For your Tuesday afternoon:

Congressional Budget Office Director Douglas Elmendorf posts on the agency’s most recent long-term budget outlook.  According to Elmendorf, Medicaid, Medicare and Social Security alone account for account for 80 percent of the growth in spending over the next 25 years and 90 percent over the next 70 years.

Tevi Troy of the National Review Online’s The Corner cites a Chicago Tribune story that said “it’s not uncommon for a physician to be paid $25 to $75 for a Medicaid patient’s routine visit,” to conclude: “If doctors are already reluctant to participate in existing government run plans like Medicare and Medicaid, adding an additional public plan could discourage them even further.”

Peter Suderman of the libertarian magazine Reason has a piece explaining why he believes “[health] reform efforts are now in disarray,” specifically because of attempts to include a public plan option.

TPM Muckraker’s Zachary Roth reports that health care is “characterized by consolidation, not competition.”

The New America Foundation’s New Health Dialogue posts a letter from the Center for American Progress, Wal-mart and SEIU to President Obama where they agree to support an employer mandate to provide health insurance along with “the strongest possible commitment to rein in health care costs,” and adds  “For now it is encouraging to see Wal-Mart not only talking the talk, but walking the walk on shared responsibility for our health care goals.”

Uwe Reinhardt on the New York Times’ Economix responds to a reader who found two different posts “inconsistent.”

It’s another sign of the media’s attempts to capitalize on Americans’ interest in the current health care debate: Yesterday, MSNBC premiered a new show on health issues, “Dr. Nancy“. hosted by Nancy Snyderman, a physician and veteran television reporter. If the debut show was any indication, it will offer standard cable-news fare. For the first segment, Snyderman had a long piece examining Michael Jackson’s death and the role of his personal physician. For the second, she interviewed HHS Secretary Kathleen Sebelius and FDA Commissioner Margaret Hamburg:

(Via Sarah Lovenheim at the Washington Post.) 

Elsewhere, Heritage’s The Foundry has an overview of Sen. Jim DeMint’s, R-S.C., new health overhaul proposal.  DeMint wants to “reclaim the money left in [the Troubled Asset Relief Program (TARP)] and use it to pay for this over the next 10 years.” The plan would provide vouchers for buying insurance, expand health savings accounts and address the medical malpractice issue by “[reducing] predatory and frivolous malpractice lawsuits.” DeMint is not a member of either the Finance or HELP committees, which have jurisdiction over health reform.

Over on the other side of the aisle, the New Republic’s Jonathan Cohn argues for more focus on issues besides a public plan. He says, “Yes, the public plan is a key element of reform. But it is not the only one… to put it another way, reform without a public insurance plan would be a major disappointment. But reform without adequate subsidies, good benefits, and cost control would also be a major disappointment, too.”

The Washington Post’s Ezra Klein unintentionally illustrates Cohn’s point in a post about health insurance exchanges, writing: “It’s been hard to get people to care about the exchanges. So maybe this will help: The Health Insurance Exchange is where the public plan will live.  And if the exchange doesn’t survive, or thrive, then neither will the public plan.”

For research wonks: the National Library of Medicine has released a new tool with specialized searches that the agency says is “meant to inform comparative effectiveness research.”  It’s the first public government resource like this that I’ve seen.

Also for the wonks, a major event in health policy circles, AcademyHealth’s Annual Research Meeting, is underway in Chicago.  The best way to follow the action online is through Twitter, as a variety of participants are “tweeting” different panels.  You don’t need an account to view.

The politicians are taking a break, and so we’re taking a break this afternoon from political blogging….and plunging into the wonkier side of the web. Sometimes, a deep-in-the-weeds policy controversy starts swirling and significant players take to their chosen venues to respond.

Last week a couple of bloggers became riled up over a panel at the American Medical Assocation known as (are you ready for this mouthful?) the RUC, a.k.a. the AMA/Specialty Society Relative Value Scale Update Committee. The panel makes recommendations for the amount physicians should be paid for each service perfomed.

The brewing policy debate started on a much more general topic, as these controversies often do, with Health Affairs founding editor John Iglehart interviewing former CMS Administrator Kerry Weems about staff and resource shortages at the agency, which oversees Medicare and Medicaid. 

The gist is this: many health reformers argue that establishing a larger role for primary care doctors, especially in a “medical home” type model, is a key to reining in health care costs.  You won’t see many specialists take to the blogosphere to on this one, but primary care docs and other experts have been pounding away at the issue for years.  A greater focus on primary care would increase salaries for these docs’ services, but could theoretically also result in lower reimbursements for specialists. 

At one point, the interview turned to the RUC (technically the Specialty Society Relative Value Scale Update Committee [RUC]), and Weems assailed the panel’s decisions:
(more…)

 A few items to end the week.  Have a great weekend, everyone! 

Office of Management and Budget Director Peter Orszag is doing a Q&A on health care with John Dickerson, chief political correspondent for Slate Magazine.

 CNN.com reports that the Southeast region of the United States has some of the highest concentration of HIV/AIDS cases.  They use data from a new HIV/AIDS Atlas by the National Minority Quality Forum.

Gary Schwitzer publishes a notice from a Society for Professional Journalists e-newsletter that advertises an all expenses-paid trip with the National Press Foundation sponsored by Pfizer to cover “cancer issues” in Washington, D.C. Schwitzer says the SPJ’s ethics code says journalists should “refuse gifts, favors, fees, free travel and special treatment, and shun secondary employment, political involvement, public office and service in community organizations if they compromise journalistic integrity.” (via Maggie Mahar.)

Henry Stern of Insure Blog points to a new report from insurance lobbying group America’s Health Insurance Plans that found the number of people with health savings accounts increased by 200% in the last two years.

The Washington Post’s Ezra Klein makes an intriguing point:

So here’s a question that few have asked, and that virtually no one knows the answer to: How important is conference committee to the way the White House is looking at health care? I’ve heard it’s pretty important. Heard the same thing about Harry Reid, actually. If that’s true, then this is what the Democratic leadership is thinking: The overriding imperative right now is to keep health reform alive.

John Goodman links to video of his testimony (and others’) before the Senate Energy and Commerce Committee on health insurance.

Comedy Central is all over the health reform promises coming from Washington: first Jon Stewart tackled the politicians, now Stephen Colbert is doing what he does best: mocking everyone.

 Here’s your afternoon roundup:

The Washington Post’s Michael Shear reports from a breakfast with President Obama’s chief of staff, Rahm Emmanuel.  Emmanuel mostly discussed health care, particularly the differences between now and reform attempts in 1993-1994.

Linda Gorman on John Goodman’s Health Policy Blog turns the public plan notion around and argues for more competition in existing government-sponsored insurance programs (like CHIP, the VA and Medicaid) by allowing enrollees to use a government voucher to choose private insurance.

Arnold Kling on the National Review Online has a column arguing that “we are seeing is a non-debate over non-reform. The Democratic proposals promise to entrench the status quo, which does not fit with the principles of personal responsibility and fails to allocate resources sensibly.”

TPM DC’s Brian Beutler discusses the idea of nonprofit cooperatives in place of a public plan option in a health reform bill, argues: “there’s no evidence that potential Republican support for the idea of a co-operative health care system will translate into Republican support for the broader reform bill they’re attached to.”  Beutler, who points to Senate Health, Education, Labor and Pensions Committee ranking member Mike Enzi as a key example, continues, “it raises concerns among Democrats–or at least it should–that Republicans might try to weaken the bill only to turn around and vote against it.”

The Center for American Progress Action Fund’s Matthew Yglesias responds to Ezra Klein’s prediction that a health reform bill “could go the way of the stimulus.” Yglesias disagrees: “My take is that we’ll either get a very strong progressive bill or we’ll get a real legislative train wreck. Ezra’s analogy was to the stimulus bill, but my analogy would be to comprehensive immigration reform—tons of moving pieces mean you can lurch from dramatic change to hopeless coalition breakdown and back again very rapidly.”

NPR has a fun group of interactive photos where they’re asking readers to identify the lobbyists present at the Senate Health, Education, Labor and Pensions markup hearing on June 17th.