Hospitals Aren't Waiting for Verdict On Health Care
Sunday, 17 June 2012 11:58
The New York Times
By Nina Bernstein
Giant aquariums now soothepediatric patients at Maimonides Medical Center in Brooklyn. It has added
welcome signs in 10 languages, a state-of-the-art cardiac operating room and
programs to keep chronically ill adults safely at home. But as Pamela S. Brier,
the chief executive, was walking to the main entrance last week, she spotted a
rain-soaked plastic bag on the front steps.
Millions of dollars in revenue now depend on improving patients’ perceptions of the
hospital. “I can’t stand it,” Ms. Brier muttered, and she darted over, her
cream chiffon dress fluttering, to scoop up the litter herself.
It was the first Monday in June, counting down to a United States Supreme Court
decision that could transform the landscape of American health care. But like
hospitals across the country, Maimonides is not waiting around for the verdict.
Win, lose or draw in court, administrators said, the policies driving the federal health care law are already embedded
in big cuts and new payment formulas that hospitals ignore at their peril. And
even if the law is repealed after the next election, the economic pressure to
care differently for more people at lower cost is irreversible.
“If the Supreme Court overturns this law — I pray it won’t — the world will go on
changing,” Ms. Brier said. “In some ways, we’ve changed ahead of it.” But she
added, “Trying to manage all these different aspects of the health care system
as they are changing does make you crazy.”
The century-old hospital, at the Borough Park crossroads of Hasidic, Asian,
Caribbean and Hispanic neighborhoods, is often cited by state regulators as an
example of good management and community service.
It has been in the black since 1996, after Ms. Brier took charge of operations, and
has increased patient volume every year while achieving some of the nation’s
best clinical outcomes, including exceptionally low mortality rates for pneumonia, heart
failure and heart attacks.
Yet even in a city with notoriously cranky consumers and cramped spaces, Maimonides’s patient satisfaction scores are abysmal —
especially in its maternity units, which deliver 8,000 babies a year. And
starting next year, under “value-based purchasing” contracts mandated by the
health care law and already entrenched in Medicaid and Medicare rules, failure to improve the satisfaction of
surveyed patients will cost hospitals.
hospitals have resorted to hiring outside consultants who coach nurses to
recite a script praising the care — a strategy resented by short-handed staff
members and denounced by their unions. Maimonides (pronounced my-MON-eh-deez),
a 711-bed hospital that recently added valet parking and free Wi-Fi, instead
asked labor-management teams in every unit to invent their own improvement
projects. In one initiative, nurses are making hourly rounds to offer patients
Monday, a new father spoke with heartfelt gratitude of the night nurse who had
explained that the chair where he was dozing upright opened into a bed.
treated us like family,” said the father, Iftekhar Aslam, 23, an American
citizen born in Pakistan, beaming under his baseball cap at his wife, Sobia
Khanum, and their newborn son.
not minded sharing the room, divided by a curtain, with another pair of new
parents — “Israel people,” he said, adding joyfully, “That’s New York — it’s
Khanum, 26, was pleased, too, but mentioned that her husband had been so ill
with fever before her due date that she had feared he would miss the birth. As
a contractor without insurance, she said, “he didn’t go to the hospital because
they send a huge bill.”
theory, if the health care law works as intended, Mr. Aslam could become part
of an influx of newly insured patients, offsetting government cuts in payments
to hospitals that treat a disproportionate share of the poor and uninsured. But
no one at Maimonides is counting on it.
frankly, if everything goes perfectly and everything is upheld, there’s a lot
of confusion and a lot of uncertainty here,” said Dominick Stanzione, the
hospital’s chief operating officer. “We also have an election coming up.”
The cuts, on the other
hand, seem inexorable, and not only because Medicaid and Medicare budgets are
strapped. The policy thrust in health care financing, private as well as
public, is to abandon reimbursements to hospitals according to the number of days
patients spend in a bed, in favor of models that use a fixed sum per patient or
set of patients over time, regardless of where care is delivered or how little
Maimonides’s own successes
have helped sell policy makers on the idea. Its collaboration with a state
psychiatric hospital a few years ago, for example, put medical-mental health
teams in storefront offices to manage the care of low-income patients with
serious mental illness. Such patients, who are eligible for both Medicaid and
Medicare, are among the health system’s most expensive and tend to have the
worst outcomes. The program cut hospitalizations in half and reduced
emergency-room use by 30 percent.
Ozier Muhammad/The New York Times
Pamela S. Brier, chief
executive of Maimonides Medical Center, is trying to raise the hospital’s
patient satisfaction rate.
“When the State Health Department people saw
our data, the little dollar signs danced in their heads,” Ms. Brier said.
under a government contract, Maimonides is gambling on a bigger version of that
program in partnership with 50 community agencies and Lutheran Medical Center,
its closest competitor, to care for 15,000 mentally-ill people in what policy
makers call a Health Home.
models immediately mean fewer visits to the emergency room, which is still a
hospital’s “cash cow,” said Dr. Karen R. Nelson, executive director of the
Health Home consortium. But ways for hospitals to reap part of the government
savings are still in development, and patients excluded from the Affordable
Care Act as illegal immigrants will still require costly emergency care.
hospital to undertake this when A.C.A. is uncertain is very scary,” Dr. Nelson
same time, Maimonides is competing on the old fee-for-service turf by
recruiting surgical and cancer specialists, partly to woo more commercially
too, pitfalls abound: a growing share of the hospital’s unpaid medical bills
are for patients who have private insurance but have been pushed into
high-deductible plans, administrators said. Moreover, such plans typically do
not reimburse care in the collaborative models the hospital is working so hard
to develop — a problem that could intensify, they said, if the court rejects
the individual insurance mandate but lets the rest of the health care law
between model and reality was evident last week in the emergency room, which
had more than 114,000 visits last year, up from 83,000 eight years ago.
section where triaged patients are seated to save space for more stretchers,
one of those known as “frequent fliers” was back for the seventh time in six
months, covered by Medicare.
Lewis Rosen, 62, who said he had to come in for a psychiatric visit anyway, was
unhappy with the rate of healing of an incision in his leg, despite treatment
at an outpatient wound care center and home visits by a nurse.
our own worst enemy,” said Dr. Kenneth Sable, head of the emergency department,
scrolling through Mr. Rosen’s electronic medical record. “Instant gratification
is what people have come to expect.”
man hunched on a stretcher began to cry. It was his third visit in three days
with a complicated story about a dental problem that he said had affected his
mobility. After tests, he had been referred to a neurologist, but had not gone.
want pain medication,” cried the man, Salvador Monduori, 68. “I don’t want to
hours later, when doctors concluded that there was nothing more to do, they had
to call security to make him leave, Dr. Sable said.
gurney at the other end of the room, Luis Velecela, 36, a construction worker,
was confused but stoic after a diagnosis of stomach cancer. He had no
insurance, he said, and had been treating his pain and nausea with antacid
pills until an endoscopy at Maimonides revealed the tumor.
“All hospitals in the country
are facing the same changes,” Dr. Howard L. Minkoff, head of obstetrics, said
later. “We are doing it without a net.”
Health care court ruling could paralyze Medicare
Sunday, 17 June 2012 11:52
CHICAGO | Tue Jun 5, 2012
CHICAGO (Reuters) - Opponents of President
Barack Obama's health care law have been predicting dire consequences for
seniors on Medicare ever since the legislation was signed last year. The
warnings are mostly political spin, but there could be real problems if the U.S.
Supreme Court strikes down the Affordable Care Act this month.
The ACA, a cornerstone of President Obama's health care plan, would extend
health insurance to an additional 23 million Americans by 2019. But it's run
into significant roadblocks as opponents argue that key components are
The Supreme Court could decide to uphold the law, strike down specific
portions or toss it out entirely. A decision is expected by late June.
Important improvements to Medicare would disappear if the high court decides
to toss out the entire law. The decision could paralyze the Medicare system
because the act lays out the benefits, payment rates and delivery systems. Some
of the changes already have been implemented, and others are works in
"If the law is struck down, there will be a high level of chaos and confusion
the very next day, especially in Medicare," predicts Bonnie Washington, senior
vice president of Avalere Health, a health policy consulting firm. "Every single
provider payment that Medicare makes now has been modified one way or the other
by the Affordable Care Act."
The Centers for Medicare & Medicaid Services, which runs Medicare, is not
commenting on how it might proceed if the law is nullified. But the
administration has warned the court of "extraordinary disruption" to the
CMS might attempt to assert its own administrative authority - and perhaps
use executive orders from President Obama - to continue paying claims and
providing benefits so the Medicare system doesn't freeze up. But disruption will
be virtually unavoidable.
"Some of this could be fixed with administrative authority," said Joe Baker,
president of the Medicare Rights Center, a non-profit consumer rights group.
"But I don't think most of it would be."
LOST DRUG COVERAGE
The most immediate change would hit seniors who enter the "doughnut hole" in
Medicare's Part D prescription drug program - the gap in coverage that starts if
total annual drug spending by a senior and his or her insurance company exceeds
a certain level. In 2012, coverage stops when spending reaches $2,930, and
resumes at $4,700.
This year, the Affordable Care Act calls for pharmaceutical companies to
provide a 50 percent discount on brand-name drugs to most beneficiaries who find
themselves in the gap; there's also a 14 percent discount on generic
Last year, 3.6 million seniors hit the gap and saved a collective $2.1
billion due to the health care law, according to the U.S. Department of Health
and Human Services. In the first four months of 2012, more than 416,000 people
saved an average of $724 on prescription drugs bought after they hit the cap,
for a total of $301.5 million. Last year, 3.6 million seniors entered the gap
and saved $2.1 billion, the health department says.
The Supreme Court ruling could come just as many seniors hit the gap, and
they could lose prescription drug insurance protection they were counting on
"The contracts between the government and pharmaceutical companies are made
possible by the ACA," says Anne Hance, a partner at the law firm McDermott Will
& Emery, who specializes in federal and state health insurance. "If the ACA
is struck down, the question will be whether there is still a statutory
obligation for the pharmaceutical companies to provide the discounts."
Pharmaceutical companies could decide to continue the drug discounts
voluntarily in order to protect sales of their branded drugs in the Part D
program, and to avoid patient shifts to generics. Drug companies also might want
to continue the discounts for public relations reasons.
But seniors worried about gap coverage should review the branded drugs they
"Ask your doctor if there are lower-cost alternatives that you could use if
necessary that are just as effective," says Washington, of Avalere
This fall's enrollment season for prescription drug plans also could be
affected by a court ruling. Enrollment runs from mid-October to early December,
and pharmaceutical companies are submitting their bids this week to the Centers
for Medicare & Medicaid Services based on the terms of the Affordable Care
"The timing for CMS would be very difficult," says Tricia Neuman, vice
president of the Henry J. Kaiser Family Foundation and director of its Medicare
Policy Project. "They would need to scramble very quickly to make decisions on
payments for 2013 just as the bids are coming. There wouldn't be a lot of time
to make adjustments."
Medicare's new free annual wellness visit and other screening services also
Starting next year, seniors could expect to pay higher premiums than they
otherwise would have faced for Medicare Part B (physician visits and other
outpatient services). The law was expected to reduce Medicare spending by $428
billion between 2010 and 2019, through cuts in payments to doctors and
hospitals, and changes in the way health care is delivered, according to the
Kaiser Family Foundation.
If the law is struck down and those savings provisions do not take effect,
Medicare spending will rise, which would lead to higher Part B premiums. By law,
Centers for Medicare & Medicaid Services sets the Part B premium so that
beneficiaries cover 25 percent of the program's cost.
"That means if Part B spending rises, beneficiaries will pay higher
premiums," Neuman warns.
(The writer is a Reuters columnist. The opinions expressed are his
(Editing by Jilian
Emery and Dan Grebler)
Preserving the Medicare Guarantee: Why I've Been Working with Paul Ryan
Sunday, 17 June 2012 11:47
Posted: 03/19/2012 4:46 pm
People on both sides of the aisle want to know why a progressive Democrat is working with the author of last year's House Budget on Medicare reform. Here's why:
When I was 27 years old, I organized legal aid clinics to help low income seniors. It was a life-altering experience. I'd be invited into someone's home and after coffee and a few stories about the grandkids or the Great Depression, my host would reluctantly pull out a shoebox, swallow his or her pride and ask for my help.
The shoebox would be full of supplemental Medicare insurance policies. Often there were more than ten separate policies. These policies were supposed to cover the benefits, co-pays and deductibles that Medicare didn't, but most weren't worth the paper they were printed on. Unscrupulous insurance agents would prey on a senior's health concerns and fear of being a burden on loved ones in order to extract monthly payments often for multiple policies that offered benefits that the senior already had, didn't need and usually couldn't afford.
The victims of these scams -- seniors who had lived through two world wars -- would look at me with shame in their eyes and tell me that they should have known better.
Stopping those insurance rip-offs was one of the reasons I ran for Congress.
Fighting for Seniors
It took a little over a decade to build a coalition strong enough to beat the insurance companies, but in 1990, then Senator Tom Daschle and I passed a law regulating the private market for supplemental Medicare insurance policies. We created benefit standards so that seniors would know exactly what they were signing up for and we imposed heavy fines on anyone who took advantage of seniors. That Medigap law is still the model for consumer protection today.
I did not stop fighting for seniors there. In the early 1990s then Representative Olympia Snowe and I were among the first to propose bipartisan legislation to add a prescription drug benefit to Medicare. When a Medicare Prescription Drug benefit was ultimately added to Medicare, Senator Snowe and I began pressing for legislation that would empower Medicare to use its market power to negotiate the best prices for seniors.
Congressman Ed Markey and I authored a law to create Medicare's first home-based health program for seniors with chronic illnesses. I've written and passed laws to give Medicare beneficiaries access to life saving cancer drugs and to ensure that seniors don't have to give up the prospect of a cure when they go into hospice care. The Department of Health and Human Services recently reported that -- thanks in part to a reform I authored in the Affordable Care Act -- Medicare Advantage premiums are down, enrollment is up and more and more seniors have quality health coverage.
In just the last year, I have introduced legislation to expand a senior's choice of mental health professionals, reduce Medicare fraud and bring transparency to Medicare payments. I also authored a discussion paper with Chairman Paul Ryan exploring ways in which Democrats and Republicans might work together to ensure a sound future for Medicare.
The Medicare Guarantee is at Risk
I know that polls show that the majority of Americans like Medicare the way it is today. But don't let that number confuse what's at stake: unless Congress enacts meaningful Medicare reform in the near future, seniors will be faced with inevitable cost-shifting and eventual benefit cuts until Medicare doesn't look anything like the program does today.
The Congressional Budget Office projects that the Medicare Hospital Trust Fund will be out of money by 2022. And as MedPac explained in its report to Congress last year, Congress's continued inability to come up with a long term solution for Medicare's reimbursement rate for doctors "is undermining confidence in the Medicare program."
Last year, Congress passed a mere 60-day extension of Medicare physician pay rates in order to avoid asking doctors to swallow a 27.4 percent cut to Medicare physician pay. Although a 'deal' was eventually reached to pay doctors for their services through the end of this year, chronic payment uncertainty and already low reimbursement rates are forcing more and more doctors to consider dropping or limiting the number of Medicare patients they are willing to treat. This is a significant problem given that retiring Baby-Boomers are no longer a theoretical problem. Starting this year, an average of 10,000 Americans will enroll in Medicare each day for the next 20 years.
The Medicare Guarantee is Our Nation's Most Solemn Promise
I believe the most important aspect of Medicare is not the structure of the program but the guarantee to all Americans that they will have high quality health care as they get older. I will always fight to protect traditional Medicare, but in my mind, what makes Medicare so important is its guarantee It is one of our nation's most solemn promises and history has shown what can happen when it doesn't exist.
Before Congress created Medicare in 1965, more than 50 percent of American seniors didn't have health insurance, mostly because of its unaffordable cost. It was not uncommon for the sick elderly to be treated like second class citizens, and as a result, many aging Americans without family to care for them, ended up destitute without necessary health care, or on the street. It was a disgraceful time in our nation's history; we must take steps to ensure that it never happens again.
Traditional Medicare Doesn't Work the Same for Everyone
Contrary to popular belief, every Medicare beneficiary is not currently enrolled in Medicare's government-administered health insurance plan. In Oregon, for example, 56 percent of seniors currently get all or some of their health coverage from a private plan. (15 percent of Oregon seniors purchase private Medigap policies to supplement their traditional Medicare, while 41 percent of Oregon's Medicare beneficiaries are enrolled in private health insurance plans through Medicare Advantage.) It is worth noting that many Medicare Advantage plans in Oregon save money over traditional fee-for-service Medicare.
While most seniors are very happy with the Medicare benefits that they get from the government, it is important to remember that Medicare isn't perfect and doesn't work the same for everyone.
For example, traditional Medicare does not offer catastrophic coverage or dental benefits. To get those options, seniors have to pay for supplemental private insurance. While many private plans offer the option of prescription coverage as part of their insurance packages, under traditional Medicare, seniors have to sign up for those benefits separately. While some seniors like the freedom Medicare gives them to find and choose their own participating doctors, some prefer an integrated private health plan that has identified a network of doctors, testing facilities and pharmacies that work together, collaboratively on the needs of their enrollees .
And again, just because you are enrolled in Medicare's government-administered option does not mean that you are guaranteed to find a doctor willing to take on new Medicare patients. Seniors in historically-low reimbursement states like Oregon have long had difficulty finding doctors and more and more seniors in other parts of the country are starting to encounter this problem. For this reason, many seniors in Oregon have been grateful to learn that Medicare gave them the option of enrolling in a private plan.
Finally, Medicare's copays and deductibles are not insignificant for a senior living on a fixed income, regardless of plan choice. While Americans under the age of sixty-five pay an average of 3 percent of their total income on health care, Americans over the age of sixty-five are spending 16 percent of their total income on their health needs. It is projected that by 2020, that number will reach 26 percent. With nearly 62 percent of seniors living on incomes of less than $30,000 annually, this is particularly worrisome no matter what it says on a beneficiary's Medicare card.
Not All Plans that Include Private Insurance Choices are Created Equal
While allowing seniors to choose between traditional Medicare and privately-administered health plans would not "end Medicare as we know it," (since this choice already exists in Medicare) changing the program in a way that would undermine or end the Medicare Guarantee certainly deserves that description.
There is no question in my mind that last year's House Republican Budget would have ended the Medicare Guarantee, that is why I voted against it. Not only did the Republican plan eliminate Medicare's traditional government-administered insurance program, it failed to include tough consumer protections for seniors. The vouchers it would have given seniors to purchase health insurance weren't guaranteed to cover the cost of health insurance over time. Seniors aren't guaranteed to have health insurance if affordability isn't guaranteed as well.
Voters would be right to consider their representative's vote on that budget as an indication of their representative's commitment to the Medicare Guarantee. Put simply, if you want to be sure that your Member of Congress will not vote to end the Medicare Guarantee in the future, you would probably be better off with a representative who didn't vote to end it in the past.
But doing nothing is also a direct threat to the Medicare Guarantee. Congress must pass meaningful reform within the next few years and since it is highly unlikely that Democrats are going to win a super majority of seats in both the House and the Senate this year, the only way to pass legislation upholding the Guarantee is for Democrats and Republicans to work together. To protect Medicare, we have to get the dangerous ideas off the table and start looking for solutions that will ensure that seniors will always be able to get the care they need.
This is why I started talking to Paul Ryan about Medicare.
What Wyden-Ryan Really Says
There have been a lot of mischaracterizations. So, let's be clear about what the Wyden-Ryan plans really says.
Wyden-Ryan doesn't eliminate the traditional Medicare plan, instead it guarantees that seniors who want to enroll in Medicare's traditional fee for service plan will always have that option.
Wyden-Ryan doesn't privatize Medicare because Medicare beneficiaries already have the option of enrolling in private health insurance plans. Wyden-Ryan makes those private plans more robust and accountable by forcing them to -- for the first time -- compete directly with traditional Medicare.
Wyden-Ryan protects the purchasing power of traditional Medicare and private sector innovation to make both types of Medicare stronger and more senior-friendly. All participating private plans will be required to offer benefits that are at least as comprehensive as traditional Medicare and any plan that is found taking advantage of seniors or providing inadequate care will be kicked out of the system. Cherry picking healthier seniors will be made unprofitable by a robust risk-adjustment mechanism and policed by the Medicare administrators.
Wyden-Ryan would also uphold the Medicare Guarantee by ensuring that seniors will always be able to afford their health benefits. Unlike a voucher program that would give seniors a fixed amount of money to purchase health plans, Wyden-Ryan would adjust premium support payments each year to reflect the actual cost of health insurance premiums. In addition, low income seniors, including dual-eligibles will receive additional benefits to cover out of pocket costs - ensuring that seniors have the same choices regardless of income. Yes, if private plans are able to devise a way to provide the same health benefits as traditional Medicare for less money, a senior might have to pay extra if he or she still wants to enroll in the government option. But if you could get the exact same benefits for less money, why would you want to pay more?
Beyond that, Wyden-Ryan creates a catastrophic benefit that does not exist in traditional Medicare, ensuring that no senior is bankrupted by a major illness.
Finally, Wyden-Ryan isn't a piece of legislation. It does not include legislative language or specifications detailing exactly how the system would work. If Wyden-Ryan or something like Wyden-Ryan gets to the legislative stage, those specifications will be important to get right as the devil is always in the details. Right now, however, Wyden-Ryan is simply a policy paper intended to start a conversation about how Democrats and Republicans might work together to uphold the Medicare Guarantee.
Using Wyden-Ryan for Political Cover Harms Seniors
Yes, just as some in my party criticize Wyden-Ryan without knowing what the plan really does, some Republicans will undoubtedly declare their support for Wyden-Ryan without knowing what that means or believing in its principles. Mitt Romney, for example, claims to have helped write Wyden-Ryan even though I have never spoken to him about Medicare reform and have yet to hear him declare that there should always be a role for traditional government-run Medicare.
Those who say they support Wyden-Ryan simply for political cover are neither helping seniors nor being bipartisan. Rather, using Wyden-Ryan for political purposes harms seniors by making a bipartisan agreement to uphold the Medicare Guarantee that much harder. Anyone who does this deserves to be called out on it.
However, by that same token, those of us who care about the Medicare Guarantee shouldn't discourage Republicans from working in a bipartisan way to preserve the program in the future. Even though it might blunt some political attacks, we should be encouraging Republicans to take dangerous reforms off the table and pledge their support for Medicare. Just as we should be working to educate our conservative colleagues about the importance of a program many of them clearly don't understand. The upcoming election is important, but after the election, we're going to have to pass Medicare reform and that is going to require us to work together.
This week, Congressman Ryan will be unveiling the House Republican Budget. I do not know know what the details of the budget will be. I didn't write it and I can't imagine a scenario where I would vote for it. I do know, however, that because we worked together, Paul Ryan now knows more about the Medicare Guarantee and protecting seniors from unscrupulous insurance practices than he did before. If that is reflected in his budget this year, as someone who has been fighting for seniors since he was 27 years old, I think that's a step in the right direction.
Follow Sen. Ron Wyden on Twitter: www.twitter.com/@RonWyden
Center on Budget and Policy Priorities
Tuesday, 29 May 2012 11:54
May 14, 2012
LOWER-THAN-EXPECTED MEDICARE DRUG COSTS MOSTLY
REFLECT LOWER ENROLLMENT AND SLOWING OF OVERALL
DRUG SPENDING, NOT RELIANCE ON PRIVATE PLANS
by Edwin Park and Matt Broaddus
The House-passed budget would convert
Medicare to a “premium support” voucher to
purchase private health insurance or traditional
1 Some supporters of premium support
— most notably House Budget Committee
Chairman Paul Ryan, who designed the House
proposal — claim that reliance on private insurers
would lower Medicare costs. As evidence, they
cite the fact that the Medicare Part D drug benefit,
which took effect in 2006, has cost less than
predicted when Congress enacted it. They
attribute this lower spending to efficiencies
produced by competition among the private
insurers that deliver the drug benefit.
Analysis indicates, however, that reliance on
private plans to deliver the Medicare drug benefit had little or nothing to do with Part D’s lowerthan-
expected spending. The two primary factors that drove the reduction in Medicare Part D
spending (relative to the earlier cost estimates) were lower-than-expected program enrollment and
For analysis of the budget proposal to convert Medicare into a “premium support” system, see Paul N. Van de Water,
“Medicare in the Ryan Budget,” Center on Budget and Policy Priorities, March 28, 2012; Paul N. Van de Water, “What
You Need to Know about Premium Support,” Center on Budget and Policy Priorities, March 19, 2012; and Paul N. Van
de Water, “Ryan-Wyden Premium Support Proposal Not What It May Seem,” Center on Budget and Policy Priorities,
revised December 21, 2011.
See, for example, House Budget Committee Chairman Paul Ryan’s March 20, 2012 address at the American Enterprise
. See also Kathryn Nix, “Recipe for Reform: Success of Consumer-Driven Principles in
Medicare Programs,” Heritage Foundation, August 10, 2011 and Joseph Antos, “What Does Medicare Part D Say About
the Ryan Plan?,”
RealClearMarkets.com, June 15, 2011.
Half of Lower Medicare Drug Spending
Due to Lower Than Projected Enrollment
Source: CBPP analysis of the Medicare Trustees 2004
and 2012 reports.
820 First Street NE, Suite 510
Washington, DC 20002
the sharp decline in spending growth for prescription drugs throughout the U.S. health system. A
recent analysis issued by the Kaiser Family Foundation reaches similar conclusions.
This analysis expands on earlier work we have conducted on this matter
4 and finds:
News and Opinion Concerning Health Savings Accounts,Medical Costs and Health Care Reform
Tuesday, 29 May 2012 11:38
Politico: Health care reform: GOP preps plan for ruling on law. By Jake Sherman and Jennifer Haberkorn. Excerpts: House Republican leaders are quietly hatching a plan of attack as they await a historic Supreme Court ruling on President Barack Obama’s health care law. If the law is upheld, Republicans will take to the floor to tear out its most controversial pieces, such as the individual mandate and requirements that employers provide insurance or face fines.
If the law is partially or fully overturned they’ll draw up bills to keep the popular, consumer-friendly portions in place — like allowing adult children to remain on parents’ health care plans until age 26, and forcing insurance companies to provide coverage for people with pre-existing conditions. Ripping these provisions from law is too politically risky, Republicans say.
Read entire article; very interesting what the far right is contemplating to do to the Affordable Care Act--JK