The Senate may have voted to move toward the final debate on health care reform legislation recently, but there are still huge obstacles in the road to final passage.

Note that both Independents in the Senate, Joe Lieberman of Connecticut and Bernie Sanders of Vermont, were needed by the Democrats to open the floor to debate. Certainly, all eyes will be on these two senators as the debate unfolds this month. Sen. Lieberman has stated that he won’t support reform if it includes a “public option” to allow the government to compete with private insurance firms in the insurance marketplace. Sen. Sanders has stated he won’t support reform without a “public option”. So the Democrats are stretched thin to meet the 60 votes required for passage.

As it now stands, the Senate bill is 2,074 pages long. It would cost American taxpayers (your children and grandchildren) $849 billion over 10 years. It supposedly will extend insurance coverage to an additional 31 million people through a “public option” and a mandate to require everyone to carry insurance. There will be a tax imposed on higher option “Cadillac” plans. And a new source of funding will raise Medicare taxes on every individual from 1.45 percent to 1.95 percent, which is usually deducted from our paychecks.

In addition to the two independent senators previously mentioned, three other moderate Democratic senators will be getting heavy lobbying: Sen. Ben Nelson of Nebraska, Sen. Blanche Lincoln of Arkansas and Sen. Mary Landreau of Louisiana. The Democrats will need all of their votes to ensure final passage, yet each moderate Democrat must be sensitive to the business interests in their respective states.

Let the debate begin.

While federal health care reform legislation still winds its way through the halls of Congress, it’s increasingly likely that some sort of bill will finally emerge for President Obama’s signature. We feel that the final bill will amount to tepid “health insurance reform” rather than sweeping reform of the American health care system.

What many people don’t acknowledge is that health care reform is already here and it directly affects physician investors involved with ambulatory surgery centers. ASC reimbursement rates have steadily declined during the past few years and more declines are planned unless our industry succeeds in convincing Congress to enact a “floor” for ASC reimbursement.

Please read “Health Care Reform: It’s Already Here” in the current issue of our quarterly newsletter, Point of View, Winter 2009.  It’s an excellent analysis of how our industry is already being impacted and how we can help educate legislators about the positive influence that physician-owned facilities have in the medical marketplace.

The simple fact is that true reform lies in the hands of the providers of medical care; government intervention is just going to complicate the market and drive up costs.

Nueterra Healthcare stands for the goals of true reform:

• Higher quality of care
• Lower costs
• Better access to care
• More efficient delivery of care

These are the points that politicians are talking about but will probably fail to address in “reform” legislation.  Meanwhile, we have been realizing them for a number of years.

If government wants to impact the medical system in a positive way then states need to do away with the limiting certificate of need laws and also start adopting policies that will make health care truly consumer driven.  Continue to let your legislators know the facts.

The inability of our politicians to reach a cross-party consensus on health care reform is enough to drive a person crazy. Just as the Democrats reached a vote in the House of Representatives on the health care bill, (House passes health care bill), the Republicans finally offered a proposal of their own, (Text of GOP Health Care Bill)

In reality the Democrats have some good ideas and the Republicans have some good ideas. Why can’t they come together a get something done that really would benefit the citizens of this country, or just leave the system alone?

What bothers me the most about the Democratic plan in the House is that it will eventually lead us to a government-controlled system while we watch the private system go by the wayside. In doing this, the next generations are going to be left with debts that they won’t be able to pay.

I’d encourage you to contact your legislators regarding the GOP plan and insist on the following five points:

• Put a cap on medical malpractice damages. Trial lawyers (who benefit from lengthy court battles) have consistently supported the Democrats and meaningful tort reform has always been out of the question as long as the Dems control Congress. Well, it’s time to stand up to the lawyers and put a limit on medical malpractice damages. The actual chances that a victim of lousy care would be shorted are actually very slim.
• Create real incentives for individuals to open health savings accounts. I’ve consistently maintained that the only real way to reform health care in to turn patients into intelligent consumers. This is just one way to empower patients.
• Allow insurance companies to sell their plans across state lines; it’s simply putting our free enterprise system to work.
• Allow trade associations and guild members the ability to band together and purchase group insurance.
• Create state-based high-risk insurance pools for individuals who have difficulty obtaining insurance coverage.

The GOP bill doesn’t include the prohibition against denying care for people with pre-existing conditions, nor does it require individuals to have insurance or employers to provide it.  While I agree with these positions, Republicans, nevertheless, should change their stance, because no bill stands a chance of passage unless it includes these particular points.

On the positive side, the GOP would not increase taxes.