The article argues that recent executive overreach and politicization have severely undermined established norms of U.S. civil-military relations. To restore professional standards, the incoming Congress must actively exercise its oversight powers, moving beyond mere criticism to demanding transparency in defense policy and personnel decisions. Key reforms include enforcing meritocratic promotion processes, requiring documented justification for senior officer removals, and preventing the partisan use of the military. These actions are crucial for bolstering public trust and ensuring the military remains a nonpartisan instrument of civilian control.
Quantitative and Policy Analyses Related to Medicare Global Surgical Services
English Summary
This RAND report analyzes Medicare's global surgical payment system, which bundles pre-, intra-, and post-operative care into a single fee. The core finding is that Medicare may be overvaluing these services because actual patient utilization falls far short of the assumed rates built into the current payment structure. Key evidence from claims data shows that for minor procedures, only a minimal percentage (e.g., 1.8% in CY 2024) of expected post-operative visits are actually reported to CMS. Policymakers should use these findings to significantly update and potentially reduce global surgical package valuations to ensure payments accurately reflect actual clinical needs and resource consumption.
中文摘要
這份 RAND 報告分析了 Medicare 的全球性手術支付系統，該系統將術前、術中和術後護理打包成一個單一費用。核心發現指出，由於實際病患利用率遠低於當前支付結構所假設的標準，Medicare 可能對這些服務進行了過度評估。從索賠數據獲得的關鍵證據顯示，對於小型手術而言，預期的術後就診次數中，只有極小的比例（例如 2024 會計年度為 1.8%）實際提交給 CMS。政策制定者應利用這些發現，大幅更新並潛在地降低全球性手術套餐的估值，以確保支付金額能準確反映實際的臨床需求和資源消耗。
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