McClellan's legacy
Mark McClellan is leaving his post as head of the Center for Medicare and Medicaid Services. He served long and loyally, sticking to the Administration's line even when facts indicated otherwise, remaining a calming force when Part D enrollment was going nowhere. McClellan is also known for listening hard to suggestions and criticism from all sides, and working diligently to address problems.
Here's what's happened during his tenure.
Part D was passed, implemented, and operational. This was a monumental task, and one McClellan was instrumental in accomplishing. It's not his fault it is a fatally flawed program; well, maybe it is, in some small part, as he was probably involved in writing/editing/opining on the legislation. Nevertheless, under McClellan the program became reality, with the initial enrollment problems addressed (in large part).
McClellan is leaving before making a serious effort to add Health Spending Accounts (HSAs) to Medicare, a change he talked about early this year.
While some would say we'll have to wait for historians to judge McClellan's performance, we already have one group that can act as a surrogate for historians - actuaries. And their assessment is, well, instructive.
Physician utilization has continued to drive Medicare costs up and up and up. Prices for services have been held low, so docs are simply doing more procedures.
And Part D will be unbelievably expensive. 8 trillion dollars of Medicare's total long term deficit is due to Part D.
The changes, and lack of changes to Medicare over the last few years may well result in the financial collapse of the system within five years.
My take? McClellan may have done more to usher in national health care than anyone else.
And that would be quite an accomplishment.
(thanks to Kimble Ross for pointing out my error in the original post; I said it was Scott, not Mark McClellan. Mark was Bush's press secretary for several years, and is Mark's brother)