June, 2010 archive

Excerpt:

More than a decade ago, Congress set up a formula that governs how doctors get paid by the Medicare program. The intent was to slow the growth of Medicare costs, but the result was a formula that has proposed cutting payments for America’s doctors year after year after year. These are cuts that would not only jeopardize our physicians’ pay, but our seniors’ health care.

Since 2003, Congress has acted to prevent these pay cuts from going into effect. These votes were largely bipartisan, and they succeeded when Democrats ran Congress and when Republicans ran Congress – which was most of the time.

This year, a majority of Congress is willing to prevent a pay cut of 21% — a pay cut that would undoubtedly force some doctors to stop seeing Medicare patients altogether. But this time, some Senate Republicans may even block a vote on this issue. After years of voting to defer these cuts, the other party is now willing to walk away from the needs of our doctors and our seniors.

Continually cutting doctors’ reimbursements to the point that doctors cannot afford to take Medicare and Medicaid patients is indeed wrongheaded. Doctors’ take home pay is not driving the cost increases for health care.

Uwe Reinhardt, from the New York Times:

Besides, cutting doctors’ take-home pay would not really solve the American cost crisis. The total amount Americans pay their physicians collectively represents only about 20 percent of total national health spending. Of this total, close to half is absorbed by the physicians’ practice expenses, including malpractice premiums, but excluding the amortization of college and medical-school debt.

This makes the physicians’ collective take-home pay only about 10 percent of total national health spending. If we somehow managed to cut that take-home pay by, say, 20 percent, we would reduce total national health spending by only 2 percent, in return for a wholly demoralized medical profession to which we so often look to save our lives. It strikes me as a poor strategy.

I have been looking for a new doctor because of my move. The (lousy overpriced private) insurance I have is from a carrier which often provides Medicare supplemental insurance. I had difficulty getting an appointment because the office staff thought I was on Medicare (I’m hoping to live long enough to qualify) and their “quota” of Medicare patients was full. I had to get my phone call bucked up to a supervisor who was experienced enough to realize that my policy was primary, not secondary insurance, so as to get an appoint.

There’s something truly wrong about a cost-containment strategy that ultimately results in denying health care to persons who need it.

I think it’s a Republican thing. The odds are that the persons this policy ultimately penalizes–old folks like me–don’t get corporate country club memberships or have corporate jets (and, if they did, they wouldn’t be worrying about Medicare).

Republicans are all about the corporate country club membership constituency. All the rest is window dressing.