Why is it that everything in this country has to be a debate?

“Health-care groups laying groundwork for post-election debate over cost cuts

By Marilyn Werber Serafini and Mary Agnes Carey, Published: November 20

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 AmericanCollege of Cardiology, argues that proposals to address the root causes of high health-care costs have been largely ignored in Washington.

“We talk about them all the time, but there’s nothing that we’re doing in any of these proposals to get that done,” he said. “What we would like to get on the table that’s not there is a paradigm shift in thinking about how you control costs.”

“There’s going to be a Round Two [of cuts], but after the election, because of the economic pressures exerted by the national debt,” said Thomas Scully, a formerMedicare administrator under President George W. Bush and now a senior counsel at Alston & Bird, an Atlanta-based law firm that represents many hospitals, drug manufacturers and other health-care companies.

The supercommittee has examined a variety of ideas to save money in Medicare, the federal program that provides coverage to about 48 million elderly and disabled people and eats 15 percent of the federal budget.

The proposals include cutting payments to medical providers, asking beneficiaries to pay more for their coverage and increasing the eligibility age.

The health-care interests that stand to take another hit in 2013 want to begin planning now. Current efforts are informal and low-key. But several pivotal health-care leaders, most of whom have been through previous national debates and cost-cutting campaigns together, say efforts to reduce spending too often transfer costs off the federal budget and onto individuals, insurers, doctors or hospitals.

These concerns have caused “people from dramatically different quarters to start thinking about what to do to get their hands around this” and redirect the conversation, said Karen Ignagni, president of America’s Health Insurance Plans, the industry trade group. “I’ve been talking to a range of stakeholders about how to work together . . . to urge policymakers to look at what’s already out there now and build on it.”

Some ideas advance existing concepts, such as pushing broad changes in the way that Medicare and Medicaid pay doctors and hospitals, or stepping up efforts to better coordinate care for people who get both Medicare and Medicaid, known as dual eligibles.

America’s Health Insurance Plans is advocating to rapidly expand coordinated care.

Some experts are promoting plans to protect doctors and hospitals from medicalmalpractice lawsuits as long as they follow best practices and the establishment of specialized health-care courts to hear malpractice cases.”