Die USA und der drohende Sturz von der sogenannten “Fiskalklippe” – 15

Zeitlich etwas später erschien ebenfalls am 29.12.2012 in der “Huffington Post” ein  Artikel mit dem Titel “Health Care Industry Anxiously Awaiting Fiscal Cliff Outcome With Medicare, Medicaid Cuts On The Line“.

Es geht natürlich in diesem Artikel um die Folgen, die ein Sturz über die “Fiskalklippe” für das amerikanische Gesundheitssystem haben könnte.

Wir erfahren in diesem Artikel unter anderem: “Confused about the federal budget struggle? So are doctors, hospital administrators and other medical professionals who serve the 100 million Americans covered by Medicare and Medicaid.

Rarely has the government sent so many conflicting signals in so short a time about the bottom line for the health care industry.

Cuts are coming, says Washington, and some could be really big. Yet more government spending is also being promised as President Barack Obama’s health care overhaul advances and millions of uninsured people move closer to getting government-subsidized coverage.

“Imagine a person being told they are going to get a raise, but their taxes are also going to go up and they are going to be paying more for gas,” said Thornton Kirby, president of the South Carolina Hospital Association. “They don’t know if they are going to be taking home more or less. That’s the uncertainty when there are so many variables in play.”

Real money is at stake for big hospitals and small medical practices alike. Government at all levels pays nearly half the nation’s health care tab, with federal funds accounting for most of that.

It’s widely assumed that a budget deal will mean cuts for Medicare service providers. But which ones? How much? And will Medicaid and subsidies to help people get coverage under the health care law also be cut? (…).

Come Jan. 1, doctors and certain other medical professionals face a 26.5 percent cut in their Medicare payments, the consequence of a 1990s deficit-reduction law gone awry. Lawmakers failed to repeal or replace that law even after it became obvious that it wasn’t working. Instead, Congress usually passes a “doc fix” each year to waive the cuts.

This year, the fix got hung up in larger budget politics. Although a reprieve is expected sooner or later, doctors don’t like being told to sit in the congressional waiting room.

“It seems like there is a presumption that physicians and patients can basically tolerate this kind of uncertainty while the Congress goes through whatever political machinations they are going through,” said Dr. Jeremy Lazarus, president of the American Medical Association. “Our concern is that physician uncertainty and anxiety about being able to pay the bills will have an impact on taking care of patients.”

Am 29.12.2012 erschien dann nachfolgend ein dritter Artikel mit dem Titel “U.S. Fiscal Cliff: Senate Leaders Take Part In Last-Minute Talks” in der “Huffington Post“.

Dieser Artikel gibt einen detaillierten Überblick über den Stand der Verhandlungen und über die strittigen Punkte zwischen der Demokratischen Partei (Barack Obama) und der Republikanischen Partei (John Boehner).

Ich zitiere im folgenden nur die meiner Meinung nach wichtigsten Passagen aus diesem Artikel: “Senate leaders groped for a last-minute compromise Saturday to avoid middle-class tax increases and possibly prevent deep spending cuts at the dawn of the new year as President Barack Obama warned that failure could mean a “self-inflicted wound to the economy.”

Obama chastised lawmakers in his weekly radio and Internet address for waiting until the last minute to try and avoid a “fiscal cliff,” yet said there was still time for an agreement. “We cannot let Washington politics get in the way of America’s progress,” he said as the hurry-up negotiations unfolded.

Senate Republicans said they were ready to compromise. “Divided government is a good time to solve hard problems_and in the next few days, leaders in Washington have an important responsibility to work together and do just that,” said Sen. Roy Blunt of Missouri, delivering his party’s weekly address.

Even so, there was no guarantee of success.

In a blunt challenge to Republicans, Obama said that barring a bipartisan agreement, he expected both houses to vote on his own proposal to block tax increases on all but the wealthy and simultaneously preserve expiring unemployment benefits.

Political calculations mattered as much as deep-seated differences over the issues, as divided government struggled with its first big challenge since the November elections.

Speaker John Boehner remained at arms-length, juggling a desire to avoid the fiscal cliff with his goal of winning another new term as speaker when a new Congress convenes next Thursday. Any compromise legislation is certain to include higher tax rates on the wealthy, and the House GOP rank and file rejected the idea when Boehner presented it as part of a final attempt to strike a more sweeping agreement with Obama.

Yet lawmakers have until the new Congress convenes to pass any compromise, and even the calendar mattered. Democrats said they had been told House Republicans might reject a deal until after Jan. 1, to avoid a vote to raise taxes before they had technically gone up and then vote to cut taxes after they had risen.

Nor was any taxpayer likely to feel any adverse impact if legislation is signed and passed into law in the first two or three days of 2013 instead of the final hours of 2012.

Gone was the talk of a grand bargain of spending cuts and additional tax revenue in which the two parties would agree to slash deficits by trillions of dollars over a decade.

Now negotiators had a more cramped goal of preventing additional damage to the economy in the form of higher taxes across the board – with some families facing increases measured in the thousands of dollars – as well as cuts aimed at the Pentagon and hundreds of domestic programs”.

Im Klartext: Die “grosse Lösung” und der “grosse Wurf” wird jetzt in diesen letzten Tagen vor dem kommenden Neujahr nicht mehr anvisiert. Sondern man sucht jetzt eine mögliche “kleine Lösung“, um die zu erwartenden Schäden durch den Automatismus eines Falls des Landes über die “Fiscal Cliff” möglichst zu verhindern oder wenigstens abzumildern.

Soweit der aktuelle Stand der Verhandlungen, wie er aus diesen drei recht ausführlichen und informativen Artikeln in der “Huffington Post” zu entnehmen ist.

Creative Commons Lizenzvertrag Die USA und der drohende Sturz von der sogenannten “Fiskalklippe” – 15 Klaus Gauger steht unter einer Creative Commons Namensnennung-NichtKommerziell-KeineBearbeitung 3.0 Unported Lizenz

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