Consensus on health care still elusive in Congress

The White House tried ? and failed ? Thursday to cool fierce Republican opposition to its health care overhaul by announcing a $25 million preliminary program aimed at eventually revamping the nation’s controversial medical-malpractice legal system.

Republicans in Congress remained bitterly critical of Democratic health care efforts, while Democrats remained divided over how to proceed.

The malpractice plan was authorized by a two-page “presidential memorandum.” By early next year, selected states, localities and health care systems will get up to $3 million each for experimental projects aimed at better protecting doctors from frivolous lawsuits while assuring patients fair settlements in cases of malpractice.

Key Republican lawmakers scoffed.

Sen. John McCain, R-Ariz., called the plan “wasteful and unnecessary,” while House Republican Study Committee Chairman Tom Price of Georgia, a physician, said, “We don’t need to test the medical liability crisis; we need to end it.”

There continued to be little consensus on broader health issues. The day after Senate Finance Committee Chairman Max Baucus, D-Mont., offered a plan that he hoped would draw bipartisan support, few Democrats or Republicans were optimistic about finding common ground.

The Baucus plan, said House Minority Leader John Boehner, R-Ohio, “is the same big-government, costly approach the American people have already rejected.”

House Speaker Nancy Pelosi, D-Calif., reiterated her support for a government-run alternative to private insurance. The Baucus plan has no such “public option,” and instead proposes setting up nonprofit health care cooperatives at the state, regional or national levels.

Pelosi didn’t comment specifically on co-ops, but said firmly: “I fully support a public option. A public option will be in the bill that passes the House of Representatives.”

She also voiced concerns that the Baucus bill would impose too many burdens on the middle class. It would impose a 35 percent excise tax on insurers once the costs of their policies top $8,000 for individuals and $21,000 for families. Many Democrats, and some key Republicans, are concerned that those taxes will be passed back to consumers.

Baucus also found that one of his key goals had slipped away: finding Republican support. Among moderates who have sided with Democrats often on fiscal issues in the past, Sen. Olympia Snowe, R-Maine, a Finance Committee member, also voiced concerns about the middle class, while Sen. Susan Collins, R-Maine, said that while she was pleased that Baucus’ bill had no public option, she was worried that the package “does not do enough to lower health care costs for all Americans.”

In fact, she said, “some Americans could wind up paying more for their health insurance.”

Obama had hoped to get at least Republican sympathy with his malpractice proposal. When he spoke to a joint session of Congress last week, he said, “I know that the Bush administration considered authorizing demonstration projects in individual states to test these issues. It’s a good idea.”

The White House said Thursday that its program would have three goals: Put “patient safety first and work to reduce preventable injuries”; promote better communication between doctors and patients and make sure patients are compensated “in a fair and timely manner for medical injuries”; and reduce the number of frivolous lawsuits.

Two kinds of grants will be available: planning funds of up to $300,000 for one year to help design “models” to improve patient safety and make the medical liability system more efficient, and grants of up to $3 million each for up to three years for projects that are ready to go.

“Lots of states have bits and pieces of the puzzle. There are states with screening panels. There are states that have review processes,” Health and Human Services Secretary Kathleen Sebelius said at a White House news briefing.

“We think this is an opportunity to … look at what has had a proven effect lowering preventable errors; increasing patient safety, which is the number one goal; improving communications; and lowering costs. So we’ll share that data.”

Republicans want a more comprehensive overhaul of the liability system.

“We have demonstration programs: They are called Texas and California,” McCain said. “Both have enacted reforms that have reduced costs for patients and resulted in more doctors remaining in practice and more doctors serving as obstetricians, neurosurgeons and emergency room doctors. There is no need to ‘demonstrate’ that medical malpractice reform would benefit consumers.”

Democrats didn’t show much enthusiasm, either, nor did some interest groups often aligned with their party.

“The goals outlined by the White House ? such as reducing the number of injuries, fostering better communication, compensating patients quicker and reducing doctors’ premiums ? move the debate in the right direction,” said Anthony Tarricone, the president of the American Association for Justice, the major trial lawyers association.

He noted that 46 states have enacted tort revisions, and “because of these tort reforms, patients injured through no fault of their own are often unable to seek justice.”

(c) 2009, McClatchy-Tribune Information Services.