Health Care Reform Is Working: National Health Expenditures Reach Historic Low

Nancy-Ann DeParle:

Today, the CMS Office of the Actuary released its report on how much the United States spends on health care now and in the future. The report shows a 3.9 percent growth in health spending in 2010 – an historic low. Overall Medicare cost growth dropped from 7.9 to 4.5 percent between 2009 and 2010. This slow-down occurred at the same time that many seniors with Medicare received cheaper prescription drugs. According to the report, private health spending has and will continue to be low in the next few years. And the report estimates that private benefit spending growth per enrollee will be 3 percent this year, rather than 4.7 percent thanks in part to the Affordable Care Act’s policy that allows young adults to stay on their parent’s plan.

The report concludes that:

Average annual growth in national health spending is expected to be 0.1 percentage point higher (5.8 percent) under current law compared to projected average growth prior to the passage of the Affordable Care Act (5.7 percent) for 2010 through 2020. Simultaneously, by 2020, thirty million Americans are expected to gain health insurance coverage as a result of the Affordable Care Act.

The bottom line from the report is clear: more Americans will get coverage and save money and health expenditure growth will remain virtually the same. But the report doesn’t tell the whole story.

The Affordable Care Act creates changes to the health care system that typically don’t show up on an accounting table. We know these new provisions will save money for the health care system, even if today’s report doesn’t credit these strategies with reducing costs. These provisions include:

The Administration’s Partnership for Patients: Better Care, Lower Costs, a new private-publicpartnership to achieve two goals: reduce preventable hospital-acquired conditions by 40 percent and reduce hospital readmissions by 20 percent between 2010 and 2013. Over 2,000 hospitals as well as employers, physicians, nurses, and patient advocates have committed to these goals which, over the next ten years, could reduce costs to Medicare by about $50 billion and help put our nation on the path toward a more sustainable health care system.
Support for voluntary Accountable Care Organizations that make it easier for health care providers to work together to coordinate care for an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities. The Affordable Care Act rewards ACOs that lower health care costs while providing high quality care, and could generate as much as $960 million in Medicare savings over three years.
Bundled payment programs that will reward doctors and hospitals for working together to provide higher quality care to patients rather than bill for each individual procedure or test.
Demonstrations launched by the new Innovation Center that will build and test models that will save money for both Medicare and the private sector, and then expand the use of the models that work.
Important investments in programs that save money over the long-term like prevention and wellness programs.

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AND, Opposition To Health Reform Falls, Majority Want To Keep It Or Expand It

A new health care tracking poll from the Kaiser Family Foundation finds that as the opposition to the Affordable Care Act has fallen (from 46 percent to 43 percent), a majority of Americans (53 percent) want lawmakers to expand the law or keep it, and 46 percent say they are still confused by it.

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“President Obama to announce a staggering 65% increase in fuel-efficiency standards”

No matter what, he keeps going:

President Barack Obama has struck a deal with the nation’s automakers to raise mandatory fuel-efficiency standards to 54.5 miles per gallon (mpg) by 2025, a staggering 65% increase, National Journal reports.
The new figure represents a compromise between environmentalists, who had asked the government to raise the law from the present 35.5 mpg to 62 mpg, and the automakers, who pushed for 45 mpg.
One auto industry official confidentially told National Journal that the only reason they were able to strike a deal with the administration is that there will be a review in 2018 to re-assess whether the standards still made sense.
“If they’re too low, they’ll be addressed upwards. If they’re too high, they’ll be addressed downwards,” he said.

“He’ll come off as the adult in the room once this mess is resolved”

Hey, that’s not me saying. :) It’s James Warren and this is a must-read.

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As President Obama is pilloried by the left, including by bloggers and editorial writers, for supposedly selling them out during debt ceiling negotiations, a reality check is desperately needed.

Get over it, guys and gals, and remember whom you’re fuming over: a deal-making community organizer.

Recognize this man? In a showdown with ideological enemies, he fashioned compromises which made some Democratic allies apoplectic. Republicans weren’t happy, either, with what he wrought but grudgingly realized there were few alternatives.
Throughout he exhibited a preternatural calm, always seeking some common ground among disparate interests as if compromise was a goal in and of itself, not any diminution of principle as some Democrats thought.

Yes, that’s our president, the man at the center of the improbable Debt Debate of 2011. But it was also State Senator Barack Obama a decade ago. The equally rancorous issue back then was the death penalty and the setting was the Illinois legislature. Not much about him has changed.

“His ideological inclinations are liberal but, as far as being a politician, he’s about getting things done. He was always pragmatic and about getting things done,” said Peter Baroni, a Republican attorney-law professor-lobbyist in Chicago who had a bird’s eye view of Obama while serving as legal counsel to Republicans in the Illinois Senate and to its Judiciary Committee.

The death penalty was a big and tough matter in Illinois, especially amid mountainous evidence of men sitting on Death Row for crimes they did not commit. It was also a typical example of the Obama modus operandi during a period in which Illinois had at times the same sort of divided government he now faces on Capitol Hill.

Obama shepherded key proposed changes in the state’s criminal law, including the sensitive matter of taping interrogations of homicide suspects, all the while having cozy late-night poker games with legislative buddies, including conservative Republicans. He wanted to pass a bill and, to do so, couldn’t alienate too many Republicans and their law enforcement allies. Prosecutors and cops were dubious, if not downright opposed initially, to much of what he sought, notably the taping of interrogations to cut down on forced confessions and even alleged outright brutality by cops.

His ideological allies at the American Civil Liberties Union wanted the videotaping of all homicide interrogations of suspects and a blanket exclusionary rule. That meant that any evidence obtained from an interview that wasn’t videotaped would be excluded. Prosecutors and cops said no.

After many dozens of meetings in which “the guy never broke a sweat,” said Baroni, the end result was agreement to record interrogations, either by video or audio means. But the final deal had a litany of exceptions, including one allowing admission of a statement by a homicide suspect that wasn’t recorded if it was voluntarily given. Those exceptions were the counterpart of today’s proposed spending cuts driving some Democrats batty.

His M.O. was very much the same when it came to an important racial profiling bill he successfully steered, too. It required police to note the race of every driver they stop. They weren’t happy but Obama got it through and, wouldn’t you know, the percentage of African-Americans who are stopped has declined.

For sure, as now, he had a clear left-leaning ideology, at least in theory. But he was more committed to doing deals. Declaring his philosophical druthers did not deter him from taking what he could get, much in the fashion of the centrist Democratic impulses personified by Chicago political icons such as former longtime mayor Richard M. Daley and the late congressional power, former U.S. Rep. Dan Rostenkowski, a legendary chairman of the Ways and Means Committee.

Many Obama allies thought he’d sold them out on the death penalty. In retrospect, he had not. Perhaps more than any participant, he cold-bloodedly believed that his interrogation law would alter police behavior, while also protecting them from unfair charges of coercion in extracting confessions. Many participants did not see that long-term result as he did. All these years later, he’s been proven correct. You don’t hear grousing about it these days. It’s worked.

Of course, he wasn’t getting the microscopic attention he is as president. His issues didn’t even attract much interest in Illinois and he was desperately grateful for whatever notice he received — or even a returned phone call from a reporter.

There weren’t reporters and columnists chiding him for any air of condescension, as the New York Times’ David Brooks and others have done during his dueling with House Speaker John Boehner. Sitting in the Other America, out in the Heartland, I can’t point to one conversation of late where such an image of scold has been mentioned.

Perhaps the Beltway media sharpies are smarter than the rest of us. For now, I’ll rely on unscientific, anecdotal evidence to conclude that he’ll come off as the adult in the room once this mess is resolved.

And, as you watch him, be reminded of his informative pre-law school days as a community organizer in Chicago. Recall how they inspired both Rudy Giuliani and Sarah Palin to openly mock the term “community organizer” at the 2008 Republican National Convention, with the former New York mayor unable to contain derisive giggling as he openly wondered what the term stood for.

Well, it stands for giving power to the powerless. But, for Obama, it also meant a strategic set of notions about finding mutual agreement among people with the most divergent of motivations, according to Obama mentors whom I know from back then and David Maraniss, the journalist-author now working on an Obama biography.

Then, as now, he was also about seeking resolutions, not just bashing the rich. It was intellectual empiricism and street-wise practicality all at play. It was about doing a deal and moving on.

Bloomberg: “Republican Leaders Voted for Debt Drivers They Blame on Obama”

What do you know, some journalists actually do their job:

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Yet the speaker, House Majority Leader Eric Cantor, House Budget Chairman Paul Ryan and Senate Minority Leader Mitch McConnell all voted for major drivers of the nation’s debt during the past decade: Wars in Afghanistan and Iraq, the 2001 and 2003 Bush tax cuts and Medicare prescription drug benefits. They also voted for the Troubled Asset Relief Program, or TARP, that rescued financial institutions and the auto industry.
Together, a Bloomberg News analysis shows, these initiatives added $3.4 trillion to the nation’s accumulated debt and to its current annual budget deficit of $1.5 trillion.

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The wars in Afghanistan and Iraq have cost almost $1.3 trillion since the terrorist attacks on Sept. 11, 2001, according to a March 29 analysis by the Congressional Research Service. Operations in Iraq have cost $806 billion, and in Afghanistan $444 billion. The analysis shows the government has spent an additional $29 billion for enhanced security on militia bases and $6 billion remains unallocated.
Medicare Drug Benefit
The 2003 Medicare prescription program approved by President George W. Bush and a Republican-dominated Congress has cost $369 billion over a 10-year time frame, less than initially projected by Medicare actuaries.
Nine Senate Republicans, including Nebraska’s Chuck Hagel, along with 25 Republicans in the House, voted against the bill. Hagel argued that it failed to control costs and would add trillions in debt for future generations.
“Republicans used to believe in fiscal responsibility,” Hagel wrote in a 2003 editorial in the Omaha World Herald. “We have lost our way.”
TARP, the $700-billion bailout of banks, insurance and auto companies, has cost less than expected. McConnell, Boehner, Cantor and Ryan all voted in October 2008 for the program, which stoked the rise of the Tea Party movement.
Many institutions have repaid the government. The latest estimated lifetime cost of the program is $49.33 billion, according to a June 2011 report by the Treasury Department. That figure includes the $45.61 billion cost of a housing program which the administration never expected to recoup.
Rank-and-file Republicans are eager to pin the blame on Democrats, frequently pointing to the economic stimulus signed by Obama in 2009. The total cost of the stimulus will be $830 billion by 2019, according to a May 2011 Congressional Budget Office report.
That’s half the cost of the Bush tax cuts and less than two-thirds of what has been spent on the wars in Iraq and Afghanistan.

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PBO and VPB visited the Norwegian embassy on Tuesday to pay respects in wake of deadly terror attacks in Oslo.

“Obama Put Out the Call, And They Answered”

David Weigel:

The only real news in President Obama’s speech last night seemed to be his call for Americans to contact their members of Congress and demand that they compromise. On Twitter, I asked if anyone was actually doing this. I got around 75 responses within an hour. Here’s a sample.

Pat from Kansas sent this to Rep. Kevin Yoder:

I fully support the president on this. Boehner is out to lunch. He made a business analogy. Not even close. Government is NOT business. Government REQUIRES compromise to be successful. Please do not be an obstructionist. Please do your job and make government work.

Rich from Ohio sent this to Rep. Steven LaTourette:

I’m a political moderate, of decent means, living in Hudson. I think I speak for many like me. I’ve listened to both sides this evening and President’s Obama’s approach is the one I clearly prefer. My reasons:
1) Chance for historic tax rate reduction and elimination of loopholes.
2) Includes reasonable cutbacks in entitlements.
3) Includes reasonable cutbacks in defense.
4) Gives the wealthy tax rates that are still lower than 50 years ago! The vast majority of the American people favor this; after all, it is only fair.
5) Repays a debt that we have already incurred. THE MONEY HAS ALREADY BEEN SPENT; we must now pay it back.
6) Prevents this entire standoff from happening again in 6-12 months. I don’t want to see precious legislative time used to re-hash this same debate in six months.
This is a chance to do something historic and positive. Let’s not miss this opportunity, especially when the alternative sends the USA back into recession. THAT’s the real job killer.
While Speaker Boehner wants to compromise with the President, it is clear that he is being handcuffed by a handful of reckless Tea Party members who are willing to take this country into recession just to make a point. If that happens, virtually no one currently in office, Democrat or Republican, gets reelected in 2012. Please help these misinformed Representatives to understand what is a stake.
Please let me know where you stand on this critical issue.

Jason from Pennsylvania sent this to Rep. Tim Murphy.

Mr Murphy,
I strongly believe you need to put aside partisan politics, and cross party lines to raise the debt limit. This has been a non-issue for so many years and only seems to be an issue due to your lack of respect for our Commander in Chief. I don’t recall many republicans objecting during the 7 debt limit increases of George W. Bush’s administration. Now is not the time to hold the middle class and US credit rating hostage. We all agree that debt reduction and balanced budgets are necessary, but please work with the opposing party and stop listening to the tea-party base.

Maggie from Portland:

Called Earl Blumenauer’s office and told him never, ever to vote for anything like the “Cut, Cap and Balance” plan. Also, not to put my Mom out in the street, either.

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