Republicans have spent the lat two years going after CMS head Don Berwick for allegedly trying to ration care and establish some sort of centralized health care system, but now the man the GOP has labeled Obama’s ‘Health Rationing Czar’ is telling Politico’s Jennifer Haberkorn that Rep. Paul Ryan’s (R-WI) proposals to voucherize the Medicare program and block grant Medicaid would withhold care from people:
“It is paradoxical really that with all this talk of rationing, the proposal we hear about how to fix American health care is to take it away from people. That’s from the very people who are crying rationing,” Don Berwick, the administrator of CMS, said in a wide-ranging interview with POLITICO. “If you look at the proposed withdrawals of support to Medicare beneficiaries and Medicaid, it’s withholding care from the people who need the care. You tell me what that is?” […]
“When I read proposals for reform that say, ‘Sorry kid, you’re on your own,’ that’s the not the country I want to be in,” he said. “And I don’t think that’s the country the public wants to be in.”
In particular, he said the idea of block-granting Medicaid — an idea endorsed by most of the likely Republican presidential nominees — has short-term attraction as governors deal with crushing budgets but is “unsound” in the long-term.
“Block grants are throwing the states out on their own,” Berwick said. “If we block grant and the next immense influenza epidemic arrives or a major recession comes back, what do we say? ‘Sorry states, you’re on your own?’”
It’s worth noting that the Affordable Care Act also cuts Medicare, but those savings would slow the growth in the program by removing approximately $500 billion from future spending over the next 10 years. It eliminates overpayments to private insurers and slowly phases-in payment adjustments that encourage providers to deliver care more efficiently. The law also gives Berwick and his agency greater discretion to experiment with alternative payment systems — so that providers are compensated for delivering care more efficiently, rather than just ordering more tests — and establishes an innovation center for payment reform.
In other words, the ACA eliminates the inefficiencies in the health care system without sacrificing guaranteed benefits. Ryan, on the other hand, keeps a lot of the waste in the system and simply cuts the federal contribution to Medicare, passing on more of the cost of coverage to seniors without looking at ways to make the program more efficient. He would force Americans under 55 years of age into less efficient private coverage and would then leave it up to those insurers to deny treatment and benefits.