HealthLeaders Media Corner Office - May 15, 2009 | Medicare: Have We Tried Everything Yet? View as a Webpage | Subscribe for Free
Medicare: Have We Tried Everything Yet?
Philip Betbeze, Senior Editor-Leadership

Winston Churchill once said that you can depend on Americans to do the right thing—after they've tried everything else. With Medicare, we've tried just about everything else. So now what? Many believe there is consensus among the special interests that shared sacrifice is better embraced than resisted. So can our representatives be counted on do to the right thing this time? They'd better, if we expect Medicare to live past middle age.
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  May 15, 2009

Editor's Picks
Searching for $90 billion to expand healthcare
Democrats are threatening to play hardball with their attempt to reform healthcare in such a way that healthcare can be provided to however many people you believe are uninsured (I have serious issues with the 47 million number that is so casually bandied about). In any case, to do it will cost about $120 billion a year. President Obama has proposed funding the program with $60 billion in tax increases, but even that is in question as $30 billion of that number is supposed to come from limiting deductions for charitable giving, something Congress opposes. So that leaves about three-fourths of the revenue unaccounted for. Limiting employer tax deductions could fill the hole, but many are skeptical that Congress would do it that way. [Read More]
Urgent care clinics grow as families seek low-cost alternative to ERs
I can't decide whether this is good news for hospitals with overstressed EDs or not. On the one hand, ERs lose money for hospitals if you look at them as a line item. On the other hand, as much as 75% of admissions to the hospital come from them. I've heard differing opinions on the subject. Some hospitals like to dress up their ERs and spend capital and effort making them more efficient, for lots of reasons. My guess is that standalone urgent care clinics as described in this story take away unwanted ER business from hospitals, because such patients don't really need to be in the ER at all. But still, if you don't have a strategy to incorporate urgent care facilities in your hospital or health system's footprint, are you worried about their nearby proliferation? [Read More]
Should Charitable Care Tax Breaks Be Part of Healthcare Reform?
If the federal government does find a way to provide health insurance for the uninsured, presumably their tax breaks for providing charity care would no longer be necessary. Many feel their removal could even largely pay for universal care. It's a quick and easy solution, right? Not so fast. [Read More]

This Week's Headlines
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