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Mr. President, Aren’T You Lot Simply Kicking The Tin Downward The Road?

Pieces of the health tending constituent of the Obama budget are leaking out.

Based upon published reports, the Obama “down payment on wellness tending reform” will include:

• $634 billion to assist pay for wellness tending reform over the adjacent 10 years.
• $318 billion of that—about half—will come upward from taxation increases that include reducing the mortgage too charity deduction for high income Americans.
• Charging wealthier seniors to a greater extent than for the Medicare Part D drug benefit—as is done for Medicare Part B now.
• Cutting Medicare HMO payments past times $175 billion over 10 years.
• Reducing Medicare infirmary payments past times $26 billion over 10 years past times bundling inpatient too outpatient reimbursement to include the 30-days afterward discharge.
• Cutting Medicare infirmary payments past times $12 billion over 10 years for readmissions resulting from substandard care.
• Requiring drug makers to increment the rebates on drugs sold to Medicare patients from 15% to 21% saving $19.5 billion over 10 years.
  

The biggest spending reduction is the cut to Medicare HMO payments. This 1 is hardly a risky political deed every bit everyone has expected it. Competitive bidding would induce down inwards 2012 nether the proposal.

Interestingly, the Obama budget reportedly calls for creating a organization where the somebody Medicare plans volition bid marketplace to market to compete alongside the traditional Medicare excogitation rather than continuing the electrical flow organization where the authorities tries to laid the rates for them.

Ironically, that was the master copy Republican reckon for using the competitive value of managed tending to bring down long-term Medicare costs too is what should accept happened inwards the starting fourth dimension house rather than this temporary organization of overpayments the HMO manufacture has been fighting to proceed permanent.

With $318 billion inwards taxation increases too some other $175 billion inwards Medicare HMO cuts, the $634 billion "down payment" solely contemplates a full of some other $141 billion inwards federal wellness tending cuts over 10 years (which amounts to nearly 1% of annual federal spending each year). That is hardly a rounding fault on a federal wellness tending budget that CMS only announced volition already full $1.19 trillion inwards only 2009.

This week, CMS estimated that at acquaint trends annual national wellness tending spending would attain $4.35 trillion or 20% of gross domestic product past times 2018.

If the Obama direction is serious nearly non “kicking the tin farther downwards the road” too hence whatever overhaul of our wellness tending organization has to practise to a greater extent than than fritter around the edges alongside spending reductions.

More, it needs to endure paid for from existent savings—not one-half of the "down payment" coming from taxation increases every bit they are reportedly proposing.

If the excogitation is to heighten taxes to pay for a large purpose of wellness reform that only way they meliorate heighten plenty taxes to pay for the $4 trillion wellness tending organization CMS says nosotros are going to accept inwards 2018.

As the budget details come upward out over the adjacent few days the inquiry nosotros all demand to endure hollo for is, Just what is this direction willing to practise to brand wellness tending affordable over the adjacent 10 years?

Affordability volition accept a lot to a greater extent than to practise alongside the how this direction deals alongside the $2.5 trillion nosotros already pass every twelvemonth non whose taxes nosotros tin raise.

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