Senate Finance bill will become the centerpiece of reform

The health care reform bill being crafted in the Senate Finance committee, chaired by Sen. Max Baucus, will become the core of whatever bill ultimately passes both houses of Congress. We will all need to read the bill (I haven't started yet) so that we know for ourselves what the bill puts forth, rather than trusting the pundits to explain it for us.

By now everyone should realize that virtually everyone has an axe to grind when it comes to health care reform. You're not going to get a straight presentation from any major information outlet. So read the bill for yourself.

What I have picked up from reading the Wall Street Journal (still, in my mind, the most objective and accurate reporting on health care reform), as well as other news sources, is that the Finance bill has effectively killed the public option. As I have said before, I think that's a good thing, because the public option was going to start at Medicare payment rates. Most physicians aren't very good businessmen, but those who are will undoubtedly have refused to contract with the public option plan. They are already losing money on Medicare patients and can't afford higher volumes of patients at those payment rates.

Hospitals are even less adept at business than physicians, so most of them probably would have signed on with the public option. The hospital where I work is losing money on Medicare patients. For every dollar we spend to care for a Medicare beneficiary, the government is reimbursing us 90 cents. We can't afford more health insurance plans that pay at Medicare's rates.

Nancy Pelosi and other liberal Democrats will raise cain over the Senate's rejection of the public option, but in the end they will not be able to reverse the direction that Congress is moving.

There is a moderate possibility that the public option will be retained as a "trigger" option; that is, the public option will be retained in reserve and will be activated if the market fails to provide an acceptable level of coverage at a reasonable price for lower income individuals. I would support using the public option as a "poison pill" of sorts. Without the threat of austere action, the players in the health care market will not be sufficiently incentivized to produce the necessary reductions in cost (and economic profit) required to bring health care spending in line.

Let me be so bold as to suggest that you write your senators and ask them to support a delayed public option health plan to be activated only upon the failure of the market to generate the necessary reforms.