Have you looked at Australia?
Have you looked at Germany?
Have you looked at Scandinavian Countries?
You see, there is more than Canada, Britain, and France.
Oh, and all my Canadian friends like their system and think we are screw ups, which we are in terms of health care.
Have YOU SEEN WHERE THE NUMBERS ARE FROM FOR OUR SYSTEM!?!?! The Lewin Group is a primary place. It's owned by the health insurance industry. Come on people, get educated and fight back against this crap. When did American become the can't do country? Unbelievable. The country I grew up in and know can take all the best the world has to offer and make it better. I'm tired of conservative nay sayers and can't do-ers.
Lewin Group story:
washingtonpost.com
the principles of the Founding fathers are timeless. that was the genious of them. That is also why it is rare for those kind of people to walk this earth, yet there are so many trying to undo what they did, which resulted in one of the Greatest nations in history.I find it funny that people anachronistically place the founding fathers in our own day and age. You see, it's different now with our country as large as it is. Oh, and we aren't asking the government to do everything. That's stupid over the top hyperbole. How is it that my doctor with his education and experience trusted the government to get said education and experience? How is it that me driving to the doctor of my choice on my plan is government helping me? How is it that me paying my taxes to help the poor become stronger people through health and education and then making a stronger country overall through their participation is a bad thing? How is it that I can choose the course of my own career and what I would like to become educated in that says I rely on the government? How is my health and the care of my doctor's advice relying on government?
Here's your problem: when a thing as huge as health care reform is needed, the average citizen cannot do it. The Heath Care industry is huge and extremely powerful. Only the government has the resources to take it on in order to provide competition to an industry glutted with greed over people's best welfare and well being. You see, you take over the top talking points and then apply them to a far more complicated scenario that does not fit said hyperbole.
the only way to keep costs down is to ration healthcareI'm hoping Jackolope comes and comments on this as well. Apparently there is reform of the Mass Health Care to control costs that should have been put in place at the beginning. She has the info.
the only way to keep costs down is to ration healthcare
Dear Leader is not calling for a cap on costs. HR3200 caps payments to doctors and hospitals.There is a story on it. We can take what they did wrong and do the opposite, which is exactly what Obama is calling for, i.e. a cap on costs, etc. I'm so glad conservatives see failure and think that's all we can do.
This is also one of Medicare's persistent problems:At Cambridge Hospital, where Himmelstein works, the average government payment for low-income patients -- those on Medicaid or Commonwealth Care, or without insurance -- is only about 60 percent of what it costs to provide their care. Before the 2006 law, payments for Medicaid and uninsured patients covered 77 percent of the cost, according to the hospital.
Another major safety-net hospital, Boston Medical Center, is in a similar financial bind. Payments for low-income people covered 82 percent of treatment costs in 2006 but are predicted to cover only 64 percent in fiscal 2010.
Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.
HR3200 replicates the sins of Commonwealth Care and Medicare for the whole of the American population. Since when is taking a mistake and repeating it on a grander scale "reform"?The proposal would also establish a “public plan” available only through the insurance exchanges. That plan would be set up and run by the Secretary of Health and Human Services (HHS). On average, it would pay Medicare rates plus 5 percent to physicians and other practitioners (and those rates would not be determined by the sustainable growth rate formula that is used to set rates for physicians in Medicare but instead would be increased over time using an index of physicians’ input costs). On average, the public plan would pay Medicare rates for hospital and other services and supplies on fee schedules, and negotiated rates for drugs or other items or services not on a fee schedule. Providers would not be required to participate in the public plan in order to participate in Medicare. (A more detailed summary of the proposal’s key provisions is attached.)
\The U.S. is the only industrialized nation without a National health care option. Why are we allowing our country to fall behind all the other developed nations?
I'm betting dollars to donuts that you nor many of the people who frequently support UHC have any idea how any of the European health care systems work.
They aren't all what you think they are.
\
we are not falling behind
As was referenced above, we are falling behind.
we are trying to keep the govt limited in power and control of individual choices and liberties
I am not concerned with protecting the individual liberties of the few making a killing from the misery of others. That is only liberty for the rich to rob the poor and middle class. I'll stick with the Constitution which demands that we promote the welfare of We the People, which means all the people, not just the wealthy.
if this was so great, Congress would abandon their private plans and join it
but an amendment to require that was quickly shot down, faster than JFK
Dear Leader is not calling for a cap on costs. HR3200 caps payments to doctors and hospitals.
This was also done in Taxachussetts, with abysmal results:
National Journal Magazine - The Lessons Of Massachusetts
This is also one of Medicare's persistent problems:
http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html
HR3200's public plan repeats this fiscal foolishness, as the CBO analysis of the public plan clearly shows:
HR3200 replicates the sins of Commonwealth Care and Medicare for the whole of the American population. Since when is taking a mistake and repeating it on a grander scale "reform"?
HR3200 will not lower health care costs
If you don't want people to have an option fine, I'm willing to go the route of a single payer plan.
Cassandra said:"Increasing preventive care does actually lower costs in the long run."
Cassandra said:"No, increasing the cost of drugs will not lower costs- obviously!"
Cassandra said:"I have not seen any congressional assessment which can analyze the saving that may occur when people have preventive care and when we have C.E.R. in place."
Cassandra said:"I am not particularly thrilled with the plan but it improves on the status quo. It moves the bar- slightly."
Cassandra said:"I admit I wonder why it is Repubs -who were so anxious to pass a prescription drug benefit designed that larded private insurers and Big Pharma at taxpayer expense - are suddenly fiscal watchdogs. Could it be political?!"
Cassandra said:"Employer based health insurance is out of date, it is a competitive liability."
"Not sure how you can make the claim that the "manufacturing base is as strong as ever" W/O H.C. liabilities G.M. would not have disintegrated! "
Cassandra said:"Speaking for those of us most shafted by this "system", I would like to know why I should have to pay for the poor, the elderly, the disabled, state, federal and local employees and subsidize corporate employees while I get , "you are on your own,pal, open your jugular, pay 2x the going rate.." The Obama plan would give the self-employed a chance to buy into a large group policy. I see that as a baby step forward."
Cassandra said:"80 Billion was the number I heard."
Cassandra said:"Obama read Dr Gawande's articles in the New Yorker. You should ,too. The Mayo pays a salary. Doctors compensated with a salary do not have the same incentive to over-prescribe that propels the fee for service doctor. This is very important."
Cassandra said:"Obama recommends the establishment of C.E.R. and giving an advisory panel some teeth to make recommendations. Good ideas."
Cassandra said:"An ad hominem attack at this point in the post -Why, exactly, did you waste your time with so much stupidity?"
Cassandra said:"Yes I met one self -employed physician in Maine. She does not deal with insurers. Only cash. I would not call that innovation, just nostalgia."
Cassandra said:"I am pretty surprised that no one has mentioned (republican) Wyden's plan I like Ron Wyden's Health care reform idea but it is going nowhere , either. I wonder why his fellow Republicans don't get on board?"
The U.S. is the only industrialized nation without a National health care option. Why are we allowing our country to fall behind all the other developed nations?
"Why doesn’t the United States have universal health care as a right of citizenship? The United States is the only industrialized nation that does not guarantee access to health care as a right of citizenship. 28 industrialized nations have single payer universal health care systems, while 1 (Germany) has a multipayer universal health care system like President Clinton proposed for the United States.
Myth One: The United States has the best health care system in the world.
* Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990
* Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960
* Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960.
* Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana
* Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations.
* Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation."
If you are implying that you know so much more than us…please educate us on our erroneous assumptions of great wise one. :roll:
The United States has the best health care system in the world bar none.
A couple of things. Instead of subsidizing healthcare, we need to do things to make it affordable, that requires real work and an open market, not government intervention, if medical personell were actually able to make the calls necessary for treatment, the market would take care of itself, an intervening government only exacerbates the problem.Only for those that can afford it! And there are 14,000 less each day that can afford it. That is why the people consider this a crisis and one of the reasons Obama was elected.
Especially when the government solution to cost control is to simply not pay the bill.A couple of things. Instead of subsidizing healthcare, we need to do things to make it affordable, that requires real work and an open market, not government intervention, if medical personell were actually able to make the calls necessary for treatment, the market would take care of itself, an intervening government only exacerbates the problem.
In total agreement here.Especially when the government solution to cost control is to simply not pay the bill.
There is nothing in the pending healthcare legislation that will alter the economics and dynamics of the actual costs of actually caring for a patient. The unnecessary procedures will continue--to the tune of $700 Billion+--the defensive medicine will continue, the medical mistakes will continue to rise, while the number of physicians and healthcare providers willing to take Medicare remains inadequate (and likely to increase since the public plan proposes to pay doctors at medicare rates). There will be more insurance, but less care.
Restricting the supply of healthcare providers while subsidizing patients' use of those providers drives costs up not down.
Do you have any supporting evidence? "Preventive care" is a non specific term. Perhaps, we are not talking about the same thing: If you give pregnant women, infants solid prenatal/pediatric care and they have healthy babies instead of preemies, the saving is incalculable.No it doesn't. An example with PSA screening here [1] and elaboration on "number needed to treat" here [2]. When you factor in how many people need to receive the preventative care the cost savings vanish rapidly. So again, increased preventative care does not lower costs. It may be good, but it is not cheaper.
Removing the subsidy will raise the cost of drugs. Again, this may be good but it will not lower costs. You fail to address ARCs point that your desired outcome will not reduce costs.
I would certainly hope that a board of medical experts (CER) would command more attention and respect from physicians than a board of business experts (H.M.Os). Frankly, I think Americans should get over the idea that physicians are all knowing and infallible. They are not and C.E.R. could be very useful as expert supporting evidence in cases of malpractice.Mainly because preventative care has little to no savings, and comparative effectiveness research as proposed in the bills is not enforced. Enforcing CER is also difficult politically, see the HMO backlash in the 90s; not to mention it invalidates the assertion "no government bureaucrat will come between you and your doctor".
We don't know what the final proposal will be but , for me, the bottom line is that if it helps small businesses, I am for it. I prefer a single payer plan. Alternatively, I would support the Weyden planWe're paying an awful lot for that "slight" bar movement. This the faulty logic of "something must be done ... this is something ... therefore it must be done!"
I don't care about Repubs or Dems. I just want a plan I can support. My Senators are moderate Repubs so their position is of great interest to me.Seriously, why do you care about Republicans? Democrats have a filibuster proof Senate, and more than enough votes in the House. Republicans cannot stop the Democrats if they unite. The only thing holding up these bills are that the Democrats are divided. Shouting "the Republicans helped with the problem" does not change the fact that NONE of the proposed solutions are any good.
The Wyden plan would eliminate employer based H.C. Good. Might employees receive higher wages? Yes, maybe, maybe not ..it would put small businesses and large businesses on an even playing field, force employees to confront the real costs of H.C., reduce H.C. inflation.Again, this is false. If employer's stopped providing health insurance they would replace the amount with increased wages. The same way that the "employers share" of payroll taxes really comes from the employee (in reduced wages) and is counted as such by economists.
That is really unsupported by evidence. Ever fewer American are finding work in manufacturing .Those who have meager benefits do not demand higher wages unless market conditions make that possible. G.M. was doomed by its over -generous legacy H.C. expenses.Manufacturing base is as strong as ever because our share of world manufacturing exports is ~12% (leading the 'industrialized nations' as it was in 1995 and 2000) according to UN Industrial Development Org [3] If GM was not providing health care then its workers would have demanded higher wages (or other benefits) so that GM's cost per employee would have been the same and it still would have disintegrated.
I highlighted in blue, the part of your statement that makes me want to throttle you. I don't want people to pay for me! I want the system to be fair so I am not asked to pay 3 or 4 times what I should, for health insurance (through the miracle of cost shifting) just because I happen to live in this state and am self-employed!! The individual market is highly inefficient and expensive.If you are being shafted by the system wouldn't you prefer all those other people lose their special privileges? If you don't want to pay for the poor, elderly, etc. why do you want other people to pay for you? A better approach would be to have everyone buy insurance in the individual market, thus forcing insurers and hospitals to respond to each unique consumer rather than homogenized businesses.
In my family, alone, three people have had pre -cancerous polyps removed during the colonoscopy. I see that as an immense saving for the H.C. system since it is a preventive measure not a mere screening. The rest of your assumptions about my husband's care are pure speculation on your part. As it happens, he had symptoms masked by hemmoroids . The insurance co. denied payment based on the pre-existing condition clause.I find it odd given your statement above that you disagree with my perspective on colonoscopies. First you (rightly) complain about paying for other people, then turn around and want other people to pay for your husbands colonoscopy. To be clear when I refer to "how many colonoscopies it takes" I don't mean how many one person has to sit through but the "number needed to treat" as referenced above [2]. MANY people need to have colonoscopies to find those few who have cancer.
CER is a new concept. The proposal I have in mind would give "teeth" to MedPAC. The President would have to approve or reject its recommendations as a package and Congress would have 30 days to reject them.CER "with teeth" is not in any of the bills proposed. As I pointed out previously President Obama's 'recommendations' have hampered the progress of the current bills. It appears your hope is misplaced.
By all means provide evidence. What % of physicians are self-employed, today, versus, say 1965???Of your false talking points you choose to poorly defend one of them ... with anecdotal evidence that merely demonstrates that you are out of your depth. Other self-employed doctors are experimenting with what boils down to self imposed capitation (sometimes called "concierge medicine"). One of the complaints in Dr. Gawande's article which you reference is that self-employed physicians are more likely to proscribe expensive testing since they turn a better profit ... how are Dr. Gawande's findings possible if there are "no self-employed physicians anymore"?
You really believe that? Repubs had years in majority and they never lifted a finger. They waded into the H.C. waters to add a medicare drug benefit that is a gift to corporate interests. I applaud Wyden because he is one of the few who seems to treat this issue, seriously.Republicans aren't "on board" with the Wyden proposal because not enough Democrats will support it. With a filibuster proof majority in the Senate no Republican plan will ever make it through ... why waste your time on a sinking ship? Republicans are in no way preventing health care reform.
You may be right about that. We will see.To everyone who's drudging up the tired UHC comparisons please look at the actual measures being proposed. Regardless of your opinion on UHC it should be obvious that the current proposed measures are largely useless.
Preventive medicine doesn't mean that everyone should get every test available.Solidus said:No it doesn't. An example with PSA screening here [1] and elaboration on "number needed to treat" here [2]. When you factor in how many people need to receive the preventative care the cost savings vanish rapidly. So again, increased preventative care does not lower costs. It may be good, but it is not cheaper.
LOL...and George Strait has some ocean front property in Arizona to talk to you about.Solidus said:If employer's stopped providing health insurance they would replace the amount with increased wages.
Speculation.Solidus said:If GM was not providing health care then its workers would have demanded higher wages (or other benefits) so that GM's cost per employee would have been the same and it still would have disintegrated.
LOL...:lol:....Just the dems proposalsSolidus said:Republicans are in no way preventing health care reform.
This is for those who are opposed to health care reform as currently going through the maze in Washington D.C.. Here is the scenario, you have to reform health-care to do the following:
1.) Reduce overall U.S. costs (currently at 16% GDP)
2.) Provide coverage for the 75 million uninsured and under-insured.
3.) Reverse course of the current exploding budget for Medicare and Medicaid ($500+ billion for FY 2009)
4.) Lower premiums for both individuals and business
5.) Lower out of pocket costs to individuals.
6.) Insure individuals can actually get coverage; provide solutions to those who are denied benefits due to pre-existing conditions or chronic illness. In other words what is the choice for a 40+ man with prostate cancer or woman with breast cancer? Parkinson's, leukemia, kidney failure, heart disease, etc..how are these individuals covered?
Now three simple rules:
1.) You have to fix Medicare, but there is absolutely zero political chance that you can end Medicare. Thus, saying Medicare should be ended is a non-option in this debate. Nobody with any hopes of ever winning an election will propose this...EVER.
2.) Provide actual solutions with data and sources to support the argument.
3.) Simply saying that plan X, Y, or Z suck is not a sufficient argument. You have to provide an actual solution to the problems (with supporting data). So you can NOT simply complain about any current proposal UNLESS there is a real world/factually based alternative solution.
Complaining is easy, I want to see an actual counter-argument that provides for solutions (with evidence) that actually could work.
So, to answer this question directly, I would say there are ways to save significant money and appropriate ways to raise additional funds even w/o a single payer system (my preference)
Some can be addressed: Preventive health. This is not limited to expensive (sometimes unnecessary) tests 'Solidus' refers to. Businesses/Communities/ public health initiatives can do more to encourage exercise and healthy eating. Public schools can do a MUCH better job with school lunch programs, introducing kids to healthy foods. The health status of American children should be a national embarrassment.
The country can expand the number of general practitioners by offering assistance for educational expenses with strings attached. These Docs would be required to spend a predetermined number of years in under-served parts of the country.
For patients with complex health issues, coordinated care needs to improve to eliminate mistakes and redundancies. Obama has talked about this on several occasions.
Offer an insurance product that encourages people to have non-emergency surgery in cooperating off shore clinics. Medicare recipients could be encouraged to do so by giving them a % of the (considerable!) savings.
An example from Medsolutions:
MedSolution.com currently has partnerships with hospitals in India and France. India offers surgeries at up to 90 per cent less than in the United States, while France boasts the best health care system in the world.
Add a significant tax to snack foods and sodas and dedicate the tax to H.Care costs. In many ways it would make more sense to eliminate the agriculture subsidies that allow high fructose corn syrup to be so cheap and ubiquitous. Since interest groups form Joe the farmer to Cargill, Monsanto, ADM, and Coca Cola would be opposed, it will never happen. So tax the toxic results of our unwholesome industrial food system and use it for H.Care.
some cannot be addressed
We have an aging population. The demand for health care is increasing in all Western nations.
Well, saying this does not make it so. I have listed examples of the ways that preventive care saves lots of money. Under the rubric of "preventive medicine" there are many small things that can save considerable money and suffering. Another example: having a C.N.A. spend time ,daily ,with an elderly person who might otherwise be forced to move to a nursing home- at great expense.Any increase in the use of preventative medicine will raise prices.
There is no escaping that, it doesn't have to be a fancy limited preventative screening.
It is the basic principle of supply and demand.
I looked into this. It is the A.M.A. advising state government that makes the determination about Dr training numbers. States are short on funds, right now. Docs don't want to be hard working (comparatively) underpaid rural general practicioners. We could increase the number of Drs through immigration but that is a bit unfair to other countries.A better alternative would be stripping the power away from the AMA of limiting the amount of doctors licensed every year.
Well, they have an insurance system but H.C. is taxpayer funded. It certainly sounds like the best system in the world to me. You may have different metrics.France does not have the best medical system in the world, that is absolutely false and I'm willing to bet that most here know nothing about the French health care system.
NO! Where did I mention organics? Raise the tax on H.F.corn syrup and sugar. Unhealthy processed foods will become more expensive, people will eat less of it. Food choices are not limited to junk food or organics.Organic foods are incredibly expensive and all this will do is cause their prices to rise higher and the "unwholesome" foods will become cheaper which defeats the purpose of the tax.
So you say. As it stands, we are subsidizing unhealthy choices. Given that the industrial food system is making us sick, it is perfectly legitimate to tax the drug (sugar) and use it toward H.C.Taxing personal choices is not a proper function of government.
Children and the elderly take more than they receive, on an accountant's ledger. That is how it should be.That is were most of the health dollars in the U.S. are going, elderly people take way more than they put in.
A couple of things. Instead of subsidizing healthcare, we need to do things to make it affordable, that requires real work and an open market, not government intervention, if medical personell were actually able to make the calls necessary for treatment, the market would take care of itself, an intervening government only exacerbates the problem.
The economy is a good angle to use, especially the job bleed we are enduring, however let's not forget that many things our congress past and present and multiple presidents from Woodrow Wilson to today have done; quite a bit of market intrusion that made things like recessions and overvalued items possible, just about every economic problem we have today has a beginning somewhere in the past, including practices, costs of unnecessary regulation, and possibly the dumbest thing.....Nixon relaxing the gold standard for an indexed one. I see a need for real reform, but am dead certain that a government created crisis can only become a catastrophe if same government tries to fix incorrect with more incorrect.
Yeah...cut that 75M down to the more accurate 10M number and we can talk about price caps on medications and incentives given to existing private companies per-member instead of per-procedure.This is for those who are opposed to health care reform as currently going through the maze in Washington D.C.. Here is the scenario, you have to reform health-care to do the following:
1.) Reduce overall U.S. costs (currently at 16% GDP)
2.) Provide coverage for the 75 million uninsured and under-insured.
3.) Reverse course of the current exploding budget for Medicare and Medicaid ($500+ billion for FY 2009)
4.) Lower premiums for both individuals and business
5.) Lower out of pocket costs to individuals.
6.) Insure individuals can actually get coverage; provide solutions to those who are denied benefits due to pre-existing conditions or chronic illness. In other words what is the choice for a 40+ man with prostate cancer or woman with breast cancer? Parkinson's, leukemia, kidney failure, heart disease, etc..how are these individuals covered?
Now three simple rules:
1.) You have to fix Medicare, but there is absolutely zero political chance that you can end Medicare. Thus, saying Medicare should be ended is a non-option in this debate. Nobody with any hopes of ever winning an election will propose this...EVER.
2.) Provide actual solutions with data and sources to support the argument.
3.) Simply saying that plan X, Y, or Z suck is not a sufficient argument. You have to provide an actual solution to the problems (with supporting data). So you can NOT simply complain about any current proposal UNLESS there is a real world/factually based alternative solution.
Complaining is easy, I want to see an actual counter-argument that provides for solutions (with evidence) that actually could work.
NEJM said:"Sweeping statements about the cost-saving potential of prevention, however, are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs. ... Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not."
WaPo said:"In 1986, a health economist named Louise B. Russell published "Is Prevention Better Than Cure?," in which she concluded that prevention activities tend to cost more than they save. Since the book's appearance, her observation has been borne out by studies of hundreds of interventions -- everything from offering mammograms to all women and prescribing drugs to people with high cholesterol to requiring passenger-side air bags in cars and shortening the response time of ambulances. ... There are many reasons prevention usually doesn't save money. Perhaps the most important is that prevention activities target many more people than will ever come down with the disease being prevented. The reason (thankfully) is that people tend to stay healthy for most of their lives, no matter what they do."
CBO said:"Although employers directly pay most of the costs of their workers’ health insurance, the available evidence indicates that active workers—as a group—ultimately bear those costs. Employers’ payments for health insurance are one form of compensation, along with wages, pension contributions, and other benefits. Firms decide how much labor to employ on the basis of the total cost of compensation and choose the composition of that compensation on the basis of what their workers generally prefer. Employers who offer to pay for health insurance thus pay less in wages and other forms of compensation than they otherwise would, keeping total compensation about the same."
CBO said:"Some analysts have argued that domestic firms offering health insurance to their workers face higher costs for compensation than do competitors based in countries where insurance is not related to employment and that fundamental changes to the health insurance system could reduce or eliminate that disadvantage. However, such a cost reduction is unlikely to occur, except in the short run, primarily because the costs of fringe benefits are largely borne by workers in the form of lower cash wages. Other economic factors (including tax rates and currency values) are likely to have a larger impact on a nation’s competitiveness in the world market."
Cassandra said:"I would certainly hope that a board of medical experts (CER) would command more attention and respect from physicians than a board of business experts (H.M.Os). Frankly, I think Americans should get over the idea that physicians are all knowing and infallible."
Cassandra said:"That is really unsupported by evidence. Ever fewer American are finding work in manufacturing ."
Cassandra said:"Those who have meager benefits do not demand higher wages unless market conditions make that possible."
Cassandra said:"CER is a new concept. The proposal I have in mind would give "teeth" to MedPAC. The President would have to approve or reject its recommendations as a package and Congress would have 30 days to reject them."
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