April 2009 Archives
Partly because of the recession, the Medicare trustees' report is expected to project insolvency for the Hospital Insurance Trust Fund earlier than last year's 2019 estimate.
Is insolvency of the trust fund really a problem? Does it deserve the big headlines it gets every year? What are the best -- and worst -- approaches to improving the outlook for the trust fund?
-- Marilyn Werber Serafini, NationalJournal.com
7 responses: Marilyn Werber Serafini, Jason Rosenbaum, Drew Altman, James P. Gelfand, Karen Davis, John C. Goodman, John Rother
There is a general consensus on Capitol Hill that health reform legislation ought to encourage examination of the effectiveness of different treatments for the same condition. This is known as comparative effectiveness.
What treatments should be among the first to be compared?
-- Marilyn Werber Serafini, NationalJournal.com
11 responses: Karen Davis, Denis Cortese, Janet Trautwein, John Sheils, Marilyn Werber Serafini, Nancy H. Nielsen, C. Eugene Steuerle, Billy Tauzin, John C. Goodman, Darrell G. Kirch, Leonard D. Schaeffer
Democrats and Republicans say they want to keep health care reform from expanding the budget deficit. Overhauling health care, by some estimates, might cost as much as $1.5 trillion over 10 years. The big question is how to pay for it.
There is some concern that a chunk of President Obama's savings proposals, such as paying physicians more for high-quality care and providing new incentives and penalties to reduce hospital readmissions, might not actually save money for a number of years.
Should Congress bend PAYGO rules to allow potential savings down the road to fund upfront investments? How sure can the government be that savings from proposed quality initiatives would ever be realized? Could Congress be stuck finding new sources of revenue down the road?
-- Marilyn Werber Serafini, NationalJournal.com
11 responses: James P. Gelfand, Jason Rosenbaum, Janet Trautwein, Uwe Reinhardt, Karen Davis, John C. Goodman, Henry J. Aaron, Marian Wright Edelman, Uwe Reinhardt, Stuart Butler, John C. Goodman
Medical providers are increasingly nervous about proposals that Democrats and Republicans are pushing as a source of savings for health care reform. President Obama, for example, has proposed to save about $26 billion over 10 years through new incentives to reduce hospital readmissions for Medicare patients by bundling payments for episodes of care. He has other proposals that would pay doctors and hospitals more for higher-quality care, and encourage the use of medical homes to better coordinate patient care.
Would these proposals be an unfair hardship on doctors and hospitals, as some claim? Would the result be rationed care? Would doctors be forced to abandon their small practices and become hospital employees? If payments are to be combined, then who should control the rates?
-- Marilyn Werber Serafini, NationalJournal.com
8 responses: Denis Cortese, Jason Rosenbaum, John C. Goodman, Darrell G. Kirch, Stuart Butler, Karen Davis, Leonard D. Schaeffer, Nancy H. Nielsen
