Ducking the Crisis in Medicare
By STEVEN RATTNER
NESTLED within the many commendable aspects of President Obama’s health care plan — including the individual mandate — sits a problem that has gone virtually unnoticed by commentators obsessed with the Supreme Court’s review of the law: how to pay for it.
About 65 percent of the cost of the Obama health care law is supposed to be met by Medicare expense reductions and tax increases totaling roughly $1 trillion over 10 years. The deficiency with this plan is that it amounts to double-counting, using urgently needed Medicare economies to finance the new law.
Don’t get me wrong: We need to extract all sensible savings from Medicare and consider revenue increases to ensure its solvency as baby boomers swell its rolls. Thanks to escalating health care costs and repeated sweetening of benefits without commensurate increases in revenues, Medicare was underfinanced by a staggering $37 trillion as of Sept. 30.
That’s the amount — about two and a half times the annual output of the United States economy — that would have to be deposited into the Medicare trust funds to adhere to the principle that members of each generation would contribute enough to Medicare while they were working to pay for their care after age 65.
But the politics of Medicare have been poisonous, so toxic that Democrats haven’t been willing to engage seriously on the issue, while Republicans have advanced a proposal that would eviscerate Medicare rather than preserve it.
Why Medical Bills Are a Mystery
By ROBERT S. KAPLAN and MICHAEL E. PORTER
RISING health care costs are busting the federal budget as well as those of states, counties and municipalities. Policy makers and health care leaders have spent decades trying to figure out what to do about this.
Yet their solutions are failing because of a fundamental and largely unrecognized problem: We don’t know what it costs to deliver health care to individual patients, much less how those costs compare to the outcomes achieved.
When insurance companies or government bodies try to control costs, they usually make across-the-board reimbursement cuts that ultimately are unsustainable because they have no connection to the true costs of delivering care. Providers themselves do not measure their costs correctly. They assign costs to patients based on what they charge, not on the actual costs of the resources, like personnel and equipment, used to care for the patient. The result is that attempts to cut costs fail, and total health care costs just keep rising.
Regardless of what decision the Supreme Court reaches on the legality of the Affordable Care Act, measuring outcomes and costs is indispensable to driving improvements.
Drugs that target high cholesterol come with new cautions
New FDA warnings about the side effects of cholesterol-lowering statins have physicians and patients weighing the risks and benefits of taking these drugs
Problems with primary care
WHO
Dr. Russell S. Phillips
Healthcare pricing still a struggle for consumers
Comparison shopping for medical procedures can involve a web of billing codes and arcane terminology, despite efforts in California to simplify things.
By Chad Terhune, Los Angeles Times
April 15, 2012
and Kaiser Health News
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