April 29, 2009 / 11:46 PM / 10 years ago

US senators start writing healthcare overhaul bill

* Senators start fleshing out healthcare overhaul

* Proposals focus on improving care quality

By Donna Smith

WASHINGTON, April 29 (Reuters) - U.S. Senators leading the effort to revamp the U.S. healthcare system said on Wednesday they had begun fleshing out proposals aimed at improving the quality of care, but are leaving until later tough decisions on how to cover the uninsured and pay for it.

“Today we kicked off the process of writing a comprehensive health reform bill,” Senate Finance Committee Chairman Max Baucus said following a closed door meeting of panel members. The session focused on proposals aimed at changing the payment system for the Medicare program for the elderly.

Baucus, a Democrat, and Senator Charles Grassley, the top Republican on the panel, are pushing to draft far-reaching health reform legislation by June to try to get a final bill to President Barack Obama by the end of the year.

At Wednesday’s session, lawmakers looked at changing the payment structure of Medicare to reward quality rather than base payments on the number of services and procedures performed by doctors and hospitals. Baucus and Grassley said lawmakers were in broad agreement about that goal, but had a number of questions about implementation and regional impact.

The panel is focusing on the Medicare payment structure because changes in the government program can influence private healthcare providers.

Panel members are considering giving bonus payments to doctors and hospitals that deliver better care and keep their patients out of hospitals. They are also looking at better compensation for primary care doctors who oversee patient care and walk them through any treatments or procedures.

Other proposals would reward health care providers who adopt electronic health records.

Overhauling the $2.5 trillion U.S. healthcare industry to rein-in soaring costs and cover an estimated 46 million uninsured Americans is a top priority for Obama. And Democrats who control Congress have promised a bipartisan bill.

But the role of government in covering the uninsured and how it will pay for that are major sticking points.

The Finance Committee is set to tackle other aspects of the legislation later in May, including the politically explosive issue of whether a new government insurance program should be created to help cover the uninsured.

Many Democrats, including Obama, back the idea of a public plan that would compete with private insurers. Sixteen members of the Senate Democratic caucus on Wednesday wrote a letter in support of a public plan to Baucus and Senator Edward Kennedy, who also has a major role in writing the legislation as head of the Senate Health, Education, Labor and Pensions Committee.

“We need to provide quality, affordable coverage for the millions of Americans the insurance industry has failed and a public plan is the only reliable way to do just that, said Senator John Rockefeller, one of the senators signing the letter.

But Republicans and insurance companies oppose creation of a new public plan. They fear millions of people would drop their current policies and sign up for the government plan, driving private insurers out of business. The insurance industry prefers government subsidies to help people, who otherwise would not be able to afford it, buy insurance.

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