Tucked away at the back of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 is a provision reminiscent of the oft-criticized health care working group headed by former First Lady Hillary Clinton. It appears to provide taxpayer financing for an advocacy group committed to universal health care in the United States.
The provision–titled “Health Care That Works for All Americans: Citizens’ Health Care Working Group (HCWG)”–will cost taxpayers $3 million a year during fiscal years 2005 and 2006.
The purpose of the HCWG is “to provide for a nationwide public debate about improving the health care system to provide every American with the ability to obtain quality, affordable health care coverage.” The HCWG is charged with holding hearings, sponsoring community meetings, making recommendations, and publishing a national report.
The HCWG is also supposed to “provide for a vote by Congress on the recommendations that result from the debate.” In other words, the HCWG, using tax dollars, will stir debate about universal health care, and then Congress will be pressured to vote on it.
Process and Timeline
The HCWG is required to hold hearings within 90 days of the appointment of its chairperson. Within 90 days of the completion of hearings, the group is to publish a report titled “The Health Report to the American People.” The report must include a summary of:
- health care services used by individuals;
- cost and effectiveness of health care services for different age groups;
- source of coverage and payment for health services;
- reasons people are uninsured or underinsured;
- health care outcomes and costs of treating diseases; and
- health care cost containment strategies.
The HCWG also is required to “prepare and make available to the public through the Internet and other appropriate public channels, an interim set of recommendations on health care coverage and ways to improve and strengthen the health care system based on the information and preferences expressed at the community meetings.”
The public then has 90 days to submit comments. Within 120 days of the end of the comment period, the HCWG must submit to the President and Congress a final set of recommendations. The HCWG differs from the Clinton health care task force in that it will include ordinary citizens’ input and has bipartisan support.
Within 45 days of receiving final recommendations from the HCWG, the President is required to submit a report to Congress containing “additional views and comments on such recommendations; and recommendations for such legislation and administrative actions as the President considers appropriate.”
Then, within 45 days of receiving the report submitted by the President, each of the following congressional committees is required to hold at least one hearing on the HCWG’s report and its final recommendations:
- House Ways and Means Committee
- House Committee on Energy and Commerce
- House Committee on Education and the Workforce
- Senate Finance Committee
- Senate Committee on Health, Education, Labor, and Pensions.
It is worth noting the law creating the HCWG looks somewhat like the strategy used to create the so-called federal medical privacy regulations, which actually authorized more than 600,000 entities to see Americans’ medical records without their consent. Those regulations were added to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) at a time when most people were focused on the medical savings account debate.
The privacy provision required Health and Human Services (HHS) to submit to Congress recommendations regarding medical privacy. Congress and HHS held hearings on medical privacy, but most of the hearings were stacked in favor of groups wanting greater access to patients’ medical records. HHS essentially ignored thousands of public comments when revising the final federal rule.
The Clinton administration’s health care task force was widely criticized, and eventually sued, for operating behind closed doors. The Bush administration’s HCWG process appears likely to be more transparent. The supporters of patient-driven health care can take some comfort in that promise.
Although not specified in the HCWG’s mandate, two policy questions will be critical for the group to address:
- Who should dictate patients’ health care choices: the government, health care professionals, or individuals themselves?
- Should Americans be forced to use taxpayer-financed health care, even if they choose and can afford to pay privately for health insurance and services?
Sue Blevins is founder and president of the Institute for Health Freedom in Washington, DC. Her email address is [email protected].