The Center for American Progress (CAP) on Wednesday released a proposal that would cut $385 billion from U.S. health care expenditures without shifting the burden of costs onto America’s seniors and the middle class.

Dubbed “The Senior Protection Plan,” the proposal was unveiled in the face of impending budget negotiations between President Obama and Congressional leaders that will have enormous consequences for the federal safety net, particularly Medicare and Medicaid. While Obamacare has already made significant cuts to health spending, patient advocacy and provider groups have expressed concerns that a forthcoming “grand bargain” aimed at further reducing the federal budget deficit might be brokered on the backs of poor, elderly, and sick Americans.

Instead of instituting cuts that would only nominally reduce health care spending by cutting Americans’ health benefits and raising their premiums and out-of-pocket costs — as Republican proposals to slash Medicaid funding and turn Medicare into a voucher program would do — CAP’s plan hones in on the systemic factors that drive long-term medical inflation. Here are five proposals from the Senior Protection Plan aimed at cutting national health costs in a fair manner while improving the efficiency and quality of health care delivery to elderly and low-income Americans:

1) Reduce low-income Americans’ prescription drug costs. Drug manufacturers pay significantly lower rebates for drugs provided to Medicare beneficiaries than they do for drugs provided to Medicaid beneficiaries. This has led to drug companies shifting prescription drug coverage for so-called “dual eligibles” — particularly sick and poor Americans who qualify for both Medicare and Medicaid — from the Medicaid program into the Medicare prescription drug plan, allowing the companies to reap massive profits without providing these vulnerable Americans any tangible benefit. The Senior Protection Plan would extend the higher Medicaid prescription drug rebates to brand-name medications purchased by dual eligible, low-income Medicare beneficiaries, leading to more affordable drug coverage for the poorest Americans as well as significant cost savings in the lucrative drug industry. Altogether, these proposals would reduce spending by $160 billion.

2) Curb waste and excessive payments to Medicare providers. The plan calls for an additional $88.6 billion in savings by bringing Medicare reimbursement rates in line with the actual costs of care while rooting out fraud and administrative waste in the program. Skilled nursing facilities, rural hospitals, and home health providers currently receive as much as $33 billion in excess payments, while Medicare overpays hospitals for inpatient services that are no more complex or time-consuming than less costly outpatient procedures. While the Obama Administration has been aggressive in cracking down on fraud in Medicare, the Senior Protection Plan finds even more savings by asking providers and caregivers to share eligibility, claims, and benefits information electronically, while aggressively pursuing perpetrators of Medicare billing fraud.

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This post was filed from Doctors For America’s 2012 National Leadership Conference in Washington, D.C.

Zeke Emanuel — long caricatured by conservatives for supposedly supporting the rationing of care — assured a group of doctors attending Doctors For America’s annual conference on Monday morning that the health law would not control health care costs by rationing care. The law, he argued, will begin to change system incentives to encourage providers to deliver care more efficiently:

EMANUEL: We are spending $2.6 trillion…no one when we talk about cost control — no one, let me repeat, no one is talking about getting us from $2.6 to $2.7 trillion to $2 trillion. We’re talking about slowing the rate of growth. There is going to be plenty of resources in the system….Nobody is talking about health care costs going down. We’re talking about slowing the rate of growth. That’s what cost control is — control, not cost savings.

Indeed, the Congressional Budget Office (CBO) projected in 2011 that between 2013 and 2021, “growth in spending will be restrained by reductions in updates to payment rates that were included in the 2010 health care legislation.”

This post was filed from Doctors For America’s 2012 National Leadership Conference in Washington D.C.

Zeke Emanuel — a senior fellow at the Center for American Progress — addressed the Doctors For America’s 2012 National Leader Conference Monday morning and urged physicians to remain engaged in the nation’s health care debate. Emanuel predicted that the Affordable Care Act will succeed in expanding coverage and slowing the growth of health care spending by 2020, but stressed that the biggest changes will occur in how health care providers deliver services to patients — an area which doctors must lead in shaping, he maintained.

Health care systems around the country are already moving away from the existing fee-for-service reimbursment system and coordinating care in a way that improves efficiency and care quality. These successes contain valuable lessons for the kind of delivery reforms the ACA hopes to foster and offer a glimpse into the system of the future. Emanuel explained what those changes will look like, relying on the real-world experiences of Group Health of Puget Sound in Washington state:

1) “It doesn’t look like lone doctors working alone. It looks like health care teams of doctors working with nurses, working with public health professionals.” Specialized groups of providers are better equiped to provide personalized care to patients with multiple chronic conditions, who consume two-thirds of the health care dollars.

2)”You don’t wait for the patient to come to you. You have active outreach to patients.” Providers track their pateints’ physiological indicators and call them to ensure that they’re complying with medication and other interventions.

3) “You have electronic health records so you can track patients over time … so that you can track physician, nurse and other quality performance in your group.”

4) “You also don’t treat patients individually. You have team huddles, you have team plans. You standardize care for patients.”

5) “You also create specialized clinics for chronic problems, have the best people you have doing that over and over.”

The results have been impressive. Sine adopting the changes, Group Health experienced a six percent drop in readmissions, a six percent decrease in length of stay, decreases in physician visits, but a dramatic increase in telephone calls and email communications. Most remarkably, the new system saved $1.50 for every $1.00 invested in the re-engering process over a 21-month period.

Providers also experienced a boost in morale “because the health staff finally felt like they were practicing the medicine they were trained to and not just doctor reimbursment,” Emanuel stressed.

That’s the future providers can look forward to. And now, they have to work to make sure it becomes a reality.

It’s hard to believe that Republicans take the health care debate very seriously when Sen. Ron Johnson (R-WI) — one of the party’s main spokespeople on Obamacare — doesn’t even know the number of uninsured in his own state. During an appearance on MSNBC ‘s ‘Morning Joe’ on Monday, Johnson sought to dismiss the success of Massachusetts’ reform in lowering the number of uninsured by claiming that the state had most of its people covered before Mitt Romney enacted Romneycare in 2006. He then went on to falsely claim that his home state of Wisconsin enjoys similarly high rates of insurance coverage:

ZEKE EMANUEL: Look at Massachusetts, which does have an individual mandate. Has a market just the way the president’s Affordable Care Act put into place. What has happened to premiums in the individual market there? They have gone down 40 percent compared to a 14 percent increase in the rest of the country.

JOHNSON: Massachusetts already had a very high level of people insured, as does Wisconsin. Wisconsin did not need health care law to get 95 percent of the people insured.

EMANUEL: You do not have 95 percent — you have 89 percent …you don’t have 95 percent. Only in Massachusetts has over 95 percent ….

JOHNSON: In Wisconsin we have 95 percent.

Watch it:

A man who supports the complete repeal of the Affordable Care Act — while personally enjoying tax-payer supported insurance as a U.S. senator — may not be too concerned about how many people actually don’t have insurance in his own state. But according to the latest Census, nine percent of Wisconsinites are uninsured, which means that the insurance rate is at about 91, four points below Johnson’s proclamation (not to mention that 30 percent are insured through government-financed Medicare or Medicaid; 60 percent have employer-based coverage or buy insurance on the individual market).

During the segment Steve Rattner also pointed out that should the Supreme Court strike down the Affordable Care Act’s individual mandate, 16 to 20 million Americans would lose their health insurance coverage and private health insurance premiums would increase by 15 percent. But here too, Johnson seemed unperturbed, dismissing the estimates by inexplicably claiming that the ACA’s system of private insurers and providers would lead to greater “government control.”