WASHINGTON -- After a meeting Tuesday with President Obama, Alaska Sen. Mark Begich said he and other Senate Democrats left the White House believing that it is possible to overhaul the nation's health care system.
"The question is, 'Can we make this happen?' " Begich said. "And I believe walking out of that room, it felt very possible."
Obama met with Senate Democrats in an effort to push through the health care legislation in the Senate by Christmas. He emerged from his one-hour meeting saying he was "cautiously optimistic," although Senate rules require several days of procedural votes and time is running out before the holiday. The House of Representatives has already passed its version of a bill.
"The final bill won't include everything that everybody wants," Obama said after the meeting. "No bill can do that. But what I told my former colleagues today is that we simply cannot allow differences over individual elements of this plan to prevent us from meeting our responsibility to solve a longstanding and urgent problem for the American people."
But Begich's Republican counterpart, Sen. Lisa Murkowski, wasn't as optimistic, even as it looked Tuesday after their White House meeting that Democrats were nearer to their goal of achieving the 60 votes needed to get the legislation through the Senate before Congress wraps up for the year. At this stage, Murkowski is unlikely to vote for the bill.
"I'm in the camp that says we need to peel this thing back and figure out those things we can advance rather than doing reform that doesn't work, is incredibly expensive and leaves us with a system that's still broken," Murkowski said.
Murkowski was concerned in particular about what a possible expansion of the nation's Medicare system would mean in Alaska, where already it's difficult to persuade doctors to accept such older patients. Although it appears the latest version of the Senate bill will not include an expansion of Medicare for people as young as 55, the rate at which doctors are reimbursed for Medicare patients remains a concern on the part of both Murkowksi and Begich.
"It's like you've got a boat that's sinking ... and we're just adding into that already sinking boat," Murkowski said of the now-abandoned plan. "At some point in time, it's going to cause it to just go down."
Regardless, Murkowski said, the Medicare reimbursement rate is something that needs to be fixed. A recent fix that raised the rate of reimbursement didn't lead to more providers taking Medicare patients, she said. However, it encouraged providers to keep their existing patients, and as they aged into the Medicare system, those providers kept them on as patients, Murkowski said.
That "stemmed the flow," Murkowski said, but they need to keep working on containing costs. And that's where she said she's "extremely disappointed" with the health care bill she's seen, Murkowski said.
Begich has crafted amendments he said would address some concerns about Medicare in Alaska, including having enough health care providers.
One would create a pilot program to attract new doctors, nurses, physician assistants and other providers to urban Alaska -- and other states -- by offering loan repayments of $50,000 or cash payments of $37,500 each year for three years if they see mostly Medicare patients.
He also proposes increasing loan repayments from $35,000 to $50,000 annually for National Health Service Corps providers across the country. The program serves Health Professional Shortage Areas, including 77 in Alaska.
"My view is, we have a choice," Begich said. "Improve a broken system or keep the system as it is, status quo, that's broken and is going to bankrupt family after family after family and business after business after business. I'm not interested in that."
Find Erika Bolstad online at adn.com/contact/ebolstad or call her in Washington, D.C., at 1-202-383-6104.
By ERIKA BOLSTAD