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Window to Washington

An inside-the-beltway look at the legislative and regulatory process.
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By Jessica Zigmond and Rich Daly

Blog: Two questions that deserve real answers

By Rich Daly

Here's to diving below the overheated healthcare rhetoric.

It's widely assumed that tonight's vice presidential debate will be a health policy wonkfest (with zingers) that submerges deeply into the numerous conflicting approaches of the two presidential tickets. Specifically, the debate likely will focus on Medicare due to the significant changes the Obama administration has made to the program and because of the overhaul proposed by the Romney-Ryan ticket.

But there are a couple health policy questions that each campaign has rarely addressed that could give some insight and move beyond the rhetoric of which side is “ending Medicare as we know it.”

For Vice President Joe Biden:

If the Independent Payment Advisory Board is so critical for preserving Medicare that President Barack Obama's last budget proposed expanding its cost-saving powers, why has he not even proposed members to the panel?

Sheriff Joe could try shrugging off the question based on the fact that the panel's first cost-cutting proposals are not due for another 15 months. But wouldn't knowing the specific qualifications of the 15 members help ease provider's concerns that it will cut the program without understanding the effect those cuts ultimately will have on beneficiaries? The president's reference in last week's debate to the panel's members as “doctors, etc.” was pretty thin gruel for a provider community desperate for details about the powerful and controversial panel.

For Paul Ryan:

If the deficit is such a priority problem that it requires serious changes to Medicare, then why are the changes your ticket is proposing not even going to begin for 10 more years?

The Romney-Ryan plan has tried to assuage seniors that they won't be affected by their Medicare plan by applying it only to people who are now 55 and younger. But that also has the effect of putting off any change in the trajectory of the federal government's historic debt for another decade. Some providers are worried that the mounting debt burden will lead Republicans to slash provider rates while waiting for the beneficiary savings to kick in.

Addressing those two questions will help the debate move beyond scary (and childish) talk of grandmas and cliffs.

You can follow Rich Daly on Twitter @MHRDaly.

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