Here are the first signs that our side is about to CAVE on Medicare

[bigdarryl]

We need to start recruiting REAL!! Progressives for 2012 to run against these chicken shit Democrats in the primary this is ridiculous. http://www.huffingtonpost.com/2011/06/24/schumer-medicare-debt_n_884007.html

[Sarah Ibarruri]

1. Oh God. What's wrong with Democrats? I can't believe what I've been seeing for decades.

It's just too much. They're such wimps.

[awoke_in_2003]

28. They are doing exactly...

what their bosses (not us) tell them to do.

[Zambero]

2. Let's see...

Polls indicate that 75% don't want Medicare privatized or watered down, and 75% favor taxes increased on the top 2% as a means of keeping the program solvent. Republican legislators on the other hand are solidly in the 25% minority, damn what the public thinks. Why should Democrats retreat from a position of strength when Republicans have indicated they won't budge one iota on the tax issue? So there's an impasse -- why not let voters decide? Could it be the prospect of GOP blackmail on the debt limit issue, where intransigent Republicans would just as soon facilitate an economic trainwreck so that it can be blamed on Obama with a presidential election little more than a year away?

[Mimosa]

14. ^ Great post, Zambero ^

I think you nailed it.

[juajen]

3. Perhaps I missed something, but

I only saw an agreement to streamline and reduce administrative costs. What did I miss?

[zalinda]

6. They will reduce payments to providers.

What that means is that doctors will get less money per doctor visit, if they care for a Medicare patient. So, congratulations, the dems will now make grandma go all over town trying to find a doctor that will accept Medicare. Many doctors, right now, will not accept new Medicare patients because the payment for services are too low. When that payment gets cut, those on Medicare will only be able to afford to go to the bottom of the barrel doctors, as no one else will take them.

zalinda

[woo me with science]

8. Exactly. We continue the march toward a two-tiered society.

[Telly Savalas]

10. Considering that voters outnumber politicians by about 20,000 to 1

Perhaps voters should drop the victim complex, start reading the fucking paper, and elect better people.

[Telly Savalas]

9. That's not true.

Pretty much any sane proposal to reform Medicare payment involves rebalancing things so that primary care physicians will be getting paid more.

The way the current fee-for-service system is structured is a mess. It underpays primary care providers, but creates incentives to encourage many specialists to promote overutilization of expensive procedures. (Using diagnostic radiology as a cash cow for instance.) You're correct that if primary care phyisician reimbursements were cut it would be a huge obstacle to access for seniors, but that's not being proposed by anyone advocating payment reform. On the contrary, current policy will result in a 30% decrease in reimbursement at the end of the year unless action is taken.

While there's a very wide range of opinions on what the best policy might be, pretty much anyone who knows anything about the subject will say that Medicare can provide better access and quality of care while spending less money.

[Raine1967]

20. +1

My Mother and my Grandmother lost their doctor -- he went to work for the State of NY -- in corrections in order to make a decent living.

and this man was a liberal that believed in single payor.

[Mimosa]

15. And MDs actually lose on Medicare.

Medicare payments often don't cover the costs of providing services according to an MD friend.

[bornskeptic]

17. I doubt that they mean cuts to doctors.

More likely they are pushing cuts in payments to drug compamies, medical equipment manufacturrs, or possibly hospitals.

[shimmergal]

30. And we need such cuts.

We're never going to get a handle on the ballooning cost of medical care if we can't have some price cuts. Not everywhere--the payments to primary care practitioners are one example where they're reasonable compared to other costs--but many charges of hospitals, medical equipment, and some drugs are grossly overpriced, perhaps 10 times more than what they could operate at and still make a modest profit. And the government is the only entity big enough to enforce this.

And I don't totally buy the argument that "nobody will take Medicare patients if we lower the payments" either. The average over-65 person probably gives doctors etc. much, much more "business" than most younger individuals--many of whom don't visit a doctor at all until something is really bothering them. Obviously this isn't true of some specialties (pediatrics and gyncology/obstetrics come to mind) but for internists,, general/family practitioners and a lot of specialties, if they suddenly stopped taking over-65 patients, their patient load would shrink dramatically.

[Name removed]

21. Deleted message

Message removed by moderator. Click here to review the message board rules.

[blueclown]

26. The Affordable Care Act already reduces payments to providers.

That is where most of the Medicare savings came from. In the next few years, Medicaid reimbursement rates will be raised to be close to or equal to Medicare reimbursement rates.

[Name removed]

22. Deleted message

Message removed by moderator. Click here to review the message board rules.

[ljm2002]

25. What you missed is they are bringing Medicare into the negotiations...

...when they did not have to.

There is overwhelming public support for Medicare just as it is, and for increasing taxes on the richest people to make up for any shortfall (note, "increasing taxes" in this case means "allowing the tax giveaways for the rich to expire" as they should have done 2 years ago...).

Once you bring it to the table at all, you are opening up the program to the negotiating process. In lawyer-speak, you have opened the door to the topic, so you can't stop the other side from advocating their own position, and they will try to take it farther than "just" dealing with the private aspects of Medicare.

Fools.

[vi5]

4. No, the first sign was...

"Republicans want to cut medicare...."

We pretty much know that when Republicans want something it's only a matter of time before Democrats cave.

[StarsInHerHair]

5. WhiteHouse Ph# 202-456-1111, Sen Reid ph# 202-224-3542

call them & suggest they raise the cap to at least the first $250,000 instead of what they now have for Social Security taxes, only the first $108,000

[pnwmom]

7. Yeah, let's always assume the worst about anything a Democrat says.

That's what we always do here, right?

[Telly Savalas]

11. It's documented that conservative groups pay trolls to disrupt internet discussion sites

A sure fire way to destroy rational discourse is to flood a site with distortions and half-truths.

[Proud Liberal Dem]

13. Yup

So it would seem :eyes:

[AtomicKitten]

12. Reporting on this is all over the place.

[karynnj]

16. It depends on what is meant by "delivery system reform"

There have been doctors who have advocated for changing the model for how to determine the pay they get. I am not a doctor, but I did with a group I belong to watch a documentary made by a doctor advocating for something that I think was like this. The current model pays the doctor depending on the tests he orders and procedures done.

One thing that was in ACA was to have a trial of various methods to improve healthcare while eliminating unnecessary costs. The idea was to see if there were better ways of compensating doctors than the current model that could simultaneously improve overall health. The problem with trying to use that type of change now is that I can't imagine where the estimates of savings would come from as it hasn't been done (to my knowledge). There was a NYT magazine article on doctors/hospitals using a best practices approach that was interesting that I can not find, but it would seem anything needs to be looked at. There is a problem when the US pays much more for worse healthcare. (here is an article that describes one groups of hospitals that Obama supposedly was impressed by - http://www.ksl.com/?sid=7873613&nid=148 )

I know the impulse for people here to thing that any change will be to harm Medicare and other goverment healthcare plans, but it would be better to wait until we see what the change would be. It could actually be better. It is definately not the same as the Ryan plan.

[avebury]

18. K&R

[Honeycombe8]

19. We need to take out that provision preventing negotiating for drug prices!

That was a HUGE intentional giveaway to big pharma (one of the writers of the Medicare so-called reform act under Bush went to work for a big pharma company as soon as his term ended and he'd gotten that bill passed in Congress...Billy Tauzin I think it was...his salary was over $1M a year for that pharma co. And still is, I guess.)

They stuck a provision in the bill that legally FORBID the govt from using its leverage at having millions of people to buy drugs for, to negotiate lower or bulk prices from pharmaceutical companies. An unbelievable provision. Just an out and out windfall to big pharma. They weren't even trying to hide it.

That provision needs to GO. That would save Medicare a LOT of money!

[The Eagle 718]

23. Agreed nt

[blueclown]

27. In order to do that, we need a public option.

Because what will happen is that once Medicare and Medicaid begin to negotiate lower drug prices, then drug manufacturers will then start to charge more for drugs on private insurance plans. There needs to be an option for those who don't want to pay for private insurance plans when this happens.

[shimmergal]

31. Actually, one of Obama's mistakes

in "negotiating" for his plan was he _didn't_ play the drug companies against the insurance companies, and vice versa,, etc. That could have helped to bring costs down.

[Phx_Dem]

24. If you think they'll cave right before a Presidential election

where seniors vote in huge numbers, I want what you're smoking.

[ChiciB1]

29. You Know, From What I've Seen These Past Several Years... NOTHING

surprises me! NOTHING! And I wouldn't place a bet on WHAT they would do. So many no longer even know that there are real PEOPLE who live under THEIR RULE!