When the government pays health care providers less than it costs the provider to provide the service, the providers will elect not to provide the service. I really tried hard to get another reference to provide in there…
Today President Obama named Donald Berwick to the position of head of the Centers for Medicare and Medicaid Services. This is not good news for anyone who relies on either Medicare or Medicaid for their health care.
Dr. Berwick, a Harvard medical school professor, was appointed by Obama to this post in April, but no Senate confirmation hearings had even been scheduled, so the president, as is his right, simply appointed the good doctor while Congress was in its Fourth of July recess.
Limited resources require decisions about who will have access to care and the extent of their coverage.
The social budget is limited—we have a limited resource pool. It makes terribly good sense to at least know the price of an added benefit, and at some point we might say nationally, regionally, or locally that we wish we could afford it, but we can’t.
We can make a sensible social decision and say, “Well, at this point, to have access to a particular additional benefit [new drug or medical intervention] is so expensive that our taxpayers have better use for those funds.” We make those decisions all the time. The decision is not whether or not we will ration care–the decision is whether we will ration with our eyes open.
Why were no Senate confirmation hearings even scheduled? My guess…if hearings were held, Dr. Berwick’s radical views about health “care” would become widely know to the American public, 60% of whom (at least according to one poll) want to see Obamacare repealed. Dr. Berwick’s sworn testimony at any such hearing would have driven the repeal Obamacare numbers even higher.
So, between now and the end of this congressional term in January, when Dr. Berwick’s appointment expires, Dr. Berwick will be charged, among other things, with drafting regulations that will reduce the government’s costs for Medicare and Medicaid by $500 billion, as “promised” by Obamacare.
This will not be a pretty picture.
And, don’t fall for “the Republicans were blocking the appointment” argument.
Even Max Baucus [D. Mt.], the Senate Finance Chairman, issued a statement critical of this end-around. President Obama claimed Republicans were stalling the appointment “for political purposes,” but Mr. Baucus hadn’t scheduled hearings and the nomination paperwork wasn’t even finished 11 weeks after he was named.
Although this story is about the situation in Texas, it is happening in other states as well. As it turns out, it costs more money to take care of the needs of senior citizens then what the government plan is willing to pay.
Trouble in paradise? Is this just the begnning of state and city blowback on the Nelson payoff. Hmmmm? Is it? The countries two best know Republican liberals are already pushing back against the Senate/ House/ Obama Health bill that they know will cost them plenty. Period. Read more
A spot of cold water for those who seem to think that a simple wave of the wand (or, in this case, Presidential pen) can kiss the boo-boo and make it all better…
Here’s something that has gotten lost in the drive to institute universal health insurance: Health insurance doesn’t automatically lead to health care. And with more and more doctors dropping out of one insurance plan or another, especially government plans, there is no guarantee that you will be able to see a physician no matter what coverage you have.
Consider that the Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24% the year before. The reasons are clear: A 2008 survey by the Texas Medical Association, for example, found that only 38% of primary-care doctors in Texas took new Medicare patients. The statistics are similar in New York state…
Doctors, it would seem, are just as economically motivated as any other individual and, when presented a choice of which insurers to work with, prefer those that neither stiff them on their fee nor pinch the pennies until Lincoln begs for mercy…
More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. I’ve had several new Medicare patients come to my office in the last few months with multiple diseases and long lists of medications simply because their longtime provider — who they liked — abruptly stopped taking Medicare. One of the top mammographers in New York City works in my office building, but she no longer accepts Medicare and charges patients more than $300 cash for each procedure.
How about Medicaid? Any better over on that side of the fence? HMO plans? Buehler? Buehler?
The problem is even worse with Medicaid. A 2005 Community Tracking Physician survey showed that only 50% of physicians accept this insurance. I am now one of the ones who doesn’t take it. I realized a few years ago that it wasn’t worth the money to file the paperwork for the $25 or less that I received for an office visit. HMOs are problematic as well. Recent surveys from New York show a 10% yearly dropout rate from the state’s largest HMO, the Health Insurance Plan of New York (HIP), and a 14% drop-out rate from Health Net of New York, another big HMO.
Oops… guess not.
Now, who out there wants to be a patient when the government takes over the whole show? Universal insurance through the government will place all the power in the hands of one insurer, allowing them to squeeze the medical profession at will. Given the model of Medicare and Medicaid, government insurance will lead to reimbursement being squeezed to the point where doctors will leave the profession and university students won’t enter.
Government controlled healthcare — the efficiency of the post office and the bedside manner of the IRS.
Instead of dealing with nationalizing health care out in the open, the Obama stimulus plan takes the incremental – but significant step – to add more than one million Americans to the Medicaid roles if they are unemployed, or will soon be unemployed. This plan also includes millionaires who were laid off and not only expands COBRA coverage, but pays for 65 percent of the COBRA coverage!
When I began reading this article in the Wall Street Journal, I kept thinking about the COBRA program, which allows employees to carry their previous insurance for 18 months if they get laid off or another life change event occurs. The employer does not cover the cost of the premiums, but instead, the employee is able to continue coverage by paying the premium the employer was paying during employment. Confusing isn’t it?
Let’s just get rid of that confusion by having the federal government pick up 65 percent of the COBRA premiums!
From Kimberley Strassel’s post in the WSJ, with my emphasis in bold.
Under “stimulus,” Medicaid is now on offer not to just poor Americans, but Americans who have lost their jobs. And not just Americans who have lost their jobs, but their spouses and their children. And not Americans who recently lost their jobs, but those who lost jobs, say, early last year. And not just Americans who already lost their jobs, but those who will lose their jobs up to 2011. The federal government is graciously footing the whole bill. The legislation also forbids states to apply income tests in most cases.
House Democrat Henry Waxman was so thrilled by this blowout, it was left to Republicans to remind him that the very banking millionaires he dragged to the Hill last year for a grilling would now qualify for government aid. His response? A GOP proposal to limit subsidies to Americans with incomes under $1 million was accepted during markup, but had disappeared by final passage. In this new health-care nirvana, even the rich are welcome. CBO estimates? An additional 1.2 million on the federal Medicaid dime in 2009.
The “stimulus” also hijacks Cobra, a program that lets the unemployed retain access to their former company health benefits — usually for about 18 months. The new stimulus permits any former employee over the age of 55 to keep using Cobra right up until they qualify for Medicare at age 65. And here’s the kicker: Whereas employees were previously responsible for paying their health premiums while on Cobra, now the feds will pay 65%. CBO estimates? Seven million Americans will have the feds mostly pay their insurance bills in 2009.
Wow. This is not stimulus, this is welfare!