Dear Colleagues:

Our topic for this week is a change of plan. We regret that our originally-scheduled speaker will not be able to join us.

On March 26, the House of Representatives passed H.R. 2, which the New York Times declared included “sweeping changes to the Medicare program.” They’re not “sweeping” but they are significant and passing anything at all is surprising.

The bill is known as the “Doc Fix” because, in addition to some other measures, it would repeal the Sustainable Growth Rate (SGR) formula, a measure to control spending on physician services that, as of April 1, officially imposes a 21% cut on physician fees under Medicare. The issue has festered for more than a decade, with continual “patches” – one or two year postponements – rather than a permanent “fix.” The AMA backed the 2010 health care legislation in part because it expected a “Doc Fix” as part of the deal, but it didn’t happen then, or until now (maybe), because of budget deficit politics.

What’s really surprising, is that the bill was negotiated by Speaker Boehner and Minority Leader Pelosi, and passed by a margin of 392 to 37. President Obama declared that, “this is how Congress is supposed to work.”

At the same time, the bill has been criticized for raising the budget deficit and threatening the welfare of the elderly. It also promises dramatic changes in how doctors are paid, which nobody knows quite how to implement. Is agreement only possible by assuming magical solutions? Maybe….

All best regards,
Joe White
Luxenberg Family Professor of Public Policy and Director, Center for Policy Studies

About Our Guest

Aside from serving as moderator for the Friday Public Affairs Lunch discussion, Joe White also serves as Chair of the CWRU Department of Political Science, Director of the Center for Policy Studies, and has a secondary appointment as Professor of Epidemiology and Biostatistics. His research focuses on federal budget politics and policy; health care, especially cost control and reform; the politics of social insurance programs such as Medicare and Social Security; and differences between rich democracies’ health care systems. His most extensive analysis of Social Security policy is False Alarm: Why the Greatest Threat to Social Security and Medicare is the Campaign to “Save” Them (Johns Hopkins University Press, 2003). Along with his coauthor Aaron Wildavsky, Joe also analyzed the 1983 Social Security legislation in The Deficit and the Public Interest: The Search for Responsible Budgeting in the 1980s (University of California Press and The Russell Sage Foundation, 1991). Some of Joe’s writings on health policy and budgeting can be found at http://policy.case.edu/research/health-care-federal-budget-articles/

Parking Possibilities

The most convenient parking is the lot underneath Severance Hall. We regret that it is not free. From that lot there is an elevator up to street level (labeled as for the Thwing Center); it is less than 50 yards from that exit to the library entrance. You can get from the Severance garage to the library without going outside. Near the entry gates – just to the right if you were driving out – there is a door into a corridor. Walk down the corridor and there will be another door. Beyond that door you’ll find the entrance to an elevator which goes up to an entrance right inside the doors to Kelvin Smith Library.

Friday Lunch Upcoming Topics and Speakers:

April 17: Is It Time For A New U.S. “Grand Strategy?” With Patrick C. Doherty, Co-director, Strategic Innovation Lab at Case Western Reserve University. ***Alternate Location: Clark Hall, Room 206***

April 24: Avoiding Vaccinations: Reasons and Consequences With Irena L. Kenneley, Associate Professor, Frances Payne Bolton School of Nursing.