Viewpoints: Medicare provider cuts 'won't work'; A 'pamphlet isn't a plan'

The Medicare NewsGroup: Medicare Provider Rate Cuts: Can't Work. Won't Work. And Something That Does Work
Once the presidential election is over, Congress will try to address the Medicare cost shortfall one way or another. They will almost certainly consider a method that is guaranteed to fail: Medicare rate cuts for doctors and hospitals. It's been tried before, most notably as part of the 1997 Balanced Budget Act. Not once since the BBA required annual physician rate cuts have those cuts been implemented, leading every year to the predictable and depressing final-hours "doc fix" vote. Why is such an obvious answer so obviously the wrong one? Two reasons: first, doctor and hospital participation in Medicare is voluntary. If rates are cut, some providers will flee – leaving beneficiaries high and dry. And second, for those providers who stay in Medicare, cutting rates is nothing more than shifting costs. It has nothing to do with saving money (Michael McCallister, 10/24).

Politico: A Glossy Pamphlet Isn't A Plan
One of the benefits of having served the people of Utah in the Senate for as long as I have is that I've been able to work with many presidents from both parties. From Reagan to Clinton to Bush and now Obama, I've seen how they work, who they are as men, and what their visions for America are. Yet in this year's historic presidential election, we have an incumbent president who either knowingly refuses to tell the American people what his plan for our nation would be if reelected – or won't say what he'd try to accomplish, because he knows he'd surely be booted out of office...A look at the health care section is remarkable for its look backward – not forward - to ObamaCare, hardly an achievement in most people's eyes since the president promised that it would hold down health care costs, which it's failed to do (Sen. Orrin Hatch, 10/24).

Roll Call: On Mitt Romney, Medicare And Making The Math Work
The political appeal behind pledging not to touch Medicare benefits for current and soon-to-be seniors is obvious. The political appeal of attacking the president for slashing the Medicare program by $716 billion and pledging to restore it is equally obvious. The political appeal of promising to cut deficits and debt and cap government spending at 20 percent of  the GDP is also apparent. But the combination of the three is utterly inconsistent and impossible. Something has to give -; the question is what. It is that question the 113th Congress will have to confront immediately if Romney wins, with no palatable answer (Norman Ornstein, 10/25).

Chicago Sun-Times: Mourdock's Mistake Is Speaking For God
We have the right to interpret the universe in a way that makes sense to us. What we don't have a right to do is expect -; never mind demand -; that other people share our worldview. This flies by some Republicans, and they trip over it. Particularly when it comes to abortion (Neil Steinberg, 10/24).

Los Angeles Times: Mourdock's Take On Rape And Pregnancy: What's Romney To Do?
Respect isn't the word I would use to describe Mourdock's position, though. If he respects the different beliefs about God, religious structure and abortion, he wouldn't be pressing to force his particular religious perspective on others. Instead, he'd say: Well, it's not something I can condone because of my religious beliefs, but it's not something I have the right to stop, knowing that others believe differently (Karin Klein, 10/24)

The New York Times: The Family Doctor, Minus the M.D.
The Family Health Clinic of Carroll County, in Delphi, Ind., and its smaller sibling about 40 minutes away in Monon provide full-service health care for about 10,000 people a year, most of them farmers or employees of the local pork production plant. About half the patients are Hispanic but there are also many German Baptist Brethren. Most of the patients are uninsured, and pay according to their income -; the vast majority paying the $20 minimum charge for an appointment. About 30 percent are on Medicaid. The clinics, which are part of Purdue University's School of Nursing, offer family care, pediatrics, mental health and pregnancy care. Many patients come in for chronic problems: obesity, diabetes, hypertension, depression, alcoholism. What these clinics don't offer are doctors. They are two of around 250 health clinics across America run completely by nurse practitioners (Tina Rosenberg, 10/24)

The New England Journal of Medicine: Talking With Patients About Dying
Chemotherapy near the end of life is still common, does not improve survival, and is one preventable reason why 25% of all Medicare funds are spent in the last year of life. ... If patients are offered truthful information -; repeatedly -; on what is going to happen to them, they can choose wisely. Most people want to live as long as they can, with a good quality of life, and then transition to a peaceful death outside the hospital. We have the tools to help patients make these difficult decisions. We just need the gumption and incentives to use them (Drs. Thomas J. Smith and Dan L. Longo, 10/24).

Chicago Tribune: On The Mend
One of the highlights of the budget presentation Cook County Board President Toni Preckwinkle made last week to the Tribune editorial board was an impressively streamlined $868 million spending plan for the health system. In this case, what we didn't hear from Preckwinkle and health system CEO Dr. Ram Raju was even more impressive. What we didn't hear were excuses for why the health care budget would gobble an ever greater share of taxpayer dollars (10/25).