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White House Fiscal Commission - Healthcare Recommendations - 2010-11-10

White House Fiscal Commission - Healthcare Recommendations - 2010-11-10

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Published by Rich Elmore
Healthcare cost reduction / containment recommendations from the Bowles - Simpson (co-chairs) of the White House Fiscal Recommendations
Healthcare cost reduction / containment recommendations from the Bowles - Simpson (co-chairs) of the White House Fiscal Recommendations

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Published by: Rich Elmore on Nov 11, 2010
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11/11/2010

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Reducing Health Care Costs
y
Medium Term: Fully offset the cost of the “Doc Fix” by asking doctors andother health providers, lawyers, and individuals to take responsibility forslowing health care cost growth. Offsets include:
y
Pay doctors and other providers less, improve efficiency, and reward quality byspeeding up payment reforms and increasing drug rebates
y
Pay lawyers less and reduce the cost of defensive medicine by adopting comprehensive tort reform
y
Expand cost-sharing in Medicare to promote informed consumer healthchoices and spending 
y
Expand successful cost containment demonstrations
y
Strengthen IPAB
y
Recommend additional health savings (illustrative examples to follow)
y
Long Term: Contain growth in total federal health spending to GDP+1%after 2020 by establishing a process to regularly evaluate cost growth,and take additional steps as needed if projected savings do notmaterialize
DRAFT-DO NOT CITE
 
31
MANDATORY BUDGET
 
Paying for the “Doc Fix”
y
Pay doctors, other health providers, and drug companies less andimprove efficiency and quality
y
Replace cuts required by SGR through 2015 with modest reductionswhile directing CMS to establish a new payment system, beginning in2015, to reduce costs and improve quality.
y
Require rebates for brand-name drugs as a condition of participating in Medicare Part D.
y
Increase cost-sharing in Medicare
y
Eliminate first-dollar coverage in Medigapplans.
y
Replace existing cost-sharing rules with universal deductible, singlecoinsurance rate, and catastrophic cap for Medicare Part A and Part B.
y
Pay lawyers les
 
s and reduce the cost of defensive medicine
y
Enact comprehensive medical malpractice liability reform to cap non-economic and punitive damages and make other changes in tort law.
DRAFT-DO NOT CITE
 
32
MANDATORY BUDGET
 
Health Care Savingsto Pay for the Doc Fix
20112012201320142015201620172018201920202011-20152011-2020Reform the Sustainable Growth Rate*
0 0 -3 -3
-3
-3 -3 -3 -3 -3 -10 -24
Require Drug Rebate Payments
0 0 -5 -
-6 
-7 -8 -9 -10 -11 -15 -59
Expand Cost Sharing in Medicare andCreate a Cap on Catastrophic Costs
0 0 -7 -9
-9
-10 -11 -12 -13 -14 -25 -8
Limit Medigap Cost-Sharing Coverage(Including Interaction w/ Above Provision)
0 0 -3 -
-5 
-6 -7 -7 -8 -9 -13 -5
Enact Comprehensive Tort Reform
-1 -2 -4 -
-7 
-8 -8 -8 -9 -10 -21 -64
 __  _____
 ___
 ___________
Total Deficit Reduction
-1-2-22-28
-30
-33-37-39-43-47-83-282
*Memo: Cost of Physician Pay Freeze:9192223
25
273134404499276
DRAFT-DO NOT CITE
33
MANDATORY BUDGET
Numbers are FC staff estimates, based on CBO and other available estimates

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