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Klobuchar introduces Medicare legislation

WASHINGTON, D.C. -- Sen. Amy Klobuchar introduced Medicare reform legislation on the Senate floor today, stepping into the midst of the building health-care debate as an advocate for Medicare payment reform that rewards outcomes over number of tests.

“So, to my colleagues that are conjuring up reasons not to pass reform this [year], using scare tactics about nationalized health care and engaging in fear mongering, I would say we can’t stay where we are,” said Klobuchar, pointing to the rising cost of health care for individuals and the federal government. “We can’t stay where we are. They must be getting different mail than I am... They [my constituents] are not saying, ‘Let’s stay the way we are.’ They are saying, ‘Let’s reform the system.’”

The Democrat did not specifically address other portions of the developing health-care reform legislation, including the controversial public health insurance plan option, which could be run by the government alongside existing private insurers, or the relatively new co-operative proposals, which could include the possibility of a national co-operative, owned and operated by its members.

Instead, Klobuchar focused on fixing the current Medicare system, which favors states that spend more on health care, regardless of the quality of care. This puts states with relatively low health-care costs, like Minnesota, at a disadvantage when it comes to Medicare funding, according to Klobuchar.

“We need to be sure to keep score,” Klobuchar said. “That means measuring outcomes and rewarding providers that deliver quality results.”

The Medicare Payment Improvement Act would create a value index for determining Medicare physician fees. The value would be calculated by a quality component, which would be determined by the secretary of Health and Human Services, divided by efficiency, which would be measured as total Medicare spending per beneficiary in the area. The legislation would also seek to link rewards to outcomes and reinforce coordinated health-care systems within communities.

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Comments (3)

Today's Washington Post revealed why Obama chose Green Bay to kick off his "barnstorming for early death" health care tour: "It is the findings of the Dartmouth Institute for Health Policy and Clinical Practice that have generated the most excitement in the Obama administration, all the way up to the Oval Office." For more than 10 years, the Dartmouth Institute has followed costs and care for seniors in Medicare, and concluded that spending more on healthcare does not stop people from dying, and if they die later, it costs more.

This is the same approach as the Nazi Doctors T4 program to eliminate useless eaters through more "efficiency".

Green Bay is a place the Dartmouth Institute would like to make a model for the entire U.S. In the final two years of a patient's life, it found that Medicare spent an average of $46,412 per beneficiary nationwide, but in Green Bay, Medicare spent only an average of $33,334. Nationally, a senior in the last two years of life would spend an average of 19.6 days in the hospital, including 5.1 days in the intensive care unit, but in Green Bay, a senior would spend only 14.1 days in the hospital, and just 2.1 days in the ICU.

Donald Berwick, president of the Institute of Quality Improvement, says that the more doctors, drugs, tests and therapies given to people at the end of life, the unhappier they become. Jeffrey E. Thompson, the chief executive of Gunderson Lutheran Health System in LaCrosse, Wisc., which has spending patterns similar to Green Bay, boasts that it has achieved these results by persuading patients to sign medical directives that allow their lives to be ended.

And this is bad?

1) Where is this Nazi doctors "efficiency program" nonsense coming from? Rush Limbaugh? Lyndon LaRouche?

2) Senator Klobuchar's legislation seems written to correct some unfair favoritism in the Medicare payment system. In Florida, for instance, eyeglasses and other things are covered, while in Minnesota and other states they are not.

The article doesn't say anything about the excess cost of the privatized Medicare drug benefit. Economist Dean Baker studied this in 2006 and found that: "If Medicare could negotiate the same schedule prices as Australia (the current lowest cost country), the savings over the first eight years of the drug benefit would be almost $560 billion.

"The combined savings from having Medicare negotiate prices directly with the industry and from having Medicare directly offer the benefit instead of private insurers would be more than $600 billion over the years from 2006 to 2013."

Why isn't Congress looking at this excruciatingly obvious way to save TAXPAYER DOLLARS? I am afraid it is for the same reason that the administration and folks like Baucus say that "single payer is off the table" while insisting that "everything" is on the table. Huge pressure from the industry and from those members of Congress who have received its millions of lobbying donations. And I am afraid the result will be the same: We will pay untold billions more to continue the privatized insurance system instead of seeking the least expensive and most effective alternative.