Top health care experts meeting at the Institute of Medicine last week delivered a stern message to the nation’s 15,000 oncologists and their patients: Either learn to deliver care at lower costs or watch the government and insurance companies impose limits.
Health care insurance benefits have been excluded from taxable income since 1943, when the National War Labor Board ruled employers, who were offering health plans as a way to attract workers without violating wartime wage-and-price controls, could deduct their cost as an expense without reporting their value as income for workers. As a result, employees get the benefit of the insurance without paying taxes on its value.
Obesity rates have doubled over the past two decades and will almost double again over the next two decades unless the public comes to grips with its swelling waistlines, a new study says.
Meghan McCarthy of the National Journal posted a good overview of the alternative explanations for the recent slowing in the increase in health care costs, which rose less than four percent in each of the past two years. Medicare costs, she points out, has slowed even more dramatically.The latest survey from the Kaiser Family Foundation shows insurance premiums rising just 4 percent this year.
Every reputable budget analyst recognizes that dealing with the long-term budget deficit depends on holding government health care costs in check. One line in Republican presidential candidate Mitt Romney’s speech last night not only ignored that reality, it posed a direct threat to efforts already underway to return to fiscal sanity.
To judge the level of mendacity in the campaign debate over Medicare reform, perhaps the best place to start is the recommendations offered by the Bowles-Simpson deficit commission in December 2010. Their proposal came five months after passage of the Affordable Care Act, a.k.a. Obamacare, and a few weeks after the mid-term elections when Republicans took control of the House of Representatives.
Add “upcoding” to the long list of perverse incentives created by fee-for-service medicine that are undermining efforts at controlling health care costs in this country.
The latest example came to light this week in a front page New York Times exposé of billing practices at HCA, the Florida-based chain of 163 for-profit hospitals. In 2008, the company introduced a new coding and billing system that over the two years that tripled the share of emergency room visits that received the two highest reimbursement rates paid by Medicare.
Medicare has moved to the center of this year’s presidential campaign for a single overriding reason: shrinking the nation’s long-term government deficit demands dealing with healthcare costs. No one – left, center or right – disagrees with that analysis.