Doctors Avoid Medicare Pay Cut for Another Year—but Then What?

December 7, 2010 · Posted in The Capitol · Comments Off 

Senate leaders reached an agreement Monday to delay cuts to physician reimbursement rates under Medicare for one year. The details of the negotiations have yet to be ironed out, but if the deal makes it through Congress, doctors will avert a 23 percent pay cut scheduled for January 1.

Heritage health policy expert Bob Moffit explains in a recent post that the Sustainable Growth Rate (SGR) formula, enacted in 1997, arbitrarily ties Medicare physician reimbursement to the overall performance of the economy, meaning that when payments grow faster than the economy, automatic reductions go into effect.

In theory, that is. Congress has continually delayed the reductions to avoid reducing seniors’ access to health care. (This delay is known as the “doc fix.”) As reimbursement rates drop, more physicians become inclined to limit the number of Medicare patients they see. Some are even forced to stop accepting Medicare altogether. As Congress continues to stop the cuts from going into effect, they accumulate, so failure to act now would serve doctors a crippling 23 percent pay cut in 2011.

A Red Flag

It is good news that there is agreement to delay the physician payment cuts for another year. The bad news is that the Senate leaders say that they will pay for the one-year doc fix now with hopes for savings in the future. Where will the Senators get these savings? From future improper payments of taxpayer subsidies to individuals and families for health insurance under Obamacare—that begin in 2014.

For fiscal conservatives, this raises a red flag. Obamacare creates a new system of taxpayer subsidies for low- and middle-income Americans to purchase health insurance in state health insurance exchanges beginning in 2014. If some future person, under this future system, gets an improper payment because, for one reason or another, he is no longer eligible for the subsidy, he must return a portion of it. So Senate leaders are betting on enough mistakes—improper payments—to secure the $ 19 billion. This is a fragile scenario.

A better idea is to pay for the doc fix with current offsets in other areas of spending. Raising the necessary amount of improper payments individuals must return tomorrow to pay for the spending today is, well, another congressional exercise in creative financing.

Fix It for Good

A temporary extension is far from the permanent fix that is needed. Congress should have tied the current fix to a requirement to get rid of the SGR formula for good and pay for it, too. A stable payment schedule for physicians would ensure access to care for seniors and could be paid for by cutting other spending now and using Obamacare’s Medicare cuts later. In principle, any and all savings found in Medicare should be funneled back into the program itself to strengthen it and increase its solvency, not used to fund a new entitlement program.

But Congress should not stop here. The flawed physician payment system is just one of the many symptoms of the flawed approach under which the Medicare bureaucracy micromanages seniors’ care. True transformation would resolve these flaws. Lawmakers need look no further than their own health program—the Federal Employers Health Benefit Program (FEHBP)—for the best way forward in Medicare reform. Proposals that borrow from the FEHBP’s premium support system are already out there, starting with Representative Paul Ryan’s (R–WI) Roadmap for America’s Future and echoed in both the Bipartisan Task Force’s plan for deficit reduction and a separate proposal from Ryan and Alice Rivlin.

Through the right reform, Congress could eliminate the need for a constant doc fix and several other long-term problems inherent in the current Medicare system.

The Foundry: Conservative Policy News.

Doctors Avoid Medicare Pay Cut for Another Year—but Then What?

December 7, 2010 · Posted in The Capitol · Comments Off 

Senate leaders reached an agreement Monday to delay cuts to physician reimbursement rates under Medicare for one year. The details of the negotiations have yet to be ironed out, but if the deal makes it through Congress, doctors will avert a 23 percent pay cut scheduled for January 1.

Heritage health policy expert Bob Moffit explains in a recent post that the Sustainable Growth Rate (SGR) formula, enacted in 1997, arbitrarily ties Medicare physician reimbursement to the overall performance of the economy, meaning that when payments grow faster than the economy, automatic reductions go into effect.

In theory, that is. Congress has continually delayed the reductions to avoid reducing seniors’ access to health care. (This delay is known as the “doc fix.”) As reimbursement rates drop, more physicians become inclined to limit the number of Medicare patients they see. Some are even forced to stop accepting Medicare altogether. As Congress continues to stop the cuts from going into effect, they accumulate, so failure to act now would serve doctors a crippling 23 percent pay cut in 2011.

A Red Flag

It is good news that there is agreement to delay the physician payment cuts for another year. The bad news is that the Senate leaders say that they will pay for the one-year doc fix now with hopes for savings in the future. Where will the Senators get these savings? From future improper payments of taxpayer subsidies to individuals and families for health insurance under Obamacare—that begin in 2014.

For fiscal conservatives, this raises a red flag. Obamacare creates a new system of taxpayer subsidies for low- and middle-income Americans to purchase health insurance in state health insurance exchanges beginning in 2014. If some future person, under this future system, gets an improper payment because, for one reason or another, he is no longer eligible for the subsidy, he must return a portion of it. So Senate leaders are betting on enough mistakes—improper payments—to secure the $ 19 billion. This is a fragile scenario.

A better idea is to pay for the doc fix with current offsets in other areas of spending. Raising the necessary amount of improper payments individuals must return tomorrow to pay for the spending today is, well, another congressional exercise in creative financing.

Fix It for Good

A temporary extension is far from the permanent fix that is needed. Congress should have tied the current fix to a requirement to get rid of the SGR formula for good and pay for it, too. A stable payment schedule for physicians would ensure access to care for seniors and could be paid for by cutting other spending now and using Obamacare’s Medicare cuts later. In principle, any and all savings found in Medicare should be funneled back into the program itself to strengthen it and increase its solvency, not used to fund a new entitlement program.

But Congress should not stop here. The flawed physician payment system is just one of the many symptoms of the flawed approach under which the Medicare bureaucracy micromanages seniors’ care. True transformation would resolve these flaws. Lawmakers need look no further than their own health program—the Federal Employers Health Benefit Program (FEHBP)—for the best way forward in Medicare reform. Proposals that borrow from the FEHBP’s premium support system are already out there, starting with Representative Paul Ryan’s (R–WI) Roadmap for America’s Future and echoed in both the Bipartisan Task Force’s plan for deficit reduction and a separate proposal from Ryan and Alice Rivlin.

Through the right reform, Congress could eliminate the need for a constant doc fix and several other long-term problems inherent in the current Medicare system.

The Foundry: Conservative Policy News.

Reject All Energy Mandates: It’s Just Another Subsidy

December 7, 2010 · Posted in The Capitol · Comments Off 

Department of Energy

With cap and trade out of the realm of possibilities, Members of Congress have turned their attention to mandating so-called clean energy.

Some Members hoped for a lame duck vote on a renewable electricity standard (RES), which would require that a certain percentage of our nation’s electricity production come from wind, solar, biomass, and other government-picked renewable energies. With that looking less likely, Department of Energy Secretary Steven Chu mentioned a clean energy standard that includes other carbon-free sources of energy as a possible compromise between Democrats and Republicans next year. The Hill reports:

With climate legislation that would price carbon in a deep freeze for now, Chu called for talks about other policies that could help provide a market signal powerful enough to help spur construction of new multibillion dollar reactors.

“I hope we can discuss policies that can do that,” Chu said at a nuclear energy summit hosted by the think tank Third Way and the Idaho National Laboratory. “A clean energy portfolio standard is one example of a potential policy that the administration and Congress should discuss.”

A narrower renewable-electricity standard—which would require utilities to provide growing amounts of power in coming years from wind, solar and other renewables—has long been a pillar of Democratic energy proposals, and White House press secretary Robert Gibbs plugged the idea as recently as last month.

But some Republicans—notably Sen. Lindsey Graham (R-S.C.) of late—have floated a wider “clean” standard that would give credit to nuclear energy, coal plants if they trap and store carbon, and perhaps other non-renewable sources. The renewables-only idea faces big hurdles despite a limited amount of GOP buy-in. But giving credit to nuclear power, or coal with carbon capture (a technology not yet commercialized), would in turn face opposition from green groups and some key Democrats.

Chu proposed mandate for utilities to use 25 percent clean energy by 2025 and 50 percent by 2050. While a more flexible clean energy standard is less onerous than a specified renewable one, it’s still a subsidy that carves out a guaranteed share of the market for certain energy industries. The aforementioned signal that Chu speaks of is not a good one. It signals to the government-selected industries that they do not have to worry about lowering costs.

The mandate may reward certain energy producers in the short term but will hurt both producers and consumers in the long run because it eliminates competition, drives prices higher, and encourages government dependence—hence the reason we continually see pushes for extensions of direct subsidies, capital subsidies, mandates, insurance subsidies, and specialized tax credits.

Furthermore, a clean energy standard wouldn’t significantly reduce emissions. The Energy Information Administration estimated that mandating that 25 percent of our energy come from renewables would reduce emissions by only 4.9 percent by 2030. To put this in perspective, the cap-and-trade target was to reduce carbon 80 percent by 2050. To put that number in perspective, climatologist Paul C. Knappenberger says that an 80 percent reduction would moderate temperatures by only hundredths of a degree in 2050 and no more than two-tenths of a degree by the end of the century.

Nor would it improve our energy security. Since electricity comes almost entirely from secure domestic sources and petroleum provides only about 1 percent of our electricity needs, an RES would do almost nothing to decrease our use of foreign energy.

This is not the right direction for America’s energy policy, nor should it be an acceptable alternative to cap and trade or a narrower RES.

The Foundry: Conservative Policy News.

Another Look at Kennedy vs. Nixon

December 7, 2010 · Posted in The Capitol · Comments Off 

Just published: Kennedy v. Nixon: The Presidential Election of 1960 by Edmund Kallina Jr.

An examination of what happened before, during, and after one of the closest presidential elections in history. The author concludes that there isn’t sufficient evidence to determine
whether Chicago’s Democratic machine stole more votes there than
Republicans did in downstate Illinois.

Taegan Goddard’s Political Wire

Another blow to Hamas/Fatah reconciliation

December 7, 2010 · Posted in Uncategorized · Comments Off 

Hamas today sentenced three Fatah members to death for their role in killling a Hamas militant during the 2007 Hamas takeover of Gaza.

As the pro-Fatah Palestine Press notes, Hamas had killed some 700 Fatah members during the battles and none of the Hamas killers have been tried. On the other hand, it is not like the PA could do it if they wanted to.



Elder of Ziyon

Our take: Pats hope to spark another late-season collapse for the Jets – ProFootballTalk

December 7, 2010 · Posted in The Capitol · Comments Off 

Fox News
Our take: Pats hope to spark another late-season collapse for the Jets
ProFootballTalk
As last night's score moved from 31-3 to 38-3 and Tom Brady kept throwing the ball until it was 45-3 and then he remained in the game — and threw passes — until the Pats' left drive with less than three minutes to play, we began to wonder whether the
Eye-Opener: Are Patriots the clear Super Bowl favorite now?USA Today
Rex Ryan Outcoached by BelichickWEEI.com
Woodhead refuses to say 'I told you so' to JetsNewsday
New York Daily News –Boston Herald –Boston Globe
all 1,573 news articles »

Sports – Google News

WaPo Devotes Another Supportive Article to Angry Leftist Curator and Protesters at Radical Gay Exhibit

December 7, 2010 · Posted in The Capitol · Comments Off 

Tuesday's Washington Post Style section carried this front-page headline "Pesky ant video refuses to die." But the only new developments on the National Portrait Gallery story were security officers removing two (left-wing) protesters on Saturday and the laments of  a radical curator on Monday. No one in Jacqueline Trescott's article spoke for the conservatives. An award for unintentional hilarity should go to curator Jonathan Katz, who lamented  "homophobia and raw politics" ruined his exhibit — it was "lost in the mudslinging," as if they weren't slinging mud (or bugs) at the Cross — and furthermore, "the way forward is to refocus attention to the degree by which the show, by remaining up, continues to resist politics."

Ridiculous. Anyone who's seen the show and read the exhibit captions knows the exhibit is thoroughly political, with captions railing against the "Lavender Scare" of the 1950s, and an artwork where heterosexuals are a set of clowns shaped like a hangman's noose.

read more

NewsBusters.org – Exposing Liberal Media Bias

Another sharp, Republican, conservative female politician

December 7, 2010 · Posted in The Capitol · Comments Off 

She’s the wonder waitress of Ken’s Country Kitchen in Richmond, Michigan.
American Thinker Blog

Raese Unlikely to Mount Another Campaign

December 6, 2010 · Posted in The Capitol · Comments Off 

John Raese told the Charleston Daily Mail that after four failed runs for elected office, he’s unlikely to run for either governor or Senate again in 2012.

Said Raese: “I’ve run four statewide elections, and I’ve never been successful, and I think this last time resonated with me. I never say never to anything, but at this point I’m worn out.”
Taegan Goddard’s Political Wire

Rangel Faces Another Inquiry

December 6, 2010 · Posted in The Capitol · Comments Off 

The New York Post reports that Rep. Charles Rangel (D-NY) is facing a new ethical inquiry from the Federal Election Commission, just days after the House voted to punish him with censure for 11 ethical violations.

Ironically, the probe concerns whether Rangel misused funds from his political action committee to pay legal fees to deal with the very charges for which he was censured on Thursday.
Taegan Goddard’s Political Wire

Another Observation about the 17th Amendment

December 6, 2010 · Posted in The Capitol · Comments Off 

One simple observation that people who talk as if they would prefer appointed Senators to elected ones is that they forget that what this would mean would be locking a lot of states into perpetual representation in the Senate by one party.

The best example that comes to mind is Massachusetts.   There would have been no Scott Brown if the state legislature had been able to appoint a replacement.

For that matter, the state of Texas would have had to have waited until 2007 to get its first Republican Senator rather than the state electing its first Republican to Senate in 1961 (John Tower to replace LBJ in a special election).  The bottom line is that the Texas State Legislature did not go Republican until the 2002 elections.  The next chance for that legislature to select a Senator would have been for the term starting in January of 2007.

Another example:  Alabama, which has had two Republicans Senators since 1997, would still not yet have had a Republican Senator, since the Democrats have controlled the state legislature since Reconstruction (a situation that will be different come the new legislature that will be sworn in next year).

One more:  while California is clearly a state dominated by Democrats on the state level, there is at least the chance, at the moment, that a Republican could win a Senate seat from that state. Go to appointed Senators and one guarantees Democrats from California as far as the eye can see.

I sometimes wonder if people are thinking through the likely consequences of their preferences.




Outside the Beltway

Another Whitehouse Insider Reveals Unwanted Truths About Barack Obama and The Obama Family – Get Ready to be Amazed

December 6, 2010 · Posted in The Capitol · Comments Off 

Image via Wikipedia From left to right: Barack Obama, Sasha Obama, Michelle Obama, Marian Robinson (Michelle Obama’s mother) and Malia Obama on April 13th 2009 on the South Portico of the White House. They look, to all intents and purposes, like a nice, happy family. This article uncovers the truth about the Obamas so hold off judgement until you have read it all.

Image via Wikipedia Michelle Obama, with her husband Barack following on behind, is greeted by Queen Elizabeth Windsor (Elizabeth II of Great Britain and the Commonwealth). It looks pretty friendly doesn’t it. The Obamas and the Queen are smiling. Bit what happened behind the scenes. Did Queen Elizabeth actually like the Obamas? Did sh actually suspect that he was an imposter who has no right to the presidency of the United States of America? Read the remainder of the article to find out.

Image via Wikipedia Barack and Michelle Obama with American icon Oprah Winfrey. We have always assumed that Queen Oprah liked the Obamas and what the Obamas stand for but have we been wrong all this time? Is it really the case that Oprah detests Barack even more than she does Michelle? Read the article below the official portrait of President Barack Obama to find out the answers to all these questions when they are answered by our White House insider.

Image via Wikipedia An official portrait of President Barack Obama. He seems like a presentable, well mannered and likeable man but the camera can lie as we all know. Perhaps he really smells! Perhaps he has just said something too awful to contemplate to our White House Insider who was there when this picture was taken. We reveal all in the remainder if this article.

Question: Are the Obama family really nasty?

I have found that the Obama family are well mannered, considerate and caring of others. They treat their staff very well and do not lord it around the place like the family of W Bush. Obama is perhaps the most hard working president we have ever had too.

Question: How did the Obamas get on with the Queen of England?

The Queen of England is a complete fan of the Obamas. She thought that Barack but particularly Michelle were some of the nicest, warmest and sincere people she has ever met in an official or inofficial capacity. She much preferred them to George W Bush.

What does Oprah Winfrey think of the Obamas?

Oprah Winfrey simply adores the Obamas. She will support them come what may. She always knew that Obama would face selfish and greedy Americans who have inveigled themselves into positions of power and will do what they can to protect their lion’s share of wealth from the average American but she is in no doubt that Obama’s popularity will rise again and he will get the second term in office that the country needs him to get.

Question: Is Barack Obama a nice person?

Yes! He is also determined to make America a better place for all its citizens and save the lives of its ypungsters and restore the position of America in the affections of foreign peoples.

 


Newsflavor

Another Republican Vote For DADT Repeal

December 3, 2010 · Posted in The Capitol · Comments Off 

Collins is onboard. That makes 60 votes, enough to override a filibuster, provided all of the Democrats can be kept in line. But Collin's vote comes with a big caveat, as Allahpundit notes:

Collins, at least, is sticking by the GOP’s plan to vote no on everything until a deal is reached on the Bush tax cuts. Brown’s statement doesn’t address the subject, but since he also signed the Republican pledge to make the tax cuts top priority, presumably he’s on the same page. Until something happens on taxes, this is all meaningless. Which brings us to the second qualifier: Will there be any time left in the lame duck to address DADT even after a deal on taxes is reached?





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The Daily Dish | By Andrew Sullivan

Auburn plays for 1 title — and shot at another – msnbc.com

December 3, 2010 · Posted in The Capitol · Comments Off 

FOXSports.com
Auburn plays for 1 title — and shot at another
msnbc.com
ATLANTA – Gene Chizik was still in his I'm-only-talking-about-the-game mode Friday, even though Cam Newton has been cleared to play by the NCAA. So it was left to Steve Spurrier to discuss Auburn's star quarterback.
Kiper/McShay: Cam NewtonESPN
Richt, Swinney break down South Carolina-AuburnAtlanta Journal Constitution
Hoops plays second fiddle in SECFOXSports.com
Orlando Sentinel –Bellingham Herald –Sand Mountain Reporter
all 1,421 news articles »

Sports – Google News

Auburn plays for 1 title – and shot at another – SI.com

December 3, 2010 · Posted in The Capitol · Comments Off 

Washington Post
Auburn plays for 1 title – and shot at another
SI.com
ATLANTA (AP) -Gene Chizik was still in his I'm-only-talking-about-the-game mode Friday, even though Cam Newton has been cleared to play by the NCAA. So it was left to Steve Spurrier to discuss Auburn's star quarterback. "We're glad he's playing,'' the
NCAA Bungles Cam Newton MessSan Francisco Chronicle
Auburn and Cam Newton case versus USC and Reggie Bush caseLos Angeles Times
Delany critical of Newton rulingSportingNews.com
ESPN (blog) –New York Times –Washington Post
all 2,363 news articles »

Sports – Google News

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