Our Senate and Congress destabilizing Medicare as we speak

[Phoebe Loosinhouse]

http://abcnews.go.com/Politics/Health/medicare-doc-fix-passes-senate-wait-house-vote/story?id=10952420
Medicare Payment Cuts to be Implemented Despite Senate Action
In Late Senate Vote, Democrats Promise Six-Month "Doc Fix" Extension Won't Add to Deficit

By HUMA KHAN, Z. BYRON WOLF, ROGER SERGEL and DAN CHILDS
June 18, 2010

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Congress has broken its promise to America's seniors and military families," Cecil B. Wilson, president of the American Medical Association, said in a statement Thursday. "Continued short-term actions are creating severe instability that harms seniors as physicians make decisions to protect their practices from Medicare 's volatility. Continuing down this path just slaps a Band-Aid on a problem that needs urgent surgery."

For Isabel V. Hoverman, an internist in Austin, Texas, the payment cuts mean a significant decrease in income. About 30 percent of patients in Hoverman's clinic utilize Medicare benefits, and she said a "large percentage" of her income comes from them. Hoverman said she already is turning away new Medicare patients because of the cost issue.

Because of the payment cuts, Hoverman told ABC News, doctors "will not be able to recoup the difference as it will be too costly for us to go back and rebill the difference to patients... We will have no option but to start asking our Medicare patients to find a new primary care physician, which already is extremely difficult for patients to find."

This temporary upheaval is a direct result of the Senate's inability to pass the extension in a timely manner as they have nine times before. They got hamstrung by the deficit hawks on both sides who always seem willing to put the needs of the elderly, poor and ill on the chopping block whenever it's convenient.

Even though Harry Reid "loves the Senate" despite it's pathological inability to do the right thing for the American people, this dithering will have real consequences for the Medicare system and those who rely on it and those who perform under it.

How well do you think these guys will perform under the hammer of the bi-partisan(heavily weighted with Rightwingnuts) deficit cutting commission?

[karynnj]

1. I agree with you that this really needs a long term fix

It is idiotic that it has received just ad hoc fixes each year. This might also be something where fixing the filibuster rule will be needed. Last week showed that even with many very bad "concessions", we could not get any Republicans. Not even Snowe and Collins who were the target or Brown, whose state is solidly behind it.

It is telling that no one ever was concerned about the deficit when 50 Senators and Cheney eliminated the estate tax gradually (until there is none this year) with the bizarre feature that it returns next year at 2003 levels. Ben Nelson was the only Democrat - but he was the important 50th vote. There was no cloture vote on that - so Daschle must have waived it.

There ARE deficit hawks on both sides, but I think the Republican effort is not so much "deficit hawk" because if it were to come up they would vote for a tax cut.

[babylonsister]

2. Yes, they are. "Doctors limit new Medicare patients"

Doctors limit new Medicare patients

By Richard Wolf, USA TODAY


WASHINGTON — The number of doctors refusing new Medicare patients because of low government payment rates is setting a new high, just six months before millions of Baby Boomers begin enrolling in the government health care program.

Recent surveys by national and state medical societies have found more doctors limiting Medicare patients, partly because Congress has failed to stop an automatic 21% cut in payments that doctors already regard as too low. The cut went into effect Friday, even as the Senate approved a six-month reprieve. The House has approved a different bill.

more...

http://www.usatoday.com/news/washington/2010-06-20-medicare_N.htm

[dgibby]

3. One of my Drs took one look at my insurance (TRICARE),

and told me I was screwed royally. When I told him we were told none of the so-called HRC was going to affect the military, he basically said we'd been lied to(again). I gaffed him off because he's a Repuke, and I thought it was just more scare tactics coming from the right. My bad!

When I was on AD(and young and stupid), I was one of the most gung-ho, pro military people on earth, but that was before they lied to us about getting "free" health care for life, catching us up in stop-loss, Gulf War Syndrome, etc, etc, you get the picture.

Now, I tell people to run, not walk, to the nearest exit.

If and when, this country ever begins to serve its' Vets as well as its' Vets served their country, I might, once again, recommend military service as a viable career opportunity. Until then, not so much!

[jbnow]

5. I don't get what you are saying. How is TRICARE affected by

health care reform?

I agree the military doesn't get the care it deserves after serving and much is unfair... just not sure what insurance issue you are talking about. This Medicare issue doesn't have to do with health care reform either although the republicans bitched about us not putting it or the cost in the bill, saying it was dishonest. This issue with doctor's pay comes up regularly but when Dems were the minority they didn't filibuster everything like the republicans have been doing.

btw I was reading how medical research has proven Gulf War syndrome... 3 discrete types with their own set of symptoms and as it turns out each show different parts of brain affected in the brain scans. That better mean they quit jerking people around about that as real disability.

They better get their act together. So many people will be living with the after affects of this war. We should have been putting a lot into research to learn a lot more about concussive closed head injuries and best support for ptsd (instead of making people with problems leave service and saying they had preexisting personality disorder. Shameful!)

But...l still not sure how it fits this topic

[dgibby]

6. I should have been more specific. My bad!

TRICARE for Life is the military/VA's version of MEDICARE, so what affects one, affects the other. The Dr. said, that like MEDICARE, docs will either drop their existing TRICARE pts, and/or refuse to take on any new ones, thereby limiting access. Lots of docs already limit their practices to a certain % of MEDICARE and TRICARE pts.

I'm still trying to track down more info, and will post as soon as I find anything. If anyone else knows anything, I'd appreciate the info.

[Phoebe Loosinhouse]

8. Here is how it is affected.

http://www.naus.org/news/news_tricare.html

The Straight Scoop On the Medicare Reimbursement Rate Issue
Designed as a Medicare cost-control measure in law in the late 1990's, the Sustainable Growth Rate (SGR) formula used to calculate physician reimbursement rates sets a target each year for expenditure on physician services based on growth in the gross domestic product. If expenditures exceed the target, Medicare recoups the money by cutting its physician reimbursement rate. This formula has forced Congress to step in every year since 2002 and take action to avoid cuts in the payments to Medicare doctors. But by postponing the cuts and not changing the SGR formula, the difference in the targeted and actual payments accumulates, making the cuts required under the formula even larger every year. According to the Congressional Budget Office (CBO), changing the formula would add $210 billion to the Federal deficit, the reason for the difficulty in fixing the problem.

Doctors already complain about the low reimbursement rates Medicare pays, and in some cases, this causes doctors to limit the number of Medicare patients they treat. With the linkage of TRICARE For Life with Medicare (Part B), this affects TFL beneficiaries. If cuts proceed, the American Medical Association asserts that many more doctors would be forced to limit acceptance of TFL/Medicare patients, or even stop seeing current patients. While some argue that since physician salaries in the U.S. are five times that of the average American's salary, they are already compensated well enough, the reality is that reimbursement rate cuts will affect access. The potential adverse impact on TRICARE For Life is clear if the Medicare reimbursement rate cuts take effect – less access to health care providers.

[Frustratedlady]

9. Does that include CHAMPVA? n/t

[bornskeptic]

10. That's how Tricare isaffected by Medicare reimbursement rates, not by healthcare reform.

The only thing healthcare reform did to Medicare physician reimbursement rates was nothing. That problem has been there for years, and it would still be the same problem if the healthcare bill had not passed. Congress has been putting off doing a permanent fix for almost a decade

[Phoebe Loosinhouse]

11. You're correct that healthcare reform is not the cause of this problem

I was responding only to the visible part of the poster's question "How is Tricare affected" without reading their entire post which refernced healthcare reform.

My OP did not blame this on HCR. As you noted, it's been an ongoing issue. My beef is that the assinine Senate couldn't get off their asses to pass the extension in time to prevent actual real cuts that will affect patients and providers.

[TheKentuckian]

4. What is our purpose if we abandon labor, are loose to say the least with civil liberties,

if we break our trust on Social Security, hamstring Medicare to the point it collapses, if we kow tow to the wealthy and the corporations, gut public education for every child, butcher the safety net, abandon those most in need of help, and abandon every pretense of the vision, character, and desire to lead an aspirational people into the future?


This is a "who are we?" moment in a time chock full of of them and our efforts so far are considerably less than awe inspiring. Do we stand for anything or do we seek power either for it's own sake, to keep it out of even worse hands, or a little of each?

The basics are being allowed to slip.

[donco6]

7. In my work, we weight all needs against each other.

The one that closest matches our mission is what gets funded. If we have to cut something else to fund the important thing, that's what we do. Midyear, early, late . . . doesn't matter. Why can't we expect our leaders to do that?