Common ground found on health care

Groups often at odds over health care reform - consumers, insurers, doctors, employers - reached a broad agreement Friday that could serve as a starting point for lawmakers trying to overhaul the system.

Although the long-awaited report of the Health Reform Dialogue avoided some of the most contentious issues, the agreement does have the kind of far-reaching support lawmakers will need to meet their goal of passing legislation this year.

“You can bet I’ll be working closely with these groups,” said Senate Finance Committee Chairman Max Baucus, Montana Democrat, who is trying to find consensus on Capitol Hill.

In their report, the groups said the uninsured should be covered through a combination of expanded government programs and subsidies to purchase private health coverage. They called for savings from making the health care system less wasteful and urged that prevention become the foundation for medical care. Many of their ideas are shared by President Obama and influential lawmakers such as Mr. Baucus.

But the five-page proposal was thin on details, starting with how to pay for the plan. And the groups avoided such divisive issues as whether insurers should be forced to compete with a new government-sponsored insurance plan, as Mr. Obama has proposed.

“What the agreement tries to do is achieve a balance for coverage expansion through the two key pillars of health care today,” said Ron Pollack, executive director of Families USA, a liberal advocacy group involved in the talks. “One is employer-sponsored private coverage and the other is safety-net coverage.”

The 18 groups met for six months. Along the way, two major unions pulled back from the table, but other groups representing seniors, businesses, nurses, drug makers and patients kept talking.

Participants included the National Federation of Independent Business and the health insurance industry, two players that were instrumental in sinking the last attempt at health care overhaul in the 1990s. Also participating are staunch supporters of guaranteed coverage for all, such as AARP and the American Cancer Society Cancer Action Network.

The Service Employees International Union and the American Federation of State, County and Municipal Employees took part in the talks but didn’t sign on to the agreement because some of their concerns could not be satisfied. That underscored the difficulty of getting a health care compromise.

The groups all but endorsed a requirement that every American obtain health insurance. While their agreement avoided the politically loaded term “individual mandate,” it said Congress should “enact reforms necessary so that all individuals will purchase or obtain quality, affordable health insurance.”

The agreement called for a two-prong strategy to cover the estimated 48 million uninsured. First, the Medicaid program should be expanded to cover all adults earning up to the federal poverty level, about $22,000 for a family of four. Then, subsidies or tax credits should be offered to help the middle class.

“I think what this document represents are some tough choices and some very tough consensus,” said Mary Grealy, president of the Healthcare Leadership Council, which represents the medical industry. “It tells Congress: here are some very important components for health care reform that you can now be assured have widespread agreement.”

The groups decided to sidestep the issue of whether to create a government insurance plan to compete with private companies. Mr. Obama and many Democrats, as well as union members and liberals, see that as an essential element of any final compromise. The insurance industry considers that a deal breaker.