Sen. Max Baucus, chairman of the Senate Finance Committee and one of the most influential voices in
He said that he planned to introduce a bipartisan bill with Sen. Charles E. Grassley (R., Iowa) that would adopt a mix of public and private solutions and that he hoped 70 senators would approve it.
"Enacting comprehensive health-care reform . . . is my top priority," said Baucus, a Montana Democrat. "So much that my office wonders whether I spend enough time on other matters. I want to make sure it passes this year" and is phased in over two or three years.
Baucus said passage last month of CHIP legislation insuring 11 million more children, followed by health provisions in the recent stimulus bill, was the beginning.
"Now it's time to move from first steps to giant steps," he said. "There's never been a better moment. The stars are all aligning. . . . I don't know if any president has been as committed as President Obama."
Baucus said it was too early to be specific about exactly how things would work under the legislation. He spent last year holding hearings and writing a white paper, "A Call to Action," which he said was similar to Obama's and close to the new
"We got a huge mess on our hands," he said. "Everything's got to be on the table - everything."
Baucus spoke to reporters - live and via the Internet - at the Kaiser Family Foundation in
"I do not want to eliminate that deductibility to companies," he said. "But I do think it should be trimmed or limited. It's regressive. It skews the system."
The biggest opportunity, he said, would lie in reforming payments so they rewarded quality care. "How we pay for what we get - that's where the reform has to be," he said.
Mark Pauly, a professor at the University of Pennsylvania's Wharton School, said yesterday in an e-mail that "based on the state of the science, I do not think that America is yet ready to base payment on quality in many areas. This is an aspiration, not a policy."
Baucus said he wanted universal coverage, but not a single-payer system.
"We need to come up with a uniquely American solution, which is a combination of public and private," he said. "I think we'd be spending capital inefficiently to pursue single-payer. I think there should be choice, flexibility, in our reform package. This is not a single-pay country."
Health-policy analysts said yesterday they were not surprised by Baucus' remarks.
"All along Obama has been saying he's not going to go with a single-payer," said Robert I. Field, a health-policy professor at the University of the Sciences in
Not everyone has accepted this. Rep. John Conyers Jr. (D., Mich.) will visit Philadelphia on Saturday in support of H.R. 676, the National Health Care Act, which would create a single-payer, universal health-care system. Conyers will speak at 10:30 a.m. at
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