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Sen. Mike Johanns

Sen. Mike Johanns

U.S. Sen. Mike Johanns is a former U.S. Secretary of Agriculture, Nebraska governor and Lincoln mayor.

Address: 404 Russell, Senate Office Building, Washington, DC 20510

Phone: (202) 224-4224
Fax: (202) 228-0436

You may contact Senator Johanns by emailing mike_johanns@johanns.senate.gov. If you would like to receive a response from Senator Johanns, please ensure you include your name, full address, and phone number.

Opinion

Medicare, Medicaid should not pay for health care reform

Tuesday, August 4, 2009

Dear Nebraskans,

The Senate is wrapping up its final days before adjourning until Labor Day. Even though no health care legislation has come to the floor in the Senate or the House of Representatives, health care remains a hot topic. Both houses have proposals working through the committee process, which have struggled in committee because they are significantly flawed. I, as well as my colleagues on both sides of the aisle, have many concerns as to how our current government programs, Medicare and Medicaid, will be funded given the provisions in these bills. As the weeks go on, creating a government-run health care system seems more and more foolish.

Legislation in the House of Representatives outlines about $500 billion worth of cuts to Medicare. This money would be taken out of Medicare and used to help fund the new government-run health care system. Medicare is already projected to be bankrupt by 2017, and it baffles me that some of my colleagues are actually proposing to take money out of it while simultaneously expanding the federal government's health care obligations. With so many elderly Americans relying heavily on Medicare, this proposal makes no sense.

I have similar concerns regarding Medicaid. Both the Senate and the House bills propose to significantly expand Medicaid. The National Governors Association (NGA), estimates this expansion will impose on states an unfunded mandate of nearly $130 billion annually. When I was Governor, we worked hard to ensure Medicaid reached as many eligible people as possible while carefully fitting it into a balanced budget. This provision threatens to completely upend Nebraska's budget. NGA projects this unfunded mandate will cost Nebraska $186 million annually. This money will have to be raised by either cutting other programs or raising taxes. Tough decisions about funding education and other important priorities get even harder within this new financial landscape.

In light of all this, I introduced a resolution that puts Senators on record for or against protecting Medicare funding and protecting state budgets from this enormous unfunded mandate. It says any savings found within Medicare should be inserted back into the program to help its financial viability. Just last week, the Congressional Joint Economic Committee reported that if these savings were applied toward Medicare's unfunded obligations, it would keep the program afloat an extra two years, and would reduce the accumulated Medicare shortfall by $7.3 trillion over the next 75 years.

My resolution would also ensure that creating a new, government-run system would not burden states with unfunded mandates in order to expand Medicaid. States like Nebraska, which strive to achieve a balanced budget year in and year out, simply cannot afford such costs. Medicaid is already causing financial chest pains in Washington. A Medicaid expansion would put state budgets into full blown cardiac arrest. Washington can do better. We owe it to you--the people we serve--to do better. I look forward to hearing more of your ideas and concerns as I travel throughout Nebraska for the next few weeks.

Sincerely,

Mike Johanns

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  • -Some say we don't have faith in government, others say, we will be forced out.-

    -No Tax, No Saving, That means No Way To Reform.-

    What kind of music should this reform dance to ?

    U.S. health care consumers are usually one step removed from the cost because they are covered by employer-provided insurance, which might operate as a formula for a slow pace of transfer, along with the code of mandate.

    And I share the opinion that unlike the insurer-friendly, baseless senate plan by 'some' members, only a 'strong' public option by this new administration will be capable of getting the premium inflation under control and saving the U.S in turbulence.

    To my knowledge, a dual system tends to deliver better results than a pure single payer system. Supposedly, to be or not to be might be up to the innovations like a pay for value program, otherwise, the forthcoming start-ups may fill the void with competitive deals. The competition based on 'fair' market value would be a beauty of true capitalism, not monopoly, an objective for anti-trust.

    All free states as a nation / one body, and a fundamental human right, cover all their people. The debate about a human right, or public policy

    in America is puzzling them now.

    -- Posted by hsr0601 on Wed, Aug 5, 2009, at 10:57 AM
  • The 'innovative' idea of a 'pay for value / outcome' pack came after the CBO had previously pointed out this health care reform wouldn't work without 'fundamental' change in the out of date system. It is said that as much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients, and this 700 billion dollars a year can cover a lot of uninsured people.

    The expected Benefits of this 'innovative idea' are as follows ;

    1. Meet the objective of revenue-neutral.

    Supporters of the agreement say it could save the Medicare System more than $100 billion a year and 'improve'

    care, that means more than $1trillian over next decade, and virtually needs no other resources including tax on the

    wealthiest. Supposedly even the 'conservative' number of such savings might be able to meet the objective of

    revenue-neutral.

    2. Quality and affordability.

    If you are a physician, and your pay is dependant upon your patient's outcome, you will most likely strive to

    prescribe the best medicine earlier in the process, let alone skipping the wasteful, unnecessary treatments.

    3. No intervention in decision-making.

    The innovative idea of 'a pay for outcome' will more likely prompt team approach and decision, as at Myo clinic.

    Under the 'pay for outcome' pack, for good reason, best practices as 'recommendations' would simply help them

    make a better decision, and the government won't still have to meddle in the final, actual decision-making

    process as a non-expert.

    4. Speed up the introduction of IT SYSTEM.

    The pay for 'Outcome' pack is most likely to expedite the introduction of Health Care IT SYSTEM.

    The synergy effect of the combined Health Care IT & a pay for 'outcome' system may allow the clinicians to

    'correctly' diagnose and effectively treat a patient earlier in the process so that it can measurably scale back the

    crushing lawsuits and deter the excuse for unnecessary cares to make fortunes.

    5. Accelerate the progress in medical science, in return, it saves more cash.

    6. Settle the regional disparity.

    7. Reduce the emergency room visits & save immense costs.

    Public health insurance plans such as Medicare and Medicaid paid for more than 40 percent of U.S. emergency

    room visits in 2006, according to government figures released recently. Many experts say reducing these hospital

    visits would be an important way to lower the enormous, and growing, expense of U.S. health care.

    I share the opinion that unlike the insurer-friendly senate plan by 'some' members, only a strong public option will be capable of getting the premium inflation under control and saving the U.S in turbulence.

    To my knowledge, a dual system tends to deliver better results than a pure single payer system. Supposedly, to be or not to be might be up to the innovations like a pay for value program, otherwise, the forthcoming start-ups may fill the void with competitive deals. The competition based on 'fair' market value would be a beauty of true capitalism, not monopoly, an objective for anti-trust.

    Thank You !

    -- Posted by hsr0601 on Wed, Aug 5, 2009, at 10:58 AM
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