From FireDogLake, just one example of how not to pass legislation of any sort, especially this momentous bill:
“Unless they put that back in, I can’t support it,” Defazio (an Oregon Democrat Representative) said, referring to the medicare disparity fix. “This is under active discussion. They just decided yesterday morning they’re stripping this out. The senate budget committee staff deliberated for 20 minutes and it was out and our leadership was going to accept that. But a number of us involved in the quality health care coalition said that’s unacceptable and we’re not going to support the bill unless you fix this.”
I have no idea what this detail is. If it truly is enough to affect the vote of a progressive-type Democrat, then the whole process sounds like a mess.
However this legislation comes out, what should have been a broad-based, well-thought out coherent change that most Americans would be awaiting positively is likely to look like a thrown-together omelette.
Not a good reflection on the way the United States functions these days. But entirely consistent with a government whose auditor- the GAO - cannot give an unqualified report to.
Copyright (C) Long Lake LLC 2010
The language that sparked DeFazio’s threatened switch would address what is known as “geographic disparity” in Medicare payments. Medicare pays different amounts for the same treatments and services based on where a patient is located, and over time the payment disparity has grown even though actual costs aren’t that much different.
ReplyDeleteThat means that in some states, such as Oregon, doctors receive substantially less for the same services as doctors in other areas, typically larger metropolitan areas. The reimbursement rates here are so low, DeFazio said, that some Medicare patients have trouble finding doctors who will treat them.
“There’s study after study that says it’s not justifiable to pay three times as much per Medicare beneficiary in Miami as in Eugene, Oregon,” DeFazio said. “We are the fifth lowest in reimbursement and we are in the top 5 percent in quality and outcomes. So we are being penalized for being efficient.”
Thank you, Anon. I have been too busy to keep up will these details. Sounds as tho Mr. DeFazio has a point, though as always the devil is in lots of details.
ReplyDeleteMy POV is more of a free-market solution. Why should practitioners of different training and perceived quality receive the same for the same services? Does LeBron James get paid the same as everyone else? A movie star? A top-tier lawyer vs. the average?
My fear is that laid-off ACORN workers will become healthcare providers and administrators.
ReplyDelete