In the debate over a healthcare overhaul, Maryland's experience with setting hospital rates suggests the federal government could realize savings on health spending, but at a price of more regulation for health providers. President Barack Obama and some congressional Democrats are pushing for an independent agency to set Medicare payment rates as a key to controlling costs. In Maryland, an independent agency has been setting rates since 1977 for all patients, including Medicare beneficiaries, at the state's acute-care hospitals.
President Obama's new call to impose automatic spending cuts if the healthcare overhaul adds "one dime" to federal budget deficits could help push his top domestic priority over one of the biggest hurdles in its path through Congress. But for the first time he asked Congress to mandate that future Congresses and presidents "come forward with more spending cuts if the savings we promised don't materialize." While the White House does not have a specific method in mind, health economists have suggested that one such trigger could be a limit on Medicare payments to doctors and hospitals.
More people are getting their health insurance from the government as the number of individuals with coverage from an employer declines, according to figures released by the U.S. Census Bureau. The number of people in the U.S. without health insurance rose by about 700,000 between 2007 and 2008 to 46.3 million. The proportion of uninsured was essentially unchanged at 15.4%. But the 46 million figure is disputed. Many experts say the number is probably higher now because rising unemployment is causing more people in the U.S. to lose insurance provided through jobs. Others say the problem may be overstated because some of the uninsured can afford to buy insurance but don't.
Under Massachusetts' healthcare overhaul implemented three years ago, businesses with the equivalent of 11 or more full-time workers must offer coverage or pay a penalty. But small business owners say they have had to shoulder double digit annual increases in their premiums in recent years, typically higher than the 7%-9% increases larger businesses have faced. Now these small business owners in Massachusetts have been lobbying for relief under the state's law, saying insurance has become unaffordable.
Republican Rep. Joe Wilson's shout of "You lie!" during President Obama's speech Sept. 9 brought renewed attention to questions about whether Democratic healthcare legislation would extend coverage to illegal immigrants. Although the answer is more complicated than reform proponents acknowledge, it also does not square with the dark warnings of opponents who say the proposals would bring waves of undocumented immigrants into taxpayer-funded plans, according to the Washington Post.
The government won't save much from Medicare's year-old policy of refusing to pay hospitals' extra costs to treat hospital-acquired infections and injuries such as bedsores, a new study concludes. Medicare adopted the policy last year with the goal of saving lives and cutting costs. Medicare stopped paying the extra costs of treating 10 hospital injuries and infections beginning Oct. 1, 2008. The study by California researchers examined California discharge data for Medicare beneficiaries in 2006, looking for six conditions the authors deemed "definable." They found that out of 767,995 cases in all, 828 cases involved those conditions, and only 26 of the cases would have been subject to lower payments.