Robin Strongin

By Robin Strongin. In the 1993 movie Dave, the temp agency owner posing as the President of the United States (if you haven’t seen the film, just trust me on this) is determined to come up with the funding to save a federal homeless shelter program.  Gathering all of the cabinet officials together with pencils, legal pads and calculators, they brainstorm different wasteful programs that can be cut, totaling numbers as they go, until they come up with the necessary $350 million.

A bit of Hollywood silly escapism?  No doubt.  But, you can say this for President Dave and his fictional cabinet.  At least they approached the budget process with a constructive purpose and vision.

We can only hope that the same holds true for the supercommittee, the panel of 12 Senators and Representatives created as part of the cobbled-together solution to the debt ceiling debacle.  By Thanksgiving, the supercommittee must come up with $1.5 trillion in deficit reduction that must then be ratified by the full Congress no later than December 23.

There’s no question that health care will play a key role in those calculations.  When it comes to finding ways to reduce federal deficits, health spending is the rapidly growing elephant in the room. 

And that leads to genuine concerns about this process.  Already, policymakers are bouncing around ideas to extract more money from the healthcare system and tighten belts further.  Medicare provider payment cuts.  New home health care co-pays and budget reductions.  Mandated Medicare Part D prescription drug rebates.  The upshot of each of these steps will be a health care system that’s more expensive, less accessible, but not necessarily better.

It’s important to note, though, that the supercommittee isn’t limited to only using the subtract key on the calculator.  The panel has essentially been given carte blanche to recommend any steps it deems necessary to reach that $1.5 trillion target.  That means that, in addition to budget cuts, the committee can venture into areas like entitlement reform, tax reform and a host of wide-ranging policy changes.

Thus, a supercommittee born out of political necessity and the fear of financial default could also present a rare opportunity.  In the weeks between now and Thanksgiving, these 12 lawmakers have a window of time in which to gather input and develop concepts to improve health care quality and cost-effectiveness.  The Affordable Care Act started a process to implement health system delivery and payment reforms.  It could be said that this supercommittee has an opportunity and even a mandate to accelerate that evolution.

There are important choices to be made this fall.  This new legislative entity could very easily take steps that will prompt more doctors to turn away Medicare patients, make prescription drugs more expensive for consumers and make home health care less accessible for seniors and the disabled.  Or, they can go a step beyond and generate savings through better, more innovative care.

Perhaps the supercommittee should begin its work with a screening of Dave.

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