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....