Lobbyists rumble as Medicare sickens
The showdown between private insurance providers and physicians in Washington centers on payments to doctors. But as today's editorial points out, the proposed Medicare legislation is more about leveling costs between special private plans and their traditional Medicare cousins.
According to the Center on Budget and Policy Priorities, a liberal think tank, special breaks offered by current Medicare policies have spurred the aggressive expansion of "private fee-for-service" plans under Medicare Advantage, and "slowing their rapid growth would achieve savings [cost offsets] for Medicare while improving beneficiary access to health care providers."
If you bristle at the idea of regulating the private sector, new findings from the Government Accountability Office are telling. A recent audit indicates that although Medicare Advantage was originally sold as a way to rein in medical costs, it has generally increased spending--perhaps not the soundest way to salve a growing healthcare crisis.
So the stage is set for another lobbying war between physicians and insurance companies, both of whom are worried about getting paid for what they give consumers. But where does that leave patients--and future generations of patients, for that matter?
On Health Care Policy and Marketplace Review, Robert Laszewski looks beyond the impending "extraordinary political theatre" and points to an underlying malaise: an obscure, outdated bit of budgetary math known as the Sustainable Growth Rate formula, which was originally implemented as a check on runaway cost increases. But plugging up spending in one spot won't stanch the flow across a hemorrhaging system, he observes:
"What is happening to Medicare and physicians also can't be seen in a narrow context--the same issues plague Medicaid, SCHIP, and the commercial market. Costs for hospitals, drugs, durable medical equipment, and everything else is also on the same unsustainable track."
Maggie Mahar at Health Beat Blog puts the Medicare impasse in the context of a brewing storm for elderly patients, for whom the rising cost of care is reaching a breaking point. "Neither the public sector nor the private sector has found a way to rein in runaway health care inflation," she writes, and while the current bill promises a short-term fix for doctors, a grim prognosis for Medicare's fiscal future looms large:
"Medicare needs the money. This is the back-story that many in the mainstream press are ignoring. Medicare desperately needs to begin cutting the fat in its program."
DrRich at Covert Rationing Blog, where he pontificates on how the healthcare industry disempowers patients, sees the whole debate over the Medicare bill as an ugly tangle of cynical dealmaking. Here, he breaks down the ingredients of our medical regime, noting that corruption can involve government and private insurers alike.
"To the mere goal of profit which is the lifeblood of any company (too often fueled by excessive greed, one must admit), add the much stronger and additional aims of power and influence that fundamentally motivate our politicians, regulators, administrators, and others too numerous to mention who work for the government. Then stir in the absolute need to make convoluted deals, compromises and concessions with sundry interest groups and diverse colleagues and acquaintances, influences that may or may not have anything whatsoever to do with healthcare. ..."
And you thought all the political wrangling was just about doctors' fees. From lawmakers to family physicians, healing a broken institution requires more than one professional opinion.
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Comments (3)
There is over $10 Billion in Medicaid fraud every year in NYS alone. Spitzer / Paterson cut the number of fraud inspectors from around 200 to 6, why, because the state gets matching funds for the fraud claims it processes. The future for Medicaid is to end this failed system of fraud, kickbacks, and phony billing. Our health is too important to be left up to the government.
I would like to know why they are thinking cutting our Seniors Community Programs. This is all they have for socializing amongst each other. Especially those who have lost their partners. I think this is deplorable and would like to know how to rally against this absurd bill. Our seniors have reared their children, served their country and yet they are the last to receive proper medical coverage. I don't understand how someone can come to this country, not speak the language, not have and I.D. # and receive full medicaid benefits. These benefits have full coverage for Doctor's visits, medical testing, hospital, dental and vision. Please explain this deplorable system. What can I do to help change this ridiculous system of ours? Someone please point me in the right direction.
Sincerely,
Christine Calumet
Actually, the situation surrounding immigrant Medicaid benefits is a bit more complex than that. It's hardly accurate to say that the federal healthcare system treats immigrants much better than it treats elderly people. See our earlier post:
http://weblogs.newsday.com/news/opinion/viewsday/2008/06/triaging_immigrant_health_1.html