Source: Kaiser Health News

CBO Chief Douglas Elmendorf’s post on his Director’s Blog outlining how changes to Medicare Part D would raise premiums but cut beneficiaries prescription costs triggered a round of news stories, and blog chatter.

Jacob Goldstein writing for the WSJ’s Health Blog, noted that the Medicare drug program’s infamous doughnut hole, which now leaves beneficiaries on the hook for annual prescription drug costs between about $2,700 and $4,300 per year, would be phased out and would lead to “big savings for those beneficiaries who now get stuck with the bill.”

On The Health Care Blog, Matthew Holt says we “should expect to hear a whole lot more about this.” In his view, it has to do with what has become a political reality – “Seniors care about death panels, but they usually really care about drug prices and costs.” He takes a small spin back into health policy history to try to offer a little context:

“Part of the political rationale for the Republicans passing Medicare drug coverage in 2003 was to deny the Democrats the ability to bundle seniors’ desire for drug coverage with a universal coverage bill. So far the Republicans have to say the least muddied the waters as to whether universal coverage is a good thing for Medicare recipients—or at least the ones that don’t care about their kids or grand-kids. But there’s one minor trick. The deal with big Pharma that’s part of HR 3200 cuts the donut hole in half. That’s real money for seniors.”

But he adds that, for now, seniors don’t appear to see it that way, offering a recent Silverlink/Suffolk poll that found nearly half of Medicare recipients (48%) said they did not believe the Obama administration is looking out for their best interests in health reform.

And while on the subject of seniors, Marilyn Werber Serafini takes on the issue of age rating on the National Journal’s Health Care Expert Blog. The question: how much more insurers should be allowed to charge older people than younger people? “So far, health care reform legislation in Congress has included language to allow insurers to charge older people twice as much as their younger counterparts. While that would lower premiums for people at, say, 60, whose medical costs might be higher, it would raise premiums for the younger, generally healthier, generation.” So far, John Goodman, Uwe Reinhardt and John Rother have weighed in.

KHN had a related story today.

While some focus on seniors and doughnut holes, other bloggers are looking at the whole enchilada.

Dennis Smith, on the Heritage Foundation’s The Foundry, calls one of the central issues “the health care nudge.” He notes that the White House’s “problem” with public fears about rationing and says: The White House media folks need to look no further than across the street to the Eisenhower Executive Office Building where top Presidential appointees, Peter Orzag and Cass Sunstein hang out. Both have expressed an interest in behavioral economics. Professor Sunstein is the co-author of Nudge: Improving Decisions About Health, Wealth, and Happiness, an interesting book, which emphasizes the official presentation of information in a manner that “nudges” individuals to make certain decisions. The giant House bill is chock full of “nudges” and restrictions.”

Grace-Marie Turner writes on the National Review’s Critical Condition about the Democrat’s diminishing prospects for a happy, bipartisan ending. She notes that Senator Robert Byrd has asked that the health reform bill be named after Senator Kennedy in hopes “that it will revitalize its chances of passage. But I think it’s too late.” She details recent scrapes and statements made by Democrats and Republicans alike at town hall meetings as evidence: “The Democratic leadership may invoke Senator Kennedy’s name to try to keep their own members in line, but it’s just impossible to see how they could justify shoving this unpopular bill through with votes only from Democrats and only a few hours of floor debate, as Senator Reid is threatening. The public would revolt.”

On the New Health Dialogue, Joanne Kenen offers a whole new twist on the issue of health care rationing. “Every time we think the rhetoric can’t get uglier or stranger… well, you know the end of this sentence,” she writes. Kenen then details what The Associated Press reported over the weekend about a recent Republican National Committee fundraising appeal warning that Democrats might use health system reforms to deny medical treatment to Republicans. “A questionnaire accompanying the mailing says the government could check voting registration records, ‘prompting fears that GOP voters might be discriminated against for medical treatment in a Democrat-imposed health-care rationing system.’ It asks, ‘Does this possibility concern you?’ … An RNC spokeswoman said the question had been ‘inartfully worded.’”