Those lame ducks continued to flap their wings and fly high with another major December achievement. With no media attention or ballyhooing from the Dems, the Medicare and Medicaid Extenders Act (HR 4994) was passed and signed into law by the President on December 15th. This legislation provides a one-year reprieve from a 25% reduction in Medicare payments of doctors' fees that would have otherwise kicked in on January 1, 2011 (although the name of the bill includes Medicaid, no such cuts in that program were included; instead, the bill actually provides for an expansion of some of its programs). An earlier proposed cut of 23% had already been scheduled for December 1. Fortunately, Congress took action in late November to thwart this bloodletting, at least in the short-term.
Such a draconian cut to Medicare payments would surely have resulted in a massive withdrawal of doctors from the program, a significant blow to its health and survival. Doctors stopping their treatment of patients - or suddenly asking for direct payment to continue their services - would have been devastating for the elderly, ill and most vulnerable among us. One can only imagine what would have happened had this bill not passed during the lame duck session, before the conservative/Tea Party takeover of the House. Their cry would have been, "The deficit, the deficit!" and their cheering would have been deafening as their decades-old dream of ending one of our most successful entitlements came ever-closer to realization. We must be ever vigilant in protecting these programs, and Dems must start fighting to prevent similar cuts from occurring next year when this extension ends. Otherwise, 43 million seniors and disabled, along with hundreds of thousands of doctors, will be severely impacted.
The key to this issue is the Sustainable Growth Rate (SGR), a complex formula dating to the 90's used to calculate doctors' payments. The senior New York Dem on the House Energy and Commerce's Subcommittee on Health, Rep. Eliot Engel (NY 17th), will have a one-year opportunity to discuss and influence this process in this Committee. Of course, he should expect rough sledding in the 112th Congress, but he must take up the fight, if for no other reason than to help his fellow Dems heading into the 2012 elections; Medicare and Social Security can be winning issues for Dems, if they come out strong in defense of these programs over the next two years.
As doctors' payments are discussed in Committee - along with a new formula for determining those fees - consideration must be given to an increase in payments for Primary Care Physicians (PCP). They are at the low end of the payment scale and are on the day-to-day front line of preventive medicine, acting as our gatekeepers and referring us to specialists when needed. A PCP is a diagnostician, tasked with spotting tell tale symptoms before they develop into a full-blown illness. These doctors have as many as 3,000 patient-visits a year, usually in large urban areas, and often are working in their offices until 10 p.m. plowing through mountains of paperwork. Overworked and underpaid, they are forced to spend less and less time with each patient.
How about offering these front-line providers a bonus at the end of the year for lowering the number of hospital admissions among their patients due to providing good, preventive health care? With such an incentive, they could spend more time with their patients and make better decisions on care that could translate into keeping their patients healthier and out of our very expensive hospital system. Less admissions, readmissions and fewer deaths equals savings in life and money. Even conservatives could get on board with such an idea, one would think.
For now, at least, our doctors have at least received a reprieve, and will have a much happier New Year, along with their patients.
Self-referral has contributed to the reduction of procedures done at local hospitals, who are more likey to work out a payment plan with patients. Not so much with private specialists. My current Neurology Group owns an MRI. I refuse to use their facility. I can bring my MRI to the neuro to look at if he/she wants, but I want a trained, licensed, board -certified Radiologist reading my films.
My father's Cardiologist recently stopped seeing in-patients because they are too busy doing Cardio-lite Stress Tests in the office. So, not only does your primary abandon you to the hospitalist, your specialist does too. I recently left my doc's practice, as the signs for skin care products and facials went up in the office--another problem.
Procedures in hospitals may have lessened but tend to be more expensive than in the doctors office. Just check out a simple X-Ray cost in office and a hospital. Quite a difference.
The hospitalist is involved in patient care when you are admitted the hospital and they coordinate all of your tests.
If your doctor is pushing beauty or skin products find another doctor., even if he is a dermatologist.
When I filled it out, it rejects my attempt because you MUST make a donation!!!!!!!!!
It asks for your employers name and your occupation, and even being unemployed with no occupation it demands money!
I haven't worked in 3 years.
Good luck in the New Year and I hope you find gainful employment.
http://www.healthcare-now.org/
Happy New Year.
Example: Its my understanding that unnecessary ER visits are down.
"Medical Home" and "Accountable Care Organizations" sprouting across the country are producing encouraging cost-savings and quality improvement results.
Yet, are these savings being passed-on to employers and those purchasing insurance; thus helping the economy? Or are savings growing the year-end bonus of top management at Insurance companies and other healthcare providers?
We can EASILY bring down healthcare costs by 25%. This reduction is not much. Our economically competing Western countries insure ALL and manage healthcare at 60% to 100% LESS costs per individual than we do.
Except for Medicare and VA which are federal programs, all others are at the state level; under the jurisdiction of politically appointed Health and Insurance commissioners. As new governors take the helm at the state capitals, there is where our attention, letter-writing and lobbying should be directed.
Concentrated efforts should also be in the East coast states where healthcare costs are significantly higher by a factor of 2 (looking at "per medicare enrolee" data) compared to mid-west and southern states.
Directly (financially) incentivizing individuals to be savvy consumers of healthcare will be the single biggest stimulus to the economy; while creating a more healthy individual , environmentt and society.
Yes, write to your state officials, but don't forget your Fed. Senator and member of congress.
Costs in the East are higher across the board on every thing. This is an expensive part of the country..
Those countries that you mention cover all of their citizens at half our costs, while providing better health care. That would mean going to a REAL National health program, such as IMPROVED MEDICARE FOR ALL.
What are those financial incentives you propose?
I was horrified when I realized that old and sick people were reporting to a place at a pre-arranged date and time to be exterminated. They were no longer useful to society. These elderly and even young but sick people went into machines and were euthanized. It troubled me deeply as a child seeing this and I remember my mother reassuring me that such a terrible thing would never happen in the real world. I think mom was wrong.
We may not be putting people into machines as the old B-movie suggested, but we are neglecting our elderly and most vulnerable among us, to the point that we might as well be.
It's not a problem now. I have no health insurance.
Become involved in the growing movement for single payer, removing the profit from health care with an IMPROVED MEDICARE FOR ALL.
Contact and join Healthcare-now.org PDA.org. PNHP.org All working for a single payer system, along with Public Citizen, the organization Ralph Nader created forty years ago.
What your doctor offered frankly, sounds illegal. What about contacting the health insurance commissioner in your state?.Maybe even the Attorney Genera;?
So, are they double dipping? Who gets the co-pay $$..the doctor or insurance company. Every procedure also went up. I don't mind the co-pays..if the 20% had been applied for the coming year..but in some ways..we are paying twice. Multify this action of Congress by zillions, the seniors on Medicare get a bum deal..
It is more complex than, I assume you meant to say raise Taxes? Our politics must change along with who we elect.
I appreciate your advocacy and links to help sites. thank you.
fanned!
You apparently mean "pay less in an increased tax than paying for the current tax plus the large health insurance premiums, copays, and coinsurance".
You haven't seen anything yet in either health insurance costs or taxes related to health care. The law passed and signed in March 2010, the "Affordable Care Act" has a long list of entire sections of the law that will have our health insurance premiums and other insurance-related costs sky-rocket. And there are over 600 reasons hat taxes will increase due to government-related activities and government-sponsored activities: new responsibilities, new programs, new commissions and advisory groups and more, as documented in a detailed analysis by a team of Medicare for All reviewers. The results of that analysis will soon be announced.
http://www.medicareforall.org/pages/Home.
Bob the Health and Health Care Advocate
Meanwhile those single payer advocates continue to work behind the scenes. They are not going away.
Seen too many in my own family run over until I spoke up for them.
that is Obamas plan to kill non productive, non tax paying, seniors and disabled.
They take our money and then when we try to use it, it dosent pay.
Now Obama is de funding ss so seniors and disabled are screwed.
In Nov 2012 we will have a voice.
There are 59 million people on ss, thats a lot of votes.
F&F
I know my primary care doctor works incredibly long hours - and maybe makes 100,000 a year. He also has to wait months and months for payment.
So I dont agree with you. We need our doctors. Some states have hardly any Medicare doctors anymore.
Need further proof of inequity? Life expectancy for the wealthy is 7 years more than for poor. Most docs now practice consierge medicine, further alienating the poor. Cranston was right when he said the poor should just die quickly. That's the republican plan.
Judging from these posts there are people who are very knowledgeble, and more then qualified/ competent to advocate/justify a single payer system. This is the only logical/humane solution to our huge healthcare crisis, that as everything else in our greed motivated system, mostly impacts and sacrifices the most vulnerable/defenseless class in our society, a society now well acustomed to attacking the most helpless in it's class, to shamelessly rob them, of what little they have left, until there is nothing left to take. The long term intent of the GOP, Party of Good Ol Proffit at any/all cost, is nothing short of criminal intent. In this case, for the Greedy Ol Party, it has been like takeing candy from a baby.
Yes, da money has to be removed from our health care and become non profit, and so we do need an IMPROVED MEDICARE FOR ALL.
Example: see the facts between the Medicare we have and the Medicare we will have.
http://www.medicareforall.org/pages/Improved_Medicare_for_All
Example: get answers to your questions, many of which link to more details if and when you want more.
http://www.medicareforall.org/pages/Answers
Happy New Year 1/1/11
Bob the Health and Health Care Advocate
Historically, Medicare was an anti-poverty program of the Great Society that lifted the elderly from being the poorest sector to the most affluent (on average). It is a success by any measure but now needs re-conceptualizing. Since the elderly are now the holders of the majority of America's wealth (albeit maldistributed and often illiquid) it only makes sense to means test this program (as is true to a degree with part B now) based on net worth as well as income. The primary funding source should be progressive taxation not the flat payroll tax.
This bedrock program must endure. In the long run Medicare should be open to all Americans. Means testing and buy-ins could apply across all age groups. Insofar as it operates at 95% efficiency, running all of health care through Medicare would save hundreds of billions of dollars currently skimmed by for profit entities, enabling us to cover everyone with money to spare.
And a progressive tax system is needed .
Our national values and priorities do need a complete about face.