Congress often blocks Medicare changes that would cut costs

[unhappycamper]

Congress often blocks Medicare changes that would cut costs
By Christopher Weaver and Kate Steadman | Kaiser Health News
Posted on Tuesday, November 3, 2009

WASHINGTON — The Democratic health care legislation comes studded with cautious plans to test proposals for reining in Medicare costs. History suggests, however, that even if the experiments are successful, the odds aren't high that their lessons will be applied to the entire program.

Consider the case of a 1990s pilot project that earned the support of a president, several key legislators and successive Medicare leaders from both parties. A five-year test showed that lumping together payments for doctors and hospitals for some heart surgeries encouraged them to be more efficient and reduced Medicare's cost by 10 percent. The project ran into relentless opposition from doctors and hospitals, however. The result: Congress has never approved the change for widespread Medicare use, and Medicare continues to study the issue.

Successful Medicare experiments are "certainly not enough to change policy," said Paul Ginsburg, the president of the Center for Studying Health System Change, a nonpartisan research group in Washington. Yet Democrats' hopes to "bend the cost curve" hinge in large part on introducing successful Medicare experiments into the system. Because of Medicare's clout as the insurer for 45 million older and disabled Americans, many private insurers follow its lead.

Medicare has conducted hundreds of tests, called pilots or demonstration projects, since the mid-1970s, but it can't apply them to the entire system without congressional approval. Lawmakers have made other important changes to Medicare, but pilot projects rarely have been the catalyst.

Most experiments haven't been expanded because they failed threshold tests; they didn't save money or improve care. Others passed that test but were derailed by objections from hospitals, doctors and other providers or were caught up in political fights as control of Congress shifted. Only a handful resulted in broad health-system changes. Two became permanent programs. The biggest success — a more efficient way to pay hospitals — occurred 27 years ago.


Rest of article at: http://www.mcclatchydc.com/washington/story/78261.html

[Bitwit1234]

1. WHAT is causing the extra expense I'll tell you

the privatization of parts of Medicare that the bush administration pushed. The Medicare Advantage Plan. These companies charge over 150% for services that Medicare regular charges. Most of the hospitals and clinics in Minnesota won't accept them. On top of that they can't get paid.