Health care blogger Maggie Mahar scrutinizes the Senate bill:

The current legislation goes a long way toward accomplishing the first goal by ensuring coverage for most low-income and middle-class families. The amended bill also makes medical bankruptcy unlikely: after 2014 insurers will not be able to impose annual or lifetime caps on how much they will pay out for an individual’s care.

But when it comes to addressing the other two goalsreducing costs and improving carethis will happen only if Medicare is allowed to pave the way.
The Senate bill calls for an independent Medicare Commission that would have the authority to cut waste, protecting patients from the risks of unnecessary care while simultaneously lowering costs. When the Senate HELP and Finance bills were merged, the Commission was neutered; for example, hospitals were exempted from cuts for ten years.

Now, however, an amendment introduced by Joe Lieberman, Jay Rockefeller and Sheldon Whitehouse would strengthen the Commission and let it use financial carrots and sticks to insist that hospitals begin providing better value for Medicare dollars.

Lieberman? Yes, the insurance industry does not object to letting Medicare rein in spending and improve care; after all, the private insurance industry doesn’t compete with Medicare. And so Lieberman, who some have begun to call the “Senator from Aetna,” is happy to help.

That said, this is an excellent amendment. Jay Rockefeller deserves a standing ovation for putting principles ahead of personalities, and teaming up with Lieberman in an effort to draw support from moderates.

Finally, and perhaps most importantly, keep your eye on premiums for older Americans. As the legislation now stands, both middle-class and upper-middle-class Americans in their late 50s and early 60s who don’t have employer-based coverage could find insurance totally unaffordable.

Follow up on that last point here.

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