Will Legislative Process End Health Care Harmony?

A key Senate committee will examine options to pay for an overhaul of the health care system. On Monday, the president met with leaders of the health care industry who pledged to reduce costs. Health care experts are trying to decide whether that deal represents an actual breakthrough — or a publicity stunt.

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RENEE MONTAGNE, host:

It's MORNING EDITION from NPR News. I'm Renee Montagne.

STEVE INSKEEP, host:

And I'm Steve Inskeep. Good morning.

Today we get a reminder, if any was needed, of the escalating cost of health care. President Obama's administration delivers a report on the financial status of Medicare. Without changes, the health program for seniors is expected to have a grim future.

MONTAGNE: For the administration's purposes, that bad news may be well timed. The president is pressing the health care industry to cut costs, and industry leaders are promising to try. Now health care experts want to know if that deal represents a breakthrough or a publicity stunt.

NPR's Julie Rovner reports

JULIE ROVNER: One by one, many of the groups who've killed health care overhaul efforts in the past made their way to the White House. There was the American Medical Association, which led the fight against Harry Truman's health plan. Also in the room were America's Health Insurance Plans and Pharma, the trade groups for the insurance and drug industries, respectively.

They were joined by leaders of the hospital industry, medical device makers, and the largest health workers union. Together the groups pledged to cut health care spending by $2 trillion over the next 10 years. President Obama seemed pleased by their effort.

President BARACK OBAMA: This is a historic day, a watershed event in the long, elusive quest for health care reform. And as these groups take the steps they are outlining, and as we work with Congress on health care reform legislation, my administration will continue working to reduce health care costs to achieve similar savings.

ROVNER: But there are already hard questions being asked about those savings. Most would come from things like computerizing medical records, coordinating care better for people with chronic ailments, and getting rid of care that's duplicative.

Mr. JOSEPH ANTOS (American Enterprise Institute): These are all terrific ideas, I hope they work. But you know the fact is that in many case, for example, health information technology, better coordination of care - those sorts of ideas, those ideas are we have been talking about literally for 20 years.

ROVNER: Joe Antos is a health care expert with the American Enterprise Institute.

Mr. ANTOS: So it seems implausible that after that much time talking about these things, working on them, to think that they're all going to finally come to fruition over the next few years, it strains the imagination.

ROVNER: The proposals the industry groups agreed to have something else in common. They basically don't ask any of the groups' members to make any real financial sacrifices. They simply rely on making the health care system more efficient. Antos says that's all well and good, but it's not where the real money is in health care.

Mr. ANTOS: The money is in the delivery of health care services. So if you want to save money, you have to somehow reduce the services that you deliver to people. Ideally the services that we might dispense with are the ones we don't need. But that's another thing we've been arguing about for a long, long time.

ROVNER: James Rohak, is the president-elect of the American Medical Association, one of those industry groups. He doesn't deny that the savings the groups are proposing to make aren't terribly controversial.

Mr. JAMES ROHAK (American Medical Association): Well, if you're going to harvest a tree, it's always good to get the low hanging fruit. But the difference is, is you're committed to making sure that all the fruit is harvested.

ROVNER: In other words, the groups are willing to see more in the way of savings, but Drew Altman of the Kaiser Family Foundation wonders how long all this togetherness on the part of very diverse health industry groups can really last once Congress starts the bill drafting process.

Dr. DREW ALTMAN (Kaiser Family Foundation): The big question is, when they put that legislation together and the industry sees the specifics of that legislation, will they still be at the table as supportive as they have been so far?

ROVNER: And there's another complication. Later today the Obama administration will issue the latest update on Medicare's financial situation. Last year, the program's trustees said the part of Medicare that pays for hospital and nursing home care would go broke in the year 2019. But with the economic downturn, says Antos, this year…

Mr. ANTOS: It's very likely to be 2015 to 2016, much sooner. And this is the sort of problem that can't just be papered over. We're going to have to deal with Medicare at some point very soon.

ROVNER: Which means Congress will have to find the money not only to pay for a health care overhaul but to shore up Medicare for the baby boomers, making a big price tag bigger still.

Julie Rovner, NPR News, Washington.

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