Thursday, November 4, 2010

Health Care Act Saves Much Money Peter Orszag, Former Budget Director

Tags: Treatment Trap Overuse of Medical Care Bad Medicine Making Us Sicker and Poorer

I have read two books The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do to Prevent It, 2010, by Rosemary Gibson from the Robert Wood Foundation and Janardan Prasad Singh, an economist at the World Bank and the second books that has lot more about Medicare itself based on the extensive work done at Dartmouth University. Shannon Brownlee a 30 plus medical reporter Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer, 2007.

Every treatment and test has risks not often discussed by doctors. Every CT scan, MRI, and even Colonoscopy can damage your kidneys. Just recently, but well known by workers in MRI, it was announced that a warning of four Gandolinium contrast agents for MRI is required.

Doctors are now conducting heart operations on people with no heart disease, hysterectomies on girls who don’t need them, repeated blood tests, X-rays, MRI, CT Scans, and other tests which are not without risk. For example, if you have fluids going into your veins, it is the most common place to get infections because nurses change fluids without being sterile to save time. This rush kills 100,000 patients from the wrong dose or medications and another 100,000 from infections in hospitals.

Reducing unnecessary procedures will not only save money, but also your life. With left procedures, you will most likely get better care. Hospitals and doctors will be rewarded for not carrying out unnecessary tests and procedures.

I had two close friends who died because of MRSA infections acquired from treatments which contributed to their deaths. These books lists many more.

Jim Kawakami, Nov 4, 2010,


To Save Money, Save the Health Care Act


Published: November 3, 2010 In the name of fiscal probity, the incoming Republican leadership in Congress has committed to doing whatever it takes to stop the health care reform act from taking effect. Yet many of the provisions that politicians have been taking aim at are the ones that save money — like those that reduce excessive provider payments and create new institutions to curb cost growth.


Peter Orszag's Columns for the Opinionator


If the newly elected representatives and senators are truly concerned about rising health care costs, they should work to deploy the law’s cost-containment measures fully rather than try to repeal them.

Sure, the health care law is not perfect, but it would cut the nation’s long-term fiscal imbalance by a quarter and reduce the projected deficit within Medicare by three-quarters. That may seem fanciful, given how distorted the public discussion has become. But that’s what the projections show, as long as Congress sticks to its guns and the Obama administration does a good job carrying out the provisions of the law.

Why do so many people assume that the act does almost nothing to save money? One explanation is that people’s first impressions of health care reform were formed during the summer of 2009, when the debate was dominated by the House bill. In health care reform, there’s always an underlying tension between those who are more concerned about expanding coverage and those who are more concerned about containing costs and improving quality. The House bill tilted toward coverage; the Senate bill, toward cost-effectiveness and quality.

The House bill was legitimately criticized for not doing enough to reduce costs. And that became the prism through which the legislation was and is viewed, even after improvements were later made in the Senate version and in the final law.

Peter Orszag, the director of the White House Office of Management and Budget from 2009 to 2010 and a distinguished visiting fellow at the Council on Foreign Relations, is a contributing columnist for The Times.

The act’s money-saving potential has also been clouded by an essential truth about controlling costs: it’s messy.

There are four ways to contain health care costs: by reducing payments to providers and suppliers; by rationing services; by having consumers pay a greater share; and by giving providers incentives to be more efficient.

The health care reform act includes hundreds of billions of dollars worth of cuts in payments to providers. Lowering payments within Medicare, though, without also reducing the quantity of services provided throughout the health care system ultimately only makes it harder for those on Medicare to find a doctor or hospital willing to treat them, because so many providers stop seeing Medicare patients. …

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