Talk Radio News Service: News, Politics, Media

by Julianne LaJeunesse- University of New Mexico

A health policy analyst warned the House Democratic Steering and Policy Committee Tuesday that passing health care reform now will prevent Congress from having to make drastic changes to Medicare in the future.

“By starting now, [it] will prevent Congress from having to do very severe and very crude changes to Medicare down the road,” said Commonwealth Fund President Karen Davis during a hearing Tuesday.

“Putting this off doesn’t mean that it won’t come home at some point, and we need to deal with it and begin... as this bill does,” she said.

The state of the current bill, however, isn’t viewed as perfect.

Thomas Priselac, President and CEO of Cedars-Sinai Health System in Los Angeles, told Representatives that his hospitals are committed to and applaud reform, but says H.R. 3200 has “room for improvement.”

Priselac said he’s concerned about tying the public option to Medicare rates because of what he said is “broad discretion for the Secretary to set and negotiate rates.”

He also said he questions the bill’s method of reducing patient readmissions and discharges.

“Preventing unnecessary readmissions is a complex, system-wide goal that involves hospitals, physicians, skilled nursing facilities, and other providers who manage patient’s care, as well as patients and their families,” Priselac said. “Policies that provide incentives to reduce readmissions should focus only on unplanned readmissions that are in fact related to the initial admission, and for which the greatest opportunity exists for hospitals to reduce their reoccurrence.”

Priselac says the method, which would be used as a way for determining incentive payments, is not practical because some patient discharges and readmissions are not preventable.

While there will undoubtedly be reform ideas that are left out of the House Reform proposal, most of today’s panel guests and Representatives seemed to agree that bettering the Medicare system is a good place to start health care reform.

Jacob Hacker, Yale Political Science Professor, said that if the Government continues with a public option plan, that plan must start an extensive network of providers immediately.

He said providers who want to, should be allowed to “opt out” rather than be required to “opt in.”

“Since participation will be voluntary for providers, the plan should be able to establish rates based on Medicare rates, much like many private insurers do today,” Hacker said.

Unlike Priselac, Hacker believes, "Requiring the Secretary of Health and Human Services to figure out new prices from scratch, in consultation with providers, is inefficient and gives private plans, which already have networks in place, an unfair advantage over the public plan.”