Medicare bill calls for vote of Congress on health care coverage for all Americans
H.R.1
Medicare Prescription Drug, Improvement, and Modernization Act of 2003
Title X - Medicaid and Miscellaneous Provisions
Subtitle B - Miscellaneous Provisions
Sec. 1014 - Health Care that Works for All Americans: Citizens Health Care Working Group.
(b) Purposes - The purposes of this section are -
(1) to provide for a nationwide public debate about improving the health care system to provide every American with the ability to obtain quality, affordable health care coverage; and
(2) to provide for a vote by Congress on the recommendations that result from the debate.
© Establishment - The Secretary, acting through the Agency for Healthcare Research and Quality, shall establish an entity to be known as the Citizens’ Health Care Working Group (referred to in this section as the `Working Group’).
(d) Membership -
(1) Number and appointment - The Working Group shall be composed of 15 members. One member shall be the Secretary. The Comptroller General of the United States shall appoint 14 members.
f) Designation of the Chairperson - Not later than 15 days after the date on which all members of the Working Group have been appointed under subsection
(d)(1), the Comptroller General shall designate the chairperson of the Working Group.
http://thomas.loc.gov/ (In the “Bill Number” box insert “H.R.1” and click Search”)
General Accounting Office
GAO Health Care Forum
January 13, 2004
Slide presentation
David M. Walker, Comptroller General of the United States
Slide 49:
The presence of insurance blunts sensitivity to the price of services and results in the tendency to overconsume.
Slide 51:
Tax incentives can serve to mask the cost of health care and impair achievement of desired cost-containment outcomes.
Administrative burdens reduce market efficiency and value to consumers.
Slide 52:
Reforms, although comprehensive, may need to be incremental in order to minimize disruptions and facilitate political consensus.
http://www.gao.gov/index.html (Under “From the Comptroller General” click “Slide presentation” for January 13, 2004. Then click “Health Care System Crisis: Significant Challenges Point to Need for Fundamental Reform.”)
Comment: An important provision in the Medicare Prescription Drug Bill is the requirement of “… a nationwide public debate about improving the health care system to provide every American with the ability to obtain quality, affordable health care coverage.” Further, the process provides for “… a vote by Congress on the recommendations that result from the debate.”
It is crucial that we closely observe this process that will result in a vote in Congress on systemic health care changes theoretically designed to bring quality care to every American.
The current Comptroller General, David Walker, will appoint 14 of the 15 members and the Chairperson of the Working Group. Since David Walker will be able to control the ideological complexion of the Working Group, we should try to understand his views.
Based on his health care forum presentation this month, it appears that he supports incremental reforms in the marketplace that place a greater emphasis on increasing price sensitivity for patients while decreasing the financial insulation provided by insurance.
Bill Thomas, as Co-Chair of the Bipartisan Medicare Commission helped to prove that it is nearly impossible to reach political consensus on important social issues through a bipartisan process. In drafting the Medicare Prescription Drug bill, Thomas and his colleagues made certain that the recommendations for comprehensive reform on which Congress will eventually vote will not be bipartisan, but will be produced by the independent Comptroller General (who just happens to share some of Thomas’ ideology on health care reform).
As structured, we have reason to anticipate that the Working Group will provide us with a unanimous recommendation for expanding health savings accounts, eliminating deductibility of employer-sponsored plans, Limiting tax deductibility to individually-owned catastrophic plans, shifting Medicare and Medicaid to private, marketplace plans with a commensurate reduction in the level of public funding, etc., etc.
It is unfortunate that this bill authorizes spending $6 million for this potentially phony partisan study when we really do need a consensus on comprehensive health care reform. Maybe we should approach David Walker in advance to see if he might consider allowing a true cross section of Americans to nominate the members of the committee. He is a man of integrity, even if biased, and he might consider a more democratic process.
(If you download the side show, be sure also to look at the other slides, especially slide 8. It demonstrates dramatically why some say that Social Security and Medicare spending will have to be dramatically reduced if we are to protect current tax cuts.)