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Center for Regulatory Effectiveness

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Fanne Fox and Medicare
The President of the Federal Reserve Bank of Dallas noted that Medicare was designed as "a pay-as-you-go program from the very beginning, despite warnings from some congressional leaders-Wilbur Mills was the most credible of them before he succumbed to the pay-as-you-go wiles of Fanne Foxe, the Argentine Firecracker-who foresaw some of the long-term fiscal issues such a financing system could pose. Unfortunately, they were right."

Richard Fisher goes on to explain the just the unfunded portion of Medicare liabilities is over $85 trillion. "That is more than six times as large as the bill for Social Security. It is more than six times the annual output of the entire U.S. economy."

Given the magnitude of Medicare's economic burden, it's inevitable that some preliminary efforts to limit program costs have begun. The recent rule initiating a competitive bidding process for durable medical equipment is the prime example. Not surprisingly, regulatory watchdogs are springing into action to protect public finances and public health during the reform efforts.

One limitation on many watchdogs is the fixed notice-and-comment periods on rulemakings. Because agencies are not transparently open to public input and new data throughout the regulatory development and implementation process, NGOs are not able to formally participate in crucial portions of the regulatory process.

When formal participatory mechanisms are closed, informal mechanisms, ranging from influential blogs to private contacts, remain open but not necessarily public or accessible to many affected persons. Participation in the regulatory process is now a 24/7 endeavor. The only question is whether ongoing public participation will take place in Justice Brandeis' disinfecting sunlight.

There needs to be an open accessible mechanism that allows all stakeholders to transparently participate in the regulatory process on an ongoing basis. CRE's Interactive Public Docket fills the need by allowing everyone the ability to read and comment on the major submissions to CMS' competitive bidding docket and to post detailed supporting studies. The IPD brings a transparent participation tool to watchdogs everywhere.

See Medicare Interactive Public Docket

See Richard W. Fisher remarks

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