Obama's prescription: $320 billion in cuts to Medicare, Medicaid

[chill_wind]

Obama's prescription: $320 billion in cuts to Medicare, Medicaid
By Phil Galewitz | Kaiser Health News
September 19, 2011

WASHINGTON — In his plan to trim the federal deficit, President Barack Obama on Monday proposed $320 billion in cuts to Medicare and Medicaid, largely by changing how the federal government pays health providers, by slashing payments to drug companies and by dramatically changing the way the government splits the costs of Medicaid with the states.

The biggest cut to Medicare would require pharmaceutical companies to lower their rates to some beneficiaries. The proposal would save Medicare an estimated $135 billion over 10 years starting in 2013. The change would allow the federal government to receive the same brand-name and generic rebates for low-income Medicare patients as are provided to Medicaid beneficiaries.

(snip)

One of the biggest changes proposed by Obama is how the federal government splits Medicaid spending with states, at a proposed savings of $14.9 billion over 10 years.

(snip)

Among the hardest hit providers in the Obama plan would be so-called post-acute health providers: nursing homes, long-term care hospitals, rehabilitation facilities and home health facilities, which would see $42 billion in cuts over 10 years.

(see more details and various stakeholders' comments):

http://www.mcclatchydc.com/2011/09/19/124565/obamas-prescription-320-billion.html

[banned from Kos]

1. Virtually all on providers - very good.

Providers are overcharging in many cases.

[Bluebear]

2. "virtually"... Spin.

[emulatorloo]

11. History tells me you are the one who is spinning.

[EFerrari]

25. No, Bluebear is right. Cuts to providers are cuts to a stressed program

so discounting them is extremely dishonest.

[Mimosa]

28. MDs and nurses are very depressed.

Anybody who knows people in the medical professions, ask them. They don't know WHAT to expect. A nurse I know broke into tears as she told me about patients who can no longer afford health insurance coverage.

[Mojorabbit]

17. Can you back that up with a link?

I am curious. Having just had a family member spend several months in a facility, I did not note anything like this. Thanks!

[banned from Kos]

19. "90% of Medicare/caid cuts come from reducing overpayments"

http://thehill.com/homenews/administration/182235-obama-will-propose-3t-in-cuts-threaten-veto-over-tax-cuts-for-wealthy

[Mojorabbit]

22. The same article says this?

"A senior administration official said that "there will be both provider and beneficiary policy changes," but declined to say what cuts those would include."

THe nursing homes would be providers. I am truly doubtful that 90 percent of payments to these facilities are overpayments.

[ThomCat]

26. Anyone who thinks that Medicare is overpaying for services

(other than meds) has been drinking too much republican kool-aid.

We know that republicans mandated that medicare pay top dollar for meds, and causes that problem.

But we also know that Medicare only pays fixed, mandated rates for everything else, and those rates are below what private insurance companies pay. Only Medicaid pays less that Medicare for many standard services. This is why many doctors won't accept one or both insurance plans, but will accept most private insurance plans. They aren't willing to accept the small amount that the government is willing to pay.

When fraud has been found, it has not been found within Medicare. It has come from outside corporations fraudulently billing the medicare system for non-existent patients.

The reason such over-billing isn't always found quickly is because constant budget cuts have made it necessary to cut the number of people hired within Medicare to do audits to find billing fraud. If they are forced to be too lean, they end up having to simply trust companies that bill them, because there isn't anyone available to double-check bills from those companies.

Republicans want Medicare to be cheap, and hire only the minimum number of people, but they want companies to get paid quickly too, when they submit claims for services. If companies ever start complaining that it takes too long to get paid when they submit bills to Medicare, that would be the new scandal, and the latest republican reason to dismantle government provided Medicare and outsource everything to private corporations. (regardless of cost)

[latebloomer]

21. Not sure how they're overcharging

unless they're committing fraud.

Medicare has a specific amount they will pay for each procedure. The provider gets that and no more.

And if providers' rates go down, fewer and fewer will accept Medicare.

When my MIL needed a GYN, it took me a lot of effort to find one, in a busy metropolitan area, that accepted it.

[ThomCat]

24. For a lot of those services that they mentioned,

home health care, for example, they pay very little already.

Medicare already pays so little for almost every service that it is often difficult to find places that are willing to accept Medicare.

Now that is only going to get worse.

Drug companies were getting paid too much, but that has been probably the only place where Medicare was paying too high a rate. That was because Republicans required Medicare to pay whatever rate the drug companies set, without negotiating any volume discounts. Medicare was prohibited by law from negotiating discounts.

If Obama would repeal that prohibition and mandate that government health care agencies must use their purchasing power to negotiate the best possible price from pharmaceutical companies, that would save millions of dollars every year.

[Mimosa]

29. ^ There it is, US health care system resembles that of India. Google, read. You'll be surpr

One of my MD friends was telling me the US system of health care as it exists right now resembles that of India where patients who can't afford health care often go without or become impoverished trying to pay. :(

[Myrina]

3. Slash payments to drug companies and guess what?

If they don't get their money from the gov't teat, prescription prices are going to skyrocket.

Thanks, O. NOT.

[banned from Kos]

7. I remember when liberals complained (me included) when Bush would not let

Medicare negotiate prescription drug prices in Part D.

Now when Medicare is using its purchasing power to do so some are complaining! Big Pharma is a cartel.

[frazzled]

8. You've got to be kidding me

So you're in favor of Big Pharma getting top-dollar prices for commonly prescribed drugs to older Americans instead of the negotiated prices we complained the Bush administration refused to go for? The prices that every European country manages to negotiate?

So you want Big Pharma to continue to prosper at the government teat? You think that will make them lower drug prices elsewhere?

I kind of doubt you're thinking this through beyond a way of finding justification for criticism of Obama.

[chill_wind]

4. Uh oh.

unrecs already.

:shrug:

[durablend]

5. +1 to zero

Guessin people don't wanna hear anything other than "Whoohoo yes we CAN!"

[chill_wind]

6. Thanks durablend.

:hi:

[elocs]

10. It's unseemly to complain about UnRecs of your own thread.

Your thread will get as many Recs as it gets, complaining about UnRecs on your own OP comes across as whiny.

If there is a thread that is well-written, informative, and makes good points is it any less great if it receives UnRecs or not enough Recs?

[chill_wind]

14. Thank you elocs. I'm pretty positive all of DU is aware

of your pet peeves about this.

[Old Codger]

9. Main concern here

Many Drs. and hospitals already refuse to accept many medicare patients because of low pay. I know of a clinic in Oregon that dropped hundreds of patients because they were on medicare, hopefully this will not cause too much of this reaction.

[OhioChick]

12. Good point n/t

[Bluebear]

20. +

[phleshdef]

13. So for Medicare, 135 billion out of the 6.4 trillion we will spend over 10 years.

Which comes out to be something like 2%, unless my math is way off.

Either way, after looking at the numbers, you will have to pardon me if I'm not too terribly upset about such insigificance.

[dtexdem]

15. The reforms to Part D are needed.

It was a GOP giveaway to the pharmaceutical industry. Just allowing Medicare to use its power as a big purchaser of drugs would be a good start. But cuts to rates to institutional and noninstitutional providers will only cut access; and copays for beneficiaries would only punish the poor and elderly for the sins of the rich.

[Auntie Bush]

16. It's going to be tough on people and family members who have

loved ones with Alzheimers or need long term care.

[chill_wind]

18. Families USA Press Release

(as cited in the Op as a "consumer advocacy group that's been a consistently strong supporter of Obama's health care platform")


Families USA Supports President’s Equitable Approach to Budget but Opposes Medicaid Cost Shifts to States

http://www.familiesusa.org/resources/newsroom/press-releases/2011-press-releases/familiesusa-on-budget-cuts.html

more at the site:

A helpful profile on the SC members-

The Super Committee: Where They Stand on Medicaid, Medicare, The Affordable Care Act
http://familiesusa2.org/assets/pdfs/Super-Committee-Profiles.pdf


Medicaid's Impact on The States

State Reports, September-October 2011

From Families USA, in partnership with the American Cancer Society Cancer Action Network (ACS CAN), the American Diabetes Association, and the American Lung Association.

http://www.familiesusa.org/issues/medicaid/people-with-serious-health-care-needs.html

A couple reports from earlier September:

Medicaid Cuts Could Leave Tens of Thousands of Coloradans Facing Life-Threatening Health Challenges (September 20, 2011)

http://www.familiesusa.org/resources/newsroom/press-releases/2011-press-releases/co-medicaid-disease-cuts.html

Medicaid Cuts Could Leave Hundreds of Thousands of Pennsylvanians Facing Life-Threatening Health Challenges (September 20, 2011)

http://www.familiesusa.org/resources/newsroom/press-releases/2011-press-releases/pa-medicaid-disease-cuts.html

Additional reports for California, Texas and a few other states are also there. It looks like they are working on updates through October.

[truedelphi]

23. Are these cuts in addition to the 500 billions of dollars of cuts that went through as part of the

2009 "Affordable Health Care Act"?? (Health Care Reform Bill)

If so, we might as well forget about having any sort of meaningful Health Care for our seniors.

And of course, this "Super Committee" is set up so that we cannot attack or blame our elected Congress critter or Senator or President - the blame goes to the six Republicans and the one "sold out" Dmeocrat on the Super Committee.

Great marketing idea from the Powers that Be.
Just file this Super Committee stuff under the:
"Don't blame us; our hands are clean. We had someone else do our dirty work," folder.

[McCamy Taylor]

27. GOP will never agree to cutting drug company profits.

[Mimosa]

30. But let's not cut 'defense' spending.

It's IMPORTANT!