WASHINGTON Some of President Barack Obama's former advisers are proposing major changes aimed at controlling health care costs as political uncertainty hovers over his health law.

Call it Health Care Overhaul, Version 2.0. Their biggest idea is a first-ever budget for the nation's $2.8-trillion health care system, through negotiated limits on public and private spending in each state.

The approach broadly resembles a Massachusetts law signed this summer by Democratic Gov. Deval Patrick that puts pressure on hospitals, insurers, and other major players to keep rising costs within manageable limits. It could become the Democratic counterpoint to private market strategies favored by Republican presidential nominee Mitt Romney and running mate Paul Ryan.

Health costs lie at the heart of budget problems confronting the next president. Health care accounts for 18 percent of the economy and about one-fourth of the federal budget, and many experts believe it can't grow unchecked without harming other priorities. Because the United States spends much more than other advanced countries, there's a consensus that savings from cutting waste and duplication won't harm quality.

"We think of these as the next generation of ideas," said Neera Tanden, who was a senior member of the White House team that helped pass the health law. Tanden is now president of the Center for American Progress, a Washington think tank close to the administration.

Under the proposal, the major public and private players in each state would negotiate payment rates with service providers such as hospitals. The idea is to get away from paying for each individual test and procedure. Negotiated rates could be based on an entire course of treatment. Payments would have to fit within an overall budget that could grow no faster than the average rise in wages.

The spending limits would be enforced by an independent council, but crucial details need to be spelled out. In Massachusetts, for example, budget-busting providers will be required to file plans with the state laying out how they'll amend their spendthrift ways.

The federal government would provide grants to states interested in developing their plans.

Tanden joined a brain trust of former administration officials floating the proposal recently in the New England Journal of Medicine. The group included Peter Orszag (former budget director), John Podesta (transition director), Donald Berwick (first Medicare chief), Ezekiel Emanuel (Orszag's health policy guru), and Joshua Sharfstein (former No. 2 at the Food and Drug Administration). Also on board was former Senate Majority Leader Tom Daschle, D-S.D., Obama's first pick to shepherd his health care overhaul.

Their proposal includes other ideas, such as a malpractice liability shield for doctors who follow best clinical practices, and competitive bidding for all Medicare supplies and lab tests, not just home health equipment. All of the signers support Obama's health care law, but see cost control as unfinished business.

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Bay State is a template for health care reform again

DALLAS, Sept. 3, 2012 (GLOBE NEWSWIRE) -- The National Association of Free and Charitable Clinics (NAFC) is calling on physicians and other health care professionals, as well as non-medical volunteers, to participate in the upcoming large free clinic for uninsured persons at the Dallas Convention Center, Hall A, 650 South Griffin St., on Sept. 29.

The NAFC will hold its latest C.A.R.E. (Communities Are Responding Everyday) Clinic in conjunction with the Lone Star Association of Charitable Clinics (LSACC) and the North Texas Association of Charitable Clinics (NTACC).

"We are hopeful that many individuals in the community will volunteer at this one-day, life-altering event," NAFC Executive Director Nicole Lamoureux said. "This C.A.R.E. Clinic is funded and made possible through the generosity of private citizens and sponsors, not one tax payer dollar is being utilized to pay for this clinic. In order for us to provide much needed free health care for as many uninsured patients as possible, we will need 100 doctors, 300-400 nurses and 500 or more non-medical volunteers."

Texas has the highest rate of uninsured people in the country with about 26 percent of residents in general and 22 percent of children lacking health insurance. The overall uninsured rate is about the same in the Dallas-Fort Worth area, but the situation for children is even worse with 26.4 percent lacking health insurance. Further, among people living in poverty, the rate of being uninsured soars to 46 percent.

"This free clinic is not just for the sick but also for anyone who is uninsured and has not seen a doctor recently," LSACC Executive Director Jody Hopkins said. "Some patients have not seen a doctor in several years, others need follow-ups because they have chronic diseases, and some simply need checkups or physicals. The one characteristic they all share is limited access to get such care. All participants will receive preventive, primary medical care and be connected to the area's safety-net providers and available resources."

Both medical and non-medical volunteers are needed from 8:00 a.m. until 8:00 p.m. on the day of the clinic, Sept. 29, as well as for setup on Thursday afternoon, Sept. 27, and all day Friday, Sept. 28. Medical volunteers needed for the Dallas clinic include doctors of medicine, doctors of osteopathy, nurse practitioners, physician's assistants, registered nurses, licensed vocational nurses, emergency medical technicians, medical administrators, licensed clinical social workers and more. Non-medical volunteers are needed to help with documentation, logistical support, patient intake and translation, as well as to be patient greeters and escorts.

Information on the event and how to register is available online at: http://www.nafcclinics.org/. Information on how to donate to support this and future clinics is also available at that website address by clicking on the "Donate Now" button. Patients register for an appointment by calling 800-340-1301.

This will be the 12th in a series of large C.A.R.E. Clinics held around the country to bring together physicians and other health care professionals, as well as non-medical volunteers, to serve the needs of thousands of people who might otherwise go without medical care and to connect them to local safety-net resources. Since September 2009, more than 15,000 uninsured patients have received medical care at C.A.R.E. Clinics throughout the country.

About the Organizations:

The National Association of Free and Charitable Clinics (NAFC) is the only nonprofit 501(c)(3) organization whose mission is solely focused on the issues and needs of more than 1,200 free and charitable clinics and the people they serve in the United States.

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Volunteers are Needed for Large Free Medical Clinic for the Uninsured in Dallas

WASHINGTON Some of President Barack Obamas former advisers are proposing major changes aimed at controlling health care costs as political uncertainty hovers over his health law.

Call it Health Care Overhaul, Version 2.0. Their biggest idea is a first-ever budget for the nations $2.8-trillion health care system, through negotiated limits on public and private spending in each state.

The approach broadly resembles a Massachusetts law signed this summer by Democratic Gov. Deval Patrick that puts pressure on hospitals, insurers, and other major players to keep rising costs within manageable limits. It could become the Democratic counterpoint to private market strategies favored by Republican presidential nominee Mitt Romney and running mate Paul Ryan.

Health costs lie at the heart of budget problems confronting the next president. Health care accounts for 18 percent of the economy and about one-fourth of the federal budget, and many experts believe it cant grow unchecked without harming other priorities. Because the United States spends much more than other advanced countries, theres a consensus that savings from cutting waste and duplication wont harm quality.

We think of these as the next generation of ideas, said Neera Tanden, who was a senior member of the White House team that helped pass the health law. Tanden is now president of the Center for American Progress, a Washington think tank close to the administration.

Under the proposal, the major public and private players in each state would negotiate payment rates with service providers such as hospitals. The idea is to get away from paying for each individual test and procedure. Negotiated rates could be based on an entire course of treatment. Payments would have to fit within an overall budget that could grow no faster than the average rise in wages.

The spending limits would be enforced by an independent council, but crucial details need to be spelled out. In Massachusetts, for example, budget-busting providers will be required to file plans with the state laying out how theyll amend their spendthrift ways.

The federal government would provide grants to states interested in developing their plans.

Tanden joined a brain trust of former administration officials floating the proposal recently in the New England Journal of Medicine. The group included Peter Orszag (former budget director), John Podesta (transition director), Donald Berwick (first Medicare chief), Ezekiel Emanuel (Orszags health policy guru), and Joshua Sharfstein (former No. 2 at the Food and Drug Administration). Also on board was former Senate Majority Leader Tom Daschle, D-S.D., Obamas first pick to shepherd his health care overhaul.

Their proposal includes other ideas, such as a malpractice liability shield for doctors who follow best clinical practices, and competitive bidding for all Medicare supplies and lab tests, not just home health equipment. All of the signers support Obamas health care law, but see cost control as unfinished business.

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Health cost controls follow Mass. lead