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Obama’s Medicare Half-Truth

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Obama was called a liar during his recent address to a joint session of Congress. Actually, he was not fully truthful
about the implications of cuts to Medicare. Obama repeated that his
health reform plan includes payment cuts for private Medicare Advantage
(MA) health plans:

The only thing this plan would eliminate is the
hundreds of billions of dollars in waste and fraud, as well as
unwarranted subsidies in Medicare that go to insurance companies —
subsidies that do everything to pad their profits and nothing to
improve your care. … So don’t pay attention to those scary stories
about how your benefits will be cut… That will never happen on my
watch. I will protect Medicare.

Obama’s claim that the cuts will trim insurer profits but not Medicare benefits was meant to calm nervous seniors. As I and others
have pointed out the proposed cuts will in fact reduce benefits to some
degree, contrary to the President’s assertion. But seniors, in
general, should not be concerned. First, only about 23% of Medicare beneficiaries are enrolled in an MA plan.

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Taxing Health Insurance Companies to Pay for Health Care

The Congress has investigated about every conceivable way to tax people to pay for the health care proposals—a millionaire’s tax, bigger taxes on home mortgages and charitable contributions, and a couple of dozen more ideas.

Now Congress looks to be the most interested in taxing insurance companies to pay for a big chunk of their health care proposals. The new taxes would come in two parts––a 35% excise tax on any health benefit cost above an $8,000 single and $21,000 family annual premium as well as a flat $6 billion annual tax on the industry to be allocated among the companies proportionate to their premium.

There is certain logic to this. Taxing high priced benefits could help deflate the health care economy. Taxing all of the health insurance companies that stand to get more than a $1 trillion in new business—most of it in the from new private insurance and Medicaid subsidies and the rest from the consumer’s share of those new private plan premiums—seems fair at one level.

Calling for a tax on that big rich insurance company also sounds a lot better to the politicians than looking voters straight in the eye and raising their taxes directly.Continue reading…

CBO: HELP Bill’s Public Plan Not Much Help on Costs

The green-eyeshade meanies in the Congressional Budget Office took another whack at the public plan today, at least the one contained in the health reform bill passed by the Senate Health Education Labor and Pensions committee last June. Responding to queries from ranking member Michael Enzi (R-WY), CBO chief Doug Elmendorf noted on his blog that “premiums for the public plan would typically be comparable to the average premiums of private plans offered in the insurance exchanges.”

The reason given was the HELP bill emasculated the public plan’s ability to piggyback on the administrative efficiencies of Medicare and required it to be “financially self-sufficient.”Continue reading…

What Voters Really Think About Evidence-Based Health Care

I want to call your attention to an important survey done by the California-based Campaign for Effective Patient Care. They surveyed California voters on their understanding of evidence-based medicine.The bad news is that patients think their health care treatment is generally evidence-based even though that assumption is highly questionable. The good news is that patients want it to be evidence-based.At a time when we hear anecdotal evidence, particularly from town hall meetings, that people don't want any "interference" between them and their doctors they do seem to appreciate they need to get all of the facts when making a treatment decision.Here is the survey summary. You can access all of it here.

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Groupon, Livingsocial, and digital norms

deals.livingsocial.com

Regular readers may have noticed that I am a bit of a social media junkie– this blog, Facebook, Twitter — but I am also intrigued by social media sites that are set up only for commercial purposes. It is fun and instructive to watch the evolution of these sites.

Along those lines, a few weeks ago, I wrote about Groupon. The concept: The retailer offers a discount deal in the city of your choice, but only if enough people sign up for it.

The viral power is amazing, because after you sign up for something you want, you contact all your friends asking them to do the same so you can get the deal. Meanwhile, the retailer gets noticed by people with an affinity for his/her product or service, and gets a bundle of cash in prepayments. The folks at Groupon get some kind of fee. Everyone is happy

Now arises a new site, soon to go into business, called Livingsocial. Like Groupon, you can sign up for the deal of the day, and if enough people sign up, the deal is on; but unlike Groupon, if you get three other people to sign up for the deal, you get your coupon for free.

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Recently on THCB

10,000 US Physicians have something to say, and we’re not wasting time by Dr. Daniel Palestrant What Obama Must Demand from Congress on Health Care by Robert Reich Public Still Backs the Public Plan by Merrill Goozner Not Really An Option by Gary Nissen No Alternative: An Analysis of the GOP Plan by Harris Meyer“Winners and Losers – Strategy in a Post-Reform World” by Roger Collier“Betsy McCaughey’s Infected Advocacy” by Michael Millenson“The Health care cost shifting myth” by Austin Frakt“Health care reform  good for the business of healthcare” by Robert Laszewski“Can the two Democratic parties get it together on healthcare reform?” by Jeff Goldsmith“Health Panels are a NICE way of controlling costs” by Adrian Baker “Winners and Losers – Strategy in a Post Reform World” by Bill Kramer“Our President is on the Ropes” by Dr. Stephen Kardos“Will Republicans be spoilers or problem solvers on health care reform?” by Brian Klepper and Dr. David Kibbe“The Right to Live” by David Shaywitz“Tweaking Medical Education to Leverage EHRS” by Glenn Laffel

Not Really an Option

To: Executives leading U.S. Hospitals

The public option appears to back in the national dialogue and I’m wondering how concerned you all are about that.

After all, many of you have been quite successful at minimizing the appearance of true profit by growing your cost structure on the backs of private insurers, right?

Thinking back over the last ten to fifteen years, many things have changed.Continue reading…

Reminding Washington of What the Health Care Debate is About

Picture 22This summer, we witnessed countless demonstrations on the health care debate across the country. The media has broadcast and written about impassioned pleas from conservatives and liberals alike, each swearing, with an alarming level of certainty, that their way is the only way.  As we enter the fall and as Washington returns to work, Americans must ask themselves what really matters when it comes to reform. From my standpoint, while I think it’s a good thing the country is discussing much-needed health care reform, there is one important element missing from this enthusiastic debate. The patients. Individual Americans, and their best interests, are, or at least should be, at the core of any health care dialogue. Some will be much more affected than others, regardless of what the makeup of the final language that is passed.

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Joint Commission Apes Newt, Takes on IHI

Not content with handing out demerits for bad behavior, the Joint Commission has launched an effort to help those who misbehave change their ways.

As detailed in the Wall Street Journal’s Health Blog, the mission of the Joint Commission’s new Center for Transforming Healthcare will be, in the Journal’s words, “to work on new collaborative programs with leading hospitals and health care systems to find a cause of the most deadly breakdowns in patient care, and put a stop to them.”If the name of the new group sounds familiar, you could be confusing it with Newt Gingrich’s Center for Health Transformation. That center was launched by the former House Speaker to tout the benefits of health information technology and a changed reimbursement system and then show how those benefits could work in practice through demonstration projects. Of course, with the advent of the Obama administration, the for-profit center has changed its mission just a tad from Newt-the-Wonk’s, “Paper Kills” to Newt-the-Republican-Attack-Dog’s “Democrats kill.”  Visitors to the Center’s site can now find helpful op-eds with titles like “Healthcare Rationing” and “Listen to Barney Frank or listen to America?”

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