Health Care Policy and Marketplace Review

tag:blogger.com,1999:blog-18451837035682538712012-02-02T17:18:18.824-05:00Health Care Policy and Marketplace ReviewA Health Care Reform Blog––Bob Laszewski's review of the latest developments in federal health policy, health care reform, and marketplace activities in the health care financing business.ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.comBlogger6291100tag:blogger.com,1999:blog-1845183703568253871.post-41829519518137283982012-02-01T13:02:00.005-05:002012-02-01T16:09:00.074-05:00The Wyden-Ryan Plan Will Be the Foundation for Serious Medicare Reform—and Maybe More

In two companion articles in January’s New England Journal of Medicine, Henry Aaron with Austin Frakt, and Joe Antos critique the Wyden-Ryan Medicare reform proposal.Senator Ron Wyden (D-OR) and Representative Paul Ryan (R-WI) are proposing a hybrid Medicare reform proposal combing both Republican defined contribution free market principles—a premium support scheme—with Democratic defined

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-44697776904023770542012-01-30T13:00:00.003-05:002012-01-30T14:45:03.784-05:00The New Health Law Needs to Be Repealed, Expanded, and Replaced—So Long As It Doesn’t Have a Mandate

Last week’s State of the Union speech was notable because the President hardly mentioned the new health care reform law.Avoiding what is supposed to be the centerpiece domestic accomplishment of President Obama’s first term stuck out like a sore thumb.He said almost nothing because the Obama team simply doesn’t know what to say.The fact is the Affordable Care Act (ACA) is generally unpopular, and

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-53060261152574907562012-01-19T14:54:00.010-05:002012-01-19T15:52:25.465-05:00Important Research From Medicare Demonstration Projects: Almost Nothing Works

I will suggest that most of us believe the way to control health care costs, and at the same time maintain or improve quality, is to both use the managed care tools we have developed over the years, and perhaps more importantly, change the payment incentives so that both cost control and quality are upper most in the minds of providers and payers.The Congressional Budget Office (CBO) has just

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-86423865571436066382012-01-18T16:34:00.010-05:002012-01-19T14:09:12.085-05:00Will the Feds Be Ready With the Fallback Insurance Exchanges by October 2013?

Insurance exchanges have to be up and running in all of the states by October 2013 in order to be able to cover people by January 1, 2014.If the states don't do it, the feds have to be ready with a fallback exchange. States have to tell HHS if they intend to be ready by January 1, 2013.The White House just released a report saying that good progress is being made in 28 states. That begs the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-42812623115806362672012-01-12T14:38:00.014-05:002012-01-13T14:21:16.704-05:00I Hope Trustmark Tells HHS to Go Pound Sand

Today, the Department of Health and Human Services announced that, "Trustmark Life Insurance Company has proposed unreasonable health insurance premium increases in five states—Alabama, Arizona, Pennsylvania, Virginia, and Wyoming. The excessive rate hikes would affect nearly 10,000 residents across these five states."The HHS statement continued, "In these five states, Trustmark has raised

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-30536072286167279402012-01-10T15:46:00.009-05:002012-01-10T16:24:42.229-05:002012: A Year of Huge Uncertainty in Health Care Policy

2013 may be the most significant year in health care policy ever.But we have to get through 2012 first.Once the 2012 election results are in there will be the very real opportunity to address a long list of health care issues.If Republicans win, the top of the list will include “repealing and replacing” the Affordable Care Act. If Obama is reelected, but Republicans capture both houses of

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-81555070989432795432011-12-22T09:24:00.003-05:002011-12-22T09:38:32.522-05:00A Litmus Test for Elected Officials

by Brian Klepper and David C. KibbeSix months ago, who could have imagined that a large percentage of rank-and-file Americans would support the Occupy Wall Street (OWS) against special interests’ rigging of the American dream? So why not go to the next step? Why not pointedly ask political candidates, “Will you take money from lobbyists?” and “If elected, what will you do to stop special interest

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-2184012251497096422011-12-14T23:10:00.021-05:002011-12-15T11:22:18.446-05:00Paul Ryan and Ron Wyden Blow the Medicare Reform Debate Wide Open!

House Budget Chair Paul Ryan (R-WI) and Senator Ron Wyden (D-OR) have embraced a Medicare reform plan that in concept borrows heavily from one championed by former New Mexico Senator Pete Domenici and former Clinton budget chief Alice Rivlin.Specifically, Wyden and Ryan are proposing to alter the earlier Ryan Medicare plan by:Continuing to offer the traditional Medicare plan—Ryan would have

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-54044047344429504062011-11-21T17:13:00.004-05:002011-11-21T17:24:19.985-05:00The Super Committee Failure—What’s Next?

The stock market today was shocked, simply shocked, that the Super Committee didn’t come up with a debt deal.I don’t know why. Republicans can’t vote for more taxes unless they're willing to get “primaried” from the right and risk losing their seat. Ditto for Democrats who would face the same punishment from their base if they voted to change the sacred defined benefit entitlements without at

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-53275984934061131652011-10-26T13:58:00.017-05:002011-10-26T22:40:47.641-05:00Romney Jumps on the Waiver Bandwagon--And Creates Even More Uncertainty Over the New Health Care Law

Republican presidential frontrunner Mitt Romney has pledged to end “Obamacare.” Upon taking office, he would immediately begin the process by granting the states waivers from having to implement it:“I’ll grant a waiver on Day One to get repeal started. On Day One, granting a waiver for all 50 states doesn’t stop it in its tracks entirely. That’s why I also say we have to repeal Obamacare, and I

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-81460125938455442412011-09-28T16:39:00.011-05:002011-12-15T11:23:31.043-05:00The Ryan Health Care Proposals—Not Your Congressman’s Health Plan

Update: The New Wyden-Ryan Plan - Paul Ryan and Ron Wyden Blow the Medicare Reform Debate Wide Open! In a speech at the Hoover Institution today, Representative Paul Ryan (R-WI) argued again that his proposal to reform Medicare, and now his tax credit proposal for replacing the Democratic health care law for those under-age 65, would guarantee to citizens “options like the ones members of

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-70356715506360626122011-09-27T10:22:00.001-05:002011-09-27T10:51:27.648-05:00The Health Leadership Council Medicare Proposal: Too Much Responsibility on Beneficiaries and Not Enough on Providers

The Health Leadership Council (HLC), a coalition of CEOs from many of the leading health care companies, has created a list of Medicare reform recommendations for the Super Committee tasked with finding at least $1.2 trillion in budget savings.As we begin the national debate over what to do about Medicare's unsustainable costs, I will suggest that the HLC proposal gives us one, of what will have

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-10687704116646007062011-09-20T14:30:00.002-05:002011-09-20T14:41:07.129-05:00The Debt Super Committee—Will We Get a Deal?

It’s back to work in Washington, DC and all the attention is now on the Super Committee and their goal of cutting spending by at least $1.2 trillion over ten years.If the committee fails to come up with a plan that passes the Congress, there would be $1.2 trillion in automatic cuts. The health care special interests have reason to hope they will fail—the fallback cuts would only impact Medicare

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-48446095971273286262011-08-04T14:39:00.007-05:002011-08-04T14:52:38.232-05:00Rethinking the Value of Medical Services

by Brian Klepper and David KibbeOne of American politics’ most disingenuous conceits is that health care must cost what we currently pay. Another is that the only way to make it cost less is to deny care. It has been in industry executives’ financial interests to perpetuate these myths, but most will acknowledge privately that the way we value and pay for medical services is a deep root of

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-5344096809175110072011-08-01T14:13:00.019-05:002011-08-02T04:07:59.930-05:00The Debt Deal: There Will Be Blood on the Floor on November 23rd

The debt deal is finally done. But it really isn’t an agreement on what cuts will be made, just the process that will be used to make them.The real work is left to the Congressional appropriators for the first $917 billion and for a super-committee of Congress for the second $1.2 trillion to $1.5 trillion in ten-year cuts.That second tranche is where health care will make its contribution. The

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-34164096830144454192011-07-27T14:40:00.013-05:002011-07-27T23:14:35.440-05:00We Are Reaping What We Have Sown—The Debt Standoff

On this blog a month ago, I said the politicians were starting to scare me with the apparent eagerness of some to actually take the government to default to make a political point.For weeks we have heard political leaders on both sides tell us there would be no default.But the two sides have so backed themselves into opposite corners that they have left no opportunity to meet in the middle.

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-2608776397267211202011-07-06T10:25:00.004-05:002011-07-06T15:37:47.935-05:00The Awful Dichotomy Between Health Care Politics and Policy

Amy Goldstein has an important article in today’s Washington Post detailing the place Don Berwick, the Medicare and Medicaid administrator, finds himself in.It is all but certain he will have to leave his post at year’s end, when his recess appointment expires, because the Senate will not confirm him for a lack of Republican support.Berwick is one of the most respected health care experts in the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-89885703104914458682011-06-27T16:18:00.006-05:002011-06-27T17:04:48.319-05:00The Debt Ceiling Debate—Some of These People Are Nuts

I don’t know about you but the politicians are starting to scare me with their inability to make progress in the federal debt limit discussions. Worse, is the apparent eagerness of some to actually take the government to default to make a political point.I know a lot of conservatives say missing the August 2 deadline isn’t a big deal but I think it is.The 2011 deficit is projected to be $1.6

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-5314103740045491652011-06-07T08:30:00.019-05:002011-06-07T11:51:50.589-05:00Inconvenient Facts for Both Republicans and Democrats—Neither Side’s Health Care Proposals Are Supported By Past Performance

I call your attention to Ezra Klein’s column in the Washington Post this morning.In it he cites data that has been out there for a long time but Ezra puts some perspective on it that never occurred to me before.Examining the Kaiser Family Foundation brief, “Health Care Spending in the United States and Selected OECD Countries” he points out, “Our government spends more [as a percentage of GDP] on

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-71840660361072887932011-05-25T10:06:00.014-05:002011-12-15T11:25:13.910-05:00Earth to Republicans: You Are In Big Political Trouble Over the Ryan Medicare Plan

Update: The Wyden-Ryan Medicare Plan - Paul Ryan and Ron Wyden Blow the Medicare Reform Debate Wide Open! It should now be clear to Republicans they are in trouble over the Ryan Medicare plan.Yesterday, they lost a seat in a solid Republican New York House district. Their candidate had benefited from lots of money and House leadership attention. The big issue was the Ryan Medicare plan.All month,

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-14202299714552811342011-05-12T14:30:00.000-05:002011-05-13T15:18:35.485-05:00The Lightweight Romney Health Plan

Mitt Romney has outlined his new health plan. He outlined five key steps in an op-ed in USAToday. Here is a summary:Step 1: Give states the responsibility, flexibility and resources to care for citizens who are poor, uninsured or chronically ill.who are poor, uninsured or chronically ill.Step 2: Reform the tax code to promote the individual ownership of health insurance.Step 3: Focus federal

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com7tag:blogger.com,1999:blog-1845183703568253871.post-20734286305561682362011-05-09T00:01:00.012-05:002011-05-09T00:01:01.741-05:00Neither the Republicans Nor the Democrats Want to Face the Provider Cost Problem But Both Want to Dump the Problem on the Consumer

A key piece of Paul Ryan’s deficit reduction plan is to change Medicare as we know it. It appears his bold Medicare premium support proposal is failing to gain traction--it is dead as part of any deficit reduction deal this year. Worse, his Medicare proposal looks to be giving Democrats lots of political ammunition for the 2012 elections.What lies at the heart of Ryan’s Medicare difficulties is

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-26217111953094893012011-04-24T20:36:00.011-05:002011-04-28T14:44:54.795-05:00There Aren't Enough Rich People To Pay For Medicare And Medicaid!

I hear more and more of my progressive friends arguing, in the context of deficit reduction, that we should be raising taxes before getting aggressive about reducing the cost of Medicare and Medicaid -- as well as Social Security.To a point, I agree.This country is in such a hole that it is senseless to deny that at least some new taxes will be needed to pay for all of the nation's bailouts and

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-84927029660774694872011-04-14T11:59:00.014-05:002011-04-15T08:21:46.943-05:00The Budget Fight: It Will Be A Long Hot Summer, and Fall, and Winter…

The good news is that Democrats and Republicans are finally seriously engaged over the country’s fiscal crisis.And, each side is presenting a starkly different course for the voters to choose from.When it comes to the health care entitlements, Republicans want to cut the health care entitlement benefits and therefore ease the pressure on federal spending.Obama wants to largely leave the programs

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-30035720578942998232011-04-10T20:49:00.005-05:002011-04-10T20:49:00.429-05:00What It Will Take to Bring America’s Health Care Costs Under Control––We Have to Change the Game

Last week, I posted that I was disappointed in Paul Ryan’s health care budget proposal because it lacked cost containment ideas other than the usual conservative reliance upon the market and defined contribution health care.In my last post, Why ACOs Won’t Work, I argued that the latest health care silver bullet solution, Accountable Care Organizations (ACOs), are just a tool in a big tool box of

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-73245627993168985722011-04-07T09:11:00.003-05:002011-04-07T09:17:51.188-05:00Why ACOs Won’t Work

First, I think Accountable Care Organizations (ACOs) are a great idea. Just like I thought HMOs were a good idea in 1988 and I thought IPAs were a good idea in 1994.The whole notion of making providers accountable for balancing cost, medical necessity, appropriateness of care, and quality just has to be the answer.But here’s the problem with ACOs: They are a tool in a big tool box of care and

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-84481440420712195812011-04-05T20:52:00.009-05:002011-04-05T22:35:41.049-05:00The “Path to Prosperity”—Where’s the Health Care Cost Containment?

Paul Ryan’s overview of his proposed 2012 Budget Resolution contains an honest and compelling description of America’s debt and deficit spending dilemma.Every American should read it.As I read through his discussion of the huge hole we’re in and the imperative to fix it, he had me thinking that we finally have a politician willing and ready to deal with the problem. But when I got to the end of

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-3583793469888036602011-03-10T04:41:00.016-05:002011-03-10T05:25:54.796-05:00So How Are Democrats and Republicans Different?

Just how is the way Wisconsin Republicans have handled the political confrontation over worker rights different than the way Washington, DC Democrats handled last year's health care vote?With apologies in advance to Ezra for taking some liberties with his column yesterday evening in the Washington Post:What happened in Wisconsin [Washington DC] tonight [last March]By Ezra Klein [Bob Laszewski]

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com8tag:blogger.com,1999:blog-1845183703568253871.post-36489585433720354872011-03-06T14:35:00.007-05:002011-03-06T14:35:00.069-05:00Fixing America's Health Care Reimbursement System

This post is authored by Brian Klepper and first appeared at Kaiser Health News:A tempest is brewing in physician circles over how doctors are paid. But calming it will require more than just the action of physicians. It will demand the attention and influence of businesses and patient advocates who, outside the health industrial complex, bear the brunt of the nation's skyrocketing health care

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-49634044618615703272011-03-03T21:42:00.010-05:002011-03-04T01:37:05.738-05:00The Republicans Had Better Get Organized on Health Care

If the past week is any indication, the Republicans will have real trouble come 2012 trying to convince voters they have a plan to fix the American health care system.Last weekend, President Obama endorsed the Wyden-Brown bill that would give the states the opportunity, in 2014, to take their share of the almost $1 trillion the new health law collects and use it to craft an alternative health

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-56857058207958449712011-03-01T05:00:00.002-05:002011-03-01T05:00:02.075-05:00Defined Contribution Health Care—The Conservatives' Silver Bullet

Conservatives are in a full court press these days telling us the answer to America’s out-of-control health care costs—and our fiscal crisis—is to move Medicare, Medicaid, and the tax code subsidy for private insurance to a defined contribution system.Instead of the federal government defining a benefit and then shouldering the cost of whatever that promise leads to (today’s defined benefit plan)

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-23524817978771589162011-02-15T03:09:00.004-05:002011-02-15T03:09:00.370-05:00Will the Congress Change the Health Care Law During the Next Two Years?

No. But I expect the Patient Protection and Affordability Act to be “relitigated” in 2013, to one degree or another.I recently posted on the controversy over the individual mandate. I suggested a number of alternatives to the mandate—including my own ideas.I was asked if I really thought the Congress would change the individual mandate in the short term.As I have posted before, it will be the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-77538673926025849872011-02-13T02:34:00.005-05:002011-02-13T18:37:53.009-05:00Alternatives to the Individual Mandate—Some Are A Lot Better Than Others

With Constitutional challenges to the individual mandate now threatening the very life of the new health care law, Republicans aren’t the only ones that would like to see it jettisoned and replaced with something better.And it isn’t just the Constitutional challenges that are prompting a second look. The mandate doesn't work politically and it doesn't maintain the integrity of the market because

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com8tag:blogger.com,1999:blog-1845183703568253871.post-47344113380096131892011-02-09T13:39:00.003-05:002011-02-09T14:03:00.372-05:00Things Are About to Get Ugly—-Republicans Plan to Defund the Health Bill Next Week

Word is that House Republicans will attach an amendment to the latest federal spending bill that will cut-off funding for the health care bill.The last Congress never finalized a budget for the current fiscal year—the feds have been operating under a series of continuing resolutions. The most recent one will expire on March 4th. If another resolution is not agreed to, much of the government has

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com6tag:blogger.com,1999:blog-1845183703568253871.post-16042238122288333382011-01-31T22:13:00.014-05:002011-01-31T22:33:14.111-05:00Has the Florida Judge Stopped the New Health Care Law in Its Tracks?

Reading page 75 of today's Florida opinion it sounds like that is his intent:(5) InjunctionThe last issue to be resolved is the plaintiffs’ request for injunctive relief enjoining implementation of the Act, which can be disposed of very quickly.Injunctive relief is an “extraordinary” [Weinberger v. Romero-Barcelo, 456U.S. 305, 312, 102 S. Ct. 1798, 72 L. Ed. 2d 91 (1982)], and “drastic” remedy [

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-27177902360268995572011-01-31T15:45:00.021-05:002011-02-02T01:48:54.536-05:00Now We Have Real Uncertaintly--The Entire Health Law Ruled Unconstitutional!

We all knew the question of the constitutionality over the new health care law was going to be taken up by the Supreme Court.We knew that because the law inexplicably lacked a severability clause a judge could throw the whole thing out if the individual mandate were to be found unconstitutional and critical to the legislation.And, we expected this Florida judge would likely rule against the law

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-30078724891198013712011-01-31T14:40:00.008-05:002011-02-11T15:09:20.892-05:00It Will Be Democratic Senators Leading The Charge To Fix Or Improve The New Health Law

I wrote this Kaiser Op-Ed before today's federal court ruling, that held the entire health care law unconstitutional because of the individual mandate. Now that two federal judges have held the individual mandate unconstitutional, this one overturning the entire law because of it, I have to wonder just how long the Democrats are going to wait before they try to amend the Affordability Act in

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-12061658104473369182011-01-21T14:42:00.008-05:002011-01-21T14:56:00.554-05:00"Quit the RUC"

Brian Klepper and David Kibbe have a notable column at Kaiser Health News arguing that the American Medical Association's Relative Value Scale Update Committee (RUC) is specialist dominated and steers health care resources away from primary care:Not surprisingly, the Committee’s payment recommendations have consistently favored specialists at the expense of primary care physicians. More

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com7tag:blogger.com,1999:blog-1845183703568253871.post-27096720031778994442011-01-17T14:54:00.010-05:002011-01-17T15:17:52.608-05:00The House Health Care Repeal Vote, the National Debt, and the Imperative for Democrats and Republicans to Compromise

This week's House health care repeal vote is little more than a political stunt--everyone knows the effort will die in the Senate.But, when the day is done the only way for the Republicans to do anything with the new health law will be to work out a compromise—repeal before the 2012 elections is impossible and it isn’t very likely after the 2012 elections. Even if the Republicans sweep the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-57364640424967357612011-01-10T16:55:00.009-05:002011-01-10T21:40:49.861-05:00Strong Evidence A Bipartisan Agreement on Health Care Was Possible in 2009

Readers of this blog have often heard me say that a bipartisan agreement on a health care bill was possible in 2009--driven from the Senate Finance Committee. I have continually made the point that the two sides were much closer than is commonly believed--or partisans are willing to concede.Every time I post this, the overwhelming reaction is that I am wrong--with one side inevitably blaming the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-37011604997837177572011-01-06T14:22:00.009-05:002011-01-08T14:18:43.504-05:00Karl Rove’s Criticism of AARP Was a Cheap Shot and Uninformed

Readers of this blog know that I am willing to call AARP out when I think they deserve it. Witness my recent post criticizing their reaction to the chairs of the Deficit Commission and their preliminary report when AARP acted more like a narrow minded advocate than an enlightened organization that understands the inevitability of fundamental reform to the entitlements.And, I have never been

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-72238984926977201222011-01-04T09:12:00.004-05:002011-01-10T12:15:22.439-05:00Improving The Health Law In 2011: Realistic Ways To Reach Bipartisan Compromise

This post originally appeared at Kaiser Health News.The new health care law can be changed in ways that would make it acceptable to a bipartisan majority in the new Congress -- and, therefore, to the American people. But to find this elusive middle ground requires consideration of the competing philosophies at the heart of the nation's political divisions regarding this sweeping measure.For

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-69125798069782879912010-12-15T09:13:00.013-05:002010-12-27T15:50:11.657-05:00The Democrats Had Better Hope the Supreme Court Overturns the Individual Mandate Before the Middle Class Understands How Bad It Is For Them

This post first appeared as a column at Kaiser Health NewsIs The Individual Mandate Really A Lynchpin In The New Health Law?If the Supreme Court does rule the individual mandate unconstitutional will it really bring down the whole law?I don't see it.First, the individual mandate isn't even close to what it has been made to be -- a provision that would protect the integrity of the health insurance

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-28210619309842776572010-12-09T11:54:00.007-05:002010-12-09T12:44:53.433-05:00Back to the Future—Biggest Health Plans Reported to be Building Their Own Political Coalition

I had a real sense of déjà vu this morning reading Bara Vaida’s story in Kaiser Health News:Five of the nation's largest health insurance companies are taking a key step toward building their own inside-the-Beltway coalition to influence implementation of the new health law and congressional efforts to change it. The companies – Aetna, Cigna, Humana, UnitedHealthcare and Wellpoint – are shopping

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-16710186650506685862010-12-06T16:21:00.007-05:002010-12-06T17:38:49.195-05:00What Would Happen If You Were To Pass a Big Health Care Bill Without Bipartisan Support?

During the recent health care debate I heard many people on both sides of the debate worry out loud about passing a heath care bill that did not enjoy broad support.I guess this question is no longer a theoretical one.December will be a big month when it comes to seeing some of the fallout accruing from the very partisan passage of the Patient Protection and Affordable Care Act.First, the White

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com9tag:blogger.com,1999:blog-1845183703568253871.post-36625317073271631272010-12-03T09:36:00.006-05:002010-12-03T09:47:08.441-05:00"Care and Cost"

Good friends David Kibbe and Brian Klepper have finally started their own blog--aimed at becoming a forum for many contributors to the health care debate.I suggest you add, "Care and Cost"––"Health Care Conversations About Hard Choices and Emerging Solutions" to your bookmarks.

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-16366081256812612882010-11-28T23:14:00.002-05:002010-11-29T09:25:36.424-05:00"Don't Litigate, Innovate." How To Implement A Fully Funded Alternative To The New Health Care Overhaul -- And It's Already In The Law

This post of mine first appeared at Kaiser Health News last week.What if a Republican governor and a Republican legislature had the ability to implement their version of health insurance reform and the federal government would have to pay for it? It's a great idea. And I'm thrilled to say that a bi-partisan bill has already been introduced in the Senate by Ron Wyden, D-Ore., and Scott Brown,

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-28919285664663077902010-11-23T23:58:00.002-05:002010-11-23T23:58:00.298-05:00Will it Be the Bond Market That Finally Forces Serious Health Care Financing Change?

When will the Congress and the White House finally make the hard decisions in order come to grips with the federal deficit problem?When will we finally deal with real health care reform and get the entitlements, and with them the private health care cost issue, under control?My focus on trying to answer those questions has always centered on what's going on in the health insurance market: When

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-70592324320394327452010-11-22T23:54:00.004-05:002010-11-28T16:35:34.383-05:00The 300 Page MLR Rules—About as Valuable as Taking Your Shoes Off at the Airport

This whole medical loss ratio (MLR) provision in the new health care law is a fool’s errand. When it comes to controlling health care costs it is about as productive as taking your shoes off at the airport is valuable at improving air travel security.Without a doubt, the new health care law does far too little toward making health care costs affordable. And, marginal health insurance carriers

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com7tag:blogger.com,1999:blog-1845183703568253871.post-72898028219532226502010-11-21T23:55:00.003-05:002010-11-21T23:55:00.106-05:00Health Care—Tell Us the Truth Before You Tell Us Why You Are Right

This is post of mine that appeared last week at Kaiser Health News.Just after the election, I saw an exchange between CNN’s Anderson Cooper and the head of the Tea Party House Republican caucus, Michele Bachmann. Cooper tried to pin Bachmann down on just exactly what “specific spending cuts” she would make to get federal spending under control. When he suggested that Medicare was going to need

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-89983354083632870422010-11-11T14:35:00.009-05:002010-11-12T09:41:09.347-05:00Shame on AARP For Their Response to the Deficit Commission Co-Chairs' Report

The Co-Chairs of the President’s Deficit Reduction Commission are out with their preliminary recommendations.They’ve done a great job—they’ve offended about everyone!But we have a nearly impossible but unsustainable challenge in front of us if we are ever going to crawl out of this deep hole.It is not so much what is on their list as what this list tells us about just how fundamental the changes

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-90661359514259281862010-11-08T14:29:00.020-05:002010-12-27T16:07:04.190-05:00Health Care and the 2010 Mid-Term Elections--the Only Thing Now Certain is the Uncertainty

@font-face { font-family: "Cambria"; }p.MsoNormal, li.MsoNormal, div.MsoNormal { margin: 0in 0in 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; }div.Section1 { page: Section1; } The election has given us a Republican House and a still Democratic controlled Senate. But, instead of Democrats having the 60 Senators they had when health care was passed in December, they will have a

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com6tag:blogger.com,1999:blog-1845183703568253871.post-84865900489798323362010-03-08T22:04:00.010-05:002010-03-09T22:13:40.725-05:00Passing the Democratic Health Care Bill is Not the “Right Thing To Do”

Any big health care bill will be full of compromises—political or otherwise. But this bill doesn’t even come close to deserving to be called “health care reform.”As the Democrats make their final push to pass their health care bill many of them, and most notably the President, are arguing that it should be passed because it is the “right thing to do whatever the polls say.”Their argument is

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com7tag:blogger.com,1999:blog-1845183703568253871.post-83044502664676042872010-03-07T14:42:00.007-05:002010-03-07T14:42:00.210-05:00The Issue Has Become Arrogance Not Health Care

Away from Washington people I talk to are just amazed at what the Democrats are in the process of doing on health care.What I think the Democratic leadership is missing is that this is no longer about passing a health care bill in the minds of lots of these voters—a majority of voters from what the polls say.To these people, this is about Democratic arrogance. What the polls don't measure is the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com9tag:blogger.com,1999:blog-1845183703568253871.post-34962461637931626562010-03-06T21:14:00.000-05:002010-03-09T17:38:33.862-05:00Why Rush Vendor Certification of EHR Technologies?

Why Rush Vendor Certification of EHR Technologies?by DAVID C. KIBBE and BRIAN KLEPPERA surprise move by ONC/HHS indicates the wheels may be falling off health IT reform at about the same rate they've fallen off Democrats' broader health reforms.David Blumenthal and his staff have unveiled two separate plans to test and certify EHR technology products and services. We don't think this is a good

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-86063750073477077442010-03-04T22:36:00.008-05:002010-03-04T22:46:27.966-05:00"What a Disaster Looks Like"

In case you missed Peggy Noonan's column in the WSJ yesterday, let me suggest it is worth your time.I think she hit the nail on the head:It is now exactly a year since President Obama unveiled his health care push and his decision to devote his inaugural year to it—his branding year, his first, vivid year.What a disaster it has been.At best it was a waste of history's time, a struggle that will

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-81460369443089606702010-03-01T19:47:00.001-05:002010-03-01T19:47:00.676-05:00After the Failure of Reform

After the Failure of ReformbyBrian Klepper and David C. KibbeThe stalemate in the bi-partisan health care summit was cast the moment it was announced. Republicans demanded that the reform process start anew, and Mr. Obama insisted on the Senate bill as the framework going forward. The President may now offer a more modest reform bill that can demonstrate some progress on the health care crisis,

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-61674148264008121052010-02-27T03:31:00.004-05:002010-02-27T03:35:56.096-05:00Post-Summit Health Reform: What a Mess

Everyone agrees our health care system is unsustainable and too often unfair. At the White House health care summit, that was the only common ground between Democrats and Republicans.Many Americans are either left-brain liberals or right-brain conservatives, with the remainder somewhere in the middle. These left- and right-brain types look at the same facts but come to different conclusions—no

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-6713878201011119972010-02-25T16:43:00.013-05:002010-02-25T17:44:40.234-05:00The White House Health Care Summit--Democrats: 0 Republicans: 0 -- The Republicans Win

There is politics and there is policy.On the policy front what we saw today was the same exchange of the old talking points we have watched for a longtime. No progress was made toward any kind of health care bill. That is no surprise--this was never going to be the place to fashion any kind of compromise.At the end the President asked the Republicans if it was worth it to spend another month or

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-40550606930551718872010-02-25T12:20:00.002-05:002010-02-25T12:22:58.917-05:00Live Blogging During the Health Care Summit

I am blogging live with a number of others at the NewsHour site.

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-70653101820600679322010-02-25T00:21:00.012-05:002010-02-25T14:15:28.996-05:00Obama to Uneasy Democrats: Please Walk the Plank for Me But If It Doesn't Work Out Here's Plan B

The President and the Democratic leadership have been pushing hard on the idea that the Democrats should ram their unpopular health care bill through by using reconciliation--no matter how many Democrats in swing districts lose their jobs over it this November.But Laura Meckler had an important story in the Wall Street Journal yesterday that is bound to give many of the nervous moderate Democrats

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-54543996549636366402010-02-22T15:50:00.006-05:002010-02-22T16:00:11.915-05:00The President’s Health Care Plan—Not a Game Changer

It is hard to see how the health care plan the President released this morning changes anything.There is nothing new in it save a health insurance rate regulatory board that is an awkward political proposal at best. What powers would it really have and how would it operate in conjunction with the states already charged with insurance company oversight are just two of the first questions it does

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-58347674979771428792010-02-09T17:36:00.018-05:002010-02-09T20:24:51.608-05:00Wellpoint and Their “39%” Rate Increase

Wellpoint is getting killed in the press over a “39%” rate increase for their individual health insurance block in California.HHS Secretary Sebelius has pointed to the Wellpoint individual rate increases demanding an explanation. The President even brought it up in his interview on Sunday. At a time Democrats are fond of calling insurance executives “villains” this story just adds more fuel to

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com8tag:blogger.com,1999:blog-1845183703568253871.post-4058673470251325632010-02-08T14:50:00.011-05:002010-02-08T15:03:22.469-05:00The Health Care Summit—Who’s Gonna Win the Photo-Op?

Getting Democrats and Republicans to constructively engage on health care is the best way to make progress.To date, the Democrats have blown health care reform once again by being too arrogant in thinking they could just ram their version through.The Republicans have no health care proposal. Their “black book” list of ideas they handed the President in Baltimore is a collection of second and

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-78843682967167701842010-02-07T14:39:00.006-05:002010-02-07T15:27:04.998-05:00A Way Out of the Health Care Wilderness?

I just came across an interview that I will suggest we all may have missed and perhaps charts the way out of this health care reform wilderness we now seem to be in.It was on February 2nd and was between the Washington Post’s Ezra Klein and rising Republican House star Paul Ryan (WI).Ezra asked Ryan about the bipartisan Wyden-Bennett bill as a place for both sides to find common ground. It’s a

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-53924006261042723132010-02-04T14:44:00.008-05:002010-02-04T15:38:25.224-05:00“Plan B” Has Begun

With word that the House is likely to take up the repeal of the health insurance industry anti-trust exemption it is now clear the Democratic leadership has begun Plan B.It is also clear that this is much more a part of a political Kabuki dance then any substantive effort at even piecemeal health care reform.The House probably has the votes to pass the repeal. The Senate does not. I doubt that

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-68065534354970717032010-01-30T16:23:00.009-05:002010-01-30T20:49:53.317-05:00Friday in Baltimore--The Way to Actually Accomplish Something

Intentionally or unintentionally, my sense is that the White House came out of Baltimore thinking they are now on to something, and I hope the Republicans took the same lesson away.Constructive good faith political engagement in Washington actually works.It is just incredible that House Minority Leader John Boehner has had not direct contact with the White House for about a year. A pox on both

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-36502291201679817252010-01-27T21:59:00.006-05:002010-01-27T22:34:01.395-05:00The State of the Union--The President Came to a Fork in the Road and He Took It

As Yogi Berra said, "When you come to a fork in the road, take it."The President came to a fork in the road tonight on health care reform. Would he do what many liberals have demanded--push harder to pass the Democratic health care bills? Or, do as many moderate Dems and some Republicans have called for--work to get a smaller but bipartisan health care bill?Listening to his speech he seems to be

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com10tag:blogger.com,1999:blog-1845183703568253871.post-22846714140553380052010-01-26T09:15:00.009-05:002010-01-26T09:24:26.332-05:00Plan B—There Isn’t One—But There Could Be

As the State of the Union approaches Democrats are considering their health care policy options. There are lots of reports about “Plan B”—pushing through the Senate bill with a parallel corrections bill that could be passed in the Senate using reconciliation rules.That’s as dead as the original House and Senate health care bills. Moderate Democrats have no stomach for such a legislative stunt in

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-44485195127169512092010-01-21T10:20:00.009-05:002010-01-21T14:51:44.934-05:00A Smaller Bipartisan Health Bill? What It Could Look Like

In the wake of the Massachusetts vote, Democrats are scrambling to find a way out of the health care political mess they are in.Right now they are in a daze standing by waiting to see if any of the "trial balloons" they have launched gain any traction. So far, ideas to ram though the now toxic Senate bill in the House in one parliamentary form or another are falling flat.Last night, the President

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-59765933205491448072010-01-19T21:39:00.014-05:002010-01-19T23:30:17.447-05:00Stick a Fork in It! The Democratic Effort to Pass a Health Bill is Dead

Tuesday’s Republican victory in Massachusetts means the current Democratic health care bills will not be on the President’s desk in 2010.Forget the crazy talk of ramming something through—including just having the House pass the pending Senate bill.I’ve talked to lots of people in the past few months that didn’t like the Democratic effort but conceded that the Dems won the 2008 election on a

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com14tag:blogger.com,1999:blog-1845183703568253871.post-3990990739377660282010-01-19T18:18:00.000-05:002010-01-21T19:39:21.316-05:00The Silver Lining in the Massachusetts Vote

The Silver Liningby Brian Klepper and David C. KibbeMassachusetts voters' stunning rejection of Democrat Martha Coakley, in favor of a not-very-impressive Scott Brown, should be exactly the splash of cold water that the Democratic party - and Congress as a whole - needed. The defeat can be understood in two ways: one large and one fairly small.First, the large one. This will probably send reform

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com6tag:blogger.com,1999:blog-1845183703568253871.post-76276178645113938792010-01-15T08:59:00.006-05:002010-01-15T11:28:47.498-05:00The Union “Cadillac” Tax Sweetheart Deal

Just when you thought you couldn’t be more cynical about the health care bill.As I have said before, there wasn’t a lot of hope the same administration that ignored the rule of law in granting unions priority over Chrysler bondholders was going to offend them on the “Cadillac” tax.We’ve seen the “Louisiana purchase” giving Senator Landrieu hundreds of millions for her vote, only to be upstaged by

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com11tag:blogger.com,1999:blog-1845183703568253871.post-15437133424154574002010-01-07T08:19:00.006-05:002010-01-07T08:27:15.606-05:00A Great Summary of Where We Are

Good friend Brian Klepper has an excellent round-up of recent blog reactions to the health care bill's progress in a "Special Edition of Health Wonk Review."It is posted on The Health Care Blog.It is really worth your time.

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com6tag:blogger.com,1999:blog-1845183703568253871.post-48213384916325605602009-12-23T10:43:00.017-05:002009-12-23T13:54:14.969-05:00How Will the Senate Bill Impact the Insurance Companies and Their Customers?

How will the Senate bill impact health insurance companies and their customers?Even better, how will it impact a not-for-profit health plan--one with a reputation for being a "good guy" that continually wins the country's top awards for member services and with historic profits of less than 1% of premium? And, one that is operating in Massachusetts--a market that has already been through much of

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-79684197756524518062009-12-21T11:43:00.004-05:002009-12-21T11:46:32.108-05:00The Senate Bill--Wall Street Likes It and the House Will Have To

In morning trading HMO stocks are once again hitting 52-week highs with each of the major publicly traded plans up 3% to 6% from their Friday gains.Hospitals and pharmaceutical companies are also doing pretty well.Liberals have been talking all weekend long about having to make the Senate bill better—and more like the House bill. That just won’t happen. Reid’s 60-vote majority is held together

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-56974193127484116422009-12-19T09:59:00.010-05:002009-12-19T10:07:10.153-05:00Coal in Your Christmas Stocking?

Is there anyone left, on either side of the political spectrum, who wants the Senate health care bill to pass?Republican Mississippi Governor Haley Barbour had this to say about the Senate bill last week, “This health care plan is like mackerel in the moonlight. Longer that it's out there, the more that it stinks.”And yesterday, MoveOn said this about the Senate Democratic health care bill in an

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-57863192841427636622009-12-15T15:50:00.018-05:002009-12-16T15:43:23.748-05:00Oh, Ease Up on Joe Already

The Democratic rhetoric coming from Capitol Hill today beating on Joe Lieberman is, in the least, disingenuous.The public option has not been tenable for months. It was not just Lieberman that has been against it in all forms--robust Medicare-like or the neutered variety in the House and Senate bills.All of the liberals claiming they weren't going to vote for a health bill without a public option

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-73628317710780078222009-12-11T11:11:00.020-05:002009-12-11T15:27:35.639-05:00The Medicare Buy-In Is Dead--The Liberals Are Now the Swing Votes in Health Care

The Medicare buy-in idea is dead. After Democratic Congressman Weiner's candid comment, “Never mind the camel’s nose, we’ve got his head and neck in the tent," no senator from the likes of Arkansas or Indiana is going to vote for this.Add to that yesterday's critical Washington Post editorial and the sharp response from the various doc and hospital lobbies and this was dead before Reid's request

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-37576376062467019482009-12-08T17:02:00.021-05:002009-12-08T18:30:38.231-05:00Selling Insurance Across State Lines--Now the Dems Are Pushing the Idea--Why It Won't Work

A favorite Republican health care soundbite calls for making the health insurance system more efficient by letting health plans sell across state lines.Now Democrats are jumping on that idea. The latest public option idea would have the Office of Personnel Management (OPM) contract with national not-for-profit health plans and introduce those plans into local insurance exchanges--that would be

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com27tag:blogger.com,1999:blog-1845183703568253871.post-52727396026318855382009-12-08T10:55:00.012-05:002009-12-08T11:04:30.588-05:00Liberal Demands Over Giving Up the Public Option Threaten Health Care Deals

I actually feel for Harry Reid this morning.He was on his way. He had mastered an incredibly fine balance in his health care bill.No it wasn’t real health care reform and it wasn’t going to bend any curves but the Dems long ago gave up on that looking for one big political “W” instead.The liberals were finally backing off on the public option there never were the votes for. But even the “neutered

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-43061553553658084782009-12-07T09:27:00.017-05:002009-12-07T18:15:07.211-05:00The Latest Version of the Public Option—The Democrats Could Have Saved Us Lot of Time If This is What They Call a “Public Option”

If the latest version of the public option is something that will give its proponents reason to argue they still have a way to "make the health insurance market much more competitive," then a motor scooter is a Ferrari.The details are still fuzzy but the word is that senators are working toward a compromise over the controversial public option that would create something that:Would be run by the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-78473188823148167382009-12-06T17:47:00.000-05:002009-12-10T22:12:02.447-05:002009 a Year of Surprises and Change for the EHR Technology Market

2009 a Year of Surprises and Change for the EHR Technology Marketby DAVID C. KIBBE and BRIAN KLEPPER"Oft expectation fails, and most oft thereWhere most it promises; and oft it hitsWhere hope is coldest, and despair most fits." All's Well That Ends Well (II, i, 145-147)2009 began with a bang for legacy Electronic Health Record (EHR) vendors, promising strong sales and windfall profits

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-47195866490999575082009-12-03T09:01:00.013-05:002009-12-03T09:43:25.105-05:00Good For Orszag--Budget Director Discusses Cost Containment in Dem Bills

I was encouraged by remarks White House Budget chief Peter Orszag made in Washington yesterday.There has been substantial debate in recent days about whether the pending House and Senate bills have the kind of robust cost containment we need to really "bend" any health care cost "curves."Readers of this blog know of my concern that these bills amount more to expensive entitlement expansions than

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-25961229920545473132009-11-30T13:16:00.002-05:002009-11-30T16:20:04.366-05:00There Are Four Health Insurance Renewal Cycles and Two Elections Between Now and 2014—Could be Sort of Like a “Death By a Thousand Cuts” for the Dems

The Congressional Budget Office (CBO) issued a report today saying that if the Reid bill becomes law the price of non group policies would be about 10 percent to 13 percent higher in 2016 than it would be under current law. The CBO projects that small group and large group premiums would be about the same in 2016 as they would have been anyway as the benefits of the bill would offset some of its

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-45182044870610827892009-11-29T19:16:00.000-05:002009-11-29T20:41:30.474-05:00The Senate Democratic Health Care Bill is a “Milestone” on the Road to Cost Containment—If It Is It's a Pretty Small One

The Obama administration is reportedly pleased with a recent Ron Brownstein article in the Atlantic.In it Brownstein praises the Reid Senate health care bill for the steps it takes toward containing costs. He quotes MIT economist Jonathan Gruber who says, “My summary is it's really hard to figure out how to bend the cost curve, but I can't think of a thing to try that they didn't try. They really

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-17618140894146918992009-11-25T09:45:00.009-05:002010-08-30T17:15:04.713-05:00Don't Rationalize Busting the Budget--Start Over

I detect a growing rationalization among supporters of the Democratic health care bills: The recent flare-up over when a woman should have a mammogram proves we are nowhere near ready to pass a health care reform bill that will actually control costs. So, why bother?You would be hard pressed to find any health policy expert who isn’t disappointed that cost containment has fallen off the health

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com6tag:blogger.com,1999:blog-1845183703568253871.post-32966282652301937722009-11-23T11:44:00.015-05:002009-11-24T15:24:52.237-05:00The Democratic Health Care Effort--A Political "Charge of the Light Brigade?"

The latest polls are an unmitigated disaster for Democrats even as they're on a fast track to get their health care legislation passed.This from Rasmussen this morning:“Just 38% of voters now favor the health care plan proposed by President Obama and congressional Democrats. That’s the lowest level of support measured for the plan in nearly two dozen tracking polls conducted since June.“The

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-18962638070070534422009-11-19T12:57:00.010-05:002009-11-20T09:40:21.339-05:00How Can Harry Reid Keep a Straight Face Telling Us His Health Bill Will Reduce the Deficit?

The accounting gimmickry in Harry Reid’s Senate health bill is astounding even by Capitol Hill standards.Reid says his bill will cost $850 billion and reduce the deficit by $130 billion—all over ten years.Based upon the outline Reid gave the CBO that could well be right. But let’s look at it further:Reid delays most of the spending in the bill to 2014—a year longer than in the House. More

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com9tag:blogger.com,1999:blog-1845183703568253871.post-34577099052921152642009-11-17T07:44:00.002-05:002009-11-17T09:25:47.011-05:00Why Isn't the Press Talking About Affordability--For "Ordinary Folks"?

I thought Trudy Lieberman hit the nail on the head in a post she did yesterday at the Columbia Journalism Review entitled, "Missing Persons--How Will Reform Affect Ordinary Folks." Here is a small part of it:The media have talked about affordability mostly in the context of whether the country can afford reform, not whether individuals can afford it. It’s easier for a reporter to write about

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com6tag:blogger.com,1999:blog-1845183703568253871.post-55798689114297084022009-11-16T14:45:00.019-05:002009-11-16T18:40:21.359-05:00The Outlook for a Health Care Bill in 2009

Readers of this blog know of my yearlong pessimism over our getting a trillion dollar health care bill in 2009.With the historic passage of the House bill, are we now on our way to a big health care bill in 2009—or even by early 2010?Clearly, Democrats desperately want to pass a bill. Given their compromise over abortion and the neutering of the public option in the House legislation—things most

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-2632084261045676632009-11-13T09:54:00.016-05:002009-11-13T10:58:15.934-05:00The End of the "Robust" Public Option and the Potential for "Robust" Cost Containment?

Two things happened this week that in tandem have the potential to lead to a compromise over a health care bill.First, there are unconfirmed reports that Senate Majority Leader Reid is leaning toward offering the neutered version of the public option like that in the House--not tied to Medicare rates, providers not required to participate, and provider reimbursement rates negotiated.The second

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com2tag:blogger.com,1999:blog-1845183703568253871.post-81434452623130673202009-11-11T07:56:00.008-05:002009-11-11T08:24:39.264-05:00The Best Health Care Idea All Year

Out of almost nowhere has come momentum for a proposal to create a bipartisan entitlement and tax commission to draft proposals to control the long-term costs of Social Security, Medicare, and Medicaid. The idea would require the Congress to quickly vote the recommendations up or down via a super majority vote.The idea isn't new--proposals for a such a commission have been around for a

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-93902914252336082009-11-09T00:23:00.003-05:002009-11-09T00:26:08.413-05:00The House Health Bill--Loading More People Onto the Titanic

Our health care system is truly titanic, in more than one sense of the word.Not only is it huge, but it's also growing at unsustainable rates that undermine our health care security and fiscal stability - and threaten to sink the system under its own weight.When the health care debate began in earnest just after the November 2008 election, it was supposed to be about reform-moving the nation

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com3tag:blogger.com,1999:blog-1845183703568253871.post-585470448414978142009-11-05T15:14:00.009-05:002009-11-05T23:36:34.965-05:00AMA Supports the House Democratic Health Care Bill--Take Another Look

The AMA came out in support of the House Democratic health care bill this afternoon—sort of. From their press release:“The American Medical Association (AMA) today announced support for concurrent passage of H.R. 3962 and H.R. 3961, U.S. House of Representatives health system reform bills."I would suggest the operative word is "concurrent."HR 3962 is the big House health care bill. HR 3961 is the

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com4tag:blogger.com,1999:blog-1845183703568253871.post-24927213494435777992009-11-05T10:47:00.006-05:002009-11-05T11:00:58.668-05:00The House Bill Should Be Defeated on Saturday

Here's the email I just sent my Congressman, freshman "Blue Dog" Frank Kratovil of Maryland:Please vote no this weekend on the House bill.This is not health care reform.This is at least a $1 trillion entitlement expansion paid for half with only modest provider cuts and $500 billion in taxes.Real cost containment would bend the curve and produce the savings needed to accomplish universal

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com1tag:blogger.com,1999:blog-1845183703568253871.post-39151956371396542932009-11-03T11:16:00.011-05:002009-11-03T11:49:32.495-05:00The Neutered Public Option—Where’s the Rage?

The public option contained in the House Democratic health care bill is hardly more than a neutered version of the “robust” public option one House Democrat after another said was a minimum requirement to keep their vote on health care reform. After threatening for months to fall on their swords if they didn’t get the “robust Medicare-like” version, there was nothing but enthusiastic support for

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com5tag:blogger.com,1999:blog-1845183703568253871.post-58797363690266422952009-10-30T15:58:00.004-05:002009-10-30T16:09:26.548-05:00Saving Health Care--Saving America

Saving Health Care--Saving AmericaBy BRIAN KLEPPER, DAVID C. KIBBE, ROBERT LASZEWSKI and ALAIN ENTHOVENSo far, Congress' response to the health care crisis has been alarmingly disappointing in three ways. First, by willingly accepting enormous sums from health care special interests, our representatives have obligated themselves to their benefactors' interests rather than to those of the American

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-56583838041093743062009-10-29T08:36:00.013-05:002009-10-29T09:30:37.192-05:00The Health Care Bills, the Fine Print, and a Troubling List of Budget Gimmicks

Julie Appleby has an important article today at Kaiser Health News.She has identified an important and before unreported issue in the Senate Finance health care bill.In order to keep the cost of the plan down, the Senate Finance bill literally locks in the erosion of insurance subsidies for middle class families.From her report:"The first year the legislation would take effect, people getting

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0tag:blogger.com,1999:blog-1845183703568253871.post-48969354596385512422009-10-26T10:55:00.012-05:002009-10-26T11:18:57.780-05:00“The Public Option Is Back in Play”—That Depends Upon Your Definition of the Word “Is”

It appears that Harry Reid is going to include a robust Medicare-like public option in his Senate draft. Speaker Pelosi is also doing her best to put as robust a public option in her House version as she can get the votes for.One press report after another has proclaimed the return of the public option.I’d like to see some of these reporters to do a vote count.No doubt the hype over the public

ROBERT LASZEWSKIhttp://www.blogger.com/profile/14761287683359098177noreply@blogger.com0