GOP strategy: Force Dems to vote on `job killing' taxes in health reform.

With Senate Dems threatening to force
Republicans to vote on whether to repeal
individual popular provisions in the health reform
law, Senate GOPers are mulling a response: Aides
say they may retaliate by demanding that
Democrats vote on other tax-related individual
provisions in the law that Republicans can paint
as "job killers."
In recent days Republicans have been demanding
that Senate Dems allow a vote on the repeal bill
that the House has already passed. As Brian
Beutler reports, Dems have crafted an aggressive
response: If the GOP persists, they will insist on
votes directly on whether to repeal popular
provisions like the restriction on discrimation
against people with pre-existing conditions.
Now the GOP is preparing their response to the
Dem response. According to a GOP Senate aide,
Republicans may counter by demanding a vote
on whether to repeal provisions disliked by
business, such as the one that imposes an excise
tax on medical device manufacturers. Those
manufacturers have been complaining that this
provision forces them to shoulder an unfair
burden of the cost of expanded health coverage
and could lead to layoffs.
The GOP aide says if Dems try to force votes on
individual provisions, Republicans will respond in
kind. GOP aides are combing through the
legislation to find provisions that they can
demand votes on, should it come to that.
"If Democrats are pushing for political votes on
health care, they can expect the exact same
thing," the aide says. "They don't really want to
go back and forth and relitigate this." The aide
added that Republicans would pick provisions
"that have an impact on jobs."
Translation: Republicans would demand votes on
provisions that serve their larger (and ubiquitous)
message that health reform is a "job killer."
Of course, a lot of this on both sides is bluff and
bluster, a form of brinksmanship designed to
spook the other side into backing off. But if there's
one thing we've learned from the health care
wars, it's that Republicans have not shied away
from procedural fights of this kind. Indeed, they
seem to proceed from the assumption that noisy
process fights help them by tainting the health
law -- and its architects -- with Americans' dislike
of Congress, which is at historic lows.


Source: Http://voices.washingtonpost.com/plum-line/2011/01/gop_strategy_force_dems_to_vot.html

READ MORE ................... GOP strategy: Force Dems to vote on `job killing' taxes in health reform.

GOP strategy: Force Dems to vote on `job killing' taxes in health reform.

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READ MORE ................... GOP strategy: Force Dems to vote on `job killing' taxes in health reform.

The people who will really decide whether health-care reform succeeds or fails

The New Yorker isn't allowing Atul Gawande's
latest article out from behind the paywall, but you
can read the abstract here. The basic point is well
worth keeping in mind amid all the arguments
over the Affordable Care Act: Health-care costs --
and thus our paychecks, and the federal budget
-- won't be decided by how we deliver and
structure health-care insurance. They'll be decided
by how we deliver and structure health care. And
though national policy has a role in that, it's not
always a huge role, and it's not usually a
controversial one.
Gawande relates a series of stories showing
innovation in the toughest corners of the care-
delivery system. The most inspiring is about
Jeffrey Brenner, a Camden-based physician who
began playing with his city's hospital claims data
and making maps of where the money was
being spent. It turned out that there were two city
blocks, containing two particular buildings, where
900 people were responsible for "more than four
thousand hospital visits and about two hundred
million dollars in health-care bills" over the past
seven years. So that's where he focused.
Insurers try to run from the costliest patients.
They try to kick them out for having preexisting
conditions, or they rescind their coverage, or
they price coverage beyond their reach. That just
makes them costlier, of course. Inconsistent
access to medical care means more medical
emergencies, and more medical emergencies
mean higher medical costs. Brenner, by contrast,
is lavishing them with attention. He's calling them
daily. He's checking up on their medications, their
lifestyles, their habits. He wants to open a
doctor's office in their building. His patients
averaged "sixty-two hospital and E.R. visits per
month before joining the program and thirty-
seven visits after — a forty-per-cent reduction.
Their hospital bills averaged $1.2 million per
month before and just over half a million after —
a fifty-six-percent reduction."
We don't really know if his success can be
replicated. But somebody's can be. And that'll be
where policy -- in particular, where Medicare --
comes in. The administration's vision sees things
running something like this: A promising
experiment or pilot program will come to the
attention of the newly established Center for
Medicare and Medicaid Innovation. The center will
fund it on a larger scale and study it more
intensely if. If it proves promising, the
Independent Payment Advisory Board will force
Medicare to implement it fairly quickly. And
history shows that if something works in
Medicare -- and, quite often, even if it doesn't --
it's soon adopted by private insurers.
That's if all goes well, of course. And all may not
go well. But it's important to keep in mind that we
know who costs the system money: Sick people.
And we know what costs the system money:
Their health care, particularly when it involves
catastrophic or chronic conditions. So from a
cost and quality perspective, this is where health-
care reform will live and die: In doctor's offices, in
community health centers, in operating rooms
and in people's homes.
Insurers can play a role here, as can Medicare.
But for the next few years, cost control is going
to be less about setting national policy than about
setting up the experiments that allow us to test
what national policy should be. The Affordable
Care Act's contribution to this is money, a center
dedicated to bringing these experiments up to
scale and a reform process that makes it easier to
seed them in Medicare. But for all that to work,
the component pieces need to remain in place,
and some of the experiments actually need to pan
out.

Source: Http://voices.washingtonpost.com/ezra-klein/2011/01/the_health-care_side_of_health.html

READ MORE ................... The people who will really decide whether health-care reform succeeds or fails