Friday, February 19, 2010

Medicare On the Block

      President Obama has included an amount of $371 billion over ten years to pay for the cost of preventing the reduction of Medicare payments to doctors. It may well do that, but in essence it freezes those payments for the next decade. I would expect that will not sit too well with the medical profession.
      Not only that, but he has left the details of the freeze up to Congress. Considering the politicians’ penchant for pork, that could be a disaster for MDs who do not live in the district of a powerful Congressman.
      Regardless of any other healthcare reform, it is a foregone conclusion that certain Medicare plans, in particular the so-called Medicare Advantage plans, will see changes in the near future, in the form of cuts in reimbursements to insurance companies and other providers. Undoubtedly MA customers will see substantial increases in cost and decreases in service.
      To give credit where credit is due, the President had to do something; without some action the cost of Medicare, Medicaid and Social Security will soon reach the breaking point. If the details can be worked out, perhaps they can be managed, but I wouldn’t bet on it.
      So what is happening across the aisle? The Republicans were dragged kicking and screaming into Medicare in the 1960s, and ever since the glory days of Ronald Regan they have been scheming to get rid of it.
      One would think they would enthusiastically endorse plans to reduce spending on Medicare, e.g., the establishment of information-gathering panels (Sarah Palin’s “death panels”) to determine what treatments are most effective for specific medical conditions.
      Yet Mr. Republican, Newt Gingrich himself has said, “Don’t cut Medicare. The reform bills passed by the House and Senate cut Medicare by approximately $500 billion. This is wrong.” (Actually the Obama budget anticipates $400 billion in savings.) Is it hypocrisy, or is something else going on?
      Look no further than Congressman Paul Ryan’s “Roadmap For America’s Future.” Under the plan, if one is presently under the age of 55, forget Medicare. You will get a voucher which you must use to get your own plan. If the cost of the plan goes up in the following years, that’s too bad.
      For those 55 and older, they will be eligible for traditional Medicare, except for the fact that the Roadmap, “strengthens the current program with changes such as income-relating drug benefit premiums to ensure long-term sustainability.” The Congressional Budget Office translates that to, “Some higher-income enrollees would pay higher premiums, and some program payments would be reduced.” In short, there would be Medicare cuts. Within a few years of inauguration of the Roadmap, Medicare would be slashed out of existence.
      So the secret behind the sudden enthusiasm for Medicare is not a change of heart; it’s just the same old Republican desire to kill it. Obama’s plan, although perhaps a little late, would hopefully put Medicare on a healthy diet; the Roadmap For America’s Future is specifically designed to starve the beast to death.
      It’s hypocrisy after all!

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