Heh:
Senate Democrats’ attempt to reform Medicare doctor payments separately of their larger healthcare bill is little more than a “budget gimmick,” Sen. Orrin Hatch (R-Utah) said Friday.
Actually, it’s just what the doctor ordered. Is it too clever by half? Sure. It’s a way to mollify rural Democrats who don’t want a public option to be robust (tied to Medicare reimbursement rates) without raising the cost of the health care bill over the $900 billion the president insisted be the upper limit.
I guess a few of my readers are opposed to this kind of trickery. I call it ‘effective governance’ and ‘delivering what you promised.’
I don’t see it as trickery. It really is a separate subject from private insurance reform.
Right, but it’s a concession in a different bill to get support for this one, and a concession that costs money that we aren’t counting in the cost.
It counts in the budget, it just doesn’t count in the cost of the health care reform bill. Nothing dishonest about that, other than taking a talking point away from the GOP. Win-win to me…
I don’t get your point. If the Dems had gotten tax reform through as their first priority, thus raising the bar on what would be deficit neutral in the healthcare bill, would that be “trickery”? Other than announcing National Pickle Week, very little legislation is not part of an interacting whole.
Very good move.
Find below Rep Earl Pomeroy’s response to my email sent yesterday questioning his opposition to Pelosi’s plan, which I thought had added reimbursements for rural hospitals.
Evidently the reimbursement plan falls short of what’s needed for rural hospitals. -NDD
Rep Pomeroy’s response;
They have not added in sufficient reimbursements for low paid rural areas and that is the whole point. If medicare is to be the base payments for public plan, then medicare should be fair–which it isn’t.
N.D. is paid the 3rd lowest rate in the country. Blue cross therefore pays 152 per cent of medicare and the providers scream even that is not enough. Margins averaged .03 for our nonprofit hospitals last year.
This could be fixed easily by improving medicare payment rates or having the public plan negotiate the rates. Our urban liberal friends have not wanted to do this because they would have to make other changes in the bill–like slightly reducing the premium subsidy. So they have taken the position that they are right and they don’t really care whether we lose medical specialists and maybe a hospital or two out here.
Frankly, I’m damned mad about it. What kind of health care reform asks an elderly North Dakotan to go to Rochester instead of Fgo, GF, Bis or Minot because we don’t have the capacity in our delivery system we now have. One would like to think progressive health reform would be fair for all and there would be a commitment to fix parts of the bill that needed to be addressed to achieve this end.
Unfortunately, in the House it’s been the same old politics of looking after their own districts with scant regard for rural concerns. They have not adequately addressed our under funding problem. Therefore I can not and will not support a public plan based on medicare rates.
[…]
Earl Pomeroy
While I am a supporter of single payer/public option, I can’t say that I disagree with his stand on protecting rural hospitals in my state.
I’d like to see some pressure applied by citizens of urban districts on their legislators to bargain in good faith with rural legislators on this issue. – NDD
A wedge issue which I am sure the Republicans and Blue Dogs will take the fullest advantage of.
As I see it, it’s another great argument for single payer – rather than a patch-work/flawed public option (with triggers, with opt-out, with who-knows-what). But single payer was not even open for discussion and the left gave up on it way too fast.
Yeah, there seems to be a plethora of wedge issues in this health care debate, which makes it appear as if the parties involved are spending more time creating them than resolving them.
And yes, ’tis a pity that our political leaders saw passage of single payer as being so hopeless a possibility, that they failed even to follow basic rules of negotiation. (Any negotiation strategy that starts with one’s fall back position as a compromise is obviously ridiculous.)
I hope when it’s all over one way or another we can get some honest answers from Pelosi, Baucus, Obama or other players on why they decided to take single-payer “off the table”. I’m not as sure as some that there was no strategic justification for it, but I’d sure like to know what that was.