The past few weeks have seen a flurry of activity as health stakeholder groups have taken sides on health reform legislation.
The American College of Physicians, which represents 129,000 internists across the country, said the Democrats' so-called "Tri-Committee" health reform proposal, H.R. 3200, "is closely aligned" with its policies.
The bill includes "policies on coverage, workforce, payment and delivery system reform, primary care, comparative effectiveness research, and administrative simplification that are strongly supported by the College," ACP president Joseph Stubbs, MD, said last week.
However, the Pharmaceutical Research and Manufacturers Association (PhRMA), which represents drug and biotech companies, is opposed.
"We cannot support the Tri-Committee bill," said PhRMA Senior Vice President Ken Johnson, because it fails to encourage biomedical research and innovation. In addition, changes to Medicare Part D would "constitute a tax increase on seniors because of the resulting increase in their monthly premiums as projected by the Congressional Budget Office under similar proposals," he added.
The American Nurses Association, representing 2.9 million nurses in the U.S., supports a public option, but has not said whether it favors the Senate Health Committee proposal or the Tri-Committee alternative.
America's Health Insurance Plans, which represents 1,300 organizations providing coverage to 200 million Americans, said an expanded government-run plan would be tantamount to a "death spiral" for providers. That's because the healthcare system, especially hospitals, would be paid at Medicare rates plus 10%, an amount that doesn't come close to covering costs, said a statement from AHIP spokesman Robert Zirkelbach.
If employees now covered by commercial health insurance plans gravitate toward the public option, those left in private insurance would have to pay a lot more to cover the underpayments from the government plan. "And there would be fewer people with private insurance to offset these costs, causing premiums to increase even further," AHIP said in a statement.
The American Hospital Association favors health reform, and national health insurance for people who don't get it through their employer or qualify for other programs. But the organization has "serious concerns…about establishing a new public plan that could exacerbate the underpayment of providers by paying rates at Medicare or Medicaid levels."
The AHA points to a Medicare Payment Advisory Commission projection that hospitals will have a negative 6.9% Medicare margin in 2009, down from a positive 6.2% Medicare margin in 1999 "the lowest level in more than a decade."
Nationally, treating Medicaid patients resulted in a $10.4 billion shortfall in 2007.
The American Medical Association last week reversed its position opposing a public option, saying that it supports H.R. 3200 and urges its passage. "This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform," said AMA president James Rohack, MD.
Though groups have begun taking sides, more details are expected for each of the plans and the Senate Finance Committee plans to release its bipartisan bill in the next two weeks. That should change the healthcare reform landscape even more.