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Thread: Part of the overall Health Care "plan"

  1. #1
    Senior Member Gerry Clinchy's Avatar
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    Default Part of the overall Health Care "plan"

    US Senate scheduled to vote on physician Medicare payment bill beginning Monday, October 19.

    ** The ISSUE:

    Medicare payment to physicians is set to be slashed 21.5% in January 1, 2010, with a cumulative total of 40% reduction in reimbursements planned over the next few years. This is due to the flawed Medicare physician payment formula put in place in 1999.

    Fair payment is critically important to ensure access to care for our senior citizens and the disabled. Plus, Tricare has been using Medicare rates so the issue impacts our military as well.

    Medicare cuts can prevent doctors from seeing new Medicare patients, discourage them from investing in health technology, and make many consider closing their practices altogether!

    The formula must be repealed and replaced with a fair, stable system that better matches the cost of providing care. S 1776 is critical to help get us toward that goal.
    --------------
    Seems reasonable that a formula created 10 years ago may not reflect the cost of care today, just taking into account technological advances in medical care in that 10-yr period.

    If S1776 does not pass, and Medicare participants begin having trouble finding doctors who will accept the reimbursement levels of Medicare, it might make some people want to move toward the new health care proposals.

    Or it might make some people realize that the private insurance companies negotiating lower payment schedules is minor league compared to the govt negotiating lower payment schedules.

    For those of us who are still fortunate enough to be employed, imagine taking a 20% pay cut starting January 2010. In the midst of rising costs for utilities, property taxes, and other daily commodities, such a pay cut would be a substantial one.
    G.Clinchy@gmail.com
    "Know in your heart that all things are possible. We couldn't conceive of a miracle if none ever happened." -Libby Fudim

    ​I don't use the PM feature, so just email me direct at the address shown above.

  2. #2
    Senior Member Gerry Clinchy's Avatar
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    Just to be clear on this - the flawed SGR formula on which Medicare reimbursements to physicians is based has called for a significant reduction in reimbursements to physicians across the board since 2003. EACH YEAR SINCE THEN, Congress, which has been aware of the flaw in the formula all along, has acted to POSTPONE the reduction. At the current time, a 21% decrease is scheduled for January 2010.

    If implemented as passed in 1999, physicians across the nation would eventually suffer a cumulative decrease of 40%i n Medicare reimbursements! Of course, practicing physicians know that Medicare reimbursements have already dropped nearly that much in the past 10-15 years, dragging commercial insurance reimbursements down with them. Health care costs might be rising - but it's not because doctors are getting paid more.

    None of those SGR decreases has yet actually occurred largely due to the advocacy efforts of America's physicians on behalf of their senior citizen patients, whom they could no longer afford to treat if the decreases went into effect. But Congress has so far refused to take action to permanently fix what they clearly know is a flawed formula - hospital and long term care reimbursements are based on a different formula, allowing for small increases in reimbursements each year. FIXING the Clinton administration's flawed formula should NEVER HAVE BEEN a part of the broader health care reforms currently being debated - it should have been fixed long ago.

    Each year, the AMA, the American College of Surgeons, and other physician advocacy organizations, along with their senior citizen patients, have been forced to beg Congress not to impose the draconian cuts which could make it impossible for many doctors to treat Medicare patients at all. Commercial insurance already subsidizes Medicare reimbursements to an extent - but there's no way physicians can "cost shift" to make up such double digit losses in reimbursement. The bottom line is that this flawed formula MUST BE FIXED, before any talk of health care reform can continue.
    G.Clinchy@gmail.com
    "Know in your heart that all things are possible. We couldn't conceive of a miracle if none ever happened." -Libby Fudim

    ​I don't use the PM feature, so just email me direct at the address shown above.

  3. #3
    Senior Member YardleyLabs's Avatar
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    Quote Originally Posted by Gerry Clinchy View Post
    US Senate scheduled to vote on physician Medicare payment bill beginning Monday, October 19.

    ** The ISSUE:

    Medicare payment to physicians is set to be slashed 21.5% in January 1, 2010, with a cumulative total of 40% reduction in reimbursements planned over the next few years. This is due to the flawed Medicare physician payment formula put in place in 1999.

    Fair payment is critically important to ensure access to care for our senior citizens and the disabled. Plus, Tricare has been using Medicare rates so the issue impacts our military as well.

    Medicare cuts can prevent doctors from seeing new Medicare patients, discourage them from investing in health technology, and make many consider closing their practices altogether!

    The formula must be repealed and replaced with a fair, stable system that better matches the cost of providing care. S 1776 is critical to help get us toward that goal.
    --------------
    Seems reasonable that a formula created 10 years ago may not reflect the cost of care today, just taking into account technological advances in medical care in that 10-yr period.

    If S1776 does not pass, and Medicare participants begin having trouble finding doctors who will accept the reimbursement levels of Medicare, it might make some people want to move toward the new health care proposals.

    Or it might make some people realize that the private insurance companies negotiating lower payment schedules is minor league compared to the govt negotiating lower payment schedules.

    For those of us who are still fortunate enough to be employed, imagine taking a 20% pay cut starting January 2010. In the midst of rising costs for utilities, property taxes, and other daily commodities, such a pay cut would be a substantial one.
    This is an important issue that is indirectly linked to much of the debate on health care. On a year by year basis, Congress has voted each year since 1996 to put off implementing the requirement for annual rate cuts. In the House Bill, the requirement was eliminated resulting in a CBO cost estimate of over $200 billion over the 10-year period. By pulling this issue out of the health care reform package and voting on it separately, the cost estimates for the House bill are reduced to be comparable to the costs for the Baucus bill and brings both bills under the maximum cost that Obama said he would sign.

  4. #4
    Senior Member Gerry Clinchy's Avatar
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    The cost of eliminating the anticipated reduction in reimbursements I've found stated somewhere between $240 to $247 billion.

    Since they've been delaying these decreases each year, somebody should have been anticipating that the decreases might not materialize ... as seems to be happening now. They have not planned any revenue increases to offset the $240 billion cost. This will add to the overall deficit on its own ... just won't be counted in the ObamaCare bill costs. By golly, looks like the peas under the walnut shells once again.

    Since seniors tend to vote, and 2010 is an election year that the Ds are a bit concerned about ... what da ya think will happen?

    Not saying that S1776 is a bad bill in and of itself ... but somebody should have been planning ahead.
    G.Clinchy@gmail.com
    "Know in your heart that all things are possible. We couldn't conceive of a miracle if none ever happened." -Libby Fudim

    ​I don't use the PM feature, so just email me direct at the address shown above.

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