(Intro by Dylan Ratigan) On our second day of the Florida leg of the 30 Million Jobs tour, we decided to focus on one thing — health care. Millions of people choose to retire to Florida, and across the country, millions of aging Americans need more and more health care — we're spending tons of money, but we're consistently behind other developed countries not only in overall health, but also quality of care.

So, here's our big question: shouldn't we create a medical system that incentivizes preventative care and healthier living, rather than treatments and tests?

The barrier to change in the current system is massive, as almost the entire American health care system is focused more on costs and profits than actual care.

It's something we talk about extensively in Greedy Bastards: in the U.S., we don't have a health care system, we have a treatment sales system. The more tests and treatments a doctor can sell, the more money he or she can make in fees — that means there's a financial incentive to order an extra MRI or perform a surgery that may or may not be completely necessary.

This system is commonly called the "fee for service" model for medical practice. That, in turn, is married to an employer-based health insurance monopoly — the combination drives up costs for all of us. (Perhaps that's why we spend more money than any other country worldwide on health care, but come in at #37 in quality of care.)

To discuss the issues with our model "fee for service" healthcare, Dylan was joined by former DNC chair Dr. Howard Dean — he has called "fee for service" the single biggest barrier to controlling health care costs in America. Also in this segment is Charlie Kolb, president of the Committee for Economic Development, which represents a wide variety of major corporations in this country.

Congress' failed deficit-cutting supercommittee has faded away, but the pressure on lawmakers to quickly confront a stack of expensive economic issues is only growing. Before leaving town for Christmas and New Year's, lawmakers face decisions on whether to renew payroll tax cuts that have meant an average of nearly $1,000 for more than 120 million families this year. Congressalso must determine whether to extend unemployment benefits for millions of long-term jobless Americans. Without action, both expire Jan. 1.

New Report from Business-led CED

For Immediate Release
Contact: Morgan Broman – (202) 469-7814 - morgan.broman@ced.org

Washington, D.C. November 7, 2011 – To avert a long-term debt crisis, Medicare must bring its expenditures into line with the growth of the GDP.  That is the focus of a new report, To Reform Medicare, Reform Incentives and Organization, from the business-led Committee for Economic Development (CED).  Alain C. Enthoven, the Marriner S. Eccles Professor of Public and Private Management, Emeritus, at the Stanford University Graduate School of Business, wrote the report. 
 

By Igor Volsky

A commenter noted that I was wrong to liken the Domenici/Rivlin "premium support" plan to Rep. Paul Ryan's (R-WI) privatization scheme and suggested that the two are more different than I let on. That's probably true for several reasons, as Alice Rivlin herself explained before the Super Committee yesterday:

1) Under Domenici/Rivlin, future enrollees would have an option of staying in the existing fee-for-service Medicare program, while Ryan would force tomorrow's seniors to choose a private plan from an exchange.

2) The "premium support" that seniors receive to purchase coverage in Domenici/Rivlin will initially be tied to the second highest bid plan or fee-for-service, whichever is lower, and grow at the rate of GDP+1 percent. Ryan's credit would remain independent of actual plan bids and would only grow the government contribution at the rate of inflation. Both indicators fail to keep up with health care spending, so seniors would have to pay the difference between the support and the actual cost of the plan out of pocket. But unlike Ryan, Domenici/Rivlin exempt lower income beneficiaries and dual eligibles are able to use Medicaid funding to pay for Part B premiums.

3) Domenici/Rivlin are likely to go further in regulating the private plans - and what kinds of benefits they can offer - than Ryan.

By Joe Minarik for Bloomberg Government

(Bloomberg) -- The biggest reason for the long-term public debt crisis is the rising cost of health care -- specifically, the cost of Medicare, the government program for seniors. As hard as it is to cut the cost of health care, it's even harder to show you can cut the federal government's cost of health care, even if you have a brilliant idea to do so.
Representative Paul Ryan, a Wisconsin Republican, has advanced a deficit-reduction plan that takes one of those good ideas, called "premium support," and makes it the centerpiece of his proposal to overhaul Medicare. Premium support would essentially replace the existing system of paying doctors and hospitals for the care they provide with a
government voucher to seniors to subsidize their out-of-pocket health care costs.

By Eric Lichtblau for the New York Times

At a quarter till midnight last Friday, with a deal to avert a government shutdown barely an hour old, Senator Harry Reid phoned a fellow Democratic senator, Ron Wyden, at home and startled him with some bad news. “You lost free-choice vouchers,” Mr. Wyden recalls Mr. Reid telling him. Read more...

N.C. Gov. Bev Perdue Vetoes Challenge to Health Care Reform Bill

By Mary Curtis for Politics Daily

North Carolina won't be joining the list of states challenging federal health care reform legislation -- not yet, anyway. Over the weekend, Gov. Bev Perdue, a Democrat, vetoed legislation passed by the GOP-controlled state legislature that challenges a provision that would require the purchase of health insurance. Read more...

By Roger Collier for Healthcare Finance News

The Committee for Economic Development, one of the less doctrinaire business research groups, recently released a paper that should give health reform advocates (and opponents) some food for thought.

The undated paper, “Health Care in California and National Health Reform,” authored by distinguished healthcare economist Alain Enthoven and CED’s Joseph Minarik, seems to have been written during the course of the lengthy debate on reform, with editorial updates inserted after passage of PPACA. With an emphasis on CED’s own earlier proposals for reform, rather than on the new law, much of the paper elicits a “but the train’s already left the station” reaction. Nevertheless, the findings, especially some of those embedded in the reports of interviews with major employers, are worth examining. Read more...

Washington, D.C. March 23, 2010 – The enacted Senate health-reform bill and the pending reconciliation bill extend insurance coverage to 32 million Americans who don’t have it now.  That is an important achievement.  But for the nation to afford to deliver care to those 32 million Americans into the future, we need true structural reform – turning away from command and control toward consumer choice and competition.  Read more...

By John Feehery for The Daily Caller

I had a brief chat with Rep. Dennis Kucinich and his wife last night at the Radio and Television Correspondents Dinner. While I rarely agree with Mr. Kucinich, I think he is very nice, very intellectually consistent, and a very passionate promoter of his ideals.

 

We talked about the pressures that the Democrats were under to vote for the health care bill that came from the White House. We didn’t talk about the pressure to vote against it that is coming from the American people. Read more...