Providers find lit­tle com­fort in de­feat of deficit com­mis­sion’s fi­nal re­port

Deficit re­port gar­ners more sup­port than ex­pected

Modern Healthcare - - Front Page - Jes­sica Zig­mond

Afi­nal re­port from Pres­i­dent Barack Obama’s debt-re­duc­tion com­mis­sion did lit­tle to com­fort providers who balked at last month’s draft rec­om­men­da­tions they said would jeop­ar­dize pa­tients and com­mu­ni­ties.

And enough of the com­mis­sion’s mem­bers flinched, too, so that the am­bi­tious re­port won’t re­ceive for­mal con­sid­er­a­tion by the House and Se­nate. Last week, 11 mem­bers of the 18-mem­ber Na­tional Com­mis­sion on Fis­cal Re­spon­si­bil­ity and Re­form ap­proved the fi­nal re­port, which aimed to achieve nearly $4 tril­lion in deficit re­duc­tion through 2020 and en­sure the sol­vency of So­cial Se­cu­rity.

Called The Moment of Truth, the plan has six com­po­nents, in­clud­ing dis­cre­tionary spend­ing cuts, com­pre­hen­sive tax re­form, manda­tory sav­ings, So­cial Se­cu­rity re­forms, process re­forms and health­care cost con­tain­ment. In Novem­ber, the com­mis­sion’s co-chair­men, Ersk­ine Bowles, for­mer chief of staff to Pres­i­dent Bill Clin­ton, and Alan Simp­son, a for­mer Repub­li­can sen­a­tor from Wy­oming, re­leased a draft pro­posal of the re­port (Nov. 15, p. 6). While the fi­nal re­port did not re­ceive the re­quired 14 votes needed to send it to Congress, it did re­ceive ma­jor­ity ap­proval, which en­cour­aged com­mis­sion mem­bers that their work will ini­ti­ate se­ri­ous dis­cus­sion among fed­eral law­mak­ers about fis­cal sta­bil­ity. Sen. Mike Crapo (R-Idaho) re­minded his fel­low mem­bers that 60% ap­proval is enough to pass leg­is­la­tion in Congress, and that a lack of 14 votes doesn’t sig­nal an in­abil­ity of mem­bers to move ahead ag­gres­sively on this is­sue.

Some com­mis­sion mem­bers, in­clud­ing Andy Stern, pres­i­dent emer­i­tus of the Ser­vice Em­ploy­ees In­ter­na­tional Union, de­vel­oped their own sep­a­rate plans. And oth­ers in­di­cated that some of the re­port’s rec­om­men­da­tions will be used in bud­get plans in Congress. In the end, six of the law­mak­ers on the com­mis­sion—three Repub­li­cans and three Democrats—ap­proved the re­port.

The nation’s fed­eral debt has in­creased to 62% of gross do­mes­tic prod­uct from 33% of GDP in 2001, the last year the U.S. had a bal­anced fed­eral bud­get, ac­cord­ing to the re­port. While health­care providers agree there is a great need to lower the debt and fos­ter eco­nomic growth, some ques­tioned—for a sec­ond time—the re­port’s bid to slash pay­ments to health­care af­ter sub­stan­tial changes and re­duc­tions out­lined in the Pa­tient Pro­tec­tion and Af­ford­able Care Act, such as $155 bil­lion in cuts to hos­pi­tals over 10 years.

“What’s dis­ap­point­ing is that there doesn’t seem to be a con­nec­tion be­tween con­gres­sional ac­tions ear­lier this year and these re­duc­tions,” said Tom Nick­els, se­nior vice pres­i­dent of fed­eral re­la­tions at the Amer­i­can Hos­pi­tal As­so­ci­a­tion.

The Na­tional As­so­ci­a­tion of Pub­lic Hos­pi­tals and Health Sys­tems said a num­ber of the re­port’s rec­om­men­da­tions are likely to cause prob­lems for hos­pi­tals: a cut to the Medi­care

Nick­els: Dis­con­nect with re­form cuts from ear­lier ac­tions.

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