July 22, 2014

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Thursday, January 14, 2010 - 12:05 PM

The Concord Coalition is looking to hire a research assistant to help with the Washington Budget Report and other Concord policy work.

For the full position listing and application submission click here.

Tuesday, January 12, 2010 - 11:48 AM

In my previous post, I spent some time clarifying how “advance care planning” is in no way, shape or form the same as a “death panel,” and how palliative care does not equate to any "rationing of care." Rather, both these health care interventions are patient-centered and improve the value of the health care experience for severely, chronically, and terminally ill patients and their families.

As Congress resumes its work and health reform continues to dominate talks on Capitol Hill, I'd like to put these in context given the status of health reform today.

The philosophy behind advance care planning fits nicely with the promotion of an Independent Payment Advisory Board tasked to make recommendations to Congress on slowing future Medicare cost growth. Similarly to advance care planning, where potential treatment options and often difficult decisions are discussed prior to a health crisis, the Independent Payment Advisory Board (IPAB) is being asked to evaluate the tough choices facing the longevity and fiscal health of the Medicare program in advance of a federal budget crisis. The Advisory Board would be made up of health care experts, people who entered their professions because...

Friday, January 8, 2010 - 4:15 PM

When discussing health care reform, if we cannot even be clear that “advance care planning” is in no way, shape or form the same as a “death panel,” how will we ever be able to talk about the real (and factual) challenges facing the Medicare program and its long-term sustainability?

Ugh….

Let’s be clear: there are no “death panels” included in the health reform bills adopted by the House of Representatives and the Senate, although misinformation on this topic has been swirling for months. For example, last August during the Congressional recess I was quite distraught when my own Senator Charles Grassley stated in an Iowa town hall meeting that he was worried that efforts to increase the efficiency of Medicare or to create an Independent Medicare Advisory Commission would indeed mean that the federal government would be making decisions about when to “pull the plug on Grandma.” More recently, the clause in the House bill that allowed reimbursement to Medicare providers who hold “advanced care planning consultations” with their patients has been equated with a “death panel” deciding when a senior would die.  Nothing could be further from the truth.

Having studied end of life care in graduate school and...

Wednesday, January 6, 2010 - 10:57 AM

When we finished our issue brief on the health care reform "endgame" before the holidays, we had a difficult time trying to isolate the key 10-year costs and savings of different components of the legislation. Now that we have had a bit more time with the final House and Senate versions of the legislation and the CBO analyses, we wanted to present the following table:

 House BillSenate Bill
Insurance Coverage Expansion1052871
   
Minus Offsets  

Spending Cuts

352413
CLASS Act10272
Tax Increases570474
Penalties16843
Subtotal (offsets)1,1921,002
   
Deficit Reduction-138...
Wednesday, December 23, 2009 - 4:07 PM

With the House having passed its version of health care reform (H.R. 3962) and the Senate on the verge of passing its version (H.R. 3590), the outline of a final bill is beginning to take shape. In our new Issue Brief, we look ahead at the fiscal considerations that will likely be the subject of conference committee discussions and “end game” negotiations. These include the cost of expanding coverage, the methods used to prevent that cost from adding to the deficit, and the prospects for systemic reforms to reduce cost growth over time. 

This issue brief gives The Concord Coalition’s perspective on how the bills measure up, what the risks are and how these risks could be lessened. We conclude that:

•    Both bills establish...
Tuesday, December 22, 2009 - 11:46 AM

U.S. House Speaker Nancy Pelosi and other members of Congress got a lot of good advice recently when representatives of The Concord Coalition’s fiscal advisory councils visited Capitol Hill to present their recommendations.

The basic message: Elected officials must make some dramatic changes to put the country on a more responsible fiscal course, protect our economic future and avoid saddling our children and grandchildren with massive debt.

Advisory council members from across the country -- Atlanta, Iowa, Milwaukee, Northern California and Philadelphia -- met with members of Congress and their staffs as part of The Concord Coalition’s National Conference of Fiscal Stewardship this month in Washington. The Fiscal Advisory Council of Northern Virginia had already met with several members of Congress in the fall. Representatives from the University of Denver, where the Fiscal Stewardship Project featured a special student engagement initiative this year, also attended the conference and met with elected officials.

In the conference’s opening...

Thursday, December 17, 2009 - 1:48 PM

As mentioned in the last post, the Senate dramatically weakened the Independent Medicare Advisory Board in the health care legislation currently being debated.

Today, Concord released an issue brief discussing this and highlighting the fact that there is an amendment being proposed by Senator Rockefeller that would restore the board's potential for cost control and delivery system reform. 

The legislative process right now is quite a jumble and it is unknown whether any amendments still have a chance to be voted on or folded into the final "manager's amendment." Hopefully, Senators concerned about cost control will see the wisdom in still altering the bill to strengthen its provisions on that score. Ruth Marcus at the Washington Post had a good column about this in the paper yesterday.

Tuesday, December 1, 2009 - 10:51 PM

As you have read here, here, and here, The Concord Coalition firmly believes that having an independent Medicare commission is one of the most important elements being considered in current health care reform legislation. Without the commission -- which would be empowered to continuously evaluate Medicare costs and propose changes to the delivery of care that might be able to help reduce system-wide health care costs -- it is doubtful that current legislation will succeed in reducing long-term health care inflation. 

Unfortunately, the bill currently being debated in the Senate has effectively neutered the commission's powers (and the House didn't even have a commission in their bill). As pointed out by David Leonhardt in the New York Times, the Senate directs that the commission leave doctors and hospitals untouched by its recommendations for the first four years of its...

Monday, November 16, 2009 - 12:29 PM

For the last few weeks, members of Congress have been increasingly pushing for a bipartisan commission to tackle the nation's fiscal challenges. The impetus has been the need to raise the debt limit as the national debt rapidly approaches the $12 trillion statutory ceiling. Because legislation to raise the debt limit is must-pass, lawmakers are trying to tie commission creation to the legislative language. Senator Evan Bayh highlighted this issue in a letter to Majority Leader Harry Reid, which was co-signed by nine additional senators. The Blue Dog coalition of Democrats in the House also recently announced their support for a commission.

Last week, Budget Committee Chairman Senator Kent Conrad held...

Wednesday, November 11, 2009 - 11:01 AM

This week marks the debut of Concord's new, online budget game -- The Federal Budget Challenge.

Based on our Principles and Priorities game, which has been used for years in hundreds of classrooms and town hall meetings across the country, users work through 11 different policy categories and choose the spending and tax policies that fit their preferences while being mindful of their budgetary effects.

Developed in partnership with the California-based non-profit Next 10, this online tool tracks the effect of individual policy choices on interest costs and the projected 10-year budget deficit as the choices are made. The game has already been mentioned in The Wall Street Journal and The New York Times.

It is important to point out what this game is and isn't. The...