Admitting gridlock was at hand, lawmakers on the so-called supercommittee cast blame and pointed fingers at one another Sunday as the panel’s leaders prepared to formally acknowledge their failure early this week, bracing for the reaction from financial markets. Using the weekly Sunday political news shows as their outlet, Republicans and Democrats on Congress's special deficit committee did not officially throw in the towel on their mandate of finding $1.2 trillion in savings before Thanksgiving. However, most of the lawmakers spoke of their efforts in the past tense and said it would take something akin to a miracle to reach a deal, which unofficially must be unveiled before midnight Monday to meet the panel's parliamentary rules.
Regardless of whether Congress's supercommittee meets its deadline for finding ways to reduce the federal deficit, budget and policy experts are braced for Washington to soon face the painful task of finding even more savings—and they anticipate that health spending, which makes up more than a fifth of the federal budget, will be a main target. Some health-care leaders are already laying the groundwork to redirect a debate they're expecting in 2013, after the 2012 election. They hope to prevent spending from simply being shifted from one part of the system to another. Jack Lewin, chief executive of the American College of Cardiology, argues that proposals to address the root causes of high health-care costs have been largely ignored in Washington.
The Supreme Court will rule next year on the constitutionality of the healthcare reform passed in 2010. But constitutionality notwithstanding, Republican opposition to the new law has been vigorous and consistent. In recent GOP presidential debates the candidates have been unanimous in condemning it, in particular objecting to the requirement that almost all Americans obtain health insurance or pay a penalty. On the surface, Republican and conservative opposition to the new requirement seems perfectly logical. There is a long history of conservative preference for limited government and individual responsibility. But scratching the surface of those principles reveals a murkier picture.
In-store medical clinics like those at Walmart ? having established a beachhead with relatively healthy patients looking for convenient, low-cost care for simple problems ? are eyeing a bigger prize, the millions of Americans with costly illnesses such as diabetes and heart disease. Just as Walmart and other retailers shook up the prescription drug business by offering $4 generic drugs, the industry now aims to apply its negotiating and marketing clout to tackle problems that vex consumers and the health sector: unpredictable costs, a lack of primary care doctors and inefficient management of chronic illnesses, whose costs drive the majority of health care spending. "It's sad that the existing health care establishment has not figured out a way to make primary care affordable and accessible," says Jerry Avorn, a professor of medicine at Harvard. "We should not be surprised if someone outside of our world comes in and does it for us."
There's little question that Medicare and Medicaid -- the two federal health care programs for the elderly, disabled and the poor -- are in the supercommittee's sights along with Social Security cuts. Nursing homes and hospitals are worried the panel will take an ax to federal reimbursements, which would come on top of other recently enacted cuts to such providers. Dave Dillon, a spokesman for the Missouri Hospital Association, said his members are most worried the supercommittee will shave so-called "provider taxes," which many states use to generate federal matching funds to pay for Medicaid. Right now, Missouri imposes a 6 percent levy on hospitals, the legal maximum, which generates $900 million in revenue annually. Missouri then doles that funding back out to providers -- and snags federal matching funds in the process.
Massachusetts General Hospital is launching Boston’s second hand transplant program, hoping eventually to pioneer a new way of replacing patients’ limbs without subjecting them to a lifetime of dangerous antirejection drugs - an advance that could turn a rare operation into a routine one. The idea is to transplant a donor’s bone marrow along with the hand to trick the recipient’s immune system into accepting the donated hand as its own. The hospital has had early success with this experimental approach with certain kidney transplant patients.