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Thread: Doctors: Senators 'took a vacation,' left Medicare a mess

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    Doctors: Senators 'took a vacation,' left Medicare a mess

    Today, CNN revealed:

    The AMA's TV, radio and print ads slam senators for failing to pass the "doc fix" before taking their week-long break. The group has a long history of pushing to reform the formula used to calculate Medicare payments to doctors…

    "Medicare payments are stuck where they were in 2001, while medical costs are up by 20% according to the government's own data," Rohack said.
    http://money.cnn.com/2010/06/03/news..._fix/index.htm

    The Medicare payments argument is greatly inconsistent with the larger picture associated with Medicare expenditures. If one examines Medicare enrollment and Medicare expenditures data, one finds Medicare expenditures per Medicare enrollee came to:

    2001: $6,181
    2008: $10,357
    Change: +67.6%

    Moreover, in its latest Article IV consultation with the U.S., the International Monetary Fund explained:

    Per capita health spending in the United States is the highest in the OECD, and is still rising. U.S. health spending represents over 15percentof GDP, compared to less than 10 percent in the G-6 group, and grew by about 5 percent a year in real terms over 2000-06 compared with 3 percent in G-6. Without major reform, the Council of Economic Adviser project that health care’s share of GDP will continue to rise rapidly, reaching around 28 percent of GDP in 2030 and 34 percent in 2040 (15 percent of GDP accounted by Medicare and Medicaid). Despite the large spending, health outcomes in the United States are less favorable than in many OECD countries.

    In my opinion, the issue over Medicare reimbursements is an early litmus test as to whether the special interest appetite for taxpayer financing will take precedence over fiscal discipline. If Congress appeases the AMA, it will send a dramatic signal that the very modest cost-savings measures in the recent health care law are not credible. Moreover, it will send a worrisome signal that Congress is not capable of making the even tougher decisions that will be necessary for the U.S. to return to a fiscally sustainable path. In the long-term, fiscal sustainability will depend on far-reaching health care reform that addresses that industry’s chronic excessive cost growth issue.

    Although I had supported easing the transition on Medicare payments, but only if it were fully funded by offsetting spending reductions and/or tax hikes, this salvo fired by the AMA leads me to believe that in the larger interest of moving toward credible fiscal consolidation, the far better approach would be for Congress to draw the line and reject any changes to Medicare payments. Such payments per patient have exploded by more than 67% since 2001.

    In the long-run, Congress will need to spend less than it would otherwise under base law. Transferring spending from one sector to another is a much weaker approach, as it indicates that Congress lacks the ability to actually rein in spending.

    Unfortunately, as government has typically demonstrated a bias toward accommodation, my guess is that Congress will cave in to the AMA’s pressure. That development will likely embolden other special interest groups to seek increased taxpayer payments, even as the nation’s debt continues to climb and its long-term fiscal imbalances remain yet to be addressed.
    Last edited by donsutherland1; 06-03-10 at 07:51 PM.

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    Quote Originally Posted by donsutherland1 View Post

    2001: $6,181
    2008: $10,357
    Change: +67.6%
    Damn, that just scares me. What accounts for such a steep rise?
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    Quote Originally Posted by Fiddytree View Post
    Uh oh Megyn...your vagina witchcraft is about ready to be exposed.

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    ok, but if you don't do the doc fix our doctors are gonna ditch

    it's already happening

    Texas doctors fleeing Medicare in droves | Houston & Texas News | Chron.com - Houston Chronicle

    they'll refuse to treat certain classes of cases

    http://www.nytimes.com/2009/04/02/bu.../02health.html

    it's been going on for years

    http://www.nytimes.com/1992/04/12/us...2?pagewanted=2

    as always, there's just no way out

    as always, these things are so predictable

    ie, everyone KNEW what was in this bill

    and, as almost always, if not always, it aint gonna happen

    that is, no one's gonna be standin up to no ama

    sorry

    good thread, thanks
    Last edited by The Prof; 06-03-10 at 08:07 PM.

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    Redress,

    It's the industry's excessive cost growth issue, which results from a combination of industry structure and functions that is largely responsible. The age structure changes of the Medicare population is far too small to explain the dramatic increase in payments per patient.

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    reuters, sunday:

    Soaring costs force Canada to reassess health model - Yahoo! News

    health care looks to cost ontario, for example, seventy percent of its budget in 12 years

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    Quote Originally Posted by The Prof View Post
    ok, but if you don't do the doc fix our doctors are gonna ditch
    That would open up an opportunity for increasing competition in the field e.g., allowing licensed foreign medical doctors to enter into the U.S. market. With medicare payments per enrollee increasing at a nearly 7.7% per year clip (2001-2008), compensation is hardly a credible argument why some are choosing to leave the field. The health cost growth curve is not sustainable. Congress needs to begin to move toward fiscal discipline.

    ie, everyone KNEW what was in this bill
    As I noted in several theads on the health care law, arguably its biggest flaw was what was omitted: no effort to address the excessive cost growth issue. It expanded coverage and was, theoretically budget neutral due to a combination of tax hikes/cost savings. However, the unsustainable problem at the heart of U.S. health care was not addressed. Moreover, it remains more likely than not that Congress will retreat on the small cost savings provisions when faced with having to implement them, just as appears likely on the so-called doctor's fix issue.

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    Quote Originally Posted by donsutherland1 View Post
    Redress,

    It's the industry's excessive cost growth issue, which results from a combination of industry structure and functions that is largely responsible. The age structure changes of the Medicare population is far too small to explain the dramatic increase in payments per patient.
    The portion I bolded went right over my head. Could you explain it a little more please.
    We became a great nation not because we are a nation of cynics. We became a great nation because we are a nation of believers - Lindsey Graham

    Quote Originally Posted by Fiddytree View Post
    Uh oh Megyn...your vagina witchcraft is about ready to be exposed.

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    Quote Originally Posted by donsutherland1 View Post
    compensation is hardly a credible argument why some are choosing to leave the field
    Texas doctors fleeing Medicare in droves | Houston & Texas News | Chron.com - Houston Chronicle

    Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.
    The opt-outs follow years of declining Medicare reimbursement that culminated in a looming 21 percent cut in 2010. Congress has voted three times to postpone the cut, which was originally to take effect Jan. 1. It is now set to take effect June 1.
    The uncertainty proved too much for Dr. Guy Culpepper, a Dallas-area family practice doctor who says he wrestled with his decision for years before opting out in March. It was, he said, the only way “he could stop getting bullied and take control of his practice.”
    The growth in Texas Medicare opt-outs began in earnest in 2007, when 70 doctors notified Trailblazer Health Enterprises, the state's Medicare carrier, they would no longer participate, up from seven in 2006. The numbers jumped to 151 in 2008, fell back to 135 in 2009 and are on pace for 200 in 2010. From 1998 to 2002, by contrast, no more than three a year opted out.

    Now, according to a Texas Medical Association new poll, more than four in 10 doctors are considering the move.
    Quote Originally Posted by donsutherland1 View Post
    As I noted in several theads on the health care law, arguably its biggest flaw was what was omitted: no effort to address the excessive cost growth issue. It expanded coverage and was, theoretically budget neutral due to a combination of tax hikes/cost savings. However, the unsustainable problem at the heart of U.S. health care was not addressed. Moreover, it remains more likely than not that Congress will retreat on the small cost savings provisions when faced with having to implement them, just as appears likely on the so-called doctor's fix issue.
    word

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    Redress,

    Industry structure pertains to how the system is set up ranging from the payers to hospitals, regulatory protections that inhibit interstate competition, inconsistent tax treatment, etc. Industry functions/practices concern such matters as licensing, premature adoption of technology (at the stage when it is costliest/least value-added), etc. FWIW, the IMF has estimated that up to half the increase in medical costs is associated with technology procurement practices.

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    Re: Doctors: Senators 'took a vacation,' left Medicare a mess

    This is a problem that has existed for years but kept being pushed back. It looks like that politicians wont be able to push it back anymore.
    Jackboots always come in matched pairs, a left boot and a right boot.

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