Minnesotans have had decades of experience with “managed health care.” Like health maintenance organizations called Group Health on the Iron Range and in MSP (now Health Partners.) In 1985 we launched Medicare demonstrations, using vouchered premium support payments pegged to 95% of traditional Part A and B. We in Congress started a movement toward managing care.
Medical markets responded by (1) merging community-based HMOs into one big managed care organization (MCO) like United Health Group, or (2) converting traditional … Continue reading »
Tim Pawlenty used his appearance on Fox News Sunday to show a tougher demeanor and to prove he will not make health care cost containment and access a priority. As Governor of Massachusetts Mitt Romney worked with the Democratic legislature and the health care industry to expand access to all residents of the state and to commit to cost containing behavior change. The coverage reforms came right out of conservative health policy playbooks at Wharton (in the 1980s) … Continue reading »
When the Congress passed the historic health policy reform law in March 2010, a centerpiece was new rules for the private insurance industry. The best argument against moving to a single payer system in this country has been the ability of some health insurance plans, working with health care providers, to improve care quality, efficiency, utilization, costs and satisfaction. Most traditional Blue Cross and Blue Shield plans have demonstrated how to use data to drive … Continue reading »
The Institute of Medicine yesterday announced the first phase of its analysis of disparities in Medicare payments to health care providers across the country. It found that the adjustments to payment rates needed a foundation that reflected reality not national assumptions. Minnesotans have long known that the cost of delivering health care services varies with the medical practice culture and what doctors do varies substantially. There may be as many as 70 or 80 varying regions of the … Continue reading »
When Mitt Romney was the Republican governor of Massachusetts, he took on a Democratic legislature in an effort to reduce health care costs by expanding access, improving quality, reducing excess utilization and reforming health insurance and health care payment policy. The conservative administrators of President Bush’s Medicaid program encouraged him to make the deal with a big commitment of federal dollars. Conservative Washington think tankers helped seal the deal and applauded Romney’s resolve.
Today many of Governor … Continue reading »
During the first 46 days of the new session of Congress, the House held 45 hearings involving Secretary Sebelius or other HHS officials criticizing the Affordable Care Act. Not much going on in the Democratic Senate. Especially the once-powerful Senate Finance Committee whose chairman Max Baucus (D-MT) was busy writing to Medtronic demanding the company prove that by cancelling five contracts with “group purchasing” company Novation, LLC, it was not raising the costs of the … Continue reading »
Twenty-six states have filed briefs in the 11th Circuit Court of Appeals in Atlanta asking the appellate court to uphold the decision of Federal Judge Roger Vinson of Florida declaring the ACA unconstitutional. Four more states have passed measures to prevent the laws implementation and New Hampshire voted to send back any federal money intended to implement the new law. Georgia’s M.D. Congressman Tom Price has introduced legislation in the House that will allow “balance billing” … Continue reading »
It appears obvious that no one at the Center for Medicare and Medicaid Services or at the HHS in Baltimore/Washington D.C. does. Either that, or the 429 page preliminary ACO rules were drafted by a committee looking to define accountability as the lowest common denominator. I served on MedPAC when chairman Glen Hackbarth guided us toward using the term “accountable care organization” to capture what we already know works in value-driven health and health care … Continue reading »
Senator Tom Daschle (D-SD) was as instrumental as anyone in Barack Obama’s election as president. Having lost a re-election bid to John Thune (R-SD), the former majority leader turned his talents to health policy reform and wrote a book on the subject. Drawing on several decades in the House and Senate he concluded that health system reform was impossible without changing the Medicare program. Changing Medicare, like changing health care generally, depended totally on every elected official’s … Continue reading »
The Wall Street Journal and journalist Laura Landro opened the week with a special section on health care. The title sums up the stories. Americans may not agree that everything in the new health reform law is good policy. But it is hard to argue with its timing. The issue Landro and colleagues at WSJ raise is “Reaganesque” “If not now, when? If not us, who?” Health reform is a journey not a destination. The nature of the health … Continue reading »
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