Fix Health Care Policy

Obamacare Set for Oral Argument

Today, the Supreme Court released the oral argument schedule for the consolidated Obamacare challenges. The Court will hear oral argument on March 26, 27 and 28, 2012, with a nearly unprecedented amount of time allotted for argument.

First up on March 26, the Court will hear argument on the Anti-Injunction Act, which bars suits to stop a tax before it has been imposed. The second day, the Court will hear two hours of argument on the minimum coverage provision, also known as the individual mandate. On the third and final day, the Court will hear 90 minutes of argument on severability (whether and how much of the law will remain in force if other provisions, like the individual mandate, are struck down by the Court) and then one hour on whether Congress exceeds its powers by coercing the States through its massive expansion of the state Medicaid program.  (Read the rest on The Foundry…)

Tags: Anit-Injunction Act, Individual Mandate, March 2012, Medicaid, ObamaCare, repeal the law, severability, Supreme Court

VIDEO: As Obamacare Support Falls, Lawmaker Offers Patient-Focused Plan

Support for Obamacare sunk to 29 percent in the latest Associated Press poll. The widespread dissatisfaction with President Obama’s signature achievement is one reason Rep. Tom Price (R-GA) has developed health care reform that puts patients first rather than government.

Price, chairman of the House Republican Policy Committee, understands health care better than most. Before coming to Congress, he spent nearly 20 years in private practice as an orthopedic surgeon. He’s now using the lessons from that experience to undo the damage of Obamacare by promoting a plan called the Empowering Patients First Act.

In a sit-down interview at Heritage this week, he shared his thoughts on the contrast between Obamacare and his patient-centered plan.  (Read the rest on The Foundry…)

Tags: doctor-patient relationships, Empowering Patients First Act, ObamaCare, rep. tom price

Ryan-Wyden: The Basic Ingredients of Structural Medicare Reform

Congressman Paul Ryan (R–WI) and Senator Ron Wyden (D–OR) have proposed a new bipartisan framework for structural Medicare reform. It continues the conversation with the American people on a solution to save the popular but financially troubled entitlement program.

While there are differences between the proposal and the Heritage plan outlined in Saving the American Dream, and while their proposal does not go as far or as fast as it should in changing the massive entitlement program, it would establish a premium-support system of financing for Medicare, a variant of a defined contribution toward the health care plans chosen by retirees. This policy is central to the transformation of Medicare into a consumer-based system relying on competition rather than bureaucratic fiat.

Also, similar to the Heritage proposal, government payment for health coverage would be based on competitive bidding among health plans, and Medicare would be put on a budget. This is a crucial improvement in the functioning of the program, because pricing would be determined by market competition rather than by Washington bureaucrats.  (Read the rest on The Foundry…)

Tags: competition, consumer-based health care, defined contribution, Medicare, premium support, Rep. Paul Ryan, Saving the American Dream, Sen. Ron Wyden

Decrease in Young Uninsured: Does Obamacare Deserve Credit?

Yesterday, the Administration released data from the 2011 National Health Interview Survey that shows, among other things, that the number of uninsured young adults declined over the last year. In a short press release, the Department of Health and Human Services (HHS) touted this as evidence that Obamacare is working, specifically attributing increased coverage of young adults age 19–25 to the Obamacare provision allowing those individuals to stay on their parents’ health plans.

Undoubtedly, it’s true that some of those individuals did get coverage due to that provision, but HHS claiming credit for Obamacare for all of the increase appears to be an example of the classic statistical fallacy of confusing correlation with causation. Even more importantly, over the long term, the net effect of Obamacare’s many provisions will be to increase the already unaffordable cost of health care, which is one of the main reasons young adults and other uninsured forego coverage.  (Read the rest on The Foundry…)

Tags: HHS, ObamaCare, parents' health plans, repeal the law, unaffordable cost, uninsured, young adult

Medicare Needs a Budget and Structural Reform

Medicare faces a dismal future that could threaten its very existence. In two recent papers, Stuart Butler, Ph.D., and Robert Moffit, Ph.D. of the new Heritage Center for Policy Innovation analyze the problem and offer detailed solutions on how to reverse course.

Butler explains that many objections to Medicare reform are fueled by myths. For instance, many Americans believe that seniors have paid for their own Medicare through payroll taxes. But in reality, only Medicare Part A is financed through payroll taxes. Parts B and D are voluntary and financed through a combination of beneficiary premiums (covering just 25 percent of costs) and subsidies from taxpayers.

Next, Butler points out, there is no true Medicare trust fund. The program operates as a pay-as-you-go system, meaning revenue immediately goes out the door to pay for current benefits. Another myth is that the payroll tax is a premium and quite different from the income tax. Butler explains, “Since the Medicare payroll tax, unlike the Social Security tax, does not have an income cap, it is actually indistinguishable from a regular income tax bracket.”  (Read the rest on The Foundry…)

Tags: income tax, Medicare, pay-as-you-go, reform, trust fund

Congress Should Stop Subsidizing Warren Buffett’s Health Care, Not Increase His Taxes

Reports have surfaced that conservatives in Congress may propose further increasing income adjustment in Medicare to lessen the program’s insolvency. This is a great idea. While the left continues to argue for higher taxes for the likes of Warren Buffett to maintain the status quo of a costly, failing Medicare program, it makes more sense that Congress should simply stop subsidizing them.

As Congress continues to pursue solutions to the entitlement spending crisis, one question that must be answered is whether the United States should even have universal federal entitlements to begin with. Considering the wreckage of the nation’s finances, the answer is clearly no. It’s not only that we cannot afford it, but the very creation of popular dependency on government itself threatens prosperity.

For wealthier Americans like Buffett, the policy options are clear. The Obama Administration and its allies in Congress are obsessed with imposing higher taxes on them, regardless of the impact on investment in the economy and despite the fact that they already pay the bulk of federal income taxes. The intent behind this course of action is to maintain, largely unchanged, the existing federal entitlement regime.  (Read the rest on The Foundry…)

Tags: congress, entitlement spending, subsidizing Medicare, taxes, Warren Buffett

State Medicaid Reform That Works…If Washington Bureaucrats Will Allow It

As the fight continues against the one-size-fits-all changes enacted under Obamacare, some states continue to work on health care reform specific to the needs of their residents.

Florida is one such state. Its Medicaid Reform Pilot passed with bipartisan support in 2005 and has been implemented in five counties over the last five years. It has been a remarkable success, shifting a failing government health program away from the status quo of top-down micromanagement toward consumer-driven, patient-centered care.

In a detailed analysis written for The Heritage Foundation, Tarren Bragdon, CEO of the Foundation for Government Accountability, a Florida based think-tank, outlines the successes and difficult road ahead for the Florida Medicaid Reform Pilot. As he explains, the Reform Pilot provides an important example for state reformers because it includes such a large population of Medicaid recipients:  (Read the rest on The Foundry…)

Tags: bureaucrat, Florida, Medicaid Reform Pilot, ObamaCare, Washington state

Junk the Medicare Physician Payment Formula

In January 2012, Medicare physicians face a 27.4 percent cut in their payment for treating senior and disabled citizens.

Congress, as it has routinely since 2003, is feverishly preparing legislation to stop its own goofy Medicare payment formula from going into effect. If they don’t succeed this year, seniors can be assured of severe problems accessing physician care.

The reason Congress goes through this silly routine almost every year is that it is unable or unwilling to make serious changes in the Medicare program. Today, Medicare payment for doctors is determined by a complex fee system, the Resource-Based Relative Value Scale (RBRVS), in which payment is tied to a social-science measurement of doctors’ estimated time, energy, and resources in providing a medical service.

While the Reagan Administration (naturally) opposed RBRVS, its advocates sold it (incredibly) to the Bush Administration and Congress in 1989 as a “scientific” way to pay doctors. So the government sets the fees for over 7,000 medical services, and that payment is further restricted by price controls. Since 1989, doctors cannot legally charge Medicare patients more than government officials say.  (Read the rest on The Foundry…)

Tags: doc fix, Medicare, physician formula payment, Seniors