Saturday, February 9, 2013

Medicare and Deficit Reduction, Health Reform Strategic Plan

This post covers the following:

1) Various proposals on Medicare as to deficit reduction
2) My thoughts on strategic planning on health reform

1) Deficit reduction

here are several reports that contain proposals from various organizations on Medicare's possible role in deficit reduction. 

a) see

 b) center for american progress


Real Help for Medicare and the Deficit

  d) LCAO 

  e) Kaiser Family Foundation: Policy Options to Sustain Medicare for the Future

this has many useful options considered, not all of which would I recommend.  

f) Any others? 

Please let me know which options you support.

  2) Strategic Plan

here are my thoughts on an overall strategy going forward re health reform

a) Communications plan

what mystifies me are findings by American Cancer Society Cancer Action Network (acscan) and focus groups that show that when explained the public supports Obamacare. [see Polling: Public Wants States to Use Federal Funds to Cover Uninsured Through Medicaid
this is an important article that shows that given the right info the public supports provisions of obamacare.]

Yet we have not done more to communicate with the public. The herndon alliance and HHS have certainly tried but the key players in the field, the white house, congress, and other key orgs have not done enough.  I think acscan's findings need wide exposure.  I welcome thoughts about how to engage more of these key players.  My guess is the white house felt it was better not to pay too much attention to the issue during the campaign. Obama did discuss some of the key points in Obamacare and did address medicare to some extent.  perhaps in 2014, press about those provisions being implemented will get more attention which will help.  I hope that someone will develop a strategic plan on how to get the most mileage from the 2014 changes which start taking place when the HIEs start to promote their programs probably sometime before october.  see my posting about this


 Such efforts should include partnerships with foundations such as kaiser, rwj, commonwealth, etc., think thanks such as brookings, urban institute, rand, and others such as medicare rights center, alliance for health reform.


 In the DC and Maryland areas, several major employers have cut hours significantly and have not restored.  I would like to understand the policy that is driving this and would appreciate any explanation you can provide and also any articles that show things were reversed.. Do you know if Whole Foods or McDonalds have reversed their cuts,
c) Cost curve

 one of the points that might bear highlighting is that the ACA may have already contributed to a significant slowing of health care inflation. 

d) Duals

I think one area that can help considerably is to improve the coordination of care and finances for dual eligibles.  one way to achieve this might be to integrate the medicare and medicaid funds, e.g., turn the medicare funds over to the states so that only one entity is coordinating the care.  there are other steps that can improve services for duals, such as the use of care management teams






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