Maureen <[email protected]> wrote: >> (2.) His stance on medicare advantage. This will raise costs, make >> outcomes worse, and eliminate choice > > A stance is not legislation or expenditure so you can't cut it. When > he puts it in the bill, you can cut it. >
I won't do Sam's thing of responding to every little thing since that's impossible to follow. Rather I'll start with ARRA, that's *one* example of legislation that includes expenditure (yes, including Medicare policy) and provides for policy shaping depending on the President's "stance". And, yes, a stance is, in fact, expenditure because there's broad discretion to shape policy (and therefore expenditure) within existing law. One example is Afghanistan. The President doesn't need legislation to engage with a perceived enemy, and actions taken within that discretion can lead to de facto legislation. In other words, an ex ante stance can lead to ex post legislation. If you want one example within Medicare I will give you 2: * CMMI - a $10B (b = billion) venture capital fund for Medicare innovation. Could be a good idea, but it's ARRA legislation, an expenditure, and will enable further expenditures. * Medicare Advantage's submissions system: RAPS vs the new EDPS. CMS suddenly announced the change last october with few specifics and that's triggered millions (billions or trillions?) of spend. So there's your legislation, examples, and an explanation of why a stance can incur significant spen ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Order the Adobe Coldfusion Anthology now! http://www.amazon.com/Adobe-Coldfusion-Anthology/dp/1430272155/?tag=houseoffusion Archive: http://www.houseoffusion.com/groups/cf-community/message.cfm/messageid:336749 Subscription: http://www.houseoffusion.com/groups/cf-community/subscribe.cfm Unsubscribe: http://www.houseoffusion.com/groups/cf-community/unsubscribe.cfm
