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The legislation sets up a research center to compare the effectiveness of medical treatments, and critics fear that bureaucrats will start issuing justifications for denying patients access to the latest medical technology. Republicans as well as Democrats had previously called for a major investment in such research to help make sense of which kinds of treatments, medications and technologies are worth the cost. The legislation specifies that the research findings cannot be used to impose mandates, guidelines or recommendations for payment, coverage or treatment
-- or used to deny coverage. Acceptance of the research is likely to be slow in coming, and the medical community
-- not government and insurance companies -- will probably take the lead in vetting it. Although some polls show a majority oppose the bill, most surveys find the public about evenly divided. Blendon, the public opinion expert, believes it's premature to say that the public has rejected it. Curiously, many individual components
-- doing away with insurance denials for pre-existing conditions, tax credits to help pay premiums, insurance purchasing pools
-- are widely popular. Obama reads those findings to mean that Democrats have a chance to turn around public opinion, and he's embarking on a campaign to sell the bill. Democrats say the bill -- even as it cuts Medicare to pay for expanded coverage for working families
-- will add at least nine years of solvency to the program's giant hospital insurance trust fund, now projected to be exhausted in 2017. Technically that's true -- but only on paper. Savings from the Medicare cuts will be invested in government IOUs, like any other trust fund surplus. The special Treasury securities count as an asset on Medicare's books
-- making the program's precarious financial situation seem more reassuring. But the government will spend the actual money. And when time comes for Medicare to redeem the IOUs, lawmakers will have to scramble to come up with the cash. The key point is that the Medicare savings will be received by the government only once, the Congressional Budget Office said, "so they cannot be set aside to pay for future Medicare spending and, at the same time, pay for current spending ... on other programs."
[Associated
Press;
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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