With respect to the ongoing search for savings within the healthcare industry, Medicare costs continue to represent the ultimate honey pot - and confusion seems to be the order of the day.
Yesterday’s L.A. Times, in explaining where the president’s “savings” would come from, said: “He (President Obama) has proposed more than $600 billion in cuts and changes to the government’s Medicare and Medicaid programs.”
Today, the same paper reported that the American Medical Association is now supporting the president’s plan partly because of “an agreement to stop planned cuts in Medicare payments that are worth $228 billion to doctors over 10 years.” Yet there has been no other report of any new agreement.
At the same time, the New York Times reports that the House version of the bill will be amended to provide for savings in the Medicare program, specifically targeting geographical areas that have experienced higher costs.
This has caused the nonpartisan Congressional Research Service to charge that the proposal “would not accurately identify and reward” individual doctors, as reported in the Times.
The Congressional Research Service also said, according to the Times, “Medicare might penalize efficient doctors providing high-quality care just because they were in a region where per capita spending was high and the quality of care, on average, was low.”
The issue is being obfuscated to the point that no senior on Medicare can make a rational decision as to the plan’s impact on his or her future care.
Until the terms of the plan are specifically spelled out, wariness should be the order of the day for those so affected.
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Comments: 33
What's your source, specifically, for that statement?
I have this problem, I know where the specific reference is, and I would be glad to send it, but, found here is out of date
. I know the press conference is covered on the whitehouse.gov site, but I have no desire to look it up for you. I have moved on. The savings are there, just as Dexter asserts.
Report Emphasizes Shortfall in Medicare
[excertped from]
Washington Post
By Jonathan Weisman Staff Writer
Thursday, March 24, 2005; Page A01
The two independent trustees overseeing Social Security and Medicare broke with the Bush administration's trustees yesterday, saying Medicare's financial problems far exceed Social Security's and are in urgent need of attention.
Republican Thomas R. Saving and Democrat John L. Palmer said Social Security's condition has changed little since they joined the Social Security and Medicare Boards of Trustees in 2000. But in the trustees' report released yesterday, they wrote that Medicare's prospects have "deteriorated dramatically" with rising medical costs and the addition in 2003 of a prescription drug benefit.
...
"The financial outlook for Social Security has improved marginally since 2000," wrote Saving and Palmer. "In sharp contrast, Medicare's financial outlook has deteriorated dramatically over the past five years and is now much worse that Social Security's."
Over time we received various machines which was the latest in its category. Untold new style cannulas (oxygen tubes) and different measuring cups for meds. In the years she used various equipment supplied through Medicare we received an obscene number of sample type deliveries from companies trying to get us to use their products. There must have been a disconnect between the companies sending the items and Medicare. After her doctors and the state servicing agency made an agreement to not allow any payments for any new items unless they received a prescription from the doctor the deliveries only "slowed down".
Medicare was a good provider of services but there was a huge gap in verifying shipments which would turn into payments if we hadn't denied or appealed them. Just by broadening our experience I am sure there are tons of waste which could be removed with better oversight I learned it was the states which had the primary over sight and Missouri was lousy at doing it.
I am sure some seniors might worry about changing benefits but just as we experienced over zealous suppliers many of those who received Medicare could put forth minimal effort to stop some of the over payments and payments for wasted supplies and equipment.
You might be interested in the WSJ article at -
http://online.wsj.com/article/SB10001424052970203917304574412680569936844.html?mod=djemEditorialPage
It contains one view about end of life care.
In each state, we could have an allopathic (Traditional Western Medicine)-only plan (TWM), a largely Traditional Ethnic plan (TEP), and an equally mixed TWM/TEP plan (Mixed), three choices for individuals to choose from. In the TEP and Mixed plans, gatekeepers would be of the rate-payer's choosing, generally not M.D.s.
So, if I'm in TEP, I can elect an acupuncturist as my gatekeeper, and if she thinks I need to see a TWM for something, she could refer me out to one who plays well with TEP's.
This way, you would keep the people screaming at each other separated by a Mixed population.
If I make my acupuncturist my primary, I save enormous amounts of money for a person in my demographic. I am almost 60, a Stage II breast cancer survivor, with major arthritis challenge in my gene pool (both my parents).
If I decide to visit Virginia, where I have family, I could take myself to Patch Adams's clinic, if a TEP referred me there, for example. I am just assuming he plays well with others.
I am interested in what others think of this idea. I do not want to be in a TWM-only plan, I don't care what the bribes might be to get me there.
Why not just update everyone equally and drop the sensationalism? I am just as concerned as any senior is about these issues.
I do not like the nature and look of the character and nature some of most of these negotiations that are coming out, at least how they are being reported.
The general tenor of the reports always seem to be aimed to make it look like President Obama is making these sweetheart deals with drug companies, insurance companies, in secret against the people, but the complex but fully understandable back story that the American people need to hear is the real truth of why these talks are being held and deals are being made.
It seems according to Bill Moyers the other night that America is the market that pays for all these drugs, we always get to pay retail while to export these drugs around the world other countries demand and get profit concessions from the drug company. The only place that caves into their threats is our country ... and the big difference is the money and the election process.
The speculation is good because each one of these news fiascos does get a little bit more the truth out ... eventually.
Do you know of any other demographic group that is being threatened with hundreds of billions of reductions in fundings? (reductions that, in this particular group, could make the difference between life and death in some cases.)
You mentioned the high cost of drugs in the U.S. versus other countries. Are you aware of the reports that Obama has agreed to continue to outlaw the negotiation of drug costs under Medicare with the pharmaceuticals as well as agreeing to continue to outlaw the purchase of cheaper drugs by Americans from Canadian and European pharmacies?
These concessions were reportedf to have been negotiated by the chief lobbyist for the drug industry during a half dozen meetings with Obama in the White House. That particular lobbyist was previously the politician on Capitol Hill who ushered in the industry-friendly legislation creating Medicare Part D and who, as a result, was rewarded with his present $2 million per year job.
Until the details are decided and are honestly and accurately reported, seniors have every reason to be scared.
And yes, I am familiar with some of Obama's reported meeting and agreements, but I don't how many of them are real, final or what the situation exactly is on some of these things. Maybe you could find out about some of that and make a post for everyone.
No crooks lived there I assume.
The savings will come in when we are aware of what this crooked doctors do at our expense and tax dollar expense.
Years ago I was talking to a nurse friend , she said, when the doctor need to pay for his vacation he just increased the number of hysterctomy he did.
I stay away from doctor as much as I can, refuse x ray and drugs.
I am healthy, god willing I will die in my sleep.
Ten years ago I suddenly found I could barely walk across the street or up a flight of stairs and was diagnosed with congestive heart failure. The doctors determined that my ejection fraction was 13% (normal range is 60% and up)and they told my wife that my life expectancy was about five years, the final phase of which would be spent in the hospital. (the most costly cause of hospitalization in the U.S. has been reported to be congestive heart failure.)
After a series of tests over a two year period, a regimen of expensive drugs was refined and prescribed. As a result of these drugs, my ejection fraction has increased to 45% and I have never even been to an emergency roon, let alone hospitalized. Today I am completely asymptomatic.
The highest rate of cost associated with Medicare is from hospitalization.
I believe the relevance of my experience and others like me supports the theory that one way to cut costs would be to reduce hospitalizations by making drugs more available and more affordable, not less...
A second related suggestion would be to also make home healthcare more available and more affordable. I've seen too many situations where I believed hospital patients could have been cared for at home, at least for a period of time sufficient to justify the savings.
From a 7/29 press relase by Sen. Amy Klobuchar. D-MN:
Washington, D.C. – Today, U.S. Senators Amy Klobuchar (D-MN), Herb Kohl (D-WI) and Al Franken (D-MN) introduced legislation to reform the Medicare payment system to reward hospitals for quality, efficient care. The Medicare Payment Fairness Act of 2009 would reform Medicare by paying hospitals for the quality, not quantity, of care. These changes would reduce the regional differences in Medicare spending by shifting the nation to a coordinated, integrated delivery system – like Minnesota. Studies have shown that more integrated care could save taxpayers an additional $100 billion a year.
“We need to reform Medicare to pay hospitals for the quality of care they provide and transform the current health care system into one that concentrates on delivering the best care for patients,” said Klobuchar. “This bill complements the Medicare Payment Improvement Act that I introduced last month, and is another step towards rewarding quality care and improving our Medicare system.”
“As it stands, the Medicare reimbursement system provides perverse incentives,” said Kohl. “Currently, geographic areas that provide the most inefficient care oftentimes get the highest reimbursements. We need to ensure that all health care systems provide better care in a more efficient way, and reward those systems that already do so. Otherwise, we’ll never get costs under control.”
“As Congress considers national health care reform, they have a lot to learn from how we do things in Minnesota,” said Franken. “We understand that health care quality ought to be rewarded, and that patient-centered health care is better for Minnesotans than a profit-centered system. Implementing a Value Index is not just a critical step in reforming our national health care costs, it’s also a step towards ensuring that Minnesota doctors aren’t penalized for being ahead of the curve.”
Speak for yourself. Some of us can make a rational decision.
The documented figures for adverse events from treatment, per year, are between 220,000 and 250,000.
Some 106,000 of those are non-errors, meaning the doc prescribed the medication indicated for the issue, but the person died as a consequence of treatment.
Some 80,000 deaths were from infections acquired because of treatment.
About 45,000 were general hospital errors.
Unnecessary surgery took 12,000.
7,000 were attributed to general errors. Sources on this sort of thing are Starfield, Barbara, and Leape, Lucian. Leape is from Harvard and has been published in JAMA.
These statistics seem relevant to me.
The quality of hospitals vary a great deal.
My mother died in April of MRSA after a hip operation. My son believes if she had stayed in Oregon, she would still be with us. After all, she survived a heart valve operation five years ago in flying shape.
My good friend, a public health nursing instructor, confirms that Oregon has moved to a quality model, even though it is punished for that under a perverse incentive system from the federal government.
The federal government has brought us corruption in all sorts of -industrial complexes which make our need for care greater than it otherwise might be, e.g., our agricultural-industrial complex, never even mind the infamous military-industrial complex or our pharmaceutical-industrial complex.
I have seen quoted text from Ezekiel Emanuel, Rahm's brother, that, of course a taxpayer-funded system would accord greater priority to returning a person in the taxpayer class to health than it would to those not paying taxes. People are shocked at this, but to me, he is just saying something that is obvious. This is how things work in a materialistic environment, which is what government is. Relative values are placed on life, with some of us more equal than others.
Shareholders in for-profit companies could receive discounts on care from the model of care they represent. There are probably non-cash benefits that could be apportioned to shareholders if plans that are too big to fail are converted to cooperatives that must be chartered in each state, to keep them small enough to not crash us all if they crash.
States, counties, groups, and individuals need to take responsibility for the health of persons in their locales.
The collateral (citizens, each with dignity and something to share) needs to be local enough that rate-payers can examine the collateral without flying to D.C. in a chartered plane.
Dontcha think? Hey Spencer, are you still on this thread?
"My good friend, a public health nursing instructor, confirms that Oregon has moved to a quality model, even though it is punished for that under a perverse incentive system from the federal government. "
That was my point in my comment above. There are billions of dollars to be saved in Medicare. MN is being penalized in reimbursement costs for prividing quality health care.
What you believe makes a difference in how you heal. We need to grant people the freedom and dignity to decide where they will go for care.
If we could allow wide access to care information, we would make such progress.
Perhaps we will get an audit of the Federal Reserve and start an honest assessment of how we have strayed so badly from anything resembling freedom.