I...I don't want doctors competing for my business. I don't want to shop around for the best care. I want health care to be good enough in general that I don't have to do that. I don't want stratification. I want everyone to pay their taxes and have access to high-quality care in return.

I mean...motherfucker. I ain't expect interstates to compete for my business, wooing me with lower tolls and better pavement.

[Edited on March 1, 2010 at 4:00 PM. Reason : Peace, we outta here.]

3/1/2010 4:00:38 PM

The article makes a lot of insights, but it's ultimate argument is flawed. The simple truth is this: America spends significantly more on health-care than other nations and that extra expense is not realized in quality. A correlation between an increase in the # of insured, and the increase in the total health care-costs doesn't account for per-capita and per-procedure cost increases.

It doesnt make sense to blame doctors for high prices. Insurance customers can choose from a wide variety of in-network doctors.

[Edited on March 1, 2010 at 4:03 PM. Reason : .]

3/1/2010 4:02:32 PM

The altered cost of insurance-covered health care services DOES affect consumption behavior.

For example: Patient John Doe, 30, has high deductible health insurance. Once he meets his deductible of $2500, any service or drug is covered at 80%. Otherwise, John pays fully out of pocket. John has a history of GI disease, but he is lucky enough to be able get by on low-cost generic medications, his controlled disease has no symptoms, and he is otherwise healthy. Being generally healthy, the usual health care services Mr. Doe consumes are a yearly visit to his GI doc, some related blood tests, his daily meds, and the very occasional trip to the PCP for a cold. John knows he is at an increased risk for colorectal cancer because of his GI disease. His GI doc recommends a colonoscopy every 5 years. Now, it has been 4 years since his last colonoscopy and Mr. Doe breaks his arm while playing sports. The associated costs exceed his $2500 deductible. Don't you think John calls his GI doc to get that colonoscopy done early, when it will be discounted 80%? And, while he's at it, don't you think he calls the dermatologist to get that weird bump on his neck looked at? When he is feeling sick, now that his deductible has been met, John probably has a much easier decision on his hands when considering whether to go to the doctor right away or take some OTC meds for a few days first.

3/1/2010 4:08:50 PM

Froshkiller's approach to life:

Quote :

"I want... I want... I don't want... I want..."

You probably voted for whichever kid was offering free-pizza-fridays in school didn't you

3/1/2010 4:13:01 PM

I didn't deny that it made sense in theory.

3/1/2010 4:13:19 PM

its human nature. You have to get the consumer back into the cost equation.

Anyone want to guess what the medicare deductible went up to this year? And I hear people bitching about it several times a week. It will make you laugh

3/1/2010 4:43:27 PM

I'll admit I didn't even know Medicare HAD a deductible. What is it - $50 or something meaningless like that?

3/1/2010 4:46:49 PM

jcs1283 don't you think john asslicking doe forgoes care that is well below his deductible yet uncomfortably beyond his general means

[Edited on March 1, 2010 at 4:58 PM. Reason : fuck me i should get tested for hiv but i need that $50 for beer this weekend]

3/1/2010 4:56:11 PM

"who cares"

[Edited on March 1, 2010 at 4:58 PM. Reason : quote from FroshKiller]

3/1/2010 4:58:17 PM

155 up from 135.

3/1/2010 5:06:00 PM

^x3 - Besides the point in this example. If John Asslicking Doe can't come up with less that $2500 for a rainy day, the man needs to change his lifestyle. But let's go with no. John Asslicking Doe doesn't forgo care. He doesn't have too! Needing care that is well below his deductible yet uncomfortably beyond his general means, Mr. Asslicking Doe uses the ER under a false name, getting that HIV test while saving the 50 bucks for beer. He can have his cake and eat it too!

3/1/2010 5:29:29 PM

I think we're all missing a significant point which is that the blue-collar types out there view seeking healthcare as "unmanly"

3/1/2010 5:44:02 PM

http://www.reuters.com/article/idUSTRE61O4NV20100301?type=politicsNews

YES!!! First cracks appearing in the democratic push since the HC summit.... Hopefully this means the "big bill" is dead.... One down, one to go... Keep it up, repubs!


Edit... News is rolling in now:
http://blogs.wsj.com/washwire/2010/03/01/stupak-its-not-just-abortion/

Quote :

"A big concern among House members, Stupak said, is that they will be forced to vote on the Senate bill with no assurance the package of changes aimed at appeasing House members will ever get approved. “You’re going to make members vote for a bill that’s going to be hung around your neck come Election Day,” he said. “After sending so much legislation to the Senate, we just don’t trust that they’re going to do it.” Asked whether he had enough antiabortion Democrats to block the bill, Stupak said he hasn’t “whipped” –or counted — the votes since Pelosi has yet to put forward a formal health package. But regardless of how that group votes, he doesn’t think the legislation will pass. “I’m not optimistic they’d get the votes in the House,” he said."

[Edited on March 1, 2010 at 7:26 PM. Reason : s]

3/1/2010 7:18:52 PM

Breaking News: The most conservative democrat in the House, who hasn't "counted the votes," still isn't "optimistic," which is same he has ever been for months on end.

Your articles also says

Quote :

""In a matter of days, we will have a proposal," Pelosi said during an event in Denver, according to Fox News."

which sounds to me like the wheels are still turning.

3/1/2010 8:32:26 PM

Time will tell

3/1/2010 9:17:17 PM

Supplanter by now you must have realized they will have to pass something with the name health reform on it. It is political suicide for the Dems not to pass SOMETHING.

Im hoping it wont amount to much, and we can actually look to moving to HSAs next year.

3/2/2010 9:11:30 AM

eyedrb, really, the Democrat's current proposals don't do that much. I am really at a loss of how something so moderate could inspire such outrage.

[Edited on March 2, 2010 at 9:56 AM. Reason : ``]

3/2/2010 9:52:31 AM

Because just as the Democrats must pass SOMETHING, Republicans must block EVERYTHING.

3/2/2010 10:19:18 AM

they should've meaningfully included the GOP in something as huge as this.

3/2/2010 10:42:03 AM

Socks, I disagree. The current plan gives govt control of all healthcare/ins within 5 yrs. Thats pretty Fing big. IMO. Not to mention adding yet another entitlement when we cant afford the ones we have already.

Add that to the washington spending spree and you should understand the outrage.

3/2/2010 10:42:04 AM

Quote :

"gives govt control of all healthcare/ins within 5 yrs."

wut?

3/2/2010 10:43:09 AM

eyedrb,

But this isn't creating a new entitlement program. Nor is the government taking over the health insurance industry. Maybe we should communicate what specifically we think the Democrats are proposing. Here is what I am hearing:

1) Regulating Insurance Companies So that they cannot deny coverage based on pre-existing condition

2) Individual mandate to ensure that #1 doesn't lead to an adverse selection death spiral

3) Subsidies to help low income individuals cover a portion of their insurance costs (so #2 doesn't impose unfair burden on the poor).

That are the 3 big spokes I see in all current Democrat proposals. What do you see?

3/2/2010 11:46:50 AM

I see a projected cost. (which will be entirely low)

I see taxes for 10 yrs, service for 6. And heralded as savings.

I see the govt forcing everyone to buy thier insurance through an insurance exchange. Oh yeah, which is directly controlled by the govt and an unelected position.

I see that instead of moving to lower costs, this is just much more than the same. Sure we are now forcing people to buy insurance. However, that will now only shift the incentive to start using it more, which will drive up costs. Go read some of the articles I posted yesterday Socks.

We already have programs for the poor Socks. And they are bankrupting states. Adding 15M more onto medicaid roles is like hitting another iceberg with the titanic and thinking its a good idea. "well if we just rip a hole in the other side, it might balance things out."

And if you do not purchase insurance and take the fine. You still do not have insurance. However, you could wait until you are sick and buy it then.

Oh, and lets not forget doing away with prexisting conditions and "premium discrimination". What do you think that will do to the insurance industry when they can no longer adjust for risk?

[Edited on March 2, 2010 at 12:23 PM. Reason : .]

3/2/2010 12:22:29 PM

Maybe he's worried that a moderate level of health care reform is a slippery slope to even more reform happening down the road. But, besides the weakness of slippery slope arguments in general, I don't honestly see any big health care reform packages coming after this one during the Obama Presidency, especially not anything bigger than this, considering how much work even this has taken.

3/2/2010 12:25:48 PM

haha. And the income tax will only affect the richest of the rich. Same with AMT. geez. Not only do we not have any money but we are in debt up to our eyes, and people are acting like 5 yr olds screaming for someone to buy them a new toy.

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=522446

• "This bill does not control costs (or) reduce deficits. Instead, (it) adds a new health care entitlement when we have no idea how to pay for the entitlements we already have."

• "The bill has 10 years of tax increases, about half a trillion dollars, with 10 years of Medicare cuts, about half a trillion dollars, to pay for six years of spending. The true 10-year cost (is) $2.3 trillion."

• "The bill takes $52 billion in higher Social Security tax revenues and counts them as offsets. But that's really reserved for Social Security. So either we're double-counting them or we don't intend on paying those Social Security benefits."

• "The bill takes $72 billion from the CLASS Act (long-term care insurance) benefit premiums and claims them as offsets."

• "The bill treats Medicare like a piggy bank, (raiding) half a trillion dollars not to shore up Medicare solvency, but to spend on this new government program."

• "The chief actuary of Medicare (says) as much as 20% of Medicare providers will either go out of business or have to stop seeing Medicare beneficiaries."

• "Millions of seniors who have chosen Medicare Advantage (Medicare through a private insurer) will lose the coverage that they now enjoy."

3/2/2010 12:28:48 PM

Like eyedrb I believe that the true, short-term and long-term costs of this bill are being misrepresented, and purposefully, if for no other reason than B for billion has become common place, while T for trillion still warrants a second look. Lyndon Johnson had to take the same approach:

http://www.npr.org/templates/story/story.php?storyId=112234240

From the above story:

Johnson maneuvered every step of the way getting this bill through Congress, and one of the things he did — and this is a little dicey in today's climate — was suppress the costs. So this young kid gets elected from Massachusetts, Ted Kennedy, in 1962, and Johnson is explaining to him [over the phone] how you get a health bill through. And what he tells him is don't let them get the costs projected too far out because it will scare other people:

"A health program yesterday runs $300 million, but the fools had to go to projecting it down the road five or six years, and when you project it the first year, it runs $900 million. Now I don't know whether I would approve $900 million second year or not. I might approve 450 or 500. But the first thing Dick Russell comes running in saying, 'My God, you've got a billion-dollar program for next year on health, therefore I'm against any of it now.' Do you follow me?"

3/2/2010 12:44:19 PM

I see all the liberals in this thread don't want to address the key point which is that this bill, if passed, will bankrupt the health insurance industry, setting the stage for a complete govt. takeover and single-payer system.

3/2/2010 1:40:07 PM

eyedrb,

It sounds like your biggest worry is how much you think the program will cost.

First, I would point out that the last CBO cost assessment I am aware of was the one that was conducted on the House Bill back in November. And that analysis found that Democratic health reforms would actually reduce the budget deficit between 2010 and 2019:

Quote :

"CBO has just released a revised estimate of the net budgetary impact of H.R. 3962, the Affordable Health Care for America Act, the health care reform bill that was passed by the House of Representatives on November 7. The revised estimate corrects a mistake that CBO made in its earlier assessment of a provision that would establish the Community Living Assistance Services and Supports (CLASS) program, a federal insurance program for long-term care. In the previous estimate, which was transmitted on November 6, CBO and the staff of the Joint Committee on Taxation (JCT) estimated that changes in direct spending and revenues from enacting H.R. 3962 would yield a net reduction in federal budget deficits of $109 billion over the 2010-2019 period. To reflect the change in our assessment of the CLASS provision, CBO and JCT now estimate that the legislation would yield a net reduction in deficits of $138 billion over the 10-year period."

http://cboblog.cbo.gov/?p=428

Now, you could say "well, what about after that!?". Its hard to say. I have not seen any cost estimates for that period and I probably wouldn't trust them if I did. You are never going to get 100% certainty with these things. Do you think the CBO could have foresaw in 1935 the impact that baberbooms would have in 80 years when they were considering the Social Security Act??? (not quite sure if the CBO even did this stuff back then but you get my point)

But in any case, I am not worried about this bill "bankrupting" us. Why? Because deficit is about more things than this single bill. If the government acts appropriately, we can close the deficit and make health insurance affordable for everyone by making budget cuts in other areas.

If you don't believe that will happen, then I am still not sure what you're complaining about. If you actually think the government will recklessly spend us into a fiscal crisis, then not passing this bill really won't change that. They will just find something else to drive us deeper into debt.

What I am trying to say is that fiscal solvency and health care are two related but in the end decidedly different issues.

3/2/2010 1:57:51 PM

Quote :

"Its hard to say"

LOL... It's hard to say

Let me give you a hint... If they had to create massive tax hikes for four years before paying out benefits for only 6 of those preceding ten years, that should give you the answer.

Unless you're proposing a 4yr, 6yr duty cycle of benefits off, benefits on.

Jesus you people

Quote :

"They will just find something else to drive us deeper into debt."

and we will oppose that "something else" just as strongly as we are opposing this reckless wasteful 2400 page entitlement debacle.

[Edited on March 2, 2010 at 2:09 PM. Reason : s]

3/2/2010 2:08:28 PM

Socks, Im well aware of what the CBO says. As mentioned in the summit, the CBO can only analyze the info that is given to them.

Again, look at the bullets I pasted before. You are double counting money. You tax for 10 yrs for 6 yrs of benefits. The actual costs, imo, are lowballed. Look at SS and Medicare, even Mass for thier projected vs actual costs. Also, they removed the 205B "doctor fix" from the bill so it would show savings. It is now a seperate bill, but very much health care/medicare related.

CBO can only give 10 yr figures.

Budget cuts in other areas? You do realize that entitlement spending is over 60% and the fastest growing. They are also the hardest to cut/reform. Both sides play political games when it comes to addressing serious cuts. SS was last term, now its Medicare. The problem with these medicare cuts are they are just transferred to another NEW entitlement.

I agree, something needs to be done to stop the growth of entitlements....adding another at this point just isnt an option. You are pulling money from Medicare (insolvent) and SS (insolvent) to shore up this new entitlement. Which will quickly be insolvent. Move in the right direction and back govt out of this stuff.

These are the cuts that need made. These are the icebergs at 12 oclock. Its plain as day to everyone who pays attention, even politicians. THey instead just expect the next guy to try to avoid them. Which is kinda how washington works.

3/2/2010 2:10:31 PM

another issue which is overlooked IMO: increased coverage does not mean increased access. who is going to treat all these newly insured patients?

3/2/2010 2:22:36 PM

eyedrb,

It sounds to me like your entire problem with the Democrat's proposed reforms is that you think that SS and medicare will be insolvent.

I hope you see my confusion. I don't see what that has to do with whether this bill is a good bill or not.

The argument "we can't afford it" doesn't really hold up when you consider the fact that "we" have control of all those other pieces of the budget too. We can afford reform if we want to by raising taxes and cutting spending in other areas.

So the question becomes, do we really want to afford these reforms? In other words, are the Democrat's proposals good or not? I think they are. You haven't directly explained why they are not.

[Edited on March 2, 2010 at 3:11 PM. Reason : ``]

3/2/2010 2:57:18 PM

These people have already been receiving treatment in emergency rooms and clinics.

But even still-- the market will ensure that supply meets demand.

3/2/2010 3:02:35 PM

The invisible hand of affordable health care.

3/2/2010 3:09:22 PM

o dam... never heard it described like that. sign me up - i love adam smith

3/2/2010 3:19:56 PM

on the propriety of action

that action being the passage of the health care bill

3/2/2010 3:26:11 PM

Quote :

"setting the stage for a complete govt takeover "

The slopes, they are slippery!

Given all the time and work getting a moderate amount of health care reform has cost, I think the chances that health care reform will be taken up again in the next 7 years is pretty slim, and especially not at this level, and definitely not anything bigger than this.

3/2/2010 3:27:15 PM

the day after signing the health care bill into law

obama: ok what's next guns?

biden: abortion mandate

obama: k

3/2/2010 3:28:14 PM

its just one more footstep down....


though its apparently a fairly long road since Hayek published this book in 1944 and we still have not got there yet.

[Edited on March 2, 2010 at 3:46 PM. Reason : ``]

3/2/2010 3:34:19 PM

Socks, I dont understand how you can say i havent said why this bill is bad. I think Ive made my point very clear. It does nothing to slow the growth of health care costs. in fact it will likely raise the costs. Hell even Warren Buffet says this.

You raised the SS, Medicare point. And said it doesnt matter. I beg to differ. The tax money collected from the new taxes from this bill will go where? The same fund our SS taxes go into. Right? And what happened to those funds?


Someone, Boone, i think mentioned that supply will take care of demand. LOL I would say ordinarily it would, but arent you fighting against that already? I mean, we dont have an endless supply of doctors or money. And im sure you would argue that some are being "priced out" of health insurance. So isnt supply taking care of demand? Demand has increased, while supply is decreasing. Usually that results in increased costs... However, the PLAN is to reduce what is actually paid to the ones who actually do the work. Do you still think supply will take care of demand? haha

3/2/2010 3:51:36 PM

^ - That is kind of what I was thinking about when I asked who would take care of all the newly covered people, but I was probably thinking more simplistically and less theoretically. You hear and read all the time about regional disparities in access, primary care shortages, physicians having to schedule appointments every 10 minutes to stay afloat (and having enough patients to fill this schedule). I guess I'm just saying you don't often hear about people working in health care being starved for potential patients. If anything, you read about health care being the only sector continuing to grow. It just seems logical to me that giving people enough money to pay for medical services they are otherwise not pursuing due to cost would only be one half of the equation. For the desired effect, something has to give on the provider side too. What is it? - longer waits for appointments? more hours worked per physician? (not likely according to a recent JAMA article) more PA and NP primary care? more FMGs? forced access to physician services through admissions from the ED?

3/2/2010 4:50:36 PM

Well looking around the globe, the answer is longer waits and less tech/machines. Also rationing the number of procedures and less docs.

3/2/2010 5:02:17 PM

I'd rather not deal with governmental rationing of health care thanks.

I like free market rationing a hell of a lot better.

3/2/2010 5:14:59 PM

^it is a lot easier to swallow and more fair.

3/2/2010 5:56:08 PM

Obama to unveil revisions to his proposal tomorrow, including some form of tort reform, support for undercover fraud and abuse investigators, and possibly allowing people to buy insurance across state lines. And the scale may be dialed back to reduce sticker-shock. Tune in tomorrow.

And with that, I can really support this reform package. Sure, there is some fuzzy math when it reduces the deficit by further contributing to the insolvency of Medicare and SS. The terms are awfully favorable to the unions, virtually scrapping the "Cadillac tax" in favor of a tax on the rich. And the tax penalties for the uninsured who can afford coverage are simply too low. Heck, a well-executed public option cut off from the general fund would do a lot of good, IMO. But every major deal is a compromise, and this one looks pretty good overall. Props to Obama for reaching out across the aisle. What is pathetic is that he may not get a single republican vote in congress, despite throwing a lot of bones to the GOP when he really didn't have to. I hope this revised bill makes it through the House.

3/2/2010 6:54:57 PM

Quote :

"Well looking around the globe, the answer is longer waits and less tech/machines."

Well that's true for pretty much anything else as well. We have more money than everyone else.

3/2/2010 6:55:50 PM

^ - I'm sorry, but you can't buy doctors off the shelf. It takes a substantial investment to fund a new medical school and new residency spots, and even then you need to wait almost a decade.

http://www.kevinmd.com/blog/2009/02/op-ed-more-coverage-requires-more.html

From above: "As a primary care physician in southern New Hampshire, I’ve been able to observe a universal coverage experiment, similar to what Congress is likely to consider, taking place in the neighboring Massachusetts. Since that state’s universal coverage law took effect in 2006, its health care system has been inundated with almost half a million new patients. The demand for medical services has rapidly outpaced the supply of care physicians able to provide care. In its most recent annual survey, the Massachusetts Medical Society found that the average wait time for a new patient to see a primary care doctor averaged 50 days. When you consider that this is a state with the highest density of physicians per capita nationally, it is frightening to think what the wait times would be in other parts of the country should universal coverage be enacted on a federal level."

3/2/2010 7:52:46 PM

Cheaper health-care is going to increase demand, whether it's a government or a "free-market" solution.

Other countries have wait lists, while the USA has people simply going without. Since the poor don't get care, those of adequate means can get the care they need on a whim.

3/2/2010 9:11:30 PM

Healthcare isn't likely to get cheaper. It's just gonna get subsidized for a lot of poor folks, and it'll be a requirement for everyone else. Initially, there will be a shortage of general practitioners, because specializing is where the money is at. But the AMA can do something about that by allowing more medical schools to be accredited and allowing more doctors to get certified. As it stands right now, we have the most rigorous standards for doctors anywhere in there world, which is a big reason why they get paid more than anywhere else.

In the long run, doctor shortages shouldn't be an issue because we (Americans) are willing to pay for top-notch, speedy care. In other countries, long wait-times are often the indirect result of price controls and limited healthcare budgets, and rationing is the direct result.

3/2/2010 9:34:23 PM

http://www.cnn.com/2010/POLITICS/03/02/health.care/index.html?hpt=T3

Quote :

"Obama embraces some GOP health care proposals Washington (CNN) -- President Obama extended a bipartisan olive branch to GOP leaders in the health care debate Tuesday, stating in a letter that he is willing to consider several of their ideas in a compromise plan. Specifically, the president said he may be willing to: • Commit $50 million to fund state initiatives designed to reduce medical malpractice costs • Allow undercover investigations of health care providers receiving Medicare, Medicaid and other federal programs • Boost Medicaid reimbursements to doctors in certain states • Include language in the final bill ensuring certain high-deductible health plans can be offered in the health exchange The president said his decision to consider the GOP ideas was a result of last week's health care summit. "The meeting was a good opportunity to move past the usual rhetoric and sound bites that have come to characterize this debate and identify areas on which we agree and disagree," he wrote. "I left convinced that the Republican and Democratic approaches to health care have more in common than most people think.""

http://www.whitehouse.gov/health-care-meeting/republican-ideas

Quote :

"Republican Ideas Included in the President's Proposal It’s clear that the American people want health insurance reform. They aren’t interested in Democratic ideas or Republican ideas. They’re interested in the best ideas to reduce costs, guarantee choices and ensure the highest quality care. They’re interested in ideas that will put them back in control of their own health care. Throughout the debate on health insurance reform, Republican concepts and proposals have been included in legislation. In fact, hundreds of Republican amendments were adopted during the committee mark-up process. As a result, both the Senate and the House passed key Republican proposals that are incorporated into the President’s Proposal. Review a few of the Republican initiatives included in legislation passed by Congress: * Includes personal responsibility incentives: Allows health insurance premium to vary based on participation in proven employer wellness programs o (Sources: H.R. 3468, “Promoting Health and Preventing Chronic Disease through Prevention and Wellness Programs for Employees, Communities, and Individuals Act” (Castle bill); H.R. 4038, “Common Sense Health Care Reform & Accountability Act” (Republican Substitute bill); H.R. 3400, “Empowering Patients First Act” (Republican Study Committee bill); H.R. 3970, “Medical Rights & Reform Act” (Kirk bill), "Coverage, Prevention and Reform Act") * Advances medical liability reform through grants to States: Provides grants to States to jump-start and evaluate promising medical liability reform ideas to put patient safety first, prevent medical errors, and reduce liability premiums. o (Sources: S. 1783, “Ten Steps to Transform Health Care in America Act” (Enzi bill); H.R. 3400, “Empowering Patients First Act” (Republican Study Committee bill); H.R. 4529, “Roadmap for America’s Future Act” (Ryan bill); S. 1099, “Patients’ Choice Act” (Burr-Coburn, Ryan-Nunes bill)) * Extends dependent coverage to age 26: Gives young adults new options. o (Sources: H.R. 4038, “Common Sense Health Care Reform & Accountability Act” (Republican Substitute bill); H.R. 3970, “Medical Rights & Reform Act” (Kirk bill)) * Allows automatic enrollment by employers in health insurance: Allows employee to opt-out. o (Sources: House Republican Substitute; H.R. 3400, “Empowering Patients First Act” (Republican Study Committee bill); “Coverage, Prevention, and Reform Act” ) * Mechanisms to improve quality. o (Sources: H.R. 4529, “Roadmap for America’s Future Act;” S. 1099, “Patients’ Choice Act;” H.R. 3400, Republican Study Group bill; S. 1783, “Ten Steps to Transform Health Care in America Act” (Enzi bill)) In addition to the Republican ideas already included in the legislation that’s passed the House and the Senate, the President’s Proposal incorporates a number of additional proposals that were included in Republican plans that focus on combating waste, fraud and abuse in government. The President remains open to other policies as well. And the purpose of the Bipartisan Summit is to review all ideas and ensure that the best ideas are included in the plan. Review the new Republican initiatives included in the President’s Proposal: * Comprehensive Sanctions Database. The President’s Proposal establishes a comprehensive Medicare and Medicaid sanctions database, overseen by the HHS Inspector General. This database will provide a central storage location, allowing for law enforcement access to information related to past sanctions on health care providers, suppliers and related entities. o (Source: H.R. 3400, “Empowering Patients First Act” (Republican Study Committee bill)) * Registration and Background Checks of Billing Agencies and Individuals. In an effort to decrease dishonest billing practices in the Medicare program, the President’s Proposal will assist in reducing the number of individuals and agencies with a history of fraudulent activities participating in Federal health care programs. It ensures that entities that bill for Medicare on behalf of providers are in good standing. It also strengthens the Secretary’s ability to exclude from Medicare individuals who knowingly submit false or fraudulent claims. o (Source: H.R. 3970, “Medical Rights & Reform Act”) * Expanded Access to the Healthcare Integrity and Protection Data Bank. Increasing access to the health care integrity data bank will improve coordination and information sharing in anti-fraud efforts. The President’s Proposal broadens access to the data bank to quality control and peer review organizations and private plans that are involved in furnishing items or services reimbursed by Federal health care program. It includes criminal penalties for misuse. o (Source: H.R. 3970, “Medical Rights & Reform Act”) * Liability of Medicare Administrative Contractors for Claims Submitted by Excluded Providers. In attacking fraud, it is critical to ensure the contractors that are paying claims are doing their utmost to ensure excluded providers do not receive Medicare payments. Therefore, the President’s Proposal provision holds Medicare Administrative Contractors accountable for Federal payment for individuals or entities excluded from the Federal programs or items or services for which payment is denied. o (Source: H.R. 3970, “Medical Rights & Reform Act”) * Community Mental Health Centers. The President’s Proposal ensures that individuals have access to comprehensive mental health services in the community setting, but strengthens standards for facilities that seek reimbursement as community mental health centers by ensuring these facilities are not taking advantage of Medicare patients or the taxpayers. o (Source: H.R. 3970, “Medical Rights & Reform Act”) * Limiting Debt Discharge in Bankruptcies of Fraudulent Health Care Providers or Suppliers. The President’s Proposal will assist in recovering overpayments made to providers and suppliers and return such funds to the Medicare Trust Fund. It prevents fraudulent health care providers from discharging through bankruptcy amounts due to the Secretary from overpayments. o (Source: H.R. 3970, “Medical Rights & Reform Act”) * Use of Technology for Real-Time Data Review. The President’s Proposal speeds access to claims data to identify potentially fraudulent payments more quickly. It establishes a system for using technology to provide real-time data analysis of claim and payments under public programs to identify and stop waste, fraud and abuse. o (Source: Roskam Amendment offered in House Ways & Means Committee markup) * Illegal Distribution of a Medicare or Medicaid Beneficiary Identification or Billing Privileges. Fraudulent billing to Medicare and Medicaid programs costs taxpayers millions of dollars each year. Individuals looking to gain access to a beneficiary’s personal information approach Medicare and Medicaid beneficiaries with false incentives. Many beneficiaries unwittingly give over this personal information without ever receiving promised services. The President’s Proposal adds strong sanctions, including jail time, for individuals who purchase, sell or distribute Medicare beneficiary identification numbers or billing privileges under Medicare or Medicaid – if done knowingly, intentionally, and with intent to defraud. o (Source: H.R. 3970, “Medical Rights & Reform Act”) * Study of Universal Product Numbers Claims Forms for Selected Items and Services Under the Medicare Program. The President’s Proposal requires HHS to study and issue a report to Congress that examines the costs and benefits of assigning universal product numbers (UPNs) to selected items and services reimbursed under Medicare. The report must examine whether UPNs could help improve the efficient operation of Medicare and its ability to detect fraud and abuse. o (Source: H.R. 3970, “Medical Rights & Reform Act”, Roskam Amendment offered in House Ways & Means Committee markup)"

The President is certainly trying to paint his influence of the legislative process as bipartisan, which to some degree has to be for show because that is what you do in politics, but to some degree is very real even if the right wont acknowledge it because it isn't "bipartisan enough" but they shouldn't honestly expect this bill to be written mostly to their preferences when they're the minority party.

3/2/2010 9:49:34 PM