IMAC Would Put More Reform in Health Reform
After CBO Director Doug Elmendorf pointed out on the Hill yesterday that the House health care legislation, admirable though it is in ensuring affordable coverage for everyone, doesn’t really do anything to “bend the curve” of health care cost growth, DC is now refocusing on putting the reform in health reform. In particular, John Cohn says the administration is going to put more emphasis on the obscure proposal to change the Medicare Payment Advisory Commission into something that works better:
As first reported by David Rogers in Politico, the administration is effectively calling to reconstitute, and strengthen, MedPAC–a commission that now advises Medicare on how it pays for medical services and wares. The recommendations of this new commission, which the administration would call IMAC (the Independent Medicare Advisory Commission), would go into effect automatically, unless either the President or Congress decided to block them. It’s similar to an idea that Senator Jay Rockefeller and Representative Jim Cooper have been promoting in their respective chambers. Orszag called it “the most important game-changer” now on the table.
This is a good idea. One of the main facts about American politics is that “Congress” and “sound management of public policy issues” aren’t really concepts that go together. This is obviously a pretty profound problem with our political institutions, but it’s often possible to work around it by getting congress to change default rules in this kind of way.
10 Responses to “IMAC Would Put More Reform in Health Reform”
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July 17th, 2009 at 11:46 am
I hope you folks are actually calling the Senators on the Finance Committee who will be deciding a lot of this in the next few days and are set to sell out the public option…
July 17th, 2009 at 11:47 am
I think this is a very good idea. The first thing the commission should do is review early cancer screening tests. Because, according to the NY Times, early cancer screening tests “offer little benefit for the general public”.
If the Times is correct, we ought to STOP spending money on most routine early cancer screening tests, except for people with specific symptoms or risk factors. This is just wasted money, providing little or no health benefit.
It is time to stop wasting money on routine cancer screening tests. Hopefully the Obama commission will help us stop those tests.
July 17th, 2009 at 11:49 am
You might actually make a difference on this if you let the folks on the Finance Committee know, viz., Blanche Lincoln AR (202) 224-4843, Max Baucus MT (202) 224-2651, Kent Conrad ND (202) 224-2043, Jeff Bingaman NM (202) 224-5521, Chris Dodd CT (202) 224-2823, Ron Wyden OR (202) 224-5244, Jay Rockefeller WV (202) 224-6472, John Kerry MA (202) 224-2742, Charles Schumer NY (202) 224-6542, Debbie Stabenow MI (202) 224-4822, Maria Cantwell WA (202) 224-3441, Robert Menendez NJ (202) 224-4744, Thomas Carper DE (202) 224-2441, Bill Nelson FL (202) 224-5274, Olympia Snowe ME (202) 224-5344, Senate Leadership Harry Reid (202) 224-3542 PRESS 1, Dick Durbin (202) 224-2152…
July 17th, 2009 at 12:09 pm
Al, while I do believe that more sensible use of early detection is a good idea, this is about medicare. For many medicare patients, age alone puts them in bona fide risk groups for many cancers.
I would love to see all of those public service announcements (and advertisements for meds) replaced with, “Talk to your doctor about symptoms you have, your lifestyle and your personal medical history, and let him do his damn job.”
July 17th, 2009 at 12:28 pm
…admirable though it is in ensuring affordable coverage for everyone…
Is this the proposal that the CBO claims will still leave 17 million uninsured? I mean, it’s great in that it’ll decrease the number of uninsured by about 68%, but honestly I can’t see calling this “ensuring… coverage for everyone.”
Let’s be honest — this might be the best reform we can get, but it’s certainly a far cry from the reform we want, need, or deserve.
July 17th, 2009 at 12:36 pm
Seriously Njorl, the one sure way to “bend the cost curve” is to end Direct to Consumer advertisement. We’re the only country in the world that has DTC, and we’re the only country in the world that has massive cost and excessive use problems. It drives the consumption culture that strives to make medicine resemble a Honda dealership.
July 17th, 2009 at 1:14 pm
Once again Congress abdicates leadership. If Wall Street can conduct “regulatory capture”, so too will the hallowed halls of for-profit medical care. Will HCA, CHS or Tenet become the new Goldman Sachs?
I imagine our Founding Fathers would be disgusted.
July 17th, 2009 at 2:09 pm
Al, while I do believe that more sensible use of early detection is a good idea, this is about medicare. For many medicare patients, age alone puts them in bona fide risk groups for many cancers.
Um, isn’t this about the public option too?
July 17th, 2009 at 2:23 pm
[...] alluded earlier the White House is preparing to really throw its shoulder behind the idea of reforming the Medicare [...]
July 17th, 2009 at 4:03 pm
Alan: The legislature is no harder to corrupt than the executive branch. In fact, they have unique levers to be corrupted, such as campaign finance and voter blocs.
Policy should be split between the legislature and bureaucracy. Legislatures are elected so as to be representative of the people, and bureaucrats are hired so as to be experts at their respective fields. Both expertise and representativeness is needed to run a good government. The founding fathers wouldn’t neccesarily looked at it this way, but enough of them said things about a “natural aristocracy” of the wise ruling government that they wouldn’t exactly be appalled by the idea.