How Medicare and Medicaid helped health-care reform
One of the oddities in the funding debate over health-care reform is how reliant Democrats have been on areas of waste and overpayment. Pulling Medicare Advantage back to the funding levels of standard Medicare, for instance, is netting them between $100 billion and $200 billion (depending on the bill). Instituting reforms like bundled payments that we should've done years ago is responsible for tens of billions more.
In some sense, HCR is ruthlessly exploiting years of bad, or at least inattentive, Medicare and Medicaid management from both parties. That's even truer when it comes to the arguments that the bill has the potential to cut costs, as much of that potential comes from things we know need to be done, but we haven't had the political will to do. That, of course, is the whole theory of the independent Medicare Commission. But it leaves us with the odd conclusion that a political system where Medicare and Medicaid were better managed would be a political system where health-care reform would've been a lot harder.
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