In the midst of President Obama’s call for new Republican health care proposals, Matt Corley digs up this idea from retiring senator Kit Bond (R-MO). Bond is proposing “giving Medicare enrollees a voucher to buy health insurance on their own.” “You’re going to have to means-test the benefits,” he said, adding that upper income retirees wouldn’t “get much of a voucher.”

In essence, Medicare enrollees would receive a voucher to either purchase traditional coverage in Medicare or buy into a private insurance program. The idea sounds simple enough, but it’s actually fairly radical. Republicans want to transform Medicare from a fixed benefit to a fixed contribution. Beneficiaries would have to make up the difference between the value voucher and the cost of a particular health insurance plan — an amount that will only increase over time as health care costs outpace the value of a income-based voucher. The voucher will buy less coverage every year, forcing seniors to pay more for the same coverage. Essentially, they’re shifting the cost of insurance from the government to the individual.

As one analysis of a voucher proposal concluded, “this approach would undermine the basic protections offered by Medicare as a social insurance program, by relegating lower-income beneficiaries to lower-cost, and possibly lower-quality, plans.”

But that’s only the beginning. If Medicare becomes a fixed premium program, it will be much easier for Washington to control Medicare costs by simply trimming the level of the fixed contribution — undermining the health security of America’s poorest senior citizens.

President Barack Obama hinted that he may incorporate some Republican tort reform proposals into the existing health care reform legislation, but warned that “bipartisanship cannot mean simply that Democrats give up everything they believe in, find the handful of things Republicans have been advocating for and then we do those things.” “There’s gotta be some give and take..and that’s what I hope is accomplished,” Obama said of the forthcoming February 25th health summit:

Let’s establish some common facts. Let’s establish what the issues are, what the problems are and let’s test out, in front of the American people, what ideas work and what ideas don’t. And if we can establish that factual accuracy about how different approaches would work then I think we can make some progress. And it may be that some of the facts that come up, are ones that make my party a little bit uncomfortable.

Watch it:

“If it’s established that by working seriously on malpractice and tort reform, that we can reduce some of those costs, I’ve said from the beginning of this debate, I’d be willing to work on that,” Obama said. “On the other hand, if I’m told that that’s only a faction of the problem and that’s not the biggest driver of health care costs, then I’m also going to insist ‘okay, let’s look at that as one aspect of it, but let’s do what we were going to do,’” Obama added.

The Congressional Budget Office (CBO) has recently estimated that common Republican tort reform proposals — like capping awards for noneconomic damages — could save the federal government $54 billion over 10 years, but some progressives have questioned the budget office’s conclusion. In a letter to CBO director Douglas Elmendorf, Sen. Jay Rockefeller (D-WV) argued that the new CBO report reverses years of precedent and relies on academic studies that actually undermine the savings projection. “CBO has repeatedly concluded that cost savings associated with medical malpractice reforms would be minimal and the at evidence concerning defensive medicine is ‘inconsistent,’” Rockefeller wrote, noting that the budget office has previously determined that “the effect of medical malpractice reform “would be relatively small — less than 0.5 percent of total health care spending” and would “save [only] $5.6 billion over 10 years.””

In September, Obama directed Health and Human Services Secretary Kathleen Sebelius to authorize “demonstration projects in individual states” to test various approaches to tort reform. The Senate health care bill includes money for such demonstrations.

While in the Senate, Obama also co-sponsored “legislation aimed at reducing both medical errors and lawsuits through a program known as Sorry Works, rooted in the idea that injured patients value an apology as much as money.” That legislation would have given physicians who disclosed their errors “certain protections from liability within the context of the program, in order to promote a safe environment for disclosure.“

This morning, during a panel discussion at the Academy Health National Health Policy Conference, a top Pelosi policy aide said that the reconciliation process was “the only way” for Democrats to salvage health reform in the aftermath of the Massachusetts election. “There is only one way to get it done at this stage of the game and that’s a process that the Speaker has outlined,” Wendell Primus, Pelosi’s legislative director said. Congress would have to pass the Senate health care bill alongside a package of fixes using reconciliation.

“The House would have to take up that first because it would involve revenue changes and then the Senate would pass it and then I think hopefully with the passing of that legislation, the House, only then would take up the Senate bill and pass it.”

“The trick in all of this is that the President would have to sign the Senate bill first and then the reconciliation bill would be signed second and the parts of the reconciliation bill that trump the relevant portions of the first signed bill.” “You would really have to use the fact that a later enacted bill takes precedent over a previously enacted bill to achieve the right outcome.” Primus added. He predicted that the reconciliation package of fixes would have to increase the threshold on the Cadillac tax, include more affordability credits, close the donut hole in the Medicare Part D drug benefit, and eliminate the Cornhusker Kickback.

Other Congressional aides agreed with Primus’ assessment and argued that it would be almost impossible to put together a smaller package that achieves any of the Democrats’ objectives because many provisions are interconnected. The staffers also predicted that if Congress fails to pass health care reform before the budget window closes, it’s unlikely that future administrations would take-up the effort.

In October, Rep. Eric Cantor (R-VA) cautioned President Obama against negotiating with Iran. “The unfortunate reality for President Obama is that there is absolutely no evidence that Iran is willing to reach any agreement acceptable on U.S. terms,” Cantor wrote in an editorial for POLITICO. “The key point is that we have been down this road before – and it has reached a dead end.” Obama should demand immediate concessions “No exceptions, no excuses,” Cantor insisted.

But his warning against negotiating with a stubborn partner does not extend to the health care debate. Although Republicans have chosen to demagogue the health care reform for the better part of a year, Cantor is still asking President Obama to abandon the existing legislation. While we’re not comparing the GOP to Iran, if the President were to adopt Cantor’s own policy for engagement, Republicans would be excluded from any further negotiations.

No illusions on Iran Health reform
By REP. ERIC CANTOR

It’s a defining moment for the administration and its new policy of engagement with our enemies Republicans. As Iran Republicans moves inexorably towards becoming a nuclear power obstructionist minority, the U.S. Obama will join Great Britain, France, Russia, China and Germany House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid Thursday [February 25th] in Geneva at the Blair House in an effort to prod the Islamic Republic Republicans to change course. The unfortunate reality for President Obama is that there is absolutely no evidence that Iran is Republicans are willing to reach any agreement acceptable on U.S. terms – much less use negotiations for any purpose other than to buy more time for its illicit nuclear enrichment activities obstruction.

Engaging Iran Republicans on the nuclear health care issue is nothing new. Attempts by Great Britain Max Baucus, France Harry Reid and Germany Nancy Pelosi from 2003 to 2005 2009 to 2010 to negotiate a suspension of the Islamic Republic’s nuclear program Republican filibusters were an exercise in futility. As both sides talked, IranGOP only stepped up its enrichment activities obstructionism. In the same vein, Iran Republicans rejected a generous U.S.-supported Western Baucus/Gang-of-six package of political and economic concessions offered three years several months ago by the West Democrats in exchange for a stop to Iran’sthe GOP’s nuclear program obstructionism.

The key point is that we have been down this road before – and it has reached a dead end. This time around we simply don’t have the luxury of time.

[...]

That’s why tomorrow on February 25h in Geneva Blair House our bottom line must be an immediate halt to Iran’s nuclear enrichmentGOP obstructionist capabilities. No exceptions, no excuses.

[...]
Yet even as we head into negotiations predestined to fail, the temptation remains to bury our heads in the sand, hope and pray that somehow this time Iran will act differently, and play along with Iran’s the GOP’s stalling game. This is a mistake because it gives Iran the GOP the idea that regardless of what it says or does, the West the Democrats will inevitably come crawling back to the table out of desperation.

President Obama is following through on his controversial pledge for the United States to sit down and talk with Iran Republicans. But in doing so he cannot be afraid to call Iran’s the GOP’s bluff and pursue a different course. [...]