This is just a quick reminder. Medicare is big, it is complicated, and it has a very weird set of current procedures and incentives. Sometimes making some of those procedures less weird and screwy will result in spending less money while holding beneficiaries either harmless or making the beneficiaries slightly better off due to smaller co-insurance payments. A decent chunk of the $845 billion dollars in headline Medicare cuts are recurring, bipartisan, technocratic proposals to be less dumb in how we pay for things.
For example: These 3 proposals, which add up to about $260 billion, all say the same thing: Broadly, if a doctor does a procedure, and a doctor who’s employed by a hospital does the same procedure, the doctor in the hospital doesn’t get paid more. This is an Obama-era idea. pic.twitter.com/47qJwb3Oeu
— Sam Baker (@sam_baker) March 11, 2019
The place to honestly beat up on the budget is in MedicAID cuts. Yes, the $845 billion is a damn big club lying around on the floor but to use it is to say that the current system (which has some very stupid incentives) can’t be changed and that providers have an entitlement to the cash flow derived from dumbness.
(I don’t expect many if any of the “let’s eliminate a stupid incentive” payment cut proposal to get through Congress but that is another question for another day.)