It's back to the homework table for the nation's leading healthcare groups that met with President Barack Obama on Monday to discuss $2 trillion of cuts to the skyrocketing cost of healthcare.
They are to report back on June 1 on exactly how they plan to achieve their goal.
The $2 trillion would slow down in the rate of growth by 1.5 percent over 10 years and, according to the administration, mean a $2,500 a year in cost-savings for families.
Health and Human Services Secretary Kathleen Sebelius described the meeting she and the president had with leading stakeholders - among them America's Health Insurance Plans, the American Hospital Association and the American Medical Association - as "unprecedented." Sebelius responded to questions after the meeting on a conference call with reportersy.
She noted that many of the groups who were at the table Monday were among those who were major opponents of reform in the early 1990s.
"This is not just a photo-op, but really the beginning of a partnership that can transform the healthcare system," she said. "Today was really a breakthrough day."
In his remarks to the group at the start of the meeting, Obama noted:
- half of all bankruptcies stem from healthcare cost;
- a growing crisis for the American people is a bigger problem for businesses;
- and the explosion of healthcare costs has put the federal budget on a disastrous path.
Sebelius emphasized that Obama expects healthcare reform legislation to be passed by Congress this year. And in addition to having the organizations at the meeting Monday to work on how to cut costs, the president wants their support on the legislative side.
"He made it very clear he wants them at the table to make reform a reality this year," Sebelius said. "It's unusual to have them at the table at this stage of the game."
Industry observers say the insurance companies now see reform as a way to ensure themselves a seat at the table and avoid a public plan.
Sebelius noted there are 45 million Americans without health insurance and millions more who are under-insured.
"We have a whole spectrum of Americans, most of whom know the healthcare system does not work for them," she said.
Obama told the group healthcare legislation would have to include:
- a reduction in cost;
- a provision allowing people to choose their doctors; and
- quality healthcare insurance for all Americans.
In addition, she noted, "cherry picking by health plans cannot continue in the future."
AHIP President Karen Ignagni told the Senate Finance Committee last week that health insurers are prepared to stop charging women more for healthcare. The move follows an earlier concession by the insurance industry to stop charging more to insure members with pre-existing conditions.
"Our message is clear: The private sector will do its part to bend the healthcare cost curve," Ignagni said in a prepared statement on Monday. "We are initiating the reforms needed to make healthcare more affordable for families and employers and to put our healthcare system on a sustainable path."
Asked about the obstacles ahead, Sebelius said it's always easier to forge agreement from a 30,000-foot view. Once the details are being worked on, the tensions will arise, she said.
It's easy to be in favor of reform, she said, "as long as it looks like I want it to look."
In response to a question about that the stakeholders might want off the table in exchange for their support on reform, Sebelius said: "There was no quid pro quo. Everyone in the room ... understands that what's in place right now is unaffordable, unsustainable and unacceptable."