Archive for the ‘medicare’ Category

Medicare Rationing Begins in January, 2011

Saturday, January 9th, 2010

An article by AAPS Director Richard Amerling, MD was featured today at Medical Progress today:

House and Senate Democrat leaders, and President Obama, argue that they can “pay for” health insurance “reform” by cutting $500 billion from Medicare spending over the next decade—largely through arbitrary reimbursement cuts,— without reducing the quality of care delivered to beneficiaries.

Yet, in January, 2011, Medicare will implement a new payment system for patients receiving dialysis for end stage kidney disease that will severely ration care to this vulnerable (and largely minority) population based on equally arbitrary payment reductions. These patients will be the unfortunate canary in the Medicare coal mine: “reform” legislation will expose millions of Medicare patients to rationing and reduced quality of care.

READ ENTIRE ARTICLE

Posted in health care reform, medicare | No Comments »

Reid bill would “bend the cost curve” up

Saturday, December 12th, 2009

The Office of the Actuary of CMS released an analysis of the Reid bill  detailing increases in costs and expenditures, and unrealistic assumptions about Medicare “savings.”

The bill is likely to make more providers unwilling to treat Medicare and Medicaid beneficiaries, at the same time that demand for services increases. (more…)

Posted in health care reform, medicare | 2 Comments »

Myth 24. Medicare is the model of efficiency and fairness.

Sunday, October 18th, 2009

Medicare is immensely popular, has very low administrative costs, is already a working model,… it is said: Why not just have Medicare for all?

At one time, calling Medicare “socialized medicine for the elderly” caused stunned silence in the Congress. Now, if one opposes “socialized medicine,” at least one listener is bound to dare you to say you’re opposed to Medicare. (more…)

Posted in health care reform, medicare, mythbusters | 8 Comments »

Medicare veto override a triumph for single-payer advocates, Krugman writes

Monday, July 21st, 2008

Ostensibly, the vote was against pay cuts for doctors. But it was really about “creeping privatization of Medicare,” writes left-wing columnist Paul Krugman.

Krugman blames Medicare deficits on the Medicare Modernization Act. Not Part D, but Medicare Advantage private fee-for-service plans. He asserts that these rapidly growing plans cost the government 17% more per beneficiary, while threatening to “undermine Medicare’s universality.” Insurance companies “cherry-pick healthier and more affluent older Americans, leaving the sicker and poorer behind”—in the wonderful “traditional” Medicare system that leftists want all Americans to have.

Krugman notes, correctly, that previously payments to doctors were maintained through “bipartisan fudging.” That is, “politicians from both parties got together to waive the rules. In effect, Congress kept Medicare functioning by expanding the federal budget deficit” (NY Times 7/11/08).

President Bush vetoed the bill preventing a 10.6% cut in Medicare fees because it was attached to payment cuts to Medicare Advantage plans. In addition, in his veto message he stated: “[The bill] would imperil the long-term fiscal soundness of Medicare by using short-term budgetary gimmicks that do not solve the problem; the result would be a steep and unrealistic payment cut for physicians—roughly 20% in 2010—likely leading to another expensive temporary fix” (Iglehart JK, N Engl J Med 10.1056/NEJMp0805760).

Krugman is exultant because the Democrats’ ability to stop a filibuster and override a veto make “the odds of achieving universal health care, soon,…look a lot higher than they did just a couple weeks ago.”

The AMA also celebrated, calling the legislation a significant victory. Through paid advertisements, the AMA exerted intense pressure on Republican senators initially opposed to the measure, Iglehart noted. The bill also staves off the scheduled 2009 cut.

“Good job, AMA leadership,” writes Dr. Thomas LaGrelius, president of the Society for Innovative Medical Practice Design (SIMPD). “You made the enemy very happy.”

The bill also killed competitive bidding for new equipment, which reportedly would have saved the program billions of dollars. For example, copayments for an oxygen concentrator for Medicare beneficiaries now total $1,428 over 36 months—more than double the purchase price. Medicare rents it for $198.40/mon, and the copayment is 20%. Medical equipment suppliers lobbied fiercely against this provision (Consumer Power Report #136, 7/18/08, citing Michael Leavitt, “Will Congress Continue a Medicare Scam?” Wall St J 7/9/08). (DME suppliers posted numerous comments in response to this article, regarding the value of the follow-up services they provide, and the Medicare rules and regulations.)

Additional information:

Tags: , , ,
Posted in medicare, single payer health care | 3 Comments »

Retirees projected to need $225,000 per couple for medical costs

Saturday, June 21st, 2008

According to an annual study released by Fidelity Investments, a couple retiring this year will need about $225,000 to cover lifetime medical costs. The study assumes no employer-sponsored retiree coverage. It includes Medicare premium payments, copayments, and deductibles, as well as out-of-pocket prescription drug costs.

The figure has increased 4.7% since 2007. Fidelity’s first study in 2002 found that a couple needed $160,000 in savings to fund medical costs in retirement. Given current levels of savings, 6 in 10 retirees are “at risk” of not being able to maintain their standard of living (Eileen Alt Powell, Associated Press 3/6/08).

The very first cause listed for the rising costs, notes Dr. Lawrence Huntoon, is “the cost of a doctor’s visit”—expected Medicare fee cuts notwithstanding. Other causes are stated to include increased utilization, new technology, and increasing incidence of chronic diseases such as diabetes.

The study assumes, apparently, that Medicare will somehow be able to continue current premiums and benefits.

The federal government projects that by 2017, consumers and taxpayers will spend more than $4 trillion on medical care, $1 of every $5 spent, with the amount increasing at nearly three times the rate of inflation. The percentage paid by federal and state governments is projected to increase from 46% in 2006 to 49% over the next decade.

“Medicare, on its current course, is not sustainable,” testified Health and Human Services Secretary Michael Leavitt (Kevin Freking, Associated Press 2/26/08).

Neither John McCain, Hillary Clinton, nor Barack Obama listed dealing with the coming crisis in financing retirees’ medical care among their stated goals, according to the Kaiser Family Foundation. Obama calls for “expanded public insurance.”

The AMA’s National Health Care Policy Agenda also fails to mention this problem. It simply calls for Congress and the next Administration to “permanently replace the flawed payment formula.” Nor does the AMA allude to the problem in its ten questions for candidates.

Additional information:

Posted in economics, medicare | No Comments »

U.S. suffers from fiscal cancer, states U.S. Comptroller David Walker

Wednesday, January 23rd, 2008

Ignored by most politicians, David Walker, who heads the Government Accountability Office (GAO), is taking his message on tour. His presentation on the unsustainability of the U.S. economy can be viewed on YouTube.

The biggest contributor to the coming fiscal meltdown is the Medicare prescription drug benefit.

Boston University professor Laurence Kotlikoff asks the question “Is the United States Bankrupt?” in a paper published in the Federal Reserve Bank of St. Louis Review, July/August 2006.

“[W]e have a country at the end of its resources. It’s exhausted, stripped bear (sic), destitute, bereft, wanting in property, and wrecked (at least in terms of its consumption and borrowing capacity) in consequence of failure to pay its creditors,” Kotlikoff writes, paraphrasing the Oxford English Dictionary. “In short, the country is bankrupt and is forced to reorganize its operations by paying its creditors (the oldsters) less than they were promised.”

Mike Adams predicts that the United States will play the Ace up the sleeve. “It’s the Ace that all governments eventually play on their way to bankruptcy and collapse”: hyperinflation (NewsTarget.com 7/17/06).

Massive tax increases are likely to trigger major supply-side responses of the type that have not yet arisen in this country, Kotlikoff notes. For example, Uruguay, with very high net tax rates, has lost more than 500,000 young and middle-aged workers, largely from the nation’s best educated citizens, to Spain and other countries in recent years.

The longer Washington persists in denial, the worse the ultimate outcome, Walker warns.

Additional information:

Posted in medicare | 2 Comments »

Medicare fee cut threatened again; AMA to fight for balance billing

Thursday, December 20th, 2007

In what has become an annual ritual, Medicare announces a cut in physicians’ fees, and physicians threaten that patients will lose access to care. And this time they really mean it.

An average 10.1% fee cut was slated to take effect on Jan 1, 2008. Two-thirds of the doctors in Sarasota County said they would stop accepting new Medicare patients if federal payments don’t improve.

For the first time in either group’s memory, the AMA and the American Association of Retired Persons (AARP) are working together to lobby Congress on this issue.

Legislation crafted by the Senate Finance Committee, which postponed the scheduled cuts by 6 months and extended SCHIP funding until March 2009, was approved on a voice vote. (Kevin Freking, AP 12/18/07)

“They keep kicking the can down the highway without fixing the real problem,” said AMA board chairman Edward Langston, M.D. (David Gulliver, Sarasota Herald Tribune 12/4/07).

As House and Senate considered a measure to delay Medicare cuts until June, Rep. Pete Stark (D-CA) said, “To push the problems ahead six months is insane.” Senator Jon Kyl (R-AZ) “This kicks the can down the road. That’s going to be tougher next year. There’s a geometric progression which makes it worse each year.”

Congress would “pay for” the measure by trimming $1.5 billion from a fund established for certain insurers that entered underserved regions and by freezing payments for inpatient rehabilitation and prescription drugs provided by physicians under Medicare Part B. The AARP was unhappy that Congress did not cut payments to Medicare managed-care plans.

In response to pressure from delegates at the interim meeting of the AMA, the AMA has said it will “renew [the] fight for Medicare balance billing” —an action that AARP does not support.

The policy adopted by the House of Delegates directs the AMA to “devote its political and financial resources to initiate a measure at the appropriate time that would allow Medicare balance billing” (amednews.com 12/3/07). The resolution did not pass without dissent. Some delegates say the new policy “may draw critics who say physicians are too concerned about money.” Also, “a major push for balance billing would alienate seniors and distract Congress from working on the sustainable growth rate.”

As usual, a reprieve from a pay cut is expected to come at a price. The Pharmaceutical Care Management Assn. is pushing to include an e-prescribing mandate in legislation postponing the fee cut. PCMA is running ads that say “While you wait, thousands die each year” [from lack of e-prescribing] (David Glendinning, amednews.com 11/26/07).

It is claimed that electronic health records would help curb rising costs and hence help offset the cost of a physician pay increase. And who would pay for the EHR?

Health and Human Services Secretary Michael Leavitt said, “In my view, any new bill should require physicians to implement health [IT] that meets department standards in order to be eligible for higher payments from Medicare.” For the moment, this proposal was not enacted.

Only 10% of physicians in solo or small group practices use EHR systems, which can cost $20,000 to $40,000 to implement (iHealthBeat 12/4/07).

Additional information:

Tags: , , ,
Posted in medicare | 4 Comments »