Churchill
Let's make Medicare into a cost-cutting laboratory to
determine the more cost-effective methods of care.
By my lights, the most important Medicare "cut" would be
implementation of "evidence-based medicine.".
EBT would eliminate widespread foolishness such as the prescription of antibiotics for flu.
There are better examples of "EBT savings"
but they tend to require wonkish explanation.
Ask your doctor.
"Evidence-based-medicine" will save gobs of money,
simultaneously making use of "The Medicare Laboratory" to
demonstrate that "better healthcare is less expensive" than the
current practice of non-scientific "whimsy-based, straw-clutching, redundant medicine."
Elsewhere on the Medicare horizon...
Although "death panels" are America's new "third
rail," it is crucial that Medicare provide "end-of -life
counselling" so that medically naive patients (and medically naive
families) do not clutch at "11th hour straws" whose purpose is to
prolong death when it is no longer possible to prolong life. (N.B. Clutching at
straws is encouraged by many hospitals which see "end-of-life"
patients as dependable "cash cows" to be milked for as long as
"medical heroics" can prolong the patient's death. Not only is this practice costly, it is cruel.)
In the longer run, it would be good -- albeit politically
impractical -- if The Democratic Party stated "The
Obvious":
"The United States is destined to implement a universal
healthcare system very much like "single payer systems" -- or
"public option" systems -- used everywhere else in the developed
world to provide high-quality healthcare at half the cost." (See National
Geographic's "Cost of Care" graph at the end of this post.)
 | August 15, 2012 |
 Ezra Klein's Wonkbook | ||
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Top story: After Ryan pick, Medicare and Medicaid in spotlight
Obama and Ryan have set off a major political clash over Medicare. “With 50 million beneficiaries, Medicare is a major concern for both parties…Representative Paul D. Ryan's budget blueprint assumes the same amount of Medicare savings as President Obama's health care law, even though Mitt Romney and Mr. Ryan have said those cuts would be devastating to millions of older Americans on Medicare. As the partisan brawl over Medicare continued on Tuesday and threatened to become the focus of the race, the Obama campaign said that Mr. Ryan's budget plan -- broadly endorsed by Mr. Romney -- "would end Medicare as we know it" and shift costs to beneficiaries.” Simon Johnson in
The Romney/Ryan campaign’s first ad attacks Obama for cutting Medicare: Watch it here.
The Affordable Care Act does cut $716 billion from Medicare. Here’s how. “The Romney campaign has gone on the offense on Medicare, charging that the Affordable Care Act ‘cuts $716 billion’ from the entitlement program. That $716 billion figure is one you'll probably be hearing a lot about during this election cycle. It's worth understanding where it comes from and what the spending reductions mean for the Medicare program…The majority of the cuts, as you can see in this chart below, come from reductions in how much Medicare reimburses hospitals and private health insurance companies.”
Sarah Kliff in The Washington Post.
@ByronTau: Asked to say something nice about Romney, Obama says: “I really think he had a great health care plan when he was in Massachusetts.”
Interview: Sen. Ron Wyden on his, versus Romney-Ryan’s, Medicare reform plans. “My view is that the policies that were adopted by the Republican House majority and the Romney campaign do not preserve the Medicare guarantee…[T]he Romney approach completely pulls the rug out from under the poorest and most vulnerable seniors.”
Romney and Ryan, in fact, don’t see eye-to-eye on Medicare. ”What makes this battle unusual is the lineup on each side. Rep. Paul Ryan’s budget plan this year incorporated the Obama cuts. But presumed Republican candidate Mitt Romney, who just tapped Mr. Ryan as his running mate, says the cuts will gut Medicare, and he is pledging to repeal them. The divide on the GOP ticket--as well as Democrats’ preference for discussing other parts of the health law--reflects the difficulty of finding a politically acceptable way to overhaul Medicare.” Peter Landers in The Wall Street Journal.
KLEIN: Time to clarify a persistent misunderstanding: Paul Ryan keeps Obama’s Medicare cuts. ”Since the Romney campaign wants to run against President Obama's cuts to Medicare, it's something of a problem for them that Paul Ryan's budget includes those very same cuts to Medicare. And so they've come up with a somewhat confused and confusing argument to distinguish the two plans. Obama's cuts to Medicare are different because Ryan ‘keeps that money for Medicare to extend its solvency’ while Obama uses it ‘to pay for a new risky program of his own that we call Obamacare.’ This is basically a misunderstanding of how budgeting works. Or, at the least, it's predicated on the listener misunderstanding how budgeting works.” Ezra Klein in The one part of Obamacare that Ryan’s budget embraces is the Medicare cuts. This debate is bang-your-head-against-the-
MARCUS: The Medicare conversation we should be having. ”Aren't [Republicans] the people who have been screaming about Medicare bankrupting the country? Shouldn't they be praising cuts, not denouncing them? The on-the-merits response is that the cuts -- more accurately, reductions in the rate of growth -- involve lower reimbursements to hospitals and nursing homes, reduced payments to insurers, higher premiums for better-off beneficiaries, and savings from reforms such as lower hospital readmissions. In other words, Grandma might lose her free eyeglasses, but her basic benefits remain untouched. The fairer question is whether the savings should have been used to reduce the debt rather than underwrite low-income subsidies in Obamacare.” Ruth Marcus in The Washington Post.
But Romney and Ryan’s Medicaid cuts are larger, and happen sooner, than their Medicare cuts. “Over the next 10 years, the Ryan plan would cut Medicaid by $642 billion by repealing the Affordable Care Act and by $750 billion through new caps on federal spending--a 34 percent cut to Medicaid spending over the next decade…So all in all, Ryan's cuts could mean as many as 30 million Medcaid beneficiaries lose their coverage.” Suzy Khimm in the Washington Post.
@ezraklein: I really want Paul Ryan to respond to a question about his 2011 budget by saying, “When I was young and reckless, I was young and reckless”
Top op-ed:
KLEIN: Romney’s budget plan is a fantasy that will never, ever happen. “Consider what the Romney campaign, then, is saying: If Romney is elected, then by his third year in office, every single federal program that is not Medicare, Social Security, or defense, will be cut, on average, by 40 percent. That means Medicaid, infrastructure, education, food safety, road safety, the postal service, basic research, foreign aid, housing subsidies, food stamps, the Census, Pell grants, the Patent and Trademark Office, the FDA -- all of it has to be cut by, on average, 40 percent. If Romney tried to protect any particular priority, it would mean all the others have to be cut by more than 40 percent.” Ezra Klein in the Washington Post.
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