into privatized coverage.

Additionally, the proposal aims to overhaul health information technology (HIT) and create a nationwide network that would improve and expedite treatment, saving along the way what some projections put at trillions of dollars in a matter of years.

“What [the Enzi plan] is doing is broadening availability to 46 million uninsured, and I think that’s a good thing,” St. John’s Medical Center CEO Jim Schuessler said on Tuesday. “It’s a very major initiative that emphasizes preventative services, comprehensive management of chronic illness, and better coordination of health information technology.”

Part of the Enzi proposal addresses rural health care, not an issue unique to Wyoming per se, but one almost unheard of in large swaths of the country.
“Of course there’s [a degree of] Wyoming focus, but the Senator also had to think nationally,” Pickett said. 

“I think the primary thrust of this initiative is to close the gap between the uninsured and those who have access,” Schuessler said. “It doesn’t make a difference if it’s rural or in an urban setting.”

Schuessler explained that the Jackson Hole hospital he oversees is somewhat unique – no surprise – given the rather affluent demographic it serves. That helps situate Teton County’s lone hospital in a financially enviable position where the services it provides, particularly emergency room care, are not strained by a disproportionate number of uninsured patients.

The Enzi proposal, though, suggests a reduction in reimbursement monies to hospitals that do see high numbers of the uninsured, who often seek out and are given treatment in an emergency room, where care is significantly more costly than in an office or clinical setting. An email from Enzi’s office said that “as the bill significantly lowers the number of uninsured patients in the U.S., the amount of payments to offset costs for treating uninsured payments would also decrease.” It is was not made clear if those reimbursements would be kept proportional to the current payment structure.

Sen. Kennedy, who chairs the HELP Committee, will have to make a motion to bring Enzi’s Ten Steps to the Senate floor. That move is expected to come sometime after Congress’ August recess.

In the meantime, Sen. Enzi is seeking co-sponsors on the bill proposal, likely looking to assemble a cadre of support across party lines.

It is not yet clear what partisan obstacles might stand in the way of the major reform measure, but given Sen. Enzi’s prominence and experience in health care legislation (he has a team of specialists devoted to health care issues on his staff), the debate will likely gain momentum when Congress reconvenes and healthcare stakeholders, media and other legislators begin to chime in and take sides on the matter.

“I do think there seems to be a readiness in America today to reconsider the status quo as it relates to access to health insurance and the access it provides to routine care,” said Schuessler, who expects the American Hospital Association might endorse the proposal  for its overlap with many of the group’s established objectives. “I’m not an expert on the national politics of health care but there is a sense that we can do better than we’ve done up to now.”
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Enzi health care proposal likely to enter national dialogue | Planet JH News Article: General Health And Fitness

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