Opinion

WEDNESDAY, DEC. 9, 2009

Smart Bombs: Cutting containment carries cost

Not being a math genius, I have to wonder how Congress would hope to control health care costs by subtracting provisions that do so. A group of prominent economists doesn’t think this adds up, according to Time magazine’s Karen Tumulty. It seems in the horse-trading for votes, negotiators are emasculating some strong cost-cutting provisions that drew praise in the first place. So the economists drafted a letter and sent it to U.S. Senate Majority Leader Harry Reid, D-Nev.

One change that rankles is delaying the recommendations of the Medicare cost-control panel until 2019. Another is changing the formula for when the panel can get involved. Initially, it was to act when the rate of Medicare spending outpaced overall economic growth, which happens routinely. The change would only trigger panel activities when Medicare spending growth outstrips the pace of overall health care spending, which is hardly ever.

The economists also complain that effective strategies such as bundling payments for medical services (as opposed to fee for service) have been reduced in scope or relegated to pilot project status.

Democrats like to point to the Congressional Budget Office scoring of the Senate bill, because it finds that it would reduce the budget deficit by 2019. But that won’t happen if these technical changes remain in the final product. In “victory,” they would be handing critics the ammo needed to declare this effort a failure.

Sick Joke. If a decent public insurance option is scuttled by Congress – and the insurance lobby is working feverishly to make it so – there’s an intriguing idea to allow people in the 55- to 64-year-old age group to buy into Medicare. This is a demographic that insurance companies aren’t particularly desirous of in the first place, because the older people get, the more they need health care. Just ask any middle-age person who tries to buy health insurance how painful and expensive that can be.

But I have to think that the usual suspects would fight such a plan, because it wouldn’t take long for people below age 55 to want in. At that point, you’d risk having Medicare for all, which would save money but fail the American test of routing government subsidies through the private sector to give us the highest costs in the world without better outcomes.

Apparently, that’s an honor worth preserving.

Global warning. Critics don’t need help in deciding that a media cabal is pushing a global agenda on climate change, but the Guardian in London decided to bolster the charge anyway and got 55 other newspapers to join in. Here is a note that prefaces an editorial on climate change that ran on the front pages of 56 newspapers Monday:

“The following editorial was published today by 56 newspapers around the world in 20 languages including Chinese, Arabic and Russian. The text was drafted by a Guardian team during more than a month of consultations with editors from more than 20 of the papers involved. Like The Guardian, most of the newspapers have taken the unusual step of featuring the editorial on their front page.”

The editorial issued a call for leaders gathered in Copenhagen to act on global warming. Let the charges of “groupthink” and “coordinated campaign” fly.

Yes, the front-page placement is unusual, but even stranger is the willingness of so many papers to drop their independent voices and run the same editorial word for word. It’s not much different from letter writers cutting and pasting passages from political advocacy Web sites and affixing their signatures, which is a practice, by the way, that is frowned upon at most newspapers, including this one.

The good news is that only one U.S. newspaper – the Miami Herald – published the editorial, according to Miami New Times. The bad news is that this won’t matter to the conspiracy-minded.

Smart Bombs is written by Associate Editor Gary Crooks and appears Wednesdays and Sundays on the Opinion page. Crooks can be reached at garyc@ spokesman.com or at (509) 459-5026.


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