Medicare, Good News, Bad News

First the good news. The latest Medicare Trustee report says there is enough money to fund Medicare an additional 12 years. And everyone cheered . . .

But wait, there's more!

The life support only happens if Obamacare delivers on the cost reductions supposedly built in to saving Medicare.

To remain solvent, Medicare and Social Security will have to rely on withdrawals from the Trust Fund.

The one kept in a hermetically sealed mayonnaise on jar on Funk and Wagnall's porch.

The trust fund, which exists in paper form in a filing cabinet in Parkersburg, W.Va., are bonds backed by the government's "full faith and credit" but not by any actual assets. That trust fund, currently at $2.5 trillion, has been spent over the years to fund other parts of government.

To redeem the trust fund bonds, the government will have to borrow in public debt markets or raise taxes.

Oops!

Health and Human Services Secretary Kathleen Sebelius, another trustee, told reporters that the trustees assumed current law in making their projections, including a cut in doctor's Medicare payments of 23 percent starting in December.

Yeah, that will work.

Wonder how the docs feel about that?

And what about folks on Medicare who are told their doctor cannot afford to see them this week, or next week, or the week after . . .

This assumes of course you can find a doc that is accepting new Medicare patients.

A companion report concluded that some of the $575 billion in Medicare savings over 10 years "may be unrealistic" because future Congresses could be pressured to roll back cuts to providers in the health care law.

Unrealistic? Say it ain't so!

Just because Congress has rolled back the Medicare reimbursement cuts for the last dozen years or so doesn't mean they will continue to ignore the law they wrote which REQUIRES CMS to cut doctor reimbursements.

Poor Get Pot at a Discount

If you live in D.C. and cannot afford marijuana, taxpayers will subsidize the cost of the drug. No, I am not blowing smoke on this.

The medical marijuana law allows people to legally obtain the drug for medical reasons. But the law also includes a provision different from the 14 other states with medical marijuana laws, requiring the drug to be provided at a discount to poor residents. Who will get the reduced-price marijuana and how much it will cost, however, is still being worked out

Smoke 'em if you got 'em.

Health Wonk Review: In the Here and Now

I continue to be impressed with the quality of wonkery displayed by the folks whose submissions you'll see below. Looking back at the first 'Review I ever hosted, I was struck by how many wonk-bloggers [ed: is that even a word?] have left the 'sphere, but quite pleased to see names I recognize as still active: the Health Business Blog's David Williams, my favorite econ-blogger Jason Shafrin, and Workers Comp guru Jon Coppelman (all of whom appear in this edition, as well). I also noticed how short that review really was. I'm all for brevity when appropriate, but there's also no shame in piling on, especially when you read this week's entries.

In keeping with my newfound penchant for minimalism, posts appear in order of submission:

■ Rita Schwab has the sad tale - and important lesson - of little Taylee Blischke, who died at the hands of survived despite the efforts of incompetent, and unrepentant, physicians.

■ Bradley Flansbaum (aka The Hospitalist Leader) shares his comparison of The Great Emancipator and (what we at IB call) ObamaCare©. Guess who wins?

■ Peggy Salvatore uses an old (but timely!) joke to demonstrate the folly of government-supported EHR initiatives.

■ Rich Elmore at Healthcare Technology News reports on the Tiger Team on security and privacy recommendations on handling of personally identifiable health information. Important stuff.

■ Joanne Kenen's post is about how CareOregon, a medicaid managed care plan, has created patient-centered medical homes and adapted to its own population a successful care coordination program for patients with multiple and/or complex chronic disease. Interesting.

■ HWR co-founder Joe Paduda weighs in on the cost of voluntarily forgoing necessary health care. While I disagree with his reasoning (high deductibles and/or co-pays ate to blame), he makes a valid point:: delaying or forgoing primary care will increase future health care costs

■ Uber-wonk Dr Roy Poses posits that maybe - just maybe - having health care leaders' incentives actually aligned with patients' and the public's needs, and not so large as to elevate the leaders into the "Superclass" might work out better in the long run.

■ My favorite health care economist - Jason Shafrin - examines key provisions of ObamaCare@ from (you guessed it!) an economist's viewpoint.

■ Boston's Tinker Ready talks about "e-patient" Dave, and the contrarian's view of "positive thinking."

■ What does Joe's suddenly accelerating Camry have to do with HWR? Well, you'll have to click through to newcomer Michelle Woods' post on HIT (Health Information tech).

■ Austin Frakt, The Incidental Economist, believes that Rep. Ryan's plan for Medicare is unlikely to control costs because it is too much like the current [ed: but soon to be "late"] Medicare Advantage program.

■ Maggie Mahar takes a look at former HCA honcho - and current Florida gubernatorial candidate - Rick Scott and finds him wanting.

■ Ken Terry sings the Motown Blues, taking to task the waste of dollars being thrown at Detroit's hospitals. Stop, in the name of...common sense!

■ Workers Comp Insider's Jon Coppelman reports on the case of Americans with Disabilities versus the Occupational Safety and Health Administration. Who wins? Guess you'll have to read the post.

■ Jay Norris, of the Colorado Health Insurance Insider blog, writes about the newly-created Early Retiree Reinsurance Program, which enables federal funding to help pay for retirees’ health insurance.

■ Avik Roy, of The Apothecary (and a featured NRO blogger, as well), takes the contrarian viewpoint in defending the FDA's position i the recent Avastin kerfluffle.

■ Over at the Health Access Blog, Anthony Wright points out that California was the first state in the nation to have its legislature pass a bill to set up a health insurance exchange under health reform.

■ Dr Jaans Sidorov compares and contrasts this Administration's most recent spins with academic writings that "say it ain't so."

■ The eponymous John Goodman's Health Policy Blog reports that the The NCPA [ed: National Center for Policy Analysis] has released an evenhanded consumer’s guide to health care reform, focusing on both new benefits and costs, in a helpful Q&A format.

■ At the Health Affairs Blog, Michael O’Grady and Jennifer Baxendell Young propose an automatic adjustment mechanism in which federal Medicaid financing would increase for states suffering economic hardship, without the need for special Congressional legislation. Left unanswered: why only Michael's picture is on the post.

■ The Health Business Blog's David Williams interviews one of my favorite med-bloggers: Dr Evan Falchuk. What makes him a fave? Here's a sample: "We connect with people because we’re talking about real stuff." Trust me, this guy is important.

■ And finally, our own Bob Vineyard puts the smackdown on all the "wonderful" changes promised by ObamaCare©, including the fact that we now have fewer choices at higher costs.

That wraps up this week's episode of Health Wonkery. Please be sure to tune in again on the 16th when Jay's better half, Louise Norris, hosts the next edition.