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Wednesday, December 09, 2009

Smoke and Mirrors

Hearing President Obama say that he would refuse to sign a health care reform bill that added one dime to the deficit, my skeptical mind suspected that some financial smoke and mirrors ultimately would be involved in meeting his requirement.

According to a front-page article of the December 5 issue of the New York Times, legislation adopted by the U.S. House of Representatives and under consideration by the Senate provides for major cuts in Medicare payments for home nursing. These cuts would be one of the sources of money to pay for health care reform.

The article quoted Democratic leaders in both the House and Senate as saying that “These payment reductions will not adversely affect access to care." The House Ways and Means Committee said that the reductions would bring payments in line with costs. The Senate finance Committee said that the changes would encourage home care workers to be more productive.

Nobody suggested how these home care workers would be able to find more efficient ways to do their client’s laundry, clean their bathrooms, check on their medications, help them bathe and carry out the other mundane but important tasks for which they are responsible.

Some years ago the congress adopted a formula to control how much physicians got paid under Medicare. Every year since then, the formula has called for major cuts in fees paid to doctors and a law gets passed preventing its application. So much for cost control.

If the home nursing cuts go through, watch to see if the same procedure isn’t followed.

Politicians like to talk about change, and there always is some.

But most things stay the same.

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