Kaiser Daily Health Policy Report Feature Highlights Recent Blog Entries

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance
Article Date: 29 Apr 2009 - 5:00 PDT

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"Blog Watch" offers readers a roundup of health policy-related blog posts.

The recession's effects on health care continue: National Journal's Marilyn Weber Serafini on the Health Care Expert Blog says the Medicare Trustees are expected to predict the Medicare Hospital Trust Fund will run out of money earlier than the more recent prediction of 2019, in part due to the economy. But she asks if the insolvency is "really a problem" and whether it's deserving of the sometimes-large headlines. Responders included AARP's John Rother, who says reform of the whole delivery system could strengthen the trust fund, and National Center for Policy Analysis' John Goodman of the National Center for Policy Analysis, who focuses his discussion on cash flow, not the size of the coffers.

Medicare Part B's Trust Fund also will need more revenue, although premium increases can help avoid insolvency. Congressional Budget Office Director Douglas Elmendorf blogs about how this will work with a deep in the weeds explanation of the "hold-harmless" provision of Medicare Part B premium increases, the relationship to Social Security increases and the likelihood that some beneficiaries could face Medicare premium increases higher than others.

Meanwhile, Peter Orszag, arguably the nation's top wonk and founder of the above CBO blog, was the subject of a long New Yorker profile by Ryan Lizza in this week's issue. The American Prospect's Ezra Klein (reportedly heading to the Washington Post, by the way) pulls out a quote from Orszag where he tries to simplify his argument for conducting comparative effectiveness research: "You get paid more if the treatment has been shown to be effective and a little less if not." Klein credits National Economic Council Deputy Director Jason Furman with the idea that research will change, rather than eliminate reimbursement rates, writing: "Statins, for instance, are very effective and we want them to be widely used. So cover that at 100 percent. No out of pocket payment at all. Lumbar surgeries, conversely, are very ineffective, and the evidence suggests that fewer should be used. So cover them at 30 percent. You're not barring anyone from accessing the care they want."

Opponents of such research, especially if it includes cost measures, are receiving attention for specifics they might include in response to a Democratic reform proposal. Cato@Liberty's Michael Cannon issues a pre-emptive warning to congressional Republicans rumored to be trying to decide whether to include an individual mandate in their own health care proposal: "The more people who rely on government aid for their health care, the harder life will become for the party of tax cuts." Cannon says that "the entire free-market health policy community -- including scholars from the Heritage Foundation -- opposes such a move." Cannon argues that a mandate is a "leap to socialized medicine" even if insurers remain private entities because "by [forcing] Americans to purchase insurance, they will effectively nationalize the health insurance industry."

Speaking of Heritage, The Foundry blogger Conn Carroll endorses Sen. Jim DeMint's (R-S.C.) budget motion, which attempts to ensure that the Senate budget conferees don't "decrease the number of Americans enrolled in private health insurance, while increasing the number of Americans enrolled in government-managed, rationed health care."

Interesting elsewhere:

• Jane Sarasohn-Kahn of Health Populi looks at statistics from the NPR/Kaiser/Harvard School of Public Health poll (.pdf) that found 72% of Americans said "scientific evidence is not always clear when differentiating between different treatment options for their health";
  
  
• Andrew Van Dam of AHCJ's Covering Health points to a new Economist special report on health care and technology, including how consumers use technology to get medical advice;
  
  
• Jonathan Cohn of the New Republic's The Treatment broke the news that congressional Democrats had agreed to include reconciliation instructions in the final budget resolution and had decided on an Oct. 15 deadline;
  
  
• Michael Miller of the Health Policy and Communications Blog posts about an e-mail campaign using a 30%-off "coupon" to promote a public plan option in health proposals;
  
  
• Kyle Noonan of the New America Foundation's New Health Dialogue links to a new Health and Human Services report on small businesses and increasing costs of providing health insurance;
  
  
• Uwe Reinhardt on the New York Times' Economix says if Americans view their children as "national treasures," then all U.S. children should have access to public health insurance until they turn 22 years old;
  
  
• Igor Volsky of the Center for American Progress Action Fund's Wonk Room critiques a series of articles by Politico on the right-leaning health lobbying group, Conservatives for Patients' Rights.
  

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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