Healthcare Reform

PACIFIC RESEARCH INSTITUTE SPECIAL REPORT

Mission Impossible: Medicare’s Independent Payment Advisory Board

By John R. Graham

Before Congress passed the law federalizing health care, President Obama used to say that the government would save money by implementing the principle that if the “red pill” works just as well as the “blue pill,” but costs half as much, patients should use the red pill.

This dangerously simplistic notion is incorporated in the Independent Payment Advisory Board (IPAB), a creation of the Patient Protection and Affordable Care Act (PPACA). IPAB, governed by a 15-person board of presidential appointees, targets certain Medicare spending, and attempts to take it away from congressional oversight. As stated by an advocate: “A common theme in the health care reform debate in recent years has been the need for a board of impartial experts to oversee the health care system. . . Congress is too driven by special-interest politics and too limited in expertise and vision to control costs.”1 Much of the section of PPACA that institutes IPAB is given over to describing the byzantine rules and procedures that try to limit Congress’ ability to derail IPAB’s recommendations.

IPAB’s authority is triggered when Medicare’s future spending is anticipated to increase faster than a target rate. The target growth rate through 2018 is the average of the change in the Consumer Price Index (CPI) and the medical-care component of the CPI. For 2018 and later, the target rate is nominal Gross Domestic Product (GDP) per capital plus 1 percentage point.

For every year the projected Medicare growth rate exceeds the target, the IPAB will put forward proposals to cut spending by a certain percentage that increases to 1.5 percent (after 2017) or the projected excess, whichever is less.3 But IPAB may only attack some providers. Before 2020, it may not target providers for which rates are already cut by Obamacare – primarily hospitals.

Read Entire Report Here. . . 




The Modern Health Care Maze 

Development and Ef fects of the Four-Party System 
 
By CHARLES KRONCKE AND RONALD F. WHITE 

Our national health care system is so dauntingly complex that reform efforts seem hopelessly adrift. How should we proceed in reforming that system? As a rule, any “realistic” reform project must begin with a sur vey of its 
principal stakeholders. A stakeholder, by definition, is any par ty who has a “stake” in the outcome—that is, anyone who stands to benefit or to suf fer from either maintaining or changing the status quo.
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The Obama Health Plan
Rationing Higher Taxes, and Lower Quality Care 

Originally Posted At Heartland
By Peter Ferrara
August 11, 2009 

President Barack Obama and Congressional Democrats are rushing to enact legislation that would overhaul the 
way health care is financed and delivered in the United States. It would dramatically increase the role of government in virtually all aspects of health care. Such an initiative should be carefully studied to determine 
whether it actually solves problems in the health care arena or makes them worse. 
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What's The Prognosis For Obama's Health Care Plan? 

Originally Posted At Laffer Healthcare Report
August 4, 2009

Internationally renowned economist Dr. Arthur Laffer has released the findings of his report, “The Prognosis for National Health Insurance.” The report applies an economic model to the principles for health care reform advocated by President Barack Obama. Renowned economist emphasizes need for patient-centered reforms that provide incentives to consumers and medical providers
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Are Health Care Reform Cost Estimates Reliable? 

Originally Posted At JEC
July 31, 2009
 
Are Health Care Reform Cost Estimates Reliable? History Shows True Costs Are Often Significantly Understated 
Since the end of World War II, major health care reform proposals have generally always cost more—sometimes significantly more—than the highest cost estimates published while the legislation was pending. Consider the following examples...
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The Sources Of Insurance 
Private, Public, the Uninsured, and Reforms for the Future 

Originally Posted At Freedom Works Foundation
By Max Pappas and Kristopher Rawls 
July 8, 2009

Central to every discussion about how to improve health care in the United States is the number of those who are uninsured. This paper looks at the various sources of health insurance in America and at the number of people who are uninsured and finds the wrong number of uninsured is too often used in policy reform debates. According to the Census Bureau, there were 46 million uninsured Americans in 2007—about 15.3 percent of the population. The more relevant number for policy makers to consider is 16 million, or about 5 percent of the population. 
An accurate understanding of how many Americans are uninsured and why is critical to formulating successful health care policy for the future. While 16 million is still a large number, at just one-third the often used 46 million uninsured, it is likely to call for a different set of reforms. 
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Key Issues in Analyzing Major Health Insurance Proposals

By The Congressional Budget Office
December, 2008

Concerns about the number of people who lack health insurance and about the high and rising costs of health insurance and health care have led to proposals that would substantially modify the health insurance system in this country. Because the Medicare program already provides nearly universal coverage to the elderly, those proposals generally focus on options for providing coverage to and reducing costs for the nonelderly population. Because
most nonelderly people obtain their insurance coverage through an employer, proposals could affect that coverage in some way.
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Obama's Health Care Reform: What Will It Do to Seniors?

Originally Posted At The Heritage Foundation
By by heritage.org
June 15, 2009

Cuts Medicare to Pay for New Public Plan: Some of the projected savings for financing Obama's health agenda, including the creation of a new public plan, would come by squeezing savings out of Medicare. At a time when Medicare is dangerously close to bankruptcy, it is shortsighted to funnel funds into the creation of another government-run program instead of shoring up Medicare.
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The Cost And Coverage Impacts Of A Public Plan

By The Lewin Group
June 15, 2009

President Obama has proposed to create a “public plan” that would compete for enrollment with the private insurance industry, but has provided few details on how it would work. During the 2008 campaign, Senators Clinton and Edwards proposed a public plan administered through Medicare using Medicare provider reimbursement levels. Employers and individuals would have been able to purchase coverage from the public plan by paying a full cost premium, with subsidies provided for low-income families. 
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CAHI Cost Sudy

By Counsel for Affordable Health Insurance

Democrats in Congress are considering universal coverage, guaranteed issue and modified community rating. These reforms could increase the cost of health insurance 75 to 95 percent for most Americans who buy their own coverage, according to a new study by the Council for Affordable Health Insurance (CAHI) and Mark Litow, one of the nation’s leading health care actuaries. CAHI looked at the cost of health insurance in several states and priced a family plan with a $2,000 or $2,500 deductible (the closest deductible that’s widely available, some copays and other benefits vary). Then CAHI compared those rates to the expected increase predicted by the CAHI study. Health insurance rates will almost double for most American families who buy their own policies if Congress passes universal coverage, guaranteed issue and modified community rating! 
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Kennedy Briefing Paper
Briefing Paper For Meeting Of The Senate Committee On Health, Education, Labor...

May 21, 2099

For the greater part of the last 100 years, Americans have sought ways to provide affordable and quality health insurance coverage to all our citizens. In this journey, we have achieved notable successes, including the creation of Medicare and Medicaid in 1965, the inception of the Children’s Health Insurance Program in 1997, the expansion of prescription drug coverage for seniors in 2003, and more. We have also witnessed setbacks and defeats, including the failure of reform efforts during the Administrations of Presidents Harry Truman, Jimmy Carter and Bill Clinton. 
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Comparative Effectiveness
Refining the Standards for FDA Approval & CMS Coverage

Originally Posted At Washington Legal Foundation
By Areta L. Kupchyk And Kathleen H. McGuan
Posted May 27, 2009

Money talks. The recent $1.1 billion federal allocation for comparative effectiveness research under the American Recovery and Reinvestment Act of 2009 tells us that the government is more serious than ever about gathering data on the relative effectiveness of medical treatments. How the data will be used by the government and third party payors is the question that may be worth billions of dollars more. A fear that patients, doctors, and innovators may lose more than they gain is fueling the political, legal, and scientific debate that will determine how we compare products and use data from such comparisons. Everyone has an interest in this debate.
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A Billion Dollars A Day

The Joint Economic Committee study that exposed the true cost of HillaryCare
Authored By Dr. Lawrence Hunter and Prof. Morgan Reynolds

The JEC study from the early nineties explaining the flaws in HillaryCare, as well as showing the reality that such a plan would cost a billion dollars a day. This policy study is most relevant now, despite the collapse of HillaryCare, as Obama claims a similar universal, government-run plan will cost an order of magnitude less now, some seventeen years later.
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The Facts

Originally Posted At Patients United Now

Washington May Be Close to Taking Over Your Health Care, Could a government takeover of my health care lead to waiting lines and denied care? Yes. Politicians who want government-centered and not patient-centered health care prefer to look at patients as ‘costs’ rather than human beings. They want to save money by giving government bureaucrats the power to deny or delay care. Read More...



Is Congress Importing Healthcare Rationing From Britain?

Originally Posted At Conservatives For Patient Rights
May 7, 2009

Before Britain’s Katie Brickell was diagnosed with cervical cancer at age 23, she tried to get a routine pap test three times, but was refused because the U.K.’s national government rationing board that controls what treatments patients may receive will only pay for screenings for women 25 or older in an effort to cut costs. Denied this routine test by her government’s health care board, Katie’s cancer was found at a late stage. Her cancer is terminal.

Katie’s story is not unique, and mirrors the experiences of many of the United Kingdom’s other 61 million citizens trapped in its National Health System. As our nation goes forward in its own health care reform debate, the failures of the British system should have Americans asking some very important questions such as: “ Who should make medical decisions — me and my doctor — or a government board?”  Read More...





So Many Lessons, So Little Time


Originally Posted At Galen.org
By Brian Crowley
May 6, 2009

In the 15 years since its founding, AIMS has brought a distinctive and influential Eastern Canadian voice to regional and national debates over public policy in areas such as transfer payments, social policy, fiscal and tax policy, health care, education performance and accountability, regulatory burden, Canada-US relations and much more. AIMS is one of the world's most honoured think tanks. It is a four time winner of the prestigious Sir Antony Fisher 
Award, which recognizes excellence in public policy think tank publications and projects. No think tank in the world has won this honour more times than AIMS. In its tenth anniversary year (2004-05), AIMS also won the Templeton Freedom Prize for Institute Excellence. More than 200 think tanks world-wide are eligible for the Fisher and Templeton prizes. Of the nearly 100 recognized think tanks in Canada, AIMS is one of only 5 to make the 2008 global "Go-To Think Tanks" list published by the Think Tanks and Civil Societies Program of the Foreign Policy 
Research Institute in Philadelphia. While still the Leader of the Opposition, Rt. Hon. Stephen...
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A Better Way To Generate And Use Comparative-Effectiveness Research

Originally Posted At CATO Institute
By Michael F. Cannon
February 6, 2009

President Barack Obama, former U.S. Senate majority leader Tom Daschle, and others propose a new government agency that would evaluate the relative effectiveness of medical treatments. The need for "comparative-effectiveness research" is great. Evidence suggests Americans spend $700 billion annually on medical care that provides no value. Yet patients, providers, and purchasers typically lack the necessary information to distinguish between high- and low-value services. Read More...




Should The Government Force You To Buy Health Insurance?
There is no such thing as voluntary fascism 

Originally Posted At The Council for Affordable Health Insurance 
January 1, 2009


“There is always a well-known solution to every human problem — neat, plausible, and wrong.” – H.L. Mencken 

After passing health care “reforms” in the mid-1990s, Massachusetts residents now face one of the most expensive health insurance markets in the country. Instead of fixing the problems, Governor Mitt Romney (R) and the legislature passed an unprecedented mandate requiring both individuals and employers to purchase health insurance. While the new law has significantly reduced the number of uninsured, the state is also straining under the exploding costs.
Read More...



 
 
The Obama Health Care Plan: More Power To Washington

Originally Posted at The Heritage Foundation 
By Robert E. Moffet
October 15, 2008

Senator Barack Obama (D–IL), the Democratic presidential nominee, has unveiled an ambitious health care plan that is comprehensive in scope, sparse in detail, and limited in its cost estimates. The Senator insists that his proposal would save the typical Amer ican family $2,500 in medical costs. These savings are implausible, and the costs are unknown. Read More...




Does Barack Obama Support Socialized Medicine?

Originally Posted At CATO Institute
By Michael F. Cannon
October 7, 2008

Democratic presidential nominee Sen. Barack Obama (IL) has proposed an ambitious plan to restructure America’s health care sector. Rather than engage in a detailed critique of Obama’s health care plan, many critics prefer to label it "socialized medicine." Is that a fair description of the Obama plan and similar plans? Over the past year, prominent media outlets and respectable think tanks have investigated that question and come to a unanimous answer: no.
Read More...




Eenie, Meeny, Miney Mandate: 
Compulsory Private Health Insurance is Not Universal Choice 


Originally Posted At Pacific Research Institute 
By John R Graham
November, 2006


Mandatory health insurance is an ineffective solution to the perverse incentives that cause America’s hospitals to give uncompensated care. Although Switzerland has lower health costs and better health outcomes that the U.S., characteristics other than mandatory health insurance better explain its relative success. The notion that ever-increasing legions of middle- class uninsured drive health spending by crowding into hospital emergency rooms, has no evidence behind it. High earners who forgo health insurance voluntarily pay more taxes than they must, indicating that health insurance today does not offer value. America’s should provide universal choice in health insurance to all its residents, rather than order them into a system with severely perverse incentives. employers get them tax-free. So, while most Americans know that food spending is going up “unsustainably,” they’re pretty happy as long as they’re “covered,” and the restaurants still get paid. Read More...
 
 

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