Fix Health Care Policy

Side Effects: Bureaucracy in a Bind

Health care is a life-and-death matter. It’s also a huge part of our economy (one-sixth, to be exact).

With so much at stake, it makes sense to “go slow,” when it comes to reforming the system. But rather than take the time to get it right, the liberal leaders of Congress rammed through a wholesale restructuring of the system without giving their rank and file enough time to read—much less comprehend—what they were up to.

The rush to “reform” didn’t stop there, either. The Obamacare bill imposed a host of short-term implementation deadlines on the Department of Health and Human Services. Turns out that HHS can’t make ‘em. (more…)

Tags: Centers for Medicare and Me, EARLY Act, ObamaCare, ramming through, Side Effects, transparency

Side Effects: Obamacare Discourages Docs

The United States faces a major physician shortage, and it will only get worse. Aging baby boomers will create a growing demand for medical services at the same time Obamacare comes on line with its new demands.

Complicating matters is the fact that many physicians are also baby boomers—meaning part of the solution will increasingly become part of the problem.

The Washington Post reports that nearly 40% of doctors are 55 or older and a third of all nurses are over the age of 50. These boomers are on the cusp of retirement—and the number of students on track to graduate from medical and nursing school will not be adequate to replace them in their fields.

(more…)

Tags: baby boomers, expanded Medicaid, ObamaCare, physician shortage, Side Effects

Congressional Gimmicks leave Doctors and Taxpayers in a Lurch

The Senate voted 45-52 yesterday to oppose the $140 billion so-called “extenders bill” (HR 4213). The Hill is reporting that Sen. Max Baucus (D-MT) is going to offer a slimmed down version for consideration as early as today. Two key health provisions of the bill are expected to be a continued bailout of state Medicaid programs and a temporary Medicare ‘Doc Fix’.

The Sustainable Growth Rate (SGR), initiated in 1997, links the increase in Medicare reimbursement rates to growth in GDP. Since medical costs historically increase at a rate more than twice GDP, the SGR reduces the real payments physicians receive. A temporary “fix” has happened nine times in nine years to increase Medicare rates above SGR levels. Temporary fixes are the easy way out for politicians because they appear less costly to budget.

The Hill reports that Senator Baucus is going to use a budgetary trick by paring down the “doc fix” from 19 months to 6 months. Of course, this means that the budgetary cost of the bill will appear smaller, but in reality the only difference is that Congress will have to revisit this issue in 6 months instead of 19 months – kicking the can down the road once again. (more…)

Tags: doc fix, federal spending, Medicare, Patient Protection and Affordable Care Act, Sustainable Growth Rate, tax extenders bill

In Medical Malpractice Reform, States Should Shirk the Washington Way

It’s long been established that part of controlling rising health care spending in the United States will mean enacting meaningful medical malpractice, or “tort”, reform. Though tort reform is not a silver bullet to creating savings, it is one of many changes vital to containing patients’ medical costs.

Unfortunately, in passing the mammoth Obamacare, Congress and the president failed to take tort reform seriously, leaving out any serious provisions to encourage states to reform their medical malpractice laws. Instead, the Patient Protection and Affordable Care Act threw an illusory bone to Republicans, the main proponents of tort reform, through the inclusion of $25 million in demonstration grants to try out new state-level ideas for reform.

This week, the Department of Health and Human Services announced the winners of the grants. The money will be split among small, voluntary programs by hospitals and medical centers and “planning grants”. Completely unacknowledged are the several states where malpractice reform has already been enacted with clear results. (more…)

Tags: medical malpractice reform, ObamaCare, Patient Protection and Affordable Care Act, planning grants

Side Effects: Regulatory Pillow to Smother Grandfathered Plans

The Department of Health and Human Services has rolled out regulations governing health plans in effect prior to the passage of Obamacare. You know, the plans that “if you like it, you can keep it?”

The new regs will mostly affect the 170 million-plus Americans who carry employer-sponsored coverage. The vast majority of them (82 percent) are satisfied with their current coverage.

The new regs will make it tough for a lot of those folks to hold onto their current plans, even though the Department of Health and Human Services continues to claim otherwise. That because HHS is ready to revoke the “grandfathered” status of existing plans whenever an employer makes what it deems to be a “significant” change in terms of coverage. And the HHS regs show that common adjustments such as an increase in deductibles or co-pays or a reduction in benefits would be considered “significant.” (more…)

Tags: employer-sponsored coverage, grandfathering, ObamaCare, Side Effects

Side Effects: Donut Hole Hold-Up

Last Thursday, the White House trumpeted Obamacare’s first step in closing the Medicare “donut hole.” Checks in the amount of $250 were sent to 80,000 seniors in the “hole”—a gap in Medicare’s coverage of prescription drug benefits for seniors. Ultimately, Washington will cut 4 million of these checks, totaling $1 billion, to help paper over the coverage gap.

The gap was no accident, mind you. Congress crafted it deliberately in 2003. It enabled them to claim, with the Congressional Budget Office’s blessing, that the new entitlement to drug coverage under Medicare would cost no more than $400 billion over 10 years.

Under the “donut hole” provision, drug benefits run out for some seniors, who must then pick up the total cost of their prescriptions. However, once they pay $3,610 out of pocket, the coverage kicks back in again.

The $250 rebate checks are intended to offset a portion of those out-of-pocket expenses.

But Politico reports that, “No sooner than the Administration dropped the first batch of $250 Medicare rebate checks in the mail, they have already run into their first snafu.” (more…)

Tags: "donut hole", coverage gap, Medicare drug coverage, rebate checks, Vermont, VPharm

Side Effects: Obamacare Adds to the Ranks of the Uninsured

Imagine if Washington applied Obamacare’s regulatory approach to car sales. Forget choosing your ride based on your own needs and what you can afford. Instead, your wheels would be dictated by what Uncle Sam thought was best for you. For example, you might want—and be willing to pay for—a Mercedes, but Obamacare Motors would let you buy only a Daewoo.

That’s how Obamacare will affect choice in health care coverage. One provision bars insurance companies from putting a limit on how much they will pay in medical claims. This may sound like a consumer-friendly change, but in practice it threatens to abolish lower-cost coverage options.

Employers who can’t afford to offer their workers gold-plated Cadillac plans often provide limited-benefit plans that are quite adequate for the vast majority of consumers. Such policies are especially prevalent among part-time workers or those laboring in low-profit-margin retail or service sectors. (more…)

Tags: Cadillac plan, limited-benefit plans, low-income workers, ObamaCare, Side Effects, uninsured