For New Obama Nominee, Rationing Health Care Takes On Whole New Meaning

Besides rewarding donors with taxpayer money for the last three years, Obama keeps nominating radical policy experts who make the old Soviet Union's Public Health Commissars seem almost moderate by comparison.

The President just nominated Carter-era economist Henry Aaron to become a member of the Social Security Advisory Board.

Over the last four decades Aaron has written extensively on the inevitability of healthcare rationing. Much like Dr. Donald Berwick, outgoing chief of Centers for Medicaid and Medicare (CMS), Aaron cites the British National Health Service as a model that "sharply delineates the kinds of choices we shall have to make."

In a 1990 article for Science magazine entitled "Rationing Health Care: The Choice Before Us," Obama's newest nominee stated good old American ingenuity is responsible for out-of-control medical care costs.

The flow of technological innovation shows little sign of abating, therefore the U.S. will have to ration care to slow the growth of health care spending.

The oft-quoted Aaron (even at People's World) was also one of over a dozen economists advising Obama on healthcare reform in November 2009, urging him to strengthen "the capacity of health reform to control the growth of spending."

When interviewed about the $500 billion in Medicare cuts proposed in the health reform bill, the Medicare expert told a radio host 7 million seniors currently under Medicare Advantage would end up getting the same services as regular Medicare patients.

The story is that if one is going to extend coverage as the Senate plan would do to 25 to 35 million, or currently uninsured Americans, they're going to consume some more health care services. And the money to pay for that needs to come from somewhere.

Most of the money would come from projected growth in productivity of health care delivery under Medicare. And some of it from taxing excessively generous, or very expensive health insurance plans for the non-elderly, and some of it from other revenue sources...But there's no free lunch.

Could the "projected growth in productivity of health care delivery" Aaron mentioned in 2009 refer to the latest $1 billion initiative CMS chief Berwick is proposing? Berwick wants to shell out between $1million to $30 million to any public or private entities "who will implement the most compelling new ideas to improve care and lower costs for Medicare, Medicaid and Children's Health Insurance Program."

Recently, both men have been on the same page. Berwick wants to put "boots on the ground to transform our health care system" and Aaron proclaims "the United States is in the midst of a massive, multi-front war on federal government deficits."

In the 2009 interview Aaron defined rationing as "denying care to somebody who has the financial means to buy a product." When challenged directly whether there was any rationing in the health care reform bill, he stated, "no, there is not." Yet, he freely admitted services under the more expensive Medicare Advantage program would be cut. According to Aaron, that's not rationing, instead the "legislation would move in the direction of putting them [Medicare Advantage patients] on the same footing" as regular Medicare recipients.

If Aaron's zeal for rationing doesn't sound the warning bells on Capitol Hill, his uncompromising support for the omnipotent 15-member Independent Payment Advisory Board (IPAB) should be enough to derail his nomination.

In 2009 Aaron said the reform bill had "many admirable features" but it didn't go far enough in giving the IPAB absolute power.

Well, one of the things that the bill calls for is a commission of independent analysts and experts to make recommendations regarding the organization and delivery of care under Medicare, but only under certain circumstances, and only after considerable delay.

I think the bill could be strengthened significantly if the powers of that commission were increased, and if it was authorized to make recommendations to Congress sooner than the draft bill does.

Aaron should get his story straight. If rationing implies competition and if it isn't in the bill, then what is the Independent Payment Advisory Board for?

 

Read more M. Catharine Evans at Potter Williams Report

 

 

Besides rewarding donors with taxpayer money for the last three years, Obama keeps nominating radical policy experts who make the old Soviet Union's Public Health Commissars seem almost moderate by comparison.

The President just nominated Carter-era economist Henry Aaron to become a member of the Social Security Advisory Board.

Over the last four decades Aaron has written extensively on the inevitability of healthcare rationing. Much like Dr. Donald Berwick, outgoing chief of Centers for Medicaid and Medicare (CMS), Aaron cites the British National Health Service as a model that "sharply delineates the kinds of choices we shall have to make."

In a 1990 article for Science magazine entitled "Rationing Health Care: The Choice Before Us," Obama's newest nominee stated good old American ingenuity is responsible for out-of-control medical care costs.

The flow of technological innovation shows little sign of abating, therefore the U.S. will have to ration care to slow the growth of health care spending.

The oft-quoted Aaron (even at People's World) was also one of over a dozen economists advising Obama on healthcare reform in November 2009, urging him to strengthen "the capacity of health reform to control the growth of spending."

When interviewed about the $500 billion in Medicare cuts proposed in the health reform bill, the Medicare expert told a radio host 7 million seniors currently under Medicare Advantage would end up getting the same services as regular Medicare patients.

The story is that if one is going to extend coverage as the Senate plan would do to 25 to 35 million, or currently uninsured Americans, they're going to consume some more health care services. And the money to pay for that needs to come from somewhere.

Most of the money would come from projected growth in productivity of health care delivery under Medicare. And some of it from taxing excessively generous, or very expensive health insurance plans for the non-elderly, and some of it from other revenue sources...But there's no free lunch.

Could the "projected growth in productivity of health care delivery" Aaron mentioned in 2009 refer to the latest $1 billion initiative CMS chief Berwick is proposing? Berwick wants to shell out between $1million to $30 million to any public or private entities "who will implement the most compelling new ideas to improve care and lower costs for Medicare, Medicaid and Children's Health Insurance Program."

Recently, both men have been on the same page. Berwick wants to put "boots on the ground to transform our health care system" and Aaron proclaims "the United States is in the midst of a massive, multi-front war on federal government deficits."

In the 2009 interview Aaron defined rationing as "denying care to somebody who has the financial means to buy a product." When challenged directly whether there was any rationing in the health care reform bill, he stated, "no, there is not." Yet, he freely admitted services under the more expensive Medicare Advantage program would be cut. According to Aaron, that's not rationing, instead the "legislation would move in the direction of putting them [Medicare Advantage patients] on the same footing" as regular Medicare recipients.

If Aaron's zeal for rationing doesn't sound the warning bells on Capitol Hill, his uncompromising support for the omnipotent 15-member Independent Payment Advisory Board (IPAB) should be enough to derail his nomination.

In 2009 Aaron said the reform bill had "many admirable features" but it didn't go far enough in giving the IPAB absolute power.

Well, one of the things that the bill calls for is a commission of independent analysts and experts to make recommendations regarding the organization and delivery of care under Medicare, but only under certain circumstances, and only after considerable delay.

I think the bill could be strengthened significantly if the powers of that commission were increased, and if it was authorized to make recommendations to Congress sooner than the draft bill does.

Aaron should get his story straight. If rationing implies competition and if it isn't in the bill, then what is the Independent Payment Advisory Board for?

 

Read more M. Catharine Evans at Potter Williams Report

 

 

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