Charlie Dent Really Does Not Like Controlling Health Care Costs

Like I wrote earlier, if Congress doesn’t vote to do things that increase the deficit, and implements the Affordable Care Act as written, we don’t have a deficit problem. But Congress really really wants to increase the deficit. Here’s Charlie Dent not controlling health care costs:

A bipartisan majority of House lawmakers is pressing Medicare to reverse a proposed cut to hospital payments.

The Medicare agency recently proposed a 3.5 percent cut in payments to hospitals as well as a 2.9 percent adjustment to offset payments that it said are the result of changes in how come claims are filed.

But 219 House members said hospitals can’t afford the cuts, and urged Medicare to reconsider the proposal.

The thing about controlling health care costs is that you have to pay less money, not more. This position is incompatible with Dent’s stated goal of deficit reduction.

Malpractice Myths

Maggie Mahar debunks 7 fake conservative talking points:

1) Limit Awards, and We Can Eliminate Thousands of Frivolous Suits
2) Caps Are Needed to Rein In “Runaway Juries”
3) Caps Bring Down the Cost of Malpractice Insurance
4) Fear of Malpractice Suits Drives Overtreatment
5) Caps on Awards Would Make Health Care More Affordable
6) “Every Patient is a Potential Plaintiff”
7) Americans Patients Are Extraordinarily Litigious

Why We Need the IPAB

Kathleen Sebelius makes the case:

“A key part of the president’s plan, the Independent Payment Advisory Board, has recently been the subject of inaccurate claims. Critics say it will ration care and put bureaucrats in charge of the health care system. Nothing could be further from the truth. As this debate continues, it’s important to set the record straight. Here’s how the advisory board works. It is made up of 15 health experts, including doctors, other health care professionals, employers, economists and consumer representatives. Members will be recommended by Congress, appointed by the president and confirmed by the Senate. Contrary to critics’ contentions, the board’s work will be transparent, independent and accountable to Congress and the president…Moreover, Congress will still have the final decision on any changes.”

The idea is that actual evidence will guide Medicare’s reimbursement policies. It’s no slight to consumers to point out that the average patient is unlikely to know what works and what doesn’t. Most people don’t have good enough information to second guess their doctors or haggle with their surgeons, so they’re not in any position to withhold business from inefficient providers. Republican talking points about putting consumers in charge may sound flattering, but the idea that the average patient knows what’s worth paying for better than a medical expert is just total crap. There’s massive information asymmetries that prevent health care from functioning like a real market.

Bernie O’Hare Thinks We Spend $200 Billion a Year on Defensive Medicine

In an advertisement for Charlie Dent’s tort reform bill, Bernie O’Hare tries to sneak this whopper past us:

The practice of defensive medicine – when doctors order tests and treatments in order to protect themselves against frivolous lawsuits – is estimated to cost as much as $200 billion annually. Congressional Budget Office (CBO) analyses indicate comprehensive medical liability reform would save the government $54 billion over the next decade and cut national health care spending by 0.5 percent per year. Dent’s leislation will encourage states to adopt effective alternative medical liability laws that reduce the number of health care lawsuits initiated, reduce the average amount of time taken to resolve lawsuits and reduce the cost of malpractice insurance.

The $54 billion annual savings number includes the cost of defensive medicine:

Concerns about reducing the rate of growth of health expenditures have reignited interest in medical liability reforms and their potential to save money by reducing the practice of defensive medicine. It is not easy to estimate the costs of the medical liability system, however. This article identifies the various components of liability system costs, generates national estimates for each component, and discusses the level of evidence available to support the estimates. Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending.

That’s from a Health Affairs study, summarizing the most rigorous research that’s been done on this question to date. If Bernie has seen a better study showing that we really waste $200 billion a year on defensive medicine (4 times as much!), I’d love to know what it is.

House GOP Trying to Censor Democrats’ Constituent Mail on Medicare

Brian Beutler:

A bitter, behind-the-scenes fight over the GOP’s Medicare phase-out plan has bubbled out into the open, and now Democrats are openly charging Republicans with censoring their communications with constituents.

Several House Democrats are petitioning House Speaker John Boehner (R-OH), in a letter first reported by Roll Call, to step in and stop Republicans on the House Administration Committee from blocking Democratic Medicare mailers…

But Dems make an important point — and they have documentation to back it up. The language Republicans on the commission now reject is identical to language they approved earlier this year, before their Medicare plan cost them a seat in a conservative district in upstate New York.

Toward Better Digital Health Records

Some of the lowest hanging fruit of health care savings is converting everybody’s paper medical records to actual useable digital information:

Researchers and entrepreneurs hope to make up for the lack of integrated online patient-record systems by giving each patient a smart card containing his or her complete medical history.

Researchers in the U.K. have developed the MyCare card, which is roughly the size and shape of a credit card, with a fold-out USB plug. Another project, SmartCare, first implemented in Zambia, has recently expanded to Ethiopia and South Africa and demonstrates the potential for card-based systems in parts of the world with limited infrastructure.

However, the U.S. needs “Web-based personal health records in the cloud, available anywhere at any time without a card,” says John Halamka, chairman of the Healthcare Information Technology Standards Panel and CIO of both Harvard Medical School and Beth Israel Deaconess Medical Center.

Medicare Is the Solution, Not the Problem

Paul Krugman shows that Medicare is much better at controlling costs than private insurance:

If Medicare costs had risen as fast as private insurance premiums, it would cost around 40 percent more than it does. If private insurers had done as well as Medicare at controlling costs, insurance would be a lot cheaper.

There’s no mystery here. Bigger risk pools control costs better than smaller risk pools.

If everybody joins Team Medicare, Medicare will have more market power to push down the growth in health care suppliers’ prices, just like Amazon and Walmart push down their suppliers’ prices.

If we do what Paul Ryan and Charlie Dent want to do, and everyone splinters off into many different small private teams, then no one has enough market power to push down the growth in health care suppliers’ prices.

That is why CBO says health care costs would double for the typical senior under RyanCare: