Fix Health Care Policy

One More Step toward the Right Medicare and Medicaid Reforms

The President’s National Commission on Fiscal Responsibility and Reform is not set to release its final recommendations on how best to tackle deficit spending and entitlement reform until December 1. However, several of its members have already gone public with proposals to reduce runaway spending and put Medicare and Medicaid, two of the fastest-growing entitlement programs, on the road to solvency.

The commission co-chairs, Alan Simpson and Erskine Bowles, released a report that takes several positive steps in reforming Medicare, including opting to repeal the Sustainable Growth Formula. Alice Rivlin and Representative Paul Ryan (R–WI), also members of the commission, released transformative, long-term solutions to Medicare and Medicaid that would better serve patients and reduce the tremendous upward pressure these programs place on federal spending. (more…)

Tags: debt commission, entitlement spending, Medicaid, Medicare, sustainable growth rate formula, unfunded obligations

Time to Clean Up the Medicare Doctor Payment Mess

Congressional Quarterly is reporting that the United States Senate is going to enact a one-month reprieve for Medicare physicians, saving them once again from a draconian reduction in Medicare payment.

This entire system is a mess. Under the existing Medicare payment formula (the Sustainable Growth Rate, or SGR) for doctors that the Senate and their House colleagues enacted in 1997, physician reimbursement is tied to the performance of the general economy. If in any given year Medicare physician payment outpaces the growth in the general economy, there is an automatic proportional reduction.

Routinely, Congress has blocked the annual payment reductions, but then, under the congressional formula, the payment reductions accumulate. Yet another flaw of the Patient Protection and Affordable Care Act is that it did not fix the physician payment problem. The result: This December, Medicare doctors will face a 23 percent cut in pay. A one-month extension of the reprieve would guarantee that the cuts next month would be even greater, requiring another congressional intervention. (more…)

Tags: Medicare "doc fix", ObamaCare, Patient Protection and Affordable Care Act, physician payments, Sustainable Growth Rate

Breaking Health Care Research: Repealing Obamacare and Getting Health Care Right

As newly elected lawmakers prepare for the hard work to be done in the next Congress, the future of the hugely unpopular Patient Protection and Affordable Care Act hangs in the balance.

In recent analysis, Heritage expert Nina Owcharenko makes the case for the full repeal of the PPACA and provides a framework for replacement with reform that will transform the system to focus on doctors and patients, not government. She writes that:

“Beyond the unprecedented mandates, new taxes, massive entitlement expansion, unworkable and costly insurance provisions, and its failure to control costs, the new law concentrates enormous power in the U.S. Department of Health and Human Services (HHS). It creates a giant network for the federal micromanagement of health plans, benefits, insurance markets, and unprecedented intervention into the details of health care financing and the delivery of medical care.” (more…)

Tags: failure control costs, massive entitlement expansion, new taxes, ObamaCare, unprecedented mandates

Who Should Control Your Health Care, You Or The Government?

After President Barack Obama installed Dr. Donald Berwick as head administrator of Medicare and Medicaid by recess appointment, Press Secretary Robert Gibbs was asked at the daily press briefing if “it would have been politically troublesome in an election year to have all these comments aired out about rationing, redistribution that Dr. Berwick had talked about in the past.”

Gibbs was ready for this question, though, and shot back: “Did he say things like, ‘rationing happens today; the question is who will do it’? Did he say that?” The bait laid, the reporter responded: “That was one comment.” The trap sprung, Gibbs pounced: “Actually that was Paul Ryan. That was Paul Ryan. He’s a Republican in Congress.” The White House press corps roared with laughter.

Gibbs may have won that round, but today Berwick is scheduled to testify before the Senate Finance Committee, and conservatives will have their first chance to question the bureaucrat in charge of implementing Obamacare’s many changes to the Medicare system. Hopefully Berwick’s past statements will not dominate the hearings but instead serve as a jumping-off point to shine light on the vast new powers Obamacare granted the federal government.

For starters, in June 2009, Berwick told Biotechnology Healthcare: “The decision is not whether or not we will ration care—the decision is whether we will ration with our eyes open. And right now, we are doing it blindly.” For comparison sake, here is the full version of the Gibbs-truncated Ryan quote from a 2009 interview with The Washington Post: “Rationing happens today! The question is who will do it? The government? Or you, your doctor and your family?” (more…)

Tags: CMS Administrator Dr. Donald Berwick, federal bureaucracy, Medicare, ObamaCare, Robert Gibbs, Senate Finance Committee

The Berwick Hearing’s Best Focus: Obamacare’s Effects on Doctors and Patients

The Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Donald Berwick this morning is expected to testify before Congress in his first appearance since a controversial recess appointment in June. He will talk before the Senate Finance Committee.

President Barack Obama’s controversial decision to sidestep protocol and appoint Berwick has been magnified by media coverage of Berwick’s publications and speeches that supported highly centralized health-care systems. While a respected health policy analyst, Berwick has what he calls “romantic” views on the United Kingdom’s National Health Service, which rations care based on the cost-effectiveness of treatments. Likening Britain’s system to a “global treasure” has many senators concerned that Berwick will take the same viewpoint while implementing the new health law. (more…)

Tags: CMS Administrator Dr. Donald Berwick, Independent Payment Advisory Board, Medicaid, Medicare, National Health Service, ObamaCare

Reforming Health Care Online Chat

As part of our “Lunch With Heritage” series, we will be feature Director of Health Policy studies Nina Owcharenko. Nina will answer your questions on what is wrong with the Patient Protection and Affordable Health Care Act (PPACA) and the correct way forward. There is a lot that needs to be done but with the right education we can hold congress accountable and make sure they do what they were elected to do.

Nina recently wrote a paper on everything that needs to be done so health care can be reformed.

Tags: hold Congress accountable, impact, Nina Owcharenko, ObamaCare, right way forward

The Obamacare Burden To Your State Budget

Facing a $25 billion deficit for their next two-year budget cycle, Texas lawmakers are considering closing the gap by dropping out of Medicaid. “This system is bankrupting our state,” State Representative Warren Chisum told The New York Times. “We need to get out of it. And with the budget shortfall we’re anticipating, we may have to act this year,” he said.

And Texas is not alone. American Legislative Exchange Council director of the health and human services Christie Herrera tells NYT: “States feel like their backs are against the wall, so this is the nuclear option for them. I’m hearing below-the-radar chatter from legislators around the country from states considering this option.”

Medicaid already eats up a huge share of state budgets. In Texas, for example, more than 20 percent of the state budget is spent on Medicaid. The crisis facing states across the country is that Obamacare forces states to massively expand their already burdensome Medicaid rolls. Starting in 2014 states must expand Medicaid to all non-elderly individuals with family incomes below 138 percent of the federal poverty level. At first, Obamacare picks up the first three years of benefit costs for expansion. But in 2017 states begin to shoulder a larger and larger share of these benefit costs, maxing out at 10 percent by 2020.

But that is just the benefit costs. Obamacare does not pay for any of the costs necessary to administer the expansion of the Medicaid rolls, rolls that are expected to increase by approximately 50 percent in states like Nevada, Oregon, and Texas. The Heritage Foundation’s Ed Haislmaier and Brian Blase found that just the administrative costs of the Obamacare Medicaid expansion will cost almost $12 billion by 2020. As Heritage visiting fellow Lanhee Chen details, some states are beginning to add the benefit and administrative costs together, and the picture isn’t pretty: (more…)

Tags: American Legislative Exchange Council, Medicaid, Medicare, Milliman, ObamaCare, state budget, Texas, unfunded mandates