Tag: "Medicare"

Romney on Pre-existing Conditions

Mitt Romney on Meet the Press: “Of course there are a number of things I like about health-care reform that I’m going to put in place. One is to make sure those with pre-existing conditions can get coverage.”

Romney spokeswoman Andrea Saul: the protection applies only to those who have continuous coverage.

Sara Kliff: The continuous coverage requirement leaves a big hole through which many individuals could fall.

Tyler Cowen: I would say he is preparing for a major fold on the issue. I’ve been predicting a Romney administration would block grant Medicaid, undo some or all of the Medicare savings in ACA, but essentially keep the mandate under a different label and then claim to have “repealed and replaced.”

My suggestion: Keep the federal risk pool. Only 77,000 have enrolled and it is not costing that much. I would tighten it a bit to discourage gaming: in addition to a six-months-without-insurance requirement, I would penalize people based on their income, their assets and the length of time they have been willfully uninsured. Pay for this by keeping some of the ObamaCare taxes on the industries that were so willing to sell all the rest of us out by backing the legislation.

Sep 10, 2012 | 11 comments | by

Will ObamaCare Really Insure the Uninsured?

The further I get away from Washington the harder it is to communicate with reporters. My time these days is spent mostly with working people. Some are small-scale entrepreneurs like store owners, insurance agents, and guys that help people with computer problems. Some are low-level managers, medical technicians, a dentist or two, home repair guys, mechanics. You get the drift.

These days when a reporter calls, it is these people I’m channeling. Not professors, not lobbyists, not corporate executives. I’m not in daily touch with that type anymore. So when a reporter for a major national publication wanted to talk to me about the Affordable Care Act I knew it wouldn’t go well.

She said they were going to publish a major piece showing all the opinions about the law, pro and con. She especially wanted to quote someone who opposed the law and would refuse to purchase coverage under it.

Read More » »

Sep 06, 2012 | 14 comments | by

Marginal Revolution University, and Other Links

Tyler and Alex are starting a university at Marginal Revolution.

Harvard students cheating: what course were they taking? “Introduction to Congress.”

David Henderson gives a thumbs up to Clint Eastwood.

Why seniors won’t learn about the Medicare Advantage cuts until after the election. (video)

Sep 06, 2012 | 11 comments | by

ObamaCare vs RomneyCare, and Other Links

Aaron Carroll: there is no difference between ObamaCare’s plan for non-seniors and Romney’s plan for Medicare.

Good news: Americans really aren’t more polarized.

Keith Hennessey explains the Medicare war of words.

Aug 31, 2012 | 5 comments | by

Hospital-Employed Physicians: Same Doctor Visit, Double the Cost

Hospitals are acquiring physician practices and integrating them into hospital services. The stated goal is to improve care coordination, eliminate duplication of services and boost efficiency. However, Medicare and private insurers pay more for hospital services than the same service if done outside the hospital, such as in a doctor’s office. According to the Wall Street Journal (gated):

After David Hubbard underwent a routine echocardiogram at his cardiologist’s office last year, he was surprised to learn that the heart scan cost his insurer $1,605. That was more than four times the $373 it paid when the 61-year old optometrist from Reno, Nev., had the same procedure at the same office just six months earlier.

Aug 30, 2012 | 10 comments | by

Has David Cutler Lost it?

Last Friday the liberal Center for American Progress released a paper co-authored by Harvard professor David Cutler that amounted to a partisan – and thoroughly un-principled – attack on conservative entitlement reform proposals. When it comes to premium support proposals [e.g., Paul Ryan’s] in Medicare, the CAP paper alleged that traditional, government-run Medicare would be cheaper for senior citizens than a choice of private plans…

This position would be slightly less disingenuous had not both CAP and Cutler himself, in a paper Cutler co-authored earlier this month, taken the exact opposite position and put out similarly detailed projections about how much more seniors would pay — not because private plans would be less efficient than government-run Medicare, but because they would be more efficient.

Chris Jacobs.

Aug 29, 2012 | 11 comments | by

The U.S. Has Been on a Six Decade Spending Spree

Larry Kotlikoff takes to task the 500 economists who have endorsed Mitt Romney, including yours truly. He is particularly irritated that we are ignoring this:

In the 1950s, the U.S. saved 15 percent of national income. The net domestic investment rate was equally high. Today, America saves 1 percent of national income and invests only 5 percent of national income, with the four percentage-point difference being made up by the current account deficit — by Chinese and other foreign investment…

Every administration starting with Dwight Eisenhower’s has expanded America’s Ponzi scheme, which takes resources from young savers (including those not yet born whose current spending is zero) and gives them to old spenders. This huge intergenerational redistribution has produced an enormous increase in the absolute and relative consumption of the elderly…

This is just what the life-cycle model of saving predicts. If you take money from the young and tell them they will get it back in spades when old, and then give this money to retirees, the following will, as a matter of theory and practice, happen: The elderly will go shopping, the young won’t bother saving, national consumption will rise, and domestic investment will fall.

Expanding Social Security, Medicare and Medicaid benefits, shifting the structure of the tax system to lower the burden on retirees relative to workers, and cutting taxes have all saddled the U.S. with unsupportable obligations. Running two futile and incredibly expensive wars over the past decade have further contributed to the bills that America’s children face.

Aug 28, 2012 | 11 comments | by

Medicare Ad Wars, and Other Links

Matt Yglesias on the Medicare ad wars: this is actually one of the issues on which there’s the smallest gap between Obama’s policies and Romney’s.

Block granting Medicaid to the states: it’s working in Canada.

Laura D’Andrea Tyson: If Republican leaders were serious about strengthening Medicare, they would find a way to lower costs, rather than passing on the risk of higher premiums to the elderly. Laura. Look here.

Aug 27, 2012 | 10 comments | by

Response to Peter Orszag

In a recent editorial, Peter Orszag…offers a number of objections to premium support [as a way for Medicare beneficiaries to enter private health plans.] Unfortunately, his objections are characterized by misdiagnosis of the problem, failure to address the most compelling question regarding premium support, and failure to offer a plausible alternative.

Despite the fact that the 1990 demonstrations were a weak form of premium support, with competitive bidding only by private plans and not including FFS [fee for service] Medicare, the private plan bids for the entitlement benefit package in Denver were 25 to 38 percent below their government-determined payment rates at that time…Currently, low “bids” by private plans in Medicare — below the “benchmarks” — are taxed by the federal government at 25 percent. Under premium support there would be no such tax.

Mr. Orszag apparently believes that the savings suggested by the Denver bids and the generous additional benefits offered by private plans in high payment areas like Miami, all can be explained by the enrollment of relatively good risks by private health plans. Perhaps he’s right and properly risk adjusted bids from private health plans would be no lower than FFS Medicare’s bid in any market area. My response is, “Let’s find out.” It’s an empirical question that deserves an empirical answer.

Bryan Dowd guest post of Reihan Salam at NRO.

Aug 27, 2012 | 7 comments | by

Apologizing for ObamaCare

If the Republicans passed a spending bill to do X and paid for it by reducing Medicare payments to providers to the level of Medicaid or lower, would these folks be singing different tune?

Henry J. Aaron, an economist and a longtime health policy analyst at the Brookings Institution and the Institute of Medicine, called Mr. Romney’s vow to repeal [ObamaCare] “both puzzling and bogus at the same time.”

Marilyn Moon, vice president and director of the health program at the American Institutes for Research, calculated that restoring the $716 billion in Medicare savings would increase premiums and co-payments for beneficiaries…

“One can only wonder what’s going on inside [the Romney] headquarters in Boston and among their policy people,” said John McDonough, the director of the Center for Public Health Leadership at Harvard.

This and more in a Jackie Calmes column in the NYT this morning. And for the price of the same newspaper you also get this doozy from Eduardo Porter:

Mitt Romney’s campaign was brazenly misleading in its charge that the president’s health plan would cut medical services to older adults by reducing Medicare spending by $716 billion.

Still, Romney’s attempt to “stoke voters’ fears” pales in comparison to what Medicare’s Chief Actuary has said, a message that has either been ignored by the NYT or buried way down deep in the story.

Aug 22, 2012 | 9 comments | by
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