NU Online News Service, May 5, 2:48 p.m. EDT

WASHINGTON–Current efforts for health care reform could be derailed by proposals calling for a "public plan" coverage option and a federal health board, a conservative think tank representative told a Senate panel today.

Stuart Butler, a vice president of the Heritage Foundation, made his comments at a roundtable convened by the Senate Finance Committee on how health care should be delivered in a revamped health care system.

The proposals for a government health care plan in competition with private carriers and a federal health board to set treatment policy "are like nuclear land mines on the road to broad agreement," he said. "They could be lethal to the prospects for consensus and even to the passage of any significant legislation."

The roundtable is the second held by the committee. Sen. Max Baucus, D-Mont., chairman of the committee, said the third roundtable, on financing health care reform, would be held next week, followed by a so-called mock "markup" of health care reform legislation. Markup is the process by which a committee debates, amends and rewrites proposed legislation.

Actual drafting of legislation reforming the current health care system will be held by the committee in June, he said.

That will be followed by discussions with the Senate Health, Education, Labor and Pension Committee, which is drafting its own bill on consensus legislation that will be presented to the full Senate for action before the August recess, Sen. Baucus said.

In other comments at today's hearing, Karen Ignagni, president of America's Health Insurance Plans, argued that a new public plan "is not necessary to achieve successful health care reform."

She said it is important for policymakers to "consider the unintended consequences that could result from establishing a public plan to compete against existing private insurance plans" under a reformed health care system."

"To illustrate our concerns about how we move toward an integrated, high-quality health care delivery system under a public plan option, the committee should consider the success of the private market in offering innovative care management programs and the difficulty associated with achieving similar results in a new government plan," she said.

The BlueCross BlueShield Association submitted comments advising that insurers should partner with the government to ensure that everyone has coverage under a new health care system through several means.

Government should do this by expanding existing government programs where appropriate and by assuring that everyone ineligible for existing government programs can afford private coverage by building on the employer-based system with support for individuals who must have coverage but may have difficulty affording it, said BlueCross.

The association added that government should participate by assuring everyone can purchase health coverage regardless of health status with no variation in premiums based on health and by simplifying the shopping for and purchase of insurance through state-run online programs for comparing and purchasing coverage.

In arguing against a public plan, Mr. Butler of the Heritage Foundation said "the simple fact is that if the government is sponsoring a competition within an exchange, and also is the owner of one of the plans, there can be little doubt that the rules and regulations promulgated by Washington will favor the government-sponsored plan."

"A 'competing' public plan as a choice will inevitably become a public plan for all, and unacceptable," he said.

He also said creating a federal health board could undo any consensus. "It's one thing to have a body to spur and distribute cost-effectiveness research," he said. "It's quite another to have a board, as others have urged, that is not really answerable to anyone and starts to determine how medical care can be provided."

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