"Doc Fix" Shows (AGAIN) Why the House's Health Reform Bill Is Better Than the Senate's
Published October 21, 2009 @ 11:03AM PT
The last House committee to work on comprehensive health reform finished at the end of July. The last Senate committee (Sen. Max Baucus's Senate Finance Committee) finished last week. But the House has not been idle. News comes today that an initial score from the Congressional Budget Office says the House has refined its bill to only cost $871 billion over 10 years. Of course that is likely to get overshadowed by the train wreck in the Senate concerning Medicare's "Doc Fix." So many commentators are focused on the political clumsiness of pushing a separate bill in the Senate to fix the Medicare Sustainable Growth Rate (SGR) that they may miss what this Three Stooges-esque vignette tells us about the policy strength of these House and Senate bills.
Simply put, the House has its act together. The Senate's got a lot of work to do.
The SGR was an attempt to curb skyrocketing costs in Medicare which has not only failed, it's become the second-worst accounting trick in the federal budget over the past decade (the worst being leaving the costs of the wars in Iraq and Afghanistan out of the budget every year of the Bush Administration so the deficit wouldn't look so big.) A brainchild of the Gingrich Congress and an amendment to the 1997 Balanced Budget Act, the SGR is a formula intended to prevent physician compensation for Medicare from rising above the rate of growth in GDP each year. If physician fees were threatening to go higher, all doctors' fees across the board in Medicare would be cut to keep them within that limit. Not inherently a bad idea, but it has a huge flaw -- in most years, medical costs rise at several times the rate of growth in GDP whether you're talking public coverage or private insurance. The net result is that SGR would guarantee a major cut to Medicare nearly every year, at least until we get an explosive economic growth like we had in the 1990s. And we're not talking obvious waste like Medicare Advantage subsidies for HMOs or those motorized scooters you see in ads on cable TV -- we're talking doctors' fees. You know, the whole point of having health coverage.
So every year, Congress passes a one-year moratorium on the SGR. Every year, all Democrats in the Senate vote for it. Every year, almost all Republicans vote against the moratorium and for the cuts to take place (including every single one of the conservatives who are making "how dare we cut Medicare in any way, shape or form!" their rallying cry for defeating reform. Gotta love that blatant disregard for consistency.) Every year, doctors' fees in Medicare continue to rise at roughly the same "way, way over inflation" rate they do for private insurance, meaning if the cuts took place this year, it'd yield a 21% cut across the board. But every year, the cut never actually happens. It's like a bad sitcom whose punchline you can see coming from miles away. It's absurd. And it needs to be fixed.
Enter health care reform -- an obvious spot to fix it.
Health Reform Lite or Value Meal?
Published October 21, 2009 @ 06:00AM PT
For anyone fazed by healthcare reform histrionics, take heart. We’ve been here many times before. The real question is, for all the political, capitalistic, and social angst, what’s changed? According to medical economist J.D. Kleinke, who first arrived on the scene in 1989, only one big thing: now everybody gets to whine about the status quo on Facebook. He goes so far as to call the healthcare bills moving forward today “a violent endorsement of the status quo.” I can’t say I disagree with his logic, but two women just gave me hope for this go-round.
Kleinke points out that in 1989 we had a dysfunctional third-party payer insurance system based on fee-for-service. Some insurers, hospitals, doctors, drug companies, and even employers figured out how to game the system and make out like bandits. Medicare was forecasted to become insolvent, Medicaid programs were underfunded, and malpractice costs were supposedly bankrupting healthcare. Costs were skyrocketing along with the number of uninsured. Does all this sound familiar?
Yet in 20 years, he says, all we can come up with is to fit more insured patients into our current mess and make it harder for insurers to kick them out. Each time the smallest of reforms is proposed (like adding prescription benefits to Medicare) entrenched US stakeholders rally mass hysteria, and the result is government funding of more corporate services. That’s true, J.D., but times have changed; about that Facebook phenomenon …
Pay for Performance: Why You Should Care (Part 2 of 3)
Published October 20, 2009 @ 06:00AM PT
Part 2: Empowered Patients
Last time we dug into what P4P actually is. Today we'll give you the P4P tools to become an empowered patient, and introduce you to their quality metrics basis. This will allow you to pay for quality versus average or sub-par care.
Ready? Quick! You’re having a heart attack. Your family called 911, and now the paramedics are asking which hospital you want to go to. How do you know? Your life may depend on it.
5 Moves to Watch in Healthcare Reform
Published October 19, 2009 @ 06:00AM PT
With the frenetic activity of the last few months, you may be wondering what’s going to happen next in the healthcare reform carnival. First there was the breathless buildup to bill … after bill … after bill. Then the ensuing media circus took over. Tea partyers continue to spout hyperbolic nonsense we hope bears no resemblance to 18th century history, and many members of Congress regularly emit scaremongering tripe that has nothing to do with campaign contributions from the insurance industry. Really. Meanwhile private insurers progressively expose their ugly underbellies. What’s next?
Take a deep breath and take heart: there is an actual semi-logical legislative process. And you can follow it, in between sideshows. In fact, here is a simplified outline of the complexities, adapted from the National Health Council (you can also download the entire Health Reform Legislation: Potential Impact on Patients PDF):
Meet the New Contributing Healthcare Editor
Published October 18, 2009 @ 12:00PM PT
Editor's Note: This post was originally scheduled for Friday, 10/9. Due to a system upgrade, it got lost in the ether. My apologies for the delay in introducing myself to all of you.
A stranger has gained access to the Change.org healthcare blog and has been posting (perhaps perplexing?) stories. That would be me, the new Healthcare Contributing Editor at Change.org. I wanted to introduce myself to all you passionate healthcare advocates and activists here in our community.
You'll find that I approach healthcare from a very broad-based perspective, because I have been touched by it both professionally and personally. For instance, I've been uninsurable on an individual basis since I was, well, 4 (though I wasn't aware of it at the time.) Insurers aren't happy with my choice of parents, fearing my genetic gifts may cost them money.
I am a healthcare consultant with years of experience working with the most dysfunctional healthcare organizations in the country (the superstars don't need me.) Prior to that I worked for those types of organizations -- Columbia HCA, NovaCare, Arthur Andersen -- it's a distinguished list!
Limited Time Only: Own a Very Personal Part of Health Reform
Published October 16, 2009 @ 01:00PM PT
Today I come bearing an olive branch to those who don’t consider themselves pro-healthcare reform. It’s a chance to be a part of healthcare reform you CAN believe in, whatever side of the political aisle you call home. Don’t worry, I’m not abandoning the heart and soul of Change.org’s Healthcare forum – this one’s for all of us pro-reformers too.
Many of us celebrated the sea change of HIPAA privacy rules becoming law back in 2003. It meant that for the first time, our personal health information belonged to us (we owned it) while providers kept custody. But there was an important exception – the law still says your test results do not belong to you. It is still illegal for a laboratory to give test results directly to you, the patient, if you request them. The only way to get them is through your provider.
Pay For Performance: Why You Should Care (Part 1 of 3)
Published October 16, 2009 @ 07:00AM PT
Part 1: What Is It?
Earlier this year, amid all the yelling, name calling and finger-pointing, there was a small quiet force moving through US healthcare. It was the early adopter crowd of doctors, hospitals and health systems, girding up to become providers of coordinated, quality, and evidence-based care. I called this little-noticed movement the Silent Revolution. That loud screech I'm now hearing is the revolution reaching the mainstream.
We’ll get to the noise in Part 3 of this three-part series. First, today we’ll dig into what Pay For Performance (P4P) actually is, and in Part 2 we’ll look at how it can empower you as a patient.
- 60,586
-
Categories
Writers
Gillian Hubble
Timothy Foley
About Health Care
-
Grants Assistant
The Colorado Health Foundation -
Development Consultant
Asian Human Services -
Program Assistant
National Alliance for Caregiving -
Office Manager/Administrative Assistant
Ohlhoff Recovery Programs -
Director of Fund Raising
Southern California Hospice Foundation -
View More Jobs
Post a Job »
-
-
Busted Foundation
-
234 Supporters
-
-
-
Families USA
-
39 Supporters
-
