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Obama open to adding Republican elements to health bill

Move unlikely to sway the GOP

By Erica Werner
Associated Press / March 3, 2010

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WASHINGTON - President Obama said yesterday that he was open to four new Republican proposals on health care legislation, in a gesture of bipartisanship meant to jump-start his drive to overhaul the system.

Obama detailed the ideas, all of which were raised at a bipartisan health care summit last week, in a letter to congressional leaders. In a nod to his 2008 presidential rival, Obama also said he was eliminating a special deal for Medicare Advantage beneficiaries in Florida and other states that drew criticism at the summit from Senator John McCain, Republican of Arizona.

The proposals Obama listed are: sending investigators disguised as patients to uncover fraud and waste; expanding medical malpractice overhaul pilot programs; increasing payments to Medicaid providers; and expanding the use of health savings accounts.

“I said throughout this process that I’d continue to draw on the best ideas from both parties, and I’m open to these proposals in that spirit,’’ wrote Obama, who will make remarks today at the White House.

He rejected the GOP’s preferred approach of scrapping the existing sweeping overhaul bills and starting afresh with step-by-step changes.

“I also believe that piecemeal reform is not the best way to effectively reduce premiums, end the exclusion of people with preexisting conditions, or offer Americans the security of knowing that they will never lose coverage,’’ Obama wrote.

Obama’s announcement is not likely to win any votes from Republicans. Nor is there any guarantee that Democratic leaders will incorporate the administration’s suggestions in revised legislation. But it could give wavering Democrats political cover by showing the White House has been willing to compromise.

At its core the Democrats’ legislation would extend coverage to 30 million uninsured Americans over 10 years with a first-time mandate for nearly everyone to buy insurance and new requirements on insurers and employers. The package soon to reach the House, however, will be less expensive than the one that passed in November and will contain no government-run insurance program, making it more appealing to some moderates. Obama said he was open to these four GOP ideas:

■Conducting undercover investigations of Medicare and Medicaid providers to search for waste, fraud, and abuse.

■ Experimenting with specialized health courts as an alternative to jury trials in medical malpractice cases to cut down on defensive medicine. That idea has been promoted both by Democrats and Republicans.

The approach calls for an expert judge - not a jury - to hear the evidence and make a final determination in cases where a patient has suffered harm. Trial lawyers are strongly opposed to the concept.

■Obama also agreed that health savings accounts would be offered in new markets his plan sets up for individuals and small business to purchase coverage.

The president said he’s open to the tax-sheltered accounts, which go hand-in-hand with high-deductible policies. Premiums on those policies are lower than for regular insurance.

■Obama also suggested increasing reimbursements to Medicaid providers, a concern raised by Senator Charles Grassley, Republican of Iowa.

As expected, the changes did not appear to win over Republicans. Grassley said Obama’s willingness to include his idea didn’t change his opposition to the overall legislation. “There are other things more important,’’ like its lack of caps on liability damages and its inclusion of an individual mandate, he said.

Senator Lamar Alexander, Republican of Tennessee, said adding a few GOP ideas won’t sway Republicans: “This is not a car that can be recalled and fixed.’’

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