Impeding changes to our Health Care system

[classicman]

Insurance premiums are likely to keep going up over the next few years. Experts predict that the law's early benefits — such as expanded coverage for children and young adults — could nudge rates a little higher than would otherwise have been the case. Also, insurers and medical providers could try to raise their prices ahead of big shifts set for 2014.

Under the 10-year, $1 trillion plan, 2014 is when competitive insurance markets for individuals and small businesses are expected to open, and tax credits start flowing to help millions of middle-class households now uninsured. Medicaid will expand and pick up millions of low-income people. Most Americans would be required to carry health insurance, except in cases of financial hardship. Insurers no longer could turn away those in poor health.

More than 30 million previously uninsured people would gain coverage quickly — and they'll start going to the doctor for care previously postponed. Increased demand will push up health care spending, putting more pressure on premiums.

The cost controls in the bill are unlikely to provide much of a counterweight. Democrats scrambling to line up votes for the final bill weakened a provision that would have enforced austerity through a hefty tax on high-cost employer coverage.

Other savings in the law — mainly Medicare cuts — may prove politically unsustainable, according to the government's own experts.

The problem isn't that the 2,700-page law is devoid of ideas for curbing costs. Many mainstream proposals are incorporated in some form. But what will work?

While the law creates a commission to keep pursuing deeper Medicare savings, there's no overall cost control strategy and no single official to coordinate many experiments seeking greater efficiency.

"This bill takes a sort of spaghetti approach to cost control," said MIT economist Jonathan Gruber, who supports the broad goals of the overhaul. "You throw a bunch of stuff against the wall and see what will stick. Health care, Round Two, is when we will make a serious effort at cutting costs down, based on what this law has shown us."

If the law gets a B plus for expanding coverage to 95 percent of eligible Americans, it probably deserves a C minus or D for cost control. The U.S. spends $2.5 trillion a year on health care, with some results worse than what other developed countries get by spending far less.

"Most people who have problems with health care costs now are not going to see much change in the next few years," said Mark McClellan, who ran Medicare under former Republican President George W. Bush. "Hopefully some of these ideas will work, but it's not automatic. I do hope we can revisit this in a more bipartisan manner."

link

[TheMercenary]

I hope the premiums go out of the roof....

[TheMercenary]

Economic experts at the Health and Human Services Department concluded in a report issued Thursday that the health care remake will achieve Obama's aim of expanding health insurance -- adding 34 million to the coverage rolls.

But the analysis also found that the law falls short of the president's twin goal of controlling runaway costs, raising projected spending by about 1 percent over 10 years. That increase could get bigger, since Medicare cuts in the law may be unrealistic and unsustainable, the report warned.

http://www.nytimes.com/aponline/2010...osts.html?_r=2

[TheMercenary]

Endangered House Democrat Baron Hill justified his vote for the health-care bill by declaring:
This reform version covers more uninsured Americans than the respective House and Senate bills, while also reducing the deficit more effectively. The nonpartisan Congressional Budget Office reported that the revised bill reduces the deficit by one hundred and thirty eight billion dollars during the first ten years of the program, and reduces the deficit by more than one trillion dollars in the second ten years, effectively making it the biggest deficit reduction legislation since 1993.

Endangered House Democrat John Boccieri justified his vote for the health-care bill by declaring:

This bill may not be perfect but it strikes the proper balance of reducing costs, increasing consumer choices and lowering the staggering deficit from runaway health care spending.

Endangered House Democrat . . . eh, you're catching the drift.

Charlie Wilson of Ohio:

I have seen the CBO score and the reconciliation changes for myself. This bill will not add a dime to the deficit.

Suzanne Kosmas of Florida:

The bill before us now represents the single largest deficit reduction in over a decade, saving nearly $140 billion in the first 10 years and over $1.2 trillion in the decade to follow. This legislation provides truly fiscally responsible reform, and it contains the strongest measures ever enacted to help eliminate waste, fraud and abuse in the system, to rein in skyrocketing health care costs, and to stabilize Medicare while preserving benefits.

AmericanThinker

[TheMercenary]

Premiums are going up...

http://www.npr.org/templates/player/...37&m=126497751

[xoxoxoBruce]

What's new, medical shit has been going up 6%ish a year for awhile, even though the recession.

[TheMercenary]

What Health Law Didn't Fix: Medicare Doctor Pay

Call it Medicare's version of Groundhog Day.

For the third time this year, Congress has just days to avert a scheduled 21 percent cut in pay to doctors who treat seniors and others on the Medicare program. And while just about everyone agrees a cut of that magnitude would be devastating for Medicare and the patients it serves, no one seems to be able to figure out how to solve the problem in anything except a stopgap way.

How It Began

The trouble actually dates back to 1997, when Congress passed a balanced budget law that put the current formula in place determining how doctors will be paid. The idea was that if doctors as a group cost Medicare too much, their pay would be docked to make up the difference in future years.

But James Rohack, president of the American Medical Association, says it was clear from the start that the "sustainable growth rate" would be anything but.

"We want to keep people healthy, and this formula penalizes [doctors] for doing the quality care you want," Rohack says.

For example, he says, "by keeping people's blood sugars under control, or helping them stay out of the hospital when they have heart failure," doctors may save Medicare money overall, but run up overall physician spending that then triggers future physician pay cuts.

Finding Physicians Who Take Medicare

And if those cuts get big enough, people worry that over time there will be more patients like Janice Jessup, a Medicare beneficiary in Virginia Beach, Va.

The last time Jessup needed to find a new primary care doctor a couple of years ago, she says she called as many as 40 doctors all over town. And what did they tell her?

"They weren't taking Medicare patients anymore," she says.

Jessup, who had severely cut her leg and ended up needing substantial follow-up care, eventually went to a walk-in clinic where she did get the care she needed. But it wasn't the care she wanted.

"It isn't the full medical attention you need with a primary physician. No lab tests or anything," she says.

'Chaos' For Doctors

From the doctors' point of view, however, it's not hard to see why they're getting more reluctant to take on new Medicare patients.

"We haven't had a raise in seven years," says Joseph Stubbs, the immediate past president of the American College of Physicians, which represents more than 100,000 internists.

Stubbs says as professionals, doctors feel a strong sense of duty to continue to care for their Medicare patients, even when profits erode. But at some point the balance will tip, he says, including for his own group of nine doctors in Georgia.

"We're having to face, well, if those cuts go into effect, we need to cut personnel," he says. "It will cost us, instead of reimburse us, to take care of Medicare beneficiaries."

And Congress has now made matters even worse, Stubbs says, by delaying the cuts not a year at a time, but — because of complicated federal budget rules — only by a month or two.

That's because making the cuts disappear entirely would add to the federal deficit at eye-popping amounts. An estimate issued last week by the Congressional Budget Office said merely canceling projected cuts in Medicare pay for doctors over the next decade — without giving them any increases — could cost $276 billion over the next decade.

But the short-term fixes have left physicians wondering what their income might be, and what to tell patients.

"It is absolute chaos for us as business people," Stubbs says. "What business could deal with not knowing whether your price is going to be up in the next month, or the same, or be cut by 21 percent? It's no way to be able to plan."

Searching For A New System Isn't Easy

Groups representing patients want to ensure that there are enough doctors to serve Medicare beneficiaries. But they're wary about the doctors' prescription for fixing the problem, which calls for repealing the current formula in its entirety.

"We don't just want to just remove all limits on what doctors can charge. That's a good way to get to bankruptcy," says John Rother of the senior group AARP.

Still, Rother agrees with the physician groups that Congress has not been fair about its handling of their Medicare payments.

"No one would defend a month at a time. Even a year at a time is problematic. So we certainly believe if it can't be permanent, it ought to be a multiyear fix," he says.

Physicians, not surprisingly, are a bit more emphatic about what they want from Congress, particularly after the issue got punted from the recently enacted health overhaul bill because of its price tag.

"From a fiscal standpoint, when they say they, 'Well gee, we can't do it because it will add to the deficit,' well, the reality is every one of these temporary patches has grown the deficit," says Rohack. "They could have fixed this three years ago for less than $50 billion."

Now the number is rapidly approaching $300 billion.

So the search continues for a new system that would pay doctors on Medicare fairly, but neither too much nor too little. That search has, so far, been elusive.

And the latest delay in the cut expires on May 31.

http://www.npr.org/templates/story/s...ryId=126535110

[TheMercenary]

The ink was barely dry on President Obama's signature before the RAND Corporation released a report concluding that not only would the hard-won health care package fail to curb premium increases, but the bill would drive premiums up as much as 17 percent for young people.

This should not have been a surprise: the Congressional Budget Office had already warned that the bill would do almost nothing to reduce future premium hikes. And when New York implemented the same time of insurance reforms in the 1980s, it led to a nearly $500-per-year increase in premiums for young people. But somehow, the media didn't pay much attention.

And of course, back during the health care debate, no presidential speech was complete without a promise that "if you have health insurance today and you like it, you can keep it." But the Congressional Budget Office now says that as many as 10 million workers will lose their current insurance under the bill. Some of those will have to buy new insurance through the government-run exchanges. Millions more will be thrown onto Medicaid.

In addition, the Center for Medicare and Medicaid Studies reports that half of seniors enrolled in the Medicare Advantage program will lose their coverage under that program and be forced back into traditional Medicare.

And how many times did President Obama criticize the United States for having the highest health care spending in the world? Well, the government's chief actuary released his report on the bill recently, showing that the bill will actually increase health care spending by $311 billion over the next 10 years.

At the same time, the actuary warns that promised future spending cuts, particularly those for Medicare, are unlikely to occur.

"The longer-term viability of the Medicare reductions is doubtful," wrote Richard Foster, chief actuary of the Medicare and Medicaid systems. What cuts do occur could have a severe impact on the quality of health care. As many as 15 percent of hospitals and other institutions could be forced out of business, according to the report, "possibly jeopardizing access to care" for millions of Americans.

Continues:
http://www.realclearpolitics.com/art...ed_105494.html

[xoxoxoBruce]

That's why they should have passed a single payer system.

[TheMercenary]

As I said before, I wish if they were going to go in they at least added the GOBBERMENT option. But no... the fucks would rather appease and screw our children and grand children for generations on end and never fix the problems...

Just like the failed Bail-out programs...

Where are the jobs Dems???

You guys are about to eat a big shit sandwhich.

[TheMercenary]

As I stated earlier in this debate, they bullshitted all of us with the numbers and how much it was going to cost. Now here we are..

May 12, 2010
um...about those budget savings we were going to get from Obamacare...
Ethel C. Fenig

Whoops! There goes the Congressional Budget office again--proving with hard facts and figures that Obamacare will cost more, as a matter of fact, much, much more, $115 billion more over ten years than President Barack Hussein Obama (D) estimated.

But...but...but Obama claimed his bill would reduce costs. Ah, but as the first ever female Speaker of the House, Rep Nancy Pelosi (D-CA) stated while pushing it through, "we have to pass the bill so that you can find out what is in it."

Well ok, Barack, Nancy and all the others, we are now finding out what's in what you passed.

The budget scam that would have made Bernie Madoff blush. Medicare won't be cut.
And then there are all types of administrative money devouring costs and discretionary spending that CBO didn't mention in the original draft but are now part of the final health care legislation.


[A]dministrative expenses for the Department of Health and Human Services and the Internal Revenue Service for carrying out key requirements of the legislation.

Explicit authorizations for future appropriations for a variety of grant and other program spending for which the act identifies the specific funding levels it envisions for one or more years.

(snip)

Explicit authorizations for future appropriations for a variety of grant and other program spending for which no specific funding levels are identified in the legislation.
The $115 billion cost overrun doesn't even include the third item.

Ok the law was passed in what Pelosi believed was the most open process ever.

Greece, here we come! But who will loan us money then? China? Saudi Arabia?

hat tip: David Hogberg, investors.com

http://www.americanthinker.com/blog/...savings_w.html

[classicman]

I read something about that last night. IIRC, it appears as though there were OPTIONS for some discretionary spending that could be as much as $115 Billion.

The right picked up on it and repeated it as gospel. I don't think it was quite that cut and dried.

[TheMercenary]

Originally Posted by classicman

I read something about that last night. IIRC, it appears as though there were OPTIONS for some discretionary spending that could be as much as $115 Billion.

The right picked up on it and repeated it as gospel. I don't think it was quite that cut and dried.

Yea, the CBO report actually said the numbers were not written in stone. Here is another report on the subject from CNN:

CBO doubles some health care spending estimates

http://news.blogs.cnn.com/2010/05/11...ing-estimates/

Bottom line is it will cost more and the propaganda fed to the publick about "Deficit neutral" was bullshit...

[classicman]

Long story short ... it's a work in progress. The R's better figure out why the Single payer/Universal plan they fought off is worse than this clusterfuck of unknown shit.

[TheMercenary]

Originally Posted by classicman

Long story short ... it's a work in progress. The R's better figure out why the Single payer/Universal plan they fought off is worse than this clusterfuck of unknown shit.

They don't really have to figure out shit until they are in power again in some form. Until them it is all in the Dems lap; lock, stock, and barrel.