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Thursday, June 4, 2009

Unaccountable Commission May Run Healthcare

Three card monte is a scam in which the sucker is led to believe he is following the winning card, when in fact the skillful dealer has distracted the sucker into following the wrong card. The sucker never wins.

Right now, everyone's focus is on Obama's "historic" speech to the Muslim world in Cairo. But the real action came in a letter Obama sent to the Senate proposing to empower the 17-member Medicare Payment Advisory Commission (MedPAC) with the same level of power over the health care system as the Base Realignment and Closure Commission had over the closing of military bases:
To identify and achieve additional savings, I am also open to your ideas about giving special consideration to the recommendations of the Medicare Payment Advisory Commission (MedPAC), a commission created by a Republican Congress. Under this approach, MedPAC's recommendations on cost reductions would be adopted unless opposed by a joint resolution of the Congress. This is similar to a process that has been used effectively by a commission charged with closing military bases, and could be a valuable tool to help achieve health care reform in a fiscally responsible way.
The 2009 MedPAC member list is here. While MedPAC currently only makes suggestions regarding Medicare payments and costs, the Obama proposal would greatly expand MedPAC's power over a large percentage of the economy -- and the health and welfare of tens of millions of people -- because MedPAC's actions would have the force of law without any significant accountability. The likelihood of a joint resolution of Congress against anything MedPAC did is so small as to make MedPAC a law unto its own.

Since Medicare rules and funding drive so much of the health care industry, MedPAC will become a de facto health care Czar. And it would not be surprising if MedPAC's jurisdiction was expanded beyond Medicare itself.

While some are cheering that the move "actually looks able to deliver on controlling costs," such controls will come at the cost of citizens having any control over their health care. Somehow blind faith in an unaccountable commission has become the method of rescue for those who otherwise demand freedom. If you didn't like when a military base was was closed in your state, wait until you are denied a surgery or treatment because it is deemed too expensive by MedPAC.

The analogy of closing military bases to making health care costs decisions if fallacious. The base closing commission was a reaction to large excess capacity in military bases, largely as a result of pork barrel earmarks. Taking politicians out of the closing process was the only way to close military bases, so that politicians would not take the blame. There is no excess capacity, however, in health care services. To the contrary, if anything, there is a lack of capacity, or at least a capacity which costs too much because of new technologies and treatments.

An unaccountable commission restricting access to health care services simply is nothing like an unaccountable commission closing unneeded military bases. And if the history of the Base Closing commission is any indication, there will be plenty of irrationalities from this supposedly rational process, mostly in the form of illusory cost savings.

There will be winners and losers, and the losers will lose not their jobs, but potentially their lives. No wonder Obama wants to rush this through Congress this summer in time for an October signing. If people really knew and had time to focus on what Obama was proposing, the MedPAC and similar proposals would fail.

Obama's speech to the Muslim world will change nothing. Obama's MedPAC and similar proposals will change everything. And you were watching the speech.

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  1. Prescription costs have become increasingly difficult to manage. You can start saving by switching to generic drugs. www.medtipster.com recently launched an early version of its drug price comparison Web site. Consumers type in their drug name, dosage and ZIP code, and can find prescription drugs available on discount generic programs and where they can find them in their neighborhoods. The site will eventually offer users information on scheduled immunizations, health screenings and mini-clinics in their area; recalls and warnings; an "Ask the Pharmacist" feature; and an online community in which individuals can share information.

  2. I agree that socialized medical care is a BIG mistake. I guess we don't have a congress that cares for the every day citizen. They have their own health care. I think they need to abolish their health care program and start using the programs that we all have to use.

    People, wake up! I am going to call my senators and congressmen right now! Join me and call yours too.

  3. There is a huge opportunity for the GOP in this whole push to find some way to "cut costs" supposedly to finance new health care programs for the uninsured -- but Republicans are missing it.

    Obama and company have made clear that they want to pay for insuring the uninsured by reducing services and raising costs on the already insured -- particularly the over-65s covered by Medicare. If Republicans were trying to do this, there would already be a huge outcry drummed up by Democrats and the media to arouse the indisputably most powerful group of reliable voters in the nation, the elderly.

    There is surely no reason why the GOP cannot rally seniors to its side of this debate. An aroused senkior population would put a quick end to any further eyeing of cuts in Medicare (plus, it leads to a natural alliance with providers). Then, the Dems would have no choice but to go hard for a really big, impossible to camoflage revenue source. We have already seen how eager to avoid this the moderate Dems in the Senate are. In the end, their only option would be a modified, less-expensive and more private-sector plan like those proposed by various Republicans.

    So where is the campaign to inform and galvanize seniors?

  4. Yeah, this is not good. But if health care was nationalized, wouldn't we have the option of getting private healthcare? Health insurance and health costs are a huge problem. Why haven't the Republicans proposed a feasible alternative? If they did, the world would beat a path to their door... People don't necessarily want socialized healthcare, but people are hurting.

  5. . there is indeed an excess capacity of health care
    -- given our limited budget;
    pork is relative: if you've got plenty of money,
    you can never buy too much military security!
    likewise for health care:
    no senator wants to do the grizzly job of medical triage;
    therefore, a commission is again needed to do the job for them;
    so, it was a perfect analogy .