Health Care Reform Newsmaker Series: Sen. Max Baucus

Kaiser Family Foundation
May 21, 2009

John Reichard, CQ HealthBeat: I understood you to say, Senator, that you don’t expect to get to universal coverage, that you’re going to get it as close as you possibly can. Is that correct, and then, if so, what does that mean in terms of the ability to keep the health insurance industry at the table? You know, they’re saying that an individual mandate is necessary for guaranteed issue and rating reforms. Do those things then go away?

Senator Max Baucus: Oh, not at all. As a matter of fact, they’re very much there, and you’re correct in your sort of implications. A key to this is everyone having health insurance. It’s very, very hard to accomplish our objectives without everybody having health insurance. A primary objective is that everybody should have health insurance. That’s an objective in itself. Without that then… groups falling out, then it’s much more difficult to accomplish delivery system reform. We want the public and private health providers to be basically working together on delivery system reform. One way to get at that is to work with CMS.. work with the private sector. We want metrics, quality metrics so that CMS, Medicare and other providers are kind of working off the same page.

When I say we won’t get full universal coverage, CBO tells us we’ll get up to 94, 96 percent. There are always are going to be some people who just, you can’t find them, you know, don’t get health insurance. You never attain perfection. And this is going to be good. I think 94, 96 percent is pretty good. There will be, like undocumented aliens for example. We’re not going to cover undocumented… undocumented workers. That’s too politically explosive. But the main point that you want to make, the main point you are making is we will get near universal coverage. I like that word. Nearly everyone is going to have health insurance.

http://www.kff.org/healthreform/hr052109video.cfm

So according to Sen. Baucus, a key to reform is “everyone having health insurance.” By that he means that everyone will have health insurance – except the 12 to 18 million who won’t. That’s “pretty good,” he says.

Under single payer, instead of assigning an insurance product to each individual, everyone is automatically provided the health care that they need. They provide only their identification when they access care. Those individuals that you “can’t find” in advance will still receive care when they show up with medical needs. In a single payer system, everyone means everyone – no exceptions.

Injecting the immigration issue into the dialogue on health care reform is a very unfortunate diversion. Should undocumented immigrants be included? That happens to be an easy question for me. I’m a physician. Everyone who needs health care should get health care. Period.

There should never be any test applied to any individual that would disqualify him or her from receiving the health care that he or she needs. In my opinion, that includes immigration status, financial status, but especially the possession of an arbitrary document – a health insurance policy – that has a total disconnect with whether or not the person needs health care. Yet Sen. Baucus would use that “uniquely American” disconnect to leave about 15 million people out of the system, give or take a few million, even though that would cost more to do than to adopt a single payer system that would automatically include absolutely everyone.