Republicans Do to have a Medical Cost Control Proposal Not Already in Obamacare

The ever hopeful infinitely patient Ezra Klein attempts to find good Republican proposals for health care cost control.  He notes that the Congressional leadership’s proposal to raise the Medicare eligibility age would increase total health care spending and sins grievously against Ballance writing “But an increase in the eligibility age would be a trophy that Boehner could present to his political base — proof that he had bagged his prey. In the absence of good ideas that Republicans agree on, bad ideas that Democrats hate will do. ” But not for the Kleinest of hopes.

Of course Republicans can come up with good proposals — they just have to read the Affordable Care Act and propose strengthening it a bit.  Indeed  

Jim Capretta, who worked on budgets in the George W. Bush administration, has emerged as one of the Republican Party’s most influential voices on health-care policy.

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Capretta’s goal is to make seniors more cost-conscious at the point of service. He even sees an opportunity to build on some Obamacare reforms, despite being an implacable critic of the law. He thinks the Affordable Care Act’s effort to expand accountable care organizations — provider networks that are paid based on the quality, rather than the quantity, of care they deliver — should be encouraged. Trouble is, he says, Democrats are encouraging the spread of such networks mostly by paying them more. To hold costs down, he would like to give patients a bigger role and greater financial stake in choosing a network.

 In other words, put your government hands on their Medicare penalizing them for not going in a direction subsidized by Obamacare.

But Klein also  talked to Doctro Senator Tom Coburn MD who proposes something not at all in the ACA. 

“I’d change all physicians to time instead of fee-for-service,” he said. “What we’re doing with fee-for-service, and most people don’t realize this, is when you go to the doctor, they have this pressure to see X number of patients a day to meet their numbers.”

If we cut payments to doctors, Coburn says, “they’re going to cut the time they spend per patient. When a patient is in a room and you haven’t used your skills as a physician to really listen, you walk out and cover that absence of time by ordering tests. So if you say here’s all the hours we’ll pay for if you’re a Medicare doctor, and we can actually audit that time, doctors would have to demonstrate proof that they’re spending this time with patients.”

 Holy mother of heffalump traps Coburn is proposing making physicians hourly employees of the US government, maybe with a time clock in their offices.  That’s not Obamacare thats the British National Health Service.  Coburn’s proposal was much too far left for Obama, Clinton or Kennedy.