By Bill Bartel, The Virginian-Pilot
U.S. Sen. Mark Warner of Virginia is joining the debate on the Senate health care bill today , proposing with 10 other Democratic senators a package of amendments they hope will lay the groundwork for a shift from pay-for-service medical care to a system where payments are based on the quality and outcome of treatment.
It’s an effort, among other things “to bring price transparency to the system,” Warner said Monday. Some elements of their proposals are already included in the Senate and House bills; however, their amendments require speedier and more aggressive changes to get medical cost under control, Warner said. “We’re killing our economy.”
Much of the recent debate on the House and Senate proposals has centered on how to pay for health care reform, who should pay the bill, what procedures should or shouldn’t be covered, and the merits or flaws of a government insurance option.
The amendments developed by the 11 senators focus on requiring more accountability by creating new methods for collecting and comparing information on costs, treatments and outcomes. They would require Medicare, for example, to switch to a pay-for-performance method, rather than simply pay for services rendered.
If approved, Warner predicts consumers will be able to more easily compare prices and services to get the best value.
“What Travelocity and some of these sites did to airline fares, we hope to do with health care,” he said. “That got rid of the stuff in the market that doesn’t work.”
The amendments propose to simplify health care billings and information sharing by creating more universal standards and forms. They also propose to quicken the government’s reaction to reports of fraudulent claims.
“Right now they do pay and chase. They pay and chase later to catch the fraud,” said Aryana Khalid, a Warner aide specializing in health care. The amendments push agencies to stop mid-payment to investigate reports of fraud to catch abuses more quickly.
Joining Warner in proposing the amendments are fellow first-term Sens. Mark Begich of Alaska; Michael Bennet and Tom Udall of Colorado; Roland Burris of Illinois; Kay Hagan, of North Carolina; Ted Kaufman of Delaware; Paul Kirk of Massachusetts; Jeff Merkley of Oregon; Jeanne Shaheen of New Hampshire; and Mark Udall of New Mexico.
The group has been working on the proposal for months.
Warner said Monday that he’s not ready to say how he might vote on the entire Senate bill. Senate Majority Leader Harry Reid, D-Nev., who crafted the legislation by merging two other Senate bills, has said the debate, which began last week. could last until Christmas.
Warner said that to win his support it’s important that his amendment be included. He also restated Monday that his ''grave concern” with including a new government insurance option in the bill because of the long-term liability.
The senators’ amendments already are getting some support.
“I think it’s a good thing,” said Laurens Sartoris , president of the Virginia Hospital & Healthcare Association, based in the Richmond area. “It’s an effort toward actually reforming the delivery system.”
Sartoris said the House bill, HR3962, which passed that chamber this fall, and the Senate measure, HR3590, now being debated don’t adequately address the fee-for-service system that bases medical payments to doctors and other providers on what they do, not necessarily what is best for the patient.
The current system can penalize doctors financially, Sartoris said. Medical professionals “aren’t paid for doing better, they’re paid for doing care.”