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
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Why 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
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The “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
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So 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]
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Fixing 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
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The 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
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Defined 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)
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Will 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
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Alternatives 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
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Things 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
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