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'Uncertain future' for new Medicare commission?

From the January 1998 ACP Observer, copyright 1998 by the American College of Physicians.

By Deborah Gesensway

There will be no practicing physicians on the national commission charged with recommending long-term Medicare reforms. Neither are there any other health care providers nor representatives of patient groups.

However, three people who trained as doctors—but who are full-time members of Congress—will sit on the 17-member National Bipartisan Commission on the Future of Medicare: Sen. William Frist (R-Tenn.), Rep. Greg Ganske (R-Iowa) and Rep. Jim McDermott (D-Wash.) Drs. Frist and Ganske are surgeons; Dr. McDermott is a psychiatrist.

The commission was created as part of the Balanced Budget Act passed by Congress last summer and will report its findings by March 1, 1999.

"This is not a very broadly representative committee, and I think that surprised people," said Howard Shapiro, PhD, the College's Vice President of Public Policy. "The fact that there is very little representation from the broad medical and health community, from patient advocacy organizations and even from employers—there are no geriatricians, no people who are expert in ethics or health services research—means this has an uncertain future."

Having such a heavy representation of legislators on the commission has its advantage: any of the group's substantive recommendations will have the "buy-in of some important Congressional leaders in the health arena," making it much more likely that they may ultimately be passed into law, Dr. Shapiro said. On the other hand, having so many members of Congress involved means the debate will be politicized from the start.

Also named to the panel are: Anthony Watson, chairman of the Health Insurance Plan of Greater New York; Samuel Howard, president and CEO of Phoenix Healthcare, Tennessee; Stuart Altman, a professor at Brandeis University and the former head of the Prospective Payment Advisory Commission; Bruce Vladeck, HCFA administrator until last year; Laura D'Andrea Tyson, the former head of President Clinton's National Economic Council; Ilene Gordon, who handles Medicare issues in the Mississippi district office of Sen. Trent Lott (R-Miss.); Deborah Steelman, who advised President Bush on Social Security; Rep. Michael Bilirakis (R-Fla.); Rep. John Dingell (D-Mich.); Sen. Phil Gramm (R-Texas); Sen. Bob Kerrey (D-Neb.); Sen. Jay Rockefeller (D-W. Va.); and Rep. Bill Thomas (R-Calif.).

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