According to the NYTimes, "In a conference call with reporters Wednesday to highlight cost-containment provisions, the two senior presidential advisers, Peter R. Orszag, White House budget director, andNancy-Ann DeParle, director of health reform, cited a letter to Mr. Obama by a group of respected economists who strongly endorsed the (independent) Medicare commission ... which some House leaders view as encroachment on Congressional authority over Medicare."
Obama said of the commission, it "can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system — everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.”
Physicianvoice asks, wouldn't anti trust relief, such as limiting the hurdles for clinical integration and accountable care groups encourage better coordination - only better?
Mickey Kaus:
ReplyDeleteP.S.: At least Brownstein, unlike Ezra Klein or the first rough draft of kausfiles, got the basic mechanism of the "Independent Medicare Advisory Board" right. Except he didn't. Brownstein writes that the
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.
No. Congress could reject its proposals without substituting equivalent savings anytime it wanted to (and could obtain the President's approval or override his veto). The Reid bill simply says Congress would have to substitute equivalent savings if it wanted to use a 'fast track' filibuster proof legislative pathway it sets up (a pathway that still allows a presidential veto). Future Congress' don't have to use that fast-track and no law Congress passes this year can make them, as far as I can see.. ...
P.P.S.: Brownstein does unearth what seems to be a second Broder-shaking delegation of sweeping rule-making power by Reid:
[I]n a little known provision, the bill authorizes the HHS Secretary to implement nationwide, without any congressional action, any reform that department actuaries certify will reduce long-term spending [E.A.]
Wow. So we've got the independent Medicare board slashing spending, subject to a formalized Congressional meddling process, and we've got the Secretary of HHS slashing spending, subject to ... any check at all? ...What if the recommendations conflict? ... I smell a new Czar! ...
No doubt the pressure on Congress to water down this authority will be enormous. Since Obama has made this a priority, who will blink first? I'm hoping they all do. Again, this isn't reform, it's a hostile takeover.
Charles krauthammer: Kill the Bills - Do Health Reform Right.
ReplyDelete... The bill is irredeemable. It should not only be defeated. It should be immolated, its ashes scattered over the Senate swimming pool.
Then do health care the right way — one reform at a time, each simple and simplifying, aimed at reducing complexity, arbitrariness, and inefficiency.
First, tort reform. This is money.
I second that emotion. Read the whole thing.
Howard Dean, MD: No Reform in Senate Reform Bill.
ReplyDeleteRemember "You Lie?"
ReplyDelete