“In 2012, Obamacare will create the ‘Value-Based Purchasing Program’ in Medicare. Using a pay-for-performance scheme, the program will reimburse hospitals and other health care providers at different rates based on how they score on performance measures chosen by the Secretary of Health and Human Services. Proponents of pay-for-performance see it as a way to use financial incentives to streamline and improve the quality of health care while attempting to reduce costs. But the fact is that standardization of the practice of medicine costs patients and physicians tremendously, and evidence shows it does very little to improve health outcomes.”Details
Another reminder that the Congressional drafters of what’s come to be called ObamaCare shaved fiscal corners came early this month in a notice published in the Federal Register. The news: after May 5, 2011, no more applications will be received for the Early Retiree Reinsurance Program. Why? The applications already received plus those expected to be received by May 5 will blow through the money available.Details
“Supporters of ObamaCare acknowledge it will have some unintended consequences. Yet surprisingly little attention has been focused on the law’s most problematic provision: government subsidies to help individuals and families purchase health insurance.”Details
“President Obama’s plan for budget reform is to freeze these entitlement programs in their current arrangements and tinker at the margins — through, for instance, giving more power to Medicare’s Independent Payment Advisory Board or applying price controls to drugs sold through Medicare.
Along with higher taxes for high earners (families making $250,000 and up) and defense cuts, Obama’s deficit-reduction plan offers little innovation.
If Obama’s plan prevails, and these programs aren’t fundamentally reformed, poor and elderly Americans who depend on these programs will likely face much larger cuts in the future.”
“It is an occupational hazard for politicians to think that they and their ilk know best, and by all indications Mr. Obama rather likes centralization. In my professional lifetime in the centralized British health-care system, however, I have seen a hundred schemes of cost reduction, but I have never seen any reduction in costs, or at least any that lasted more than a few months. I can’t remember a single health minister who did not promise more efficiency at less cost, or a single one who actually managed to achieve it.”Details
“The time has come for a long-overdue, honest discussion on not just the impact that government will have on patients, doctors, and the practice of medicine, but the impact it already has had over the past forty-five years. The importance cannot be undersold as the Patient Protection and Affordable Care Act is indeed bad for doctors, but it is always the patient that suffers the most.”Details
“The Patient Protection and Affordable Care Act (PPACA) creates federal ‘accountable care organizations’ (ACOs). In theory, ACOs provide financial incentives to health care organizations to reduce costs and improve quality. In reality, given the complexity of the existing system, ACOs will not only fail; they will most likely exacerbate the very problems they set out to fix. ACOs will concentrate more and more power in fewer and fewer organizations, allowing them to become ‘too large to fail.’ Such a system undermines competition and entrepreneurship—the bedrock of innovation and job growth in this country.”Details
“Mr. Obama wants to expand the power of the 15-member panel, which was created by the new health care law, to rein in Medicare costs.
But not only do Republicans and some Democrats oppose increasing the power of the board, they also want to eliminate it altogether. Opponents fear that the panel, known as the Independent Payment Advisory Board, would usurp Congressional spending power over one of the government’s most important and expensive social programs.”
“Messrs. Ryan and Obama agree that Medicare spending must decline, and significantly. The difference is that Mr. Ryan would let seniors decide which private Medicare-financed insurance policies to buy based on their own needs, while Mr. Obama wants Americans to accept the commands of 15 political appointees who will never stand for election.”Details
“The ACA presents New York policymakers with a unique opportunity to reform its individual and small-group insurance markets. However, creating an effective market-based exchange requires policymakers to recognize that simply imposing its current high-cost insurance arrangements on the exchange may lead to the collapse of the exchange over time. Instead, reforms should build on the lessons learned from state exchanges in Utah and Massachusetts, federal programs such as Medicare Part D, and private exchanges such as New York’s HealthPass.”Details