States, Washington Must Plan Now For Real Reform

There are real problems in the health sector that must be fixed — more now than ever because of the damage already wrought by ObamaCare — and we need to be ready to move forward. Our vitally important job over the next 18 months is to help the American people understand the massive changes that are coming from ObamaCare and build the case for the right reform.

With Medicare, moving to a premium support model, as Paul Ryan has proposed, is the only way to keep the program from drowning in red ink. It is unconscionable that the White House is attacking the Ryan plan that is designed to save the program after Democrats themselves have gutted Medicare with ObamaCare. The president and his allies are hiding behind their MediScare tactics to deflect attention from what they already have done to the program.

When Ryan addresses audiences, in person and in his popular YouTube videos, people get it. The plan he has offered has been maligned beyond recognition by Democratic leaders, but the Associated Press “Fact Check” has called them on it, saying:

“Democrats are distorting the fundamentals of a Republican plan to reshape Medicare, falsely accusing the GOP of pushing a proposal that tells the elderly ‘you’re on your own’ with health care and that lets insurers deny coverage to the sick.

“THE FACTS: First, the Ryan plan explicitly forbids insurance companies from denying coverage to anyone who qualifies for Medicare, including those who have pre-existing illnesses. Second, it does not merely send money to the elderly and leave them to their own devices in arranging for medical care…

“The government would offer subsidies to pay for the coverage and set standards that insurers must follow. One condition, says the plan, is that participating insurers ‘agree to offer insurance to all Medicare beneficiaries, to avoid cherry-picking and ensure that Medicare’s sickest and highest-cost beneficiaries receive coverage.’

“Nor would the government merely send ‘X amount of dollars’ to the elderly and let them figure out whether they can afford coverage. The subsidies would go to the plan selected by the beneficiary…”


While it’s hard to get through the mainstream media, a lot of educational efforts are going on. A few examples just from yesterday:

  • The House Energy and Commerce Subcommittee on Health held a hearing yesterday about the regulatory burden of ObamaCare, with Chairman Pitts showing the huge stacks of paper with ObamaCare-related regulations issued so far. “Over 3,500 of pages of rules, notices, and corrections have been published, many of which were released as interim final rules, bypassing the traditional public comment period, and giving them the force of law,” said Chairman Pitts. “And this stack is just the beginning. More regulations are due out in the near future, including the establishment of the essential minimum benefits package, which will increase premiums and put people’s coverage at risk.”

  • The 21 members of Congress’s GOP Doctors Caucus sent a letter to the president yesterday warning of the dangers of the Independent Payment Advisory Board, calling for repeal and calling it a “blunt tool” that will “disproportionately cut care for the sickest and poorest seniors.”

  • And a survey was released this week by the Small Business and Entrepreneurship Council that showed that only 7% of small businesses have taken advantage of the small business health insurance tax credit, with the great majority saying it is of little or no help.

The states are the power centers on health care right now. While Washington is entangled in a regulatory morass, states are in a unique position to begin making progress with initiatives that work for them. That also means taking a hard look at what they have done to drive out competition and drive up prices in their health insurance markets.

These changes won’t be easy, as we saw when Arizona tried to enact legislation allowing cross-state purchasing of health insurance. The first step is to educate the public about the problems that short-sighted mandates and regulations have created, and bring the public along to understand changes that would give them more options for more affordable, portable coverage. The educational process is crucial.

With Medicaid, even Democratic governors and legislators are now demanding a block grant to get away from the Washington-may-I red tape. This is an important breakthrough. Medicaid is the largest and the worst health care program in the country. People on Medicaid have worse health outcomes than the uninsured and yet it is bankrupting the states. It must be changed.

And we need to begin to work on the specific recommendations for change that are not part of the top-line debate but are crucial.

As an example, I wrote for Wednesday’s New York Times as part of a colloquy to answer a specific question about “the one thing Medicare should stop paying for.”

“Dual-Eligibles,” Doubly Expensive

There are nearly nine million people, representing one in five Medicare beneficiaries, who are eligible for services through both Medicare and Medicaid — often called “dual eligibles.” They are the poorest and often the sickest beneficiaries, many of whom have multiple acute illnesses and long-term care needs.

Providing tools for those who are eligible for Medicare and Medicaid would save money and make the programs work better for the elderly.

They consume about 25 percent of Medicare’s spending and nearly half of Medicaid’s — more than $250 billion in 2008. Yet 95 percent of them are stuck in an antiquated 1960s fee-for-service payment model and are bounced back and forth between the two programs. Many patients get lost in a crevice between Medicare and Medicaid where no one is overseeing their total care, leading to gaps, duplication and poor outcomes.

Providing them with truly integrated care could significantly improve their lives and also help reduce health costs by providing timely, appropriate managed treatment.

And the most important thing you can do is get our book, Why ObamaCare Is Wrong for America (Broadside/HarperCollins). It is the handbook on ObamaCare and the one book that the Obama administration doesn’t want you to read. If you haven’t ordered it, this is the time. Here’s a link to our dedicated website with ordering information. You can get it on your Kindle, ebook reader, or from any virtual or brick-and-mortar bookstore. We all must be engaged in this crucial fight.


Paul Ryan: Stop the Raid; Repeal Rationing Board; Save Medicare

In this video, Rep. Paul Ryan explains that ObamaCare “ended Medicare as know it. It does two things: It raids Medicare; and it rations Medicare.”
Watch now >>


Should Congress, president overhaul Medicare?

Grace-Marie Turner
Atlanta Journal-Constitution, 06/01/11

The escalating political debate about the future of Medicare reveals a fear of change coupled with the growing recognition that change is essential to sustain the program for the future. House Budget Chairman Paul Ryan recognizes that reality in his proposal to begin modernizing the program, starting 10 years from now. He wants the next generation of seniors to have more choices and lower costs through competition. They would get guaranteed private coverage through a modernized Medicare program that works much like the health program members of Congress have today. Voters face a clear choice. Do we want to continue down a path of price controls, restrictions on access and government-rationed health care? Or do we want to modernize Medicare — and save it — so seniors have the security of access to care and choices of coverage with competition driving costs down?

Read More »

There’s No Choice But Change

Grace-Marie Turner
National Review Online: Critical Condition, 05/26/11

The outrageous distortions about the Ryan Medicare reform plan are coming from people who are accelerating the program’s path to insolvency. Here are the facts of the Ryan plan: Paul Ryan’s plan does keep the payment reductions in Medicare under current law for ten years; he doesn’t use them to create two massive new entitlement programs but to preserve Medicare. This is in stark contrast to what would happen to Medicare under current law. Without a serious course adjustment, Medicare will become a third-rate, price-controlled program that rations a lower quality of care through waiting lines and other restrictions. If the antiquated, open-ended, fee-for-service model isn’t reformed, then we will continue to pour deficit-funded dollars into the program or raise taxes to levels that would topple the economy as millions of baby boomers hit retirement. The only way to save Medicare is to change it.

Read More »

What Medicare Services to Cut, Now: ‘Dual Eligibles,’ Doubly Expensive

Grace-Marie Turner
The New York Times: Room for Debate, 06/01/11

Providing dual eligibles with truly integrated care could significantly improve their lives and also help reduce health costs by providing timely, appropriate managed treatment. The focus should be on providing tools and solutions for those who are eligible for Medicare and Medicaid to receive better-coordinated care by contracting with care management plans, a strategy to save money and make these programs work better for vulnerable senior citizens.

Read More »

Obamacare: No Friends in Free-Market, Single-Payer Camps

Arnie Cooper, 05/31/11

Galen’s Grace-Marie Turner engages in a spirited debate over ObamaCare with Margaret Flowers of Physicians for a National Health Program.

Read More »


Fiscal Solutions: A Balanced Plan for Fiscal Stability and Economic Growth
Andrew G. Biggs, Joseph Antos, Alex Brill, and Alan D. Viard, Solutions Initiative by Peter G. Peterson Foundation, 05/25/11

Is Health-Care Tax Credit Unpopular?
Sarah E. Needleman, The Wall Street Journal: In Charge, 06/01/11

Health Reform Creates Chaos With 50 States, 50 Sets Of Rules
David Gratzer, Investor’s Business Daily, 05/31/11

The Impact of the 2007-2009 Recession on Workers’ Health Coverage
Paul Fronstin, Employee Benefit Research Institute, 04/11

The Changing Politics of Doctors
Tara Parker-Pope, The New York Times: Well, 05/30/11

Irrational Exuberance and Accountable Care Organizations
Merrill Matthews, Forbes: Right Directions, 06/02/11


How Should Washington Control Medicare Spending?
James C. Capretta, The Heritage Foundation, 06/02/11

Mediscare: The Surprising Truth
Thomas R. Saving and John C. Goodman, The Wall Street Journal, 05/27/11

Experiment to lower Medicare costs did not save much money
Amy Goldstein, The Washington Post, 06/01/11

Medicare Plan for Payments Irks Hospitals
Robert Pear, The New York Times, 05/30/11


How Do Consumer-Directed Health Plans Affect Vulnerable Populations?
Amelia M. Haviland, Neeraj Sood, Roland McDevitt, and M. Susan Marquis, Forum for Health Economics & Policy, 2011


Caring for People Covered by Both Medicare and Medicaid: A Primer on Dually Eligible Beneficiaries
Alliance for Health Reform Briefing
Friday, June 3, 2011
12:15pm – 2:00pm
Washington, DC

2011 Faith & Freedom Conference and Strategy Briefing
Faith & Freedom Coalition Event
June 3-4, 2011
Washington, DC
Grace-Marie Turner will speak about repealing and replacing ObamaCare on Saturday, June 4.

9th Annual Health Care Conference
Washington Policy Center Event
Tuesday, June 7, 2011
8:00am – 1:30pm
Seatac, WA

Eastern Washington Health Care Luncheon
Washington Policy Center Event
Wednesday, June 8, 2011
12:00pm – 1:30pm
Spokane, WA

Seventh Annual State of Personalized Medicine Luncheon
Personalized Medicine Coalition Event
Thursday, June 9, 2011
12:00pm – 3:00pm
Washington, DC

The Future of Medicare and Medicaid
American Conservative Nation Public Forum
Thursday, June 9, 2011
7:00pm – 8:30pm
Washington, DC
Grace-Marie Turner will speak about the outlook for Medicare and Medicaid.

Navigating Health Care Reform Summit
RJF Agencies Event
Thursday, June 16, 2011
8:30am – 12:00pm
Golden Valley, MN

Debt Crisis Hits the States: The Growing Challenges of Medicaid and Health Care Reform
Frank Batten School of Leadership and Public Policy Event
Thursday, June 16, 2011
9:00am – 10:30am
Washington, DC

Standardizing the Standardization Process? What next for IPRs Competition and Innovation?
Stockholm Network Event
Friday, June 17, 2011
Maastricht, Netherlands