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How Reid's bill hands Obama the knife to cut treatment under Medicare

One more reason to kill the bill. Politico links to a post from Ron Brownstein in the Atlantic they say is "mandatory reading" at the White House. The key paragraphs describe two institutions, the Medicare Advisory Board and the Center for Medicare and Medicaid Innovation. Both circumvent the democratic process -- that is, the voters, although the latter looks more dangerous. Call me foily, but that translates, to me, to cuts in care. Why else would they not want to face the voters?

[T]he Reid bill maintains the two powerful institutions the Finance legislation proposed to promote these reforms and develop new ones. The one that's attracted the most attention is an independent "Medicare Advisory Board." Under the Senate bill, that board would be required to offer cost-saving proposals when Medicare spending rises too fast; Congress could not reject its proposals without substituting equivalent savings. Since the board would be prohibited from offering changes that raise taxes or "ration care," [whatever that means] and since the legislation initially exempts hospitals from its recommendations, it could choose to promote the sort of payment reforms the bill establishes. (More prosaically it might also clear away some of the expensive coverage mandates [Hmm....] that Congress imposes on Medicare under pressure from different elements of the medical industry).

The giveaway that this is about treatment cutting and not "payment reform" is that the board's proposals apply only to elders. As Dean Baker asks, if the "reform" ideas are so great, why not apply them across the board?

Given the limitations imposed on the commission, an equally important means to expand these reforms might be a second institution the legislation creates: a Center for Medicare and Medicaid Innovation in the Health and Human Services Department. Though this center has received much less attention than the Medicare Commission, it could have a comparable effect. It would receive $1 billion annually to test payment reforms; in a little known provision, the bill authorizes the HHS Secretary to implement nationwide, without any congressional action, any reform [any reform???] that department actuaries* certify will reduce long-term spending. While the House bill omitted the Medicare Commission (a top priority for Obama) it included the innovation center.

No one can say for certain that these initiatives will improve efficiency enough to slow the growth in health care spending.

Which, duh, means that it's not about spending. Heck, if spending were the issue, then single payer, which would save the country $400 billion dollars a year, would be on the table.

It's about "entitlement reform." Seriously, who do you think is going to lose out on this by the time the nudge has turned into a shove? The health insurance companies and Big Pharma, which have the money, or patients, who only have their votes?

NOTE * Hmm...

NOTE And don't say we didn't warn you....

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DCblogger's picture
Submitted by DCblogger on

the prog blogs continue to defend this piece of disaster capitalism?????????????

Submitted by jawbone on

"political" version of Hillary they elected is not progressive or liberal or even much of a Democrat -- he's a Corporatist.

They have to realize that before they can begin to understand just what a mess we're in.

So, where's all that Hope and Change, eh? Well, I think the changes we're getting is not the change we thought we voted to get.... Those of us who couldn't vote for him realized then that whatever he was bringing was not liberal or progressive or out of the Democratic values we've known since FDR.

Hope, much?

S Brennan's picture
Submitted by S Brennan on

We can't because there is a cadre of bloggers identified as liberal...say, Marshall, Klein, Drum the twit at OL and other worthless denizens who claim every Obama move is a liberal victory.

TARP, ever expanding war, restricting abortion to the upper class, excluding health care for womens reproductive systems, subsidies for insurance, no financial regulation, legalize torture, government wire tapping...are all "liberal" now. As long as Obama's fans make these claims, nobody can argue with right wing nuts.

jumpjet's picture
Submitted by jumpjet on

Or the socialist label.

Or the populist label.

Find something that sticks and disembowel Obama with it. I don't care what you have to use or do, just crush that motherfucker before he destroys everything we hold dear.

Submitted by hipparchia on

could you change ... the Center for Medicare and Medicaid. to the Center for Medicare and Medicaid Innovation.

the Center for Medicare and Medicaid Services [CMS] is the agency that runs medicare and medicaid and we don't want to demonize them.

dean baker is partly wrong [and mostly right]. the 'reforms' are going to be applied to the public option folks too, in the house bill at least. i haven't read all the way through the senate bill yet.

also, your don't say we didn't warn you link is broken.

Submitted by lambert on

Writing in haste...

As for Dean Baker, that post is old-ish, so the bill may have changed out from under him. But his argument applies nonetheless.

* * *

If you ever see something awful that's fixable and makes the blog look bad (like "Innovation"), and you have time and desire, just go ahead and edit the post.

Submitted by hipparchia on

and i mostly overlook when other people do, but this one seemed important.