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CBO finds coalition savings proposals difficult to verify

The Congressional Budget Office concluded in a June 16 letter that most of the more than $1 trillion in health system savings proposed by the American Medical Association and five other major groups either lack enough detail to be evaluated or would not involve the federal government, and therefore would not reduce government health care spending.

The CBO letter was in response to a request by Rep. Dave Camp (Mich.), the highest-ranking Republican on the House Ways and Means Committee. The proposals were made by the six organizations to help President Obama slow the annual growth in health spending by 1.5% over a decade, or at least $2 trillion, as part of national health system reform.

Nevertheless, previous CBO analyses have found that several of the ideas would produce savings. For example, reducing Medicare payments to hospitals with high readmission rates and capping noneconomic and punitive damages in medical liability cases would each save at least $5 billion over a decade.

But the CBO also said some of the proposals the six organizations presented as a way to save money over the long run initially would increase federal government spending. "If the health care industry is serious about helping to reform health care, I would suggest they go back to the drawing board and help us find real savings for the American people," Camp said.

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Most support public plan, trust physicians' opinions on health reform

Americans support many of the key elements of Democratic health reform legislation, according to the June Kaiser Health Tracking Poll, conducted June 1-8 with a sample of 1,205 adults.

For example, at least 65% support creating a public insurance plan to compete with private plans, 71% back an individual mandate to buy health insurance, and 75% agree with expanding state government programs for low-income people. But more than half of respondents oppose changing the tax exclusion for employer-sponsored health benefits, a move some Democrats are considering to help pay for national health reform (www.kff.org/kaiserpolls/posr061609pkg.cfm).

Most Americans also trust physicians' recommendations on health reform. Seventy-three percent of respondents said they were confident that doctors would recommend the right changes for the health system -- the highest of any group -- according to a June 13-14 Gallup poll based on interviews with 1,009 adults. In the same poll, 62% said they trust health care professors or researchers to do the same, 61% had faith in hospitals, 58% in President Obama, 42% in congressional Democrats and 34% in congressional Republicans (www.gallup.com/poll/120890/healthcare-americans-trust-physicians-politicians.aspx?csts=alert).

But more than half of respondents to the Kaiser poll said they believe physician organizations are not supporting efforts by the president and Congress to reform the health system this year.

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Legislation seeks to improve cancer treatment options

Sens. Arlen Specter (D, Pa.) and Pat Roberts (R, Kan.) introduced a bill June 11 designed to improve the delivery of cancer care treatment to patients.

The Medicare Prompt Pay Correction Act would amend part of the Social Security Act to revise payments for drugs and biologics under Medicare Part B. It excludes prompt-pay discounts customarily extended to wholesalers from the calculation of the manufacturers' average sales price. The senators said these discounts artificially reduce Medicare Part B drug payment rates to community oncology clinics, thereby endangering patients' access to quality, affordable cancer care in their communities.

"Community care clinics play a critical role in our nation's fight against cancer, especially in rural areas where families do not have access to larger centers," Specter said.

A companion bill has been introduced in the House and has 45 co-sponsors. The legislation is also supported by the Community Oncology Alliance, a nonprofit organization based in Washington, D.C.

The print version of this content appeared in the July 6, 2009 issue of American Medical News.

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