While Washington wonks continue to bicker over health policy, positive change is occurring outside the Beltway.
Last week, the Altarum Institute, a research organization based in Ann Arbor, Michigan, reported that the moderation in the growth of health-care costs we have seen over the past few years is continuing: Total health spending rose by less than 4 percent from February 2011 to February 2012. And it’s encouraging to see the progress that doctors, hospitals and other providers are making to improve the value of care — by cutting back on unnecessary procedures, for example, expanding their use of information technology, and switching from fee-for- service to compensation schemes aimed at maximizing the quality of treatment.
Instead of examining these changes and finding ways to encourage them, the Washington policy discussion continues to demonstrate its ability to, well, it’s not clear exactly what it does. The most senseless bloviating recently came from Charles Blahous, a senior research fellow at George Mason University, in Arlington, Virginia, and a former official in the George W. Bush White House. He claims to have shown that the 2010 health-care reform act will substantially increase the budget deficit, despite official estimates to the contrary. The Washington Post decided this warranted prominent coverage.
What Blahous actually did was play a trick. His analysis begins with the observation that Medicare Part A, which covers hospital inpatient care, is prohibited from making benefit payments in excess of incoming revenue once its trust fund is exhausted. He therefore argues that the health reform act is best compared to a world in which any benefit costs above incoming revenue are simply cut off after the trust-fund exhaustion date. Then, he argues that since the health-care reform act extends the life of the trust fund, it allows more Medicare benefits to be paid in the future. Presto, the law increases the deficit by raising Medicare benefits.
“Imagine a world without Medicare.” That’s the rallying cry of a new grassroots campaign being unveiled today by the giant seniors group AARP that will include town hall meetings in 50 states and national television ads.
Against a backdrop of proposals to overhaul the popular social insurance program and a presidential campaign likely to address entitlement spending, AARP is launching “probably the biggest outreach effort we’ve ever done on any issue” to activate its 37 million members, said Nancy LeaMond, AARP’s executive vice president.
The group will gather seniors at town hall meetings today in four cities – Richmond, Va.; Columbus, Ohio; Denver, Colo.; and Miami, Fla. – to start a conversation about the program’s future entitled, “You’ve Earned A Say.” It is also releasing a survey showing that less than half of adults ages 18 to 49 are confident Medicare will be there when they’re ready to retire.
In coming weeks, the group will hold town hall meetings in every state, and also conduct large-scale forums by phone. It recently sent members a survey to assess their views about potential Medicare and Social Security changes.
Groups on the other side of the political spectrum are also galvanizing. This week, a conservative seniors group called the 60 Plus Association put out television ads that targeted five Democratic senators and asked supporters to press them about their support for the Medicare provisions in the 2010 federal health law.
The defining political issue of 2012 won’t be the government’s size. It will be who government is for.
Americans have never much liked government. After all, the nation was conceived in a revolution against government.
But the surge of cynicism now engulfing America isn’t about government’s size. The cynicism comes from a growing perception that government isn’t working for average people. It’s for big business, Wall Street, and the very rich instead.
In a recent Pew Foundation poll, 77 percent of respondents said too much power is in the hands of a few rich people and corporations.
That’s understandable. To take a few examples:
Wall Street got bailed out but homeowners caught in the fierce downdraft caused by the Street’s excesses have got almost nothing.
Big agribusiness continues to rake in hundreds of billions in price supports and ethanol subsidies. Big pharma gets extended patent protection that drives up everyone’s drug prices. Big oil gets its own federal subsidy. But small businesses on the Main Streets of America are barely making it.