The Congressional Budget Office projects Medicare spending will grow at an average annual rate of 9 percent over the next 10 years, reaching $766 billion by 2015. The Bush administration released an estimate that total spending for Medicare Part D (the new prescription drug benefit) over the period 2006 to 2015 will be about $720…

Read More

Almost all seniors are better off under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, signed into law by President Bush on December 8, 2003. Given the closeness of the vote—220 to 215 in the House of Representatives and 54 to 44 in the Senate—and the nearness to the next election, it is…

Read More

The second term of the Bush presidency is under way, a new secretary for HHS has been chosen, and many are now wondering what will be in store for HHS in the next four years. The short answer is: HHS will be even busier than usual, but there won’t be a lot of new legislation…

Read More

A lot has been written about the adequacy of the drug benefit in the new Medicare Prescription Drug, Improvement, and Modernization Act (MMA) and the political arm-twisting needed to get the legislation through Congress. More recently, considerable attention has also been focused on the $134 billion discrepancy in the 10-year cost estimates of the legislation…

Read More

Between the president’s focus on Social Security and the release of the latest Medicare Trustees report this spring, most of the media’s attention has been focused on these two federal programs. But it is Medicaid that is presenting the more immediate challenge for both the current federal budget and the states. The federal-state Medicaid program…

Read More

Consumer-directed health plans—high-deductible health insurance plans combined with tax-advantaged savings accounts that can be used to cover unreimbursed healthcare expenditures—have generated both a lot of attention and a lot of controversy. For some, these plans represent the most significant promise for moderating healthcare spending to have emerged over the past several decades. For others, they…

Read More

Pay for performance is one of Washington’s most popular healthcare buzzwords. Although the term has raised the ire of some physicians, who seem to think it suggests being paid something “more” for what they are or should already be doing, most have embraced the concept as representing an important payment reform. Two other terms, rewarding…

Read More

It’s one thing to conceive of a pay-for-performance system in health care; it’s quite another thing to set up the system so it will work. In a previous Eye on Washington column, I described the current interest in pay for performance as a way of rewarding practitioners and institutions that “do it well, do it…

Read More