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zoom RSS 皆保険に近づけながら10年で1兆ドルまで削減したバウカス案/医療制度改革 オバマ政権

<<   作成日時 : 2009/06/30 00:41   >>

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画像 上院民主党はほとんど全てのアメリカ人を保険カバーしながら、医療費の1/3以上を削減し10年間で1兆ドルとする方法が見つかったと木曜日に述べた。オバマ政権での一番の権威であるモンタナ民主党で上院財務委員長のマックス・バウカスは、新たな方針オプションが立法実現可能なルートを提供すると言った。しかし独立記念の1週間不在となるようである。民主党は2つの上院委員会で週末にも法案の承認を狙っている。この方法は全ての関係者に影響することである。上院内で議論を交わす間に数千人が近くの公園でデモ行進を行い、公的保険プランの作成を議会に求めた。
 バウカス法案では、雇用者提供医療給付への新たな課税と雇用者への低所得雇用者の保険料補助の要求が含まれているようである。メディケア給付削減も3番目の財源を提供する。
 ノースダコタ民主党ケント・コンラッド上院議員は、法案の総コストが補助金の適応制限により削減されたと言う。連邦貧困レベルの400%(4人家族で年収88,200ドル)だったのを、300%(同 66,150ドル)まで下げた。保険購入のための税額控除を中小企業に与える計画を中止するか縮小する可能性もある。
 バウカス議員はさらに数百万人をカバーするためにメディケイドを拡張したいと考えているが、節約のため3年間拡張を延期して2013年からとする可能性がある。
 バウカスやグラスリーを含む7人の上院超党派グループは、交渉経過を発表した。「コストを下げ、すべてのアメリカ人に良質で入手可能な医療を保証するであろう二大政党提携の法案に私達の仕事を続けることを約束します」
 財務委員会で当初1兆6,000億ドルと見積もられていたが、1兆ドルまで削減した。
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医療制度改革の議会での議論 財源と国民の支持/米国医療事情
http://kurie.at.webry.info/200906/article_31.html
医療制度改革への政治的好機/米国医療事情
http://kurie.at.webry.info/200811/article_43.html
上院議員主導の医療制度改革/米国医療事情
http://kurie.at.webry.info/200811/article_25.html
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Senate Democrats Say Cost of Health-Care Bill Can Be Trimmed
http://www.nytimes.com/2009/06/26/health/policy/26health.html
By ROBERT PEAR
Published: June 25, 2009

WASHINGTON ― Senate Democrats said Thursday that they had found ways to pare the cost of a health care bill by more than a third ― to $1 trillion over 10 years ― while still covering nearly all Americans.

One of the Democrats, Senator Max Baucus of Montana, the chairman of the Finance Committee, said the new policy options provided a feasible route toward enactment of the legislation, which is President Obama’s top domestic priority.

But as senators leave town for a weeklong Fourth of July break, Democrats are nowhere near where they had hoped to be.

The Democrats had hoped that two Senate committees would approve the legislation by the end of this week. The measure could affect nearly every family, employer and health care provider in the country.

Still, Mr. Baucus was upbeat. After a meeting of his committee on Thursday, he said, “The Congressional Budget Office now tells us we have options that would enable us to write a $1 trillion bill, fully paid for.”

While senators haggled over the intricacies of policy, thousands of people held a rally in a park nearby demanding “health care reform now.” The crowd included doctors, nurses, labor union leaders and people without insurance. Many urged Congress to create a public health insurance plan, as a possible alternative to private insurance.

Mr. Baucus’s bill is likely to include a new tax on some employer-provided health benefits and a requirement for employers to help pay the cost of insurance for some of their low-income workers ― those who enroll in Medicaid or get federal subsidies to help them buy insurance.

Medicare cutbacks would provide a third major source of money to help finance coverage of the uninsured. Senators expect to trim Medicare payments to hospitals and many other health care providers.

Senator Kent Conrad, Democrat of North Dakota, said the overall cost of the bill had been reduced mainly by limiting eligibility for various subsidies. Assistance would originally have been available to people with incomes up to 400 percent of the poverty level ($88,200 for a family of four). Democrats have lowered the ceiling to 300 percent of the poverty level ($66,150 for a family of four).

Senators said the cost of the bill might also be reduced by dropping or scaling back a plan to give tax credits to small businesses, to help them buy insurance. Mr. Baucus, like House Democrats, wants to expand Medicaid to cover millions more people. But to save money, he and other Senate Democrats may delay the start of the expansion for three years, to 2013.

A bipartisan group of seven senators, including Mr. Baucus and Charles E. Grassley of Iowa, the senior Republican on the Finance Committee, had been hoping to announce a deal on Thursday. With no agreement, they issued a statement in which they promised to keep working.

“Over the past several months, we’ve made progress toward workable solutions,” the group said. “We are committed to continuing our work toward a bipartisan bill that will lower costs and ensure quality, affordable care for every American.”

The statement was a status report, but also a political document, meant to buck up the spirits of advocates of major health care legislation, who insist that public opinion is on their side, despite setbacks on Capitol Hill.

Mr. Conrad said the Finance Committee had made “remarkable progress” in whittling down the bill’s initial price tag of $1.6 trillion.

“Think of where we started this week,” Mr. Conrad said. “We were $600 billion away from having a package that added up. Now we have a number of options that all add up. We know we can have a bill that’s completely paid for, at $1 trillion.”

Senator Olympia J. Snowe, Republican of Maine, one of the core group of seven striving for an agreement, emphasized that “we have not made a deal.” But she added, “there will be no hiatus during the recess,” as senators and their aides push ahead.

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皆保険に近づけながら10年で1兆ドルまで削減したバウカス案/医療制度改革 オバマ政権 医師の一分/BIGLOBEウェブリブログ
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