Independent Women's Forum RSS feedhttp://www.iwf.orgThe RSS feed for the IWF. News/Commentary, Blog posts and publications(...)IWF RSS Reform: Scrap the SGR and Use Markets to Control Costs<p> Competition for the biggest waste of time in Washington is fierce, but certainly the annual &quot;doc fix&quot; exercise deserves to be in the running.</p> <p> Medicare&#39;s Sustainable Growth Rate was created in an attempt to control Medicare&#39;s costs by tying the program&#39;s reimbursement rates to economic growth as measured by GDP. Such cuts were always a stretch--after all, doctors and hospitals need to receive competitive payments if they are going to continue to serve the Medicare population--but if implemented today, SGR cuts would be devastating to the medical community and the Medicare population.</p> <p> That&#39;s why each year Congress has a &quot;doc fix&quot; vote to suspend the upcoming rate cuts.</p> <p> Yet just because these cuts are always put off doesn&#39;t mean they don&#39;t do plenty of harm: The whole &quot;doc fix&quot; process creates uncertainty for doctors, patients, and taxpayers, and it&#39;s become a political football ripe for abuse. The doc fix vote enables doctors&#39; groups and other medical associations to shake down their members for political cash, and it wastes time and resources in our political system that would be better spent elsewhere.</p> <p> The SGR also masks the true cost of government health programs like Medicare. With SGR technically on the books, budgetary score outfits like the Congressional Budget Office have to report on Medicare&#39;s future costs as if SGR were going to be implemented. These scores make Medicare look less costly and more financially stable than it actually is.</p> <p> Instead of passing an annual &quot;doc fix,&quot; we should finally fix Medicare&#39;s reimbursement system for good.</p> <p> Of course, the Medicare program desperately needs cost control. More than 50 million seniors already depend on Medicare, and a coming wave of Baby Boomers will add to enrollment significantly. The average senior&nbsp;<a href="">takes out $3 in benefits for each dollar he paid in</a>. Unsurprisingly, this means Medicare today faces a 75-year unfunded liability of&nbsp;<a href=";utm_medium=email&amp;utm_campaign=morningbell&amp;mkt_tok=3RkMMJWWfF9wsRonuKjAZKXonjHpfsX56eUtXqW0lMI%2F0ER3fOvrPUfGjI4AScVjI%2BSLDwEYGJlv6SgFQrLBMa1ozrgOWxU%3D">more than $30 trillion</a>.</p> <p> So how should we reform Medicare&#39;s payment structure?</p> <p> In the short term, Congress should vote to repeal the Sustainable Growth Rate formula. If we aren&#39;t going to follow it, what&#39;s the point of having it on the books? Suspending the SGR permanently would be better than the current practice of suspending it annually.</p> <p> Repealing the SGR would have several immediate benefits: For one, it would allow budget scoring agencies to more clearly depict Medicare&#39;s rising costs, and should inspire lawmakers to reform the program entirely. Repealing the SGR would also remove the annual invitation to waste time and money on the &quot;doc fix&quot; vote.</p> <p> A long-term solution to the problem of physician reimbursement entails broader reforms to the Medicare program. Ultimately, rather than relying on government projections and formulas, Congress should give Medicare patients more control over their health insurance and allow doctors to work with private insurers to treat these patients. Medicare should be reformed into a &quot;premium support&quot; program, in which seniors receive funds from the government and are free to find and buy a private health insurance plan of their choice.</p> <p> This would put these patients on equal footing with other (younger) patients who have private insurance, and would leave reimbursement rates between physicians and those insurers, getting government out of the business of setting rates. Lawmakers could even use permanent SGR repeal as a bargaining chip to advance these reforms.</p> <p> Medicare patients would ultimately be more satisfied with private insurance plans. Private insurers would have to compete for Medicare beneficiaries who would have a choice about where to spend their dollars. Not only would they compete on price, but on the quality of insurance (what&#39;s covered, size of provider network, etc.)</p> <p> And premium-support reforms would benefit taxpayers too. Premium support funding would encourage individual Medicare patients to efficiently use their health care dollars, and encourage insurers to deliver real value to this important group of consumers. Taxpayers would better be able to anticipate the programs&#39; costs and be assured that funds were being targeted wisely, since those with greater financial needs would be given a greater share of government support.</p> <p> That&#39;s the kind of &quot;fix&quot; that would benefit us all--doctors, patients, and taxpayers--and would mercifully eliminate one of Washington&#39;s most pointless and counterproductive annual political traditions.</p> HeathThu, 30 Oct 2014 14:10:00 CSTen-usIndependent Women's ForumArtificial Intelligence, Private Sector and Apple Pay • Cavuto HeathMon, 27 Oct 2014 09:10:00 CSTen-usIndependent Women's ForumJay Carney defending the President, saying he doesn't watch cable news • Cavuto HeathMon, 27 Oct 2014 09:10:00 CSTen-usIndependent Women's ForumBusinesses, specifically tech companies, spending millions in favor of lawmakers • Cavuto HeathMon, 27 Oct 2014 09:10:00 CSTen-usIndependent Women's ForumMedicaid expansion will send our nearly $18 trillion debt higher • Your World with Neil Cavuto HeathThu, 23 Oct 2014 07:10:00 CSTen-usIndependent Women's ForumEbola & earnings & Apple pay release • Cavuto HeathMon, 20 Oct 2014 14:10:00 CSTen-usIndependent Women's ForumIs the media is talking too much about Ebola • Cavuto HeathMon, 20 Oct 2014 14:10:00 CSTen-usIndependent Women's ForumBanning Flights: Private companies often step in when government drops the ball • Cavuto HeathMon, 20 Oct 2014 14:10:00 CSTen-usIndependent Women's ForumNew Workweek Initiative Highlights Problem in ObamaCare<p> The White House has unilaterally delayed enforcement of employer mandates in ObamaCare. &nbsp;But eventually, these mandates are going to kick in. &nbsp;Unless the Administration issues another executive delays, businesses of more than 200 workers will be subject to the employer mandate on January 1, 2015, just about 11 weeks from now. Then, on January 1, 2016, businesses of 50 to 200 workers will face the same mandates.</p> <p> The mandate, and its related penalties, are&nbsp;<a href="">a little bit complicated</a>. But here&#39;s one key aspect of the mandate that is create big problems for American workers. &nbsp;ObamaCare defines &quot;full time work&quot; as 30 hours per week. Effectively this means that employers can reduce the number of hours that employees work (below 30 per week) and avoid the costs associated with having to offer full-time workers ObamaCare-compliant insurance coverage. For workers, this means working fewer hours -- for a smaller paycheck -- and losing employer-sponsored insurance. It&#39;s a lose-lose situation.&nbsp;</p> <p> Importantly, people on all sides of the aisle have criticized the employer mandate because of the way it will negatively impact workers and the broader economy. Left-leaning groups like the&nbsp;<a href="">Urban Institute</a>&nbsp;have said that on top of its economic consequences, the employer mandate doesn&#39;t offer much benefit in terms of expanded insurance coverage. The Mercatus Center recently released a report called &quot;<a href="">The ACA and the New Economics of Part-Time Work</a>,&quot; which Rachel blogged about&nbsp;<a href="">here</a>&nbsp;and which shows how the law will push more Americans--particularly more American women--reluctantly into a part-time status.</p> <p> Another effort to raise awareness about ObamaCare&#39;s impact on employment is called &quot;<a href="">More Time for Full Time</a>.&quot; It features this moving video:</p> <p> <iframe allowfullscreen="" frameborder="0" height="315" src="//" width="560"></iframe></p> <p> &nbsp;</p> <p> ObamaCare&#39;s perverse employment incentives are just one of the many ways that this law is backfiring on Americans. &nbsp;Eliminating or reforming the employer mandate may offset some of the negative consequences of the law, but it won&#39;t be enough. &nbsp;ObamaCare&#39;s entire approach is mandate-centric, and depends on a web of government requirements -- on individuals, on employers, and on insurers -- that limit choices. This leads to distorted incentives and real harm to our economy, our freedoms, and the quality of our health care.&nbsp;</p> <p> That&#39;s why we need to repeal ObamaCare and start over by focusing on developing the next, better health reform package, that focuses on market competition, price transparency, and individual consumer choice to reshape the health insurance marketplace without harmful disincentives for employment or the economy at large. This week, during <a href="">Health Care Solutions Week</a>, we are doing just that by highlighting what those patient-centered, free-market solutions might be.&nbsp;</p> <p> Health reform shouldn&#39;t result in slashed hours, reduced pay, or limited choices in plans, doctors, or care. Americans deserve better.</p> HeathWed, 15 Oct 2014 17:10:00 CSTen-usIndependent Women's ForumNew Development in ObamaCare Lawsuit<p> <em>This blog is cross-posted at <a href=""></a>, IWF&#39;s blog dedicated to cases filed against the Affordable Care Act.&nbsp;</em></p> <p> In a new and surprising development, the U.S. Court of Appeals for the D.C. Circuit has ordered that the Federal Government respond to their&nbsp;<a href="">challengers&#39; petition for an&nbsp;<em>en banc</em>&nbsp;hearing</a>. This case,&nbsp;<em>Sissel v. Department of Health and Human Services</em>, centers on the Origination Clause and alleges that the Affordable Care Act was passed in an unconstitutional way. In short, according to Article 1, Section 7 of the U.S. Constitution, any legislation that raises taxes must originate in the House of Representatives. The ACA, or ObamaCare, includes 20 new taxes or tax increases, but originated in the U.S. Senate.&nbsp;</p> <p> Although Matt Sissel did not initially succeed at the D.C. Circuit, he has filed now for an&nbsp;<em>en banc</em>&nbsp;hearing, in which more judges on the appellate bench would rehear the case. The Court has now ordered the Federal Government to respond, indicating that judges are taking this request for a rehearing seriously.&nbsp;</p> <p> The case is gaining attention and support:&nbsp;<a href="">Congressional leaders</a>&nbsp;and&nbsp;<a href="">several states</a>&nbsp;have filed amicus briefs supporting Matt Sissel. The Pacific Legal Foundation is handling litigation for the case, and you can find out more at&nbsp;<a href="">their Website.</a></p> <p> Like other cases challenging ObamaCare, this is about limiting the government&#39;s power to the design put forth in the Constitution. The Founders understood that it was essential to limit the power to tax, to keep government from abusing the people. &nbsp;The people are best represented in the House, the larger of the two bodies in our bicameral legislature, and therefore the Founders put forth the requirement that tax-raising bills originate in the House. &nbsp;There is a reason why our government was designed this way, and today our judges should heed the ACA&#39;s challengers in Sissel, and uphold this important limitation.&nbsp;</p> <div> &nbsp;</div> HeathWed, 15 Oct 2014 16:10:00 CSTen-usIndependent Women's Forum Focusing On The Next, Better Health Care Reform Law<p> The Affordable Care Act (ACA) was supposed to cure our nation&#39;s healthcare ills. Yet today, we still see symptoms of dysfunction.</p> <p> We can -- we must -- do more to create a better healthcare system for all Americans. That&#39;s why this week, across the country, healthcare reformers are joining together for Healthcare Solutions Week. Together, we can finally find the right solutions to our nation&#39;s persistent problems in healthcare policy.</p> <p> Before the passage of the ACA, American health care had long suffered from several chronic problems: high and ever-rising costs, limited choices, and limited access, especially for those with health conditions. When uninsured or underinsured people received care but couldn&#39;t pay, their costs were often shifted onto those with private insurance.</p> <p> No doubt, these problems needed addressing.</p> <p> However, many misdiagnosed the root causes of these problems as excesses of the market and set out to fix them with more government control. But in reality, it was government intervention that was causing the problems in the first place: Onerous state coverage mandates, market-distorting tax incentives, and other regulations have thwarted meaningful market competition in health care and bloating the role of third-party payers, driving many of our system&#39;s inefficiencies.</p> <p> Not surprisingly, the new health law&#39;s additional layers of government intervention haven&#39;t yet solved these problems.</p> <p> We need a different direction for reform.</p> <p> During Healthcare Solutions Week, we&#39;ll examine some of the alternative methods for improving our healthcare system: We&#39;ll look for solutions that serve the principles of consumer choice, price transparency, market competition, fiscal responsibility, and patient-centered care.</p> <p> For instance, we should empower individual choice in insurance by equalizing the tax treatment of employer-based and individual plans. The current tax advantage for employer coverage isn&#39;t fair, and leads to a distorted health insurance market place.</p> <p> Individuals would have far better options&mdash;and we&#39;d have real competition among insurance providers&mdash;if we could shop for health insurance like we do other insurance products or other goods.</p> <p> And individuals and families should be free to customize their insurance coverage. Under the ACA, the federal government has set standards for what all insurance policies must cover. States have long had their own different standards of what is considered must-have coverage, and research has shown&mdash;unsurprisingly&mdash;that states with more mandated benefits also have higher average premiums.</p> <p> A better approach would be to remove such mandates so that people would have the power to choose insurance packages that make sense for them, at a price they can afford.</p> <p> Of course, everyone wants all individuals&mdash;regardless of their financial situation and health status&mdash;to be able to access quality health care.</p> <p> The ACA mandates that insurance companies take all comers. While this may sound like a compassionate regulation, it&#39;s in fact very costly and inefficient. And in spite of the ACA&#39;s labyrinth of rules and subsidies, analysts expect 30 million Americans to still lack insurance after full implementation.</p> <p> There are better ways to target assistance at those in need and make sure that everyone can access quality care. We should focus aid directly on populations that need it, rather than using costly and overly broad regulations to remake the entire healthcare payment system.</p> <p> These are the issues that will be highlighted during Healthcare Solutions Week. It isn&#39;t enough to criticize the 2010 health law. The fact is, our healthcare system had complex and serious issues that needed addressing before 2010, and it still has issues today. We need new and better solutions, and that starts with a sober look at where we&#39;ve gone wrong in the past, and a positive look at how we can improve our healthcare system for the future.</p> <p> <em>Hadley Heath Manning is the health policy director at Independent Women&#39;s Forum and contributing author to &quot;Lean Together: An Agenda for Smarter Government, Stronger Communities, And More Opportunity for Women.&quot;</em></p> HeathWed, 15 Oct 2014 11:10:00 CSTen-usIndependent Women's ForumSafety Issues: Should the FAA do more to prevent Ebola in its tracks? • Cavuto HeathMon, 13 Oct 2014 09:10:00 CSTen-usIndependent Women's ForumPolicy Focus: Doc Fix Problems and Solutions<p> Medicare&rsquo;s Sustainable Growth Rate (SGR) formula, put in place by the Balanced Budget Act of 1997, was meant to control costs in Medicare by automatically reducing doctors&rsquo; pay. But without fail since 2003, Congress blocks SGR&rsquo;s implementation each year. This is called a &ldquo;doc fix.&rdquo;</p> <p> The annual &ldquo;doc fix&rdquo; undermines the original purpose of the formula: to control Medicare costs. But allowing the SGR formula to take effect would lead to other problems. More than 50 million seniors depend on Medicare for health insurance. If physician reimbursement becomes too low, more and more doctors will close their doors to Medicare patients in favor of patients with private insurance. The government needs realistic, market-rate reimbursement policies to ensure that Medicare patients have access to the care they need.</p> <p> The temporary &ldquo;doc fix&rdquo; process is also fraught with politics: Congress often uses the annual doc fix to strike other budgetary deals, and increase contributions from medical associations. Allowing the unrealistic cuts to remain on the books also allows Congress to mask the real, long- term costs of our government health care programs.</p> <p> Clearly, the current system is broken. We need a permanent doc fix to remove doctor pay from Congressional politicking, give certainty to Medicare doctors and patients, and enable realistic cost estimates for our government health care programs. Payment reform should both treat doctors fairly and put Medicare on a fiscally-sustainable path.</p> <p> &nbsp;</p> HeathMon, 6 Oct 2014 14:10:00 CSTen-usIndependent Women's ForumEnrollment anniversary, ObamaCare creating more losers than winners • NewsmaxTV Midpoint HeathWed, 1 Oct 2014 12:10:00 CSTen-usIndependent Women's ForumWhy Does Planned Parenthood Oppose Over-The-Counter Birth Control? Because They'd Make Less Money<p> Planned Parenthood opposes making some forms of routine birth controls available&nbsp;over-the-counter. For an organization that claims to be dedicated to reproductive health and access to such services, this stance on the deregulation of common, safe, and effective contraceptives seems illogical.&nbsp; It is.</p> <p> Over-the-counter birth control would offer new options to women.&nbsp; Consumers would be able to see on the shelf the different products that are available, compare prices, and ultimately select the option that provides them with the best value, just as they choose products in other markets.&nbsp; Providers would truly have to compete for women&rsquo;s business, which would lead to lower prices, more innovation, and better products.&nbsp; What&rsquo;s not to like?</p> <p> One would expect Planned Parenthood and similar organizations to celebrate new calls for easier access, but instead these groups are accusing those calling for OTC birth control of trying to limit its availability by taking away insurance coverage for contraception.&nbsp; A controversial mandate pursuant to the Affordable Care Act requires that nonexempt insurance plans cover all FDA-approved forms of contraception from the first-dollar. This means insured women pay no copay when they pick up their prescription contraceptives.</p> <p> First, even if some birth controls were offered over-the-counter, this would not preclude insurance carriers from offering first-dollar insurance coverage for them. &nbsp;For example, &ldquo;Plan B&rdquo; emergency contraception is already available over the counter, yet the insurance coverage mandate still applies to this morning-after pill.&nbsp; Isn&rsquo;t it a little strange that &ldquo;Plan B&rdquo; is available without a prescription, and yet &ldquo;Plan A&rdquo; (or normal, before-the-fact birth control) is not?</p> <p> Even if more forms of birth control were made available OTC, the insurance coverage mandate could still apply to this class of drugs, and the government insurance program for low-income women, Medicaid, could continue to finance birth control coverage as it does today (from the first dollar), sparing participating women from the (very low) cost of contraception themselves.</p> <p> Yet Americans should ask if covering routine health care costs like contraception is really the best use of our insurance system.&nbsp; Insurance, by definition, is a contractual arrangement in which one party (the member or consumer) pays a premium for financial protection against an unforeseen loss. For example, car insurance is supposed to protect you from the costs of a major car accident, but we don&rsquo;t use it to pay for oil changes or regular maintenance to our cars. Similarly, health insurance isn&rsquo;t supposed to pay for every health care service, but to protect against the costs of a serious, costly disease or injury.</p> <p> From this perspective, it doesn&rsquo;t really make sense to cover safe, normal forms of birth control under insurance at all.&nbsp; And relying on a third party&mdash;our insurers&mdash;to pay for drugs like birth control pills doesn&rsquo;t make them free, but rather it shifts costs from individual consumers to the insured population generally.&nbsp; The cost doesn&rsquo;t disappear; it simply manifests in higher premiums. The HHS contraception mandate&nbsp;<em>could</em>&nbsp;stay in place even if birth control were available over-the-counter, but for the sake of efficiency (among other reasons), it shouldn&rsquo;t.</p> <p> Importantly, making contraceptives available OTC would give women greater access to these products since they would no longer have to see a doctor first.&nbsp; Doctors are on board with this: the American College of Obstetricians and Gynecologists supports making birth control available over-the-counter because they see the benefit of easier access and recognize that individual women are smart enough to be trusted with this safe, common drug.</p> <p> If this debate were as simple as the economics I&rsquo;ve laid out, nearly everyone would support over-the-counter options for birth control.&nbsp; But there are special interests that benefit from maintaining birth control&rsquo;s status as a controlled substance.</p> <p> Big drug companies benefit greatly from the Affordable Care Act&rsquo;s contraception mandate. The mandate means that nearly every woman in the U.S. currently uses first-dollar insurance coverage to buy birth control. This hides the cost of consumption for her, and allows pharmaceuticals to raise the prices that insurers must pay for these products.&nbsp; Those costs are built into our premiums and we all end up paying more as a result. &nbsp;This price-shielding process also encourages the consumption of the covered products (shifting consumers away from non-covered contraceptives, like condoms, or toward the more expensive products among those covered), which can mean big profits for these companies.</p> <p> Planned Parenthood&rsquo;s stance on expanding access to birth control may be illogical in light of their mission statement, but it is perfectly logical when you consider the group&rsquo;s financial interests. Planned Parenthood rakes in $1.2 billion annually; more than a third of their services involve providing contraception to women (and billing third parties for those costs).&nbsp; As a major provider of birth control and the nation&rsquo;s number one abortion provider, why would Planned Parenthood support other options for women?&nbsp; The group is simply serving its own self-interest, trying to hang on to the status quo that leads to big business and big dollars for them. Who&rsquo;s working against women now?</p> <p> &nbsp;</p> <p> &nbsp;</p> HeathMon, 29 Sep 2014 16:09:00 CSTen-usIndependent Women's Forum