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View Full Version : $247 Billion in Medicaid not counted in healthcare costs!



Eric Johnson
10-20-2009, 03:30 PM
http://www.google.com/hostednews/ap/article/ALeqM5i8RDSl65WFPHvC7xWMOPApdecI3QD9BEM6UG0

http://tinyurl.com/yhm8nf2

Analysis: Courting doctors in health care battle
By DAVID ESPO (AP) 12 hours ago

WASHINGTON In the special interest war over health care, the White House and congressional Democrats have the nation's drug makers and hospitals generally on their side; the insurance industry, not so much.

Now the bill's supporters are making a play to lock in the American Medical Association, the organization that says it represents 250,000 doctors and medical students in every state and congressional district. The principal enticement, a $247 billion measure making its way to the Senate floor, aims to wipe out a scheduled 21 percent rate cut for doctors treating Medicare patients and replace it with a permanent, predictable system for future fee increases.

-more-

TXduckdog
10-20-2009, 05:40 PM
FYI....the AMA represents about 40% of the physicians in the US.

luvmylabs23139
10-20-2009, 06:22 PM
This is a way to hide the cost of the healthcare reform. They have yet to say how they will pay for this.

TXduckdog
10-20-2009, 06:50 PM
Just in from the "not a real news agency".

Senate Leaders Reconsider Medicare 'Doctor Fix' That Critics Say Adds $247B to Debt
Democratic senators and a coalition of interest groups are pushing for a so-called "doctor fix" -- a 10-year $247 billion measure to block a planned 20 percent cut in Medicare reimbursement fees to doctors mandated by a 1997 federal law.


http://www.foxnews.com/politics/2009/10/20/democrats-attempt-block-medicare-reimbursement-fees-draws-criticism-deficit/?test=health

"Senate Budget Committee Chairman Kent Conrad, D-N.D., is leading the way in opposing the unpaid-for Stabenow bill.

"Things have got to be paid for," the moderate Democrat told reporters Tuesday. "I'm not going to advance things that aren't paid for, by cloture vote or any other vote. I'm as clear as I can be."

Conrad was referring to a procedural move known as "cloture" that allows the majority leader, with the consent of 60 senators -- two-thirds, if all 100 members are present -- to move beyond a filibuster.

And Conrad has an alternative to the Stabenow measure. He has paired up with Iowa Sen. Chuck Grassley, the top Republican on the Finance Committee, to craft an amendment that stops the cuts for two years, a $25 billion measure that both senators intend to pay for with offsets. "

YardleyLabs
10-21-2009, 03:00 PM
http://www.google.com/hostednews/ap/article/ALeqM5i8RDSl65WFPHvC7xWMOPApdecI3QD9BEM6UG0

http://tinyurl.com/yhm8nf2

Analysis: Courting doctors in health care battle
By DAVID ESPO (AP) – 12 hours ago

WASHINGTON — In the special interest war over health care, the White House and congressional Democrats have the nation's drug makers and hospitals generally on their side; the insurance industry, not so much.

Now the bill's supporters are making a play to lock in the American Medical Association, the organization that says it represents 250,000 doctors and medical students in every state and congressional district. The principal enticement, a $247 billion measure making its way to the Senate floor, aims to wipe out a scheduled 21 percent rate cut for doctors treating Medicare patients and replace it with a permanent, predictable system for future fee increases.

-more-
For the record, the costs are for Medicare, not Medicaid. The original bill being modified required that physician fees be reduced every year that health care costs rise faster than inflation. Ever since the bill was passed, bills have been adopted -- generally with Republican sponsorship -- to defer implementation to avoid fee cuts that would result in physicians refusing to accept Medicare patients. The original House bill repealed the requirement for automatic rate cuts at a cost estimated by the CBO at $247 billion over 10 years. A bill to eliminate the requirement for automatic rate cuts was just considered by the Senate. No Republicans supported a motion to end a filibuster and vote on the bill. Accordingly this bill will not pass. I assume that means that Republicans are now arguing that rates should be cut automatically.

In the meantime, the repeal of these automatic cuts has been removed from the health reform bill, bringing total costs down sufficiently so that CBO now estimates that the bill, if adopted, would reduce the deficit. There is no need to pass the rate change to pass health reform. I am certain that, in the future, a separate bill will be introduced to defer the rate cuts as they have been deferred in the past. This will pass with widespread Republican support since no one believes that such rate cuts can be imposed without disastrous consequences. For now, however, they are still hoping to force the rate revision into any health reform bill to artifically inflate the cost.

Eric Johnson
10-21-2009, 05:11 PM
...In the meantime, the repeal of these automatic cuts has been removed from the health reform bill, bringing total costs down sufficiently so that CBO now estimates that the bill, if adopted, would reduce the deficit. There is no need to pass the rate change to pass health reform.

I stand corrected.

However, you are engaging in the same smoke and mirrors that was the basis for the story. Medicare or Medicaid, the costs must be included in the cost of "healthcare reform" or else there is no true picture of the cost of the program.

Of course, there's no true picture anyway due to the sleight of hand in Senator Bachus' bill. He should be the first off the end of the plank for trying that "...such sums as may be necessary..." nonsense.

Eric

YardleyLabs
10-21-2009, 05:16 PM
I stand corrected.

However, you are engaging in the same smoke and mirrors that was the basis for the story. Medicare or Medicaid, the costs must be included in the cost of "healthcare reform" or else there is no true picture of the cost of the program.

Of course, there's no true picture anyway due to the sleight of hand in Senator Bachus' bill. He should be the first off the end of the plank for trying that nonsense.

Eric
Why shouldn't those costs stand on their own? The change is not essential for health care reform and will be addressed legislatively whether health care reform is adopted or not. Do it as part of a separate bill or don't do it all for now. If Republicans choose to vote to have physician rates paid for Medicare recipients to be automatically cut 21% now and more in the future, let them explain their votes to the electorate. It is not a matter of smoke and mirrors; it is a matter of clarity.

luvmylabs23139
10-21-2009, 06:09 PM
It was voted down in the senate. 13 democrats joined with republicans.

Gerry Clinchy
10-21-2009, 06:53 PM
Some view this as the first vote on overall health care reform, i.e. showing how much strength the administration has in the arena. We'll have to wait and see if this assessment is correct.

The prediction is that without eliminating the 20% cut to doctor fees that this legislation would have postponed for ten years, doctors will accept 30% fewer medicare patients. I believe that if doctors refuse the Medicare reimbursement for a procedure, then the "gap" insurors also will not pay the doctor.

Even if the bill had passed, the reimbursements would have been frozen at present levels for those 10 years ... while costs to the doctors would have continued to increase. By the end of the 10 years, it would have been anticipated that doctors (being under-reimbursed) would have gradually reduced the number of Medicare patients they accepted.

It would appear that this reimbursement reduction would essentially mean that those on Medicare are back to square one ... no effective insurance if they can't find a doctor who will accept the Medicare reimbursement rate.

OTOH, if doctors continue to accept Medicare patients, then they will charge higher fees to non-Medicare patients ... thus increasing costs to everyone else.

This could be one of the important failings of the government's planning. They did not plan for increasing costs. When the program was started they did not anticipate the medical advances that come at a price. Perhaps they also did not anticipate that providing health care for older citizens would increase life span, thus keeping more recipients getting benefits for a longer time.

They keep saying that Medicare will go bankrupt in a few years. There will still be money going into the fund ... so how will the limited funds be distributed? How will they choose who gets what funds are available?

dnf777
10-21-2009, 07:43 PM
Suppose Obama gets his healthcare reform with some version of a public option...that would be a victory for his administration by all measures. Assuming the sky doesn't fall, and no major swing in the economic situation occurs......basically all else stays relatively calm....would a healthcare victory "spend" all is political capital and leave him weaker.....or would it embolden him and elevate his political clout??

Gerry Clinchy
10-21-2009, 08:19 PM
Will be interesting to see, Dave.

Eric Johnson
10-21-2009, 08:39 PM
Jeff-

Since this has be OBE, not much point in debating. However, it is properly part of the reform issue as it is something about how the healthcare system in this country works.

Eric

YardleyLabs
10-21-2009, 10:03 PM
Jeff-

Since this has be OBE, not much point in debating. However, it is properly part of the reform issue as it is something about how the healthcare system in this country works.

Eric
So, are you arguing that the physician fees should be cut unless a general health plan is adopted?

dnf777
10-22-2009, 06:01 AM
The medicare fee schedule equation is the most bizarre thing I've seen! When used properly, a demonstrated increase in need, and increase in utilization, results in a decrease in funding. Not that gov't hasn't done stupid things before, but the actual authors of the plan openly admitted that it was a mistake, a flaw in their math skills, and would harm the very program they were trying to foster. What did congress do with that revelation? Said, thank you, we'll just keep using it. Try doing that to teamsters or teachers!!!

Gerry Clinchy
10-22-2009, 12:30 PM
The medicare fee schedule equation is the most bizarre thing I've seen! When used properly, a demonstrated increase in need, and increase in utilization, results in a decrease in funding. Not that gov't hasn't done stupid things before, but the actual authors of the plan openly admitted that it was a mistake, a flaw in their math skills, and would harm the very program they were trying to foster. What did congress do with that revelation? Said, thank you, we'll just keep using it. Try doing that to teamsters or teachers!!!


Well, that's one way to control costs when you've screwed up on (or are trying to conceal) your cost estimates! ;-)

Was it a flaw in their math skills or intentional to conceal the true costs of the plan in the earlier years? Remember the LBJ statement: "If they know how much this will cost, it will never pass."

Is there a reason why we distrust government cost estimates? We'd be remiss if we didn't!