Not exactly a surprise, but when they talk tough about P4P (or anything else) remember that CMS lives in the real world, and where the real power lies.
The federal government on Tuesday softened proposed double-digit cuts in reimbursement to hospitals in 2007 for procedures involving pricey medical devices, a win for medical equipment companies that had lobbied hard against the cuts.
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For more details on how Medicare folded on this one, see Health Care Renewal:
http://hcrenewal.blogspot.com/2006/08/wooden-headed-reimbursement-continues.html/
The only way for a single-payer, government sponsored national health insurance program to work efficiently would be if it were insulated from the lobbyists—in other other words, a government agency overseeing health care shouldn’t be dependent on Congress for funding.
(It has often been suggested that the SEC should be insulated in the same way. The SEC could self-fund, using the monies it collects in fines–though Wall Street has made sure that hasn’t happened.)
Conceivably it could happen with healthcare –if middle-class and upper-middle-class voters become sufficiently upset about the spiraling cost of drugs, devices, and insurance. . . .
In 2005, Paul Ellwood suggested that national healthcare should be overseen by an independent gov’t agency that would be much like the Fed.
I don’t think the FED is immune from politics–with some striking exceptions (Volcker’s reign) it has done the White House’s bidding. But it isn’t nearly as vulnerable to Congress and Congressional lobbyists as other federal agencies, so perhaps it could be a model.
Ok, now you guys are starting to get me worried. Between this post and the previous one by Eric Novack I don’t know what to think anymore.
It looks like I’m going to have to delay my retirement a little longer! 🙁
It’s just an anecdote, but it does suggest the Achilles heel of all government run health care programs, their susceptibility to political influence, lobbying, and worse.
An interesting question is why managed care was never able to take on the proponents of high-tech devices, drugs, and procedures.
Maybe the reason is that they have been bureaucracies run by executives who are more comfortable talking to administrators of other organizations than worrying about what is best for the little guys?
Increased government control over healthcare (AKA single payer, nationalized healthcare, socialized medicine, etc.)= healthcare priorities based only on lobbying power
To see more, just sit back and watch what happens in Massachusetts over the next 24 months.