2012: A Year of Huge Uncertainty in Health Care Policy

Robert Laszewski

Posted 1/10/12 on Health Policy and Marketplace Review

2013 may be the most significant year in health care policy ever.

But we have to get through 2012 first.

Once the 2012 election results are in there will be the very real opportunity to address a long list of health care issues.

If Republicans win, the top of the list will include “repealing and replacing” the Affordable Care Act. If Obama is reelected, but Republicans capture both houses of Congress, we can still expect a serious effort to change the law. Then there is the granddaddy of all problems, the federal debt. The 2012 elections could well prepare the way for entitlement reform—particularly for Medicare and Medicaid. Even if Obama is reelected, the 2013 agenda will include a serious debate about Republican ideas to change Medicare into a premium support system and block grant Medicaid to the states.

PSA and the Presidential Physical

Kenneth Lin

Posted 11/04/11 on Common Sense Family Doctor

Earlier this week, the White House released the results of President Obama’s periodic physical examination. Pronounced “fit for duty” by his personal physician, the President, who turned 50 earlier this year, had an unremarkable examination and normal blood sugar and cholesterol levels. Also, it seems that he’s finally managed to stop smoking – good for him. Interestingly, President Obama went against the advice of the U.S. Preventive Services Task Force and chose to receive a screening prostate-specific antigen test (which was normal), but, perhaps in recognition of the Task Force’s recent finding that the PSA’s harms outweigh its benefits, his physician felt it necessary to note in parentheses that this was an “informed patient request.” There’s no indication whether or not the President used any shared decision aids (such as this one from the Family Medicine department at Virginia Commonwealth University) to decide to undergo screening, but given the lengths his Administration went to prevent the new prostate recommendations from being released in the first place, this surely represents a small victory of science over politics.

Here’s what I wrote on March 1, 2010 about the President’s previous physical examination. Continue reading “PSA and the Presidential Physical”

The Administration Decides That Sooner Is Better

Roger Collier

First posted 9/28/11 on Health Care Reform Update

Hot on the heels of Monday’s news that the Obama administration had decided not to ask for a re-hearing of the Eleventh Circuit Court’s ruling that the individual mandate is unconstitutional, came today’s announcement that the Justice Department had asked the Supreme Court to hear the case.

Given that other Appeals Court decisions may also be forwarded to the Supreme Court, it is not certain which case or cases the Court will decide to hear. However, a request by the administration is almost sure to be granted.

While the rationale for the Justice Department decision cannot be known, it seems that the administration believes that it has a better than evens chance of prevailing.

The critical issue now is timing, with a hearing most likely in the spring, and a decision—in the middle of the presidential election campaign—in June 2012.

The Hypocritical and Reckless Attacks on the Ryan Medicare Plan

James C. Capretta

First published 5/2/11 on Kaiser Health News

It should be obvious by now that the president of the United States and his political allies are hoping to ride demonization of House Budget Committee Chairman Paul Ryan’s Medicare reform proposal all the way to electoral victory in November 2012.

Following the president’s April 13 campaign-style budget speech, in which he aimed his most intense partisan fire at the Ryan Medicare plan, the entire Democratic political machine has taken the cue and gotten cranked up. In recent days, the party’s campaign committees began running attack ads against the Ryan plan — a full year and a half before the next election. Professional agitators have been rounded up to heckle members of Congress in their districts. And a legion of administration apologists has filled the blogosphere and newspaper opinion pages with outrage — outrage! — at the “cruelty” of the Ryan plan.

Continue reading “The Hypocritical and Reckless Attacks on the Ryan Medicare Plan”

Does Constraining Health Cost Growth Require Choosing between Obama and Ryan?

C. Eugene Steuerle

First published 4/21/11 on The American Square

President Barack Obama and House Budget Committee Chairman Paul Ryan (R) have laid out different approaches for curbing growth in health care costs. One would empower government-appointed officials to constrain health prices and services by, for instance, strengthening the power of the Independent Payment Advisory Board (IPAB) created in 2010’s health-reform legislation. The other would provide Americans with premium support up to some dollar limit to cover their health insurance purchases. Both count on efficiency improvements as well. The political debates have quickly centered over whether Obama is heading toward ever-more cumbersome government regulation and price-setting and whether Ryan is opening up unregulated markets that would deprive many of needed health care.

It’s not that simple, though. Three questions are actually at issue:

(1) How should budget constraints be applied?

(2) Should automatic budget growth for health care programs (particularly, Medicare) finally be reined in?

(3) Should government health program budgets be limited even if neither side gets its way?

Continue reading “Does Constraining Health Cost Growth Require Choosing between Obama and Ryan?”

Controlling the Medicare Budget — Two Infeasible Proposals

Roger Collier

First published 4/21/11 on Health Care Reform Update 

How to slow Medicare’s escalating costs has been the big health care policy issue this month, with Republicans and Democrats offering competing proposals, each part of broader plans for reducing the federal deficit—projected to be $1.5 trillion this year, with the government borrowing 40 cents for every dollar it spends.

Unfortunately, neither the Medicare proposal of Representative Paul Ryan’s House Budget Committee, nor that offered in response by President Obama, can be considered realistic.

Continue reading “Controlling the Medicare Budget — Two Infeasible Proposals”

The President’s Health Care Predicament

James C. Capretta

First published 3/31/11 on Kaiser Health News

Last week marked the one-year anniversary of President Barack Obama’s health reform law. It’s an appropriate time to take a look back at the events of last year, and what they might mean in 2012 when the president will almost certainly be seeking reelection.

In early 2010, after Republican Scott Brown was elected to the Senate from Massachusetts, Obama had no choice — if he really wanted the health bill enacted — but to turn its passage into a make-or-break moment for his presidency. Nothing else would have worked. He wasn’t winning the public argument over its merits, and wasn’t going to. The balance of public opinion had been solidly against it ever since the first trillion-dollar cost estimates were released in mid-2009. The only way he was ever going to get it across the finish line was by tying the measure’s success to that of his presidency, thus forcing the hand of wavering Democrats, who didn’t want to vote yes on the legislation but were even more squeamish about derailing their own party’s fresh and promising administration. And so he made that his closing argument. As numerous press accounts documented, in private conversations with lawmakers, the president pleaded with his allies to save his presidency by voting yes on the health measure.

Continue reading “The President’s Health Care Predicament”