Pat and Geno probably won't be fighting over this one:
Mitt Romney’s ambitious plan to rein in federal Medicare spending would give America’s seniors a choice: choose government insurance or use a federal voucher to buy medical insurance from private companies. The idea, according to Romney, is to drive down costs by introducing market competition.
“Romney wants to privatize a program seniors depend on and end Medicare as we know it.’’
Douglas Holtz-Eakin, president of American Action Forum and former director of the Congressional Budget Office, thinks the plan will achieve Romney’s goal of reducing Medicare costs.
“It will control the federal budget because it caps the taxpayers’ exposure,
True, but only if the seniors on Medicare do not pay taxes.
All this proposal does is shift the cost of care from Medicare to the patient. Items not paid by Medicare and Georgia Medicare supplement plans are paid by the Medicare patient.
This is nothing more than rearranging the deck chairs.
I love it when the government supports my theory. The theory in this case is that we will go metric before we go ICD -10. Towards that end the government announced on Thursday, November 17, 2011 that that first piece of moving towards ICD-10 has been delayed.
All physicians were to begin electronically billing using the new updated form, version 5010. That was to begin in Jan. 2012. It has been moved to March 2012.
As easy as running a four minute mile (no I do not know the metric equivalent, America never went metric).
“The very first time I went to the Nashville VA hospital, I had made my appointment and waited my two months. I showed up and I waited in the lobby for about an hour and 45 minutes — almost two hours — before I just left,” Betts said.
Obama circumvented the Senate confirmation process, appointing Berwick while Congress was in recess in July 2010.
The move, which hardened GOP opposition, meant Berwick had to step down by the end of this year.
I am a longstanding health professional (an M.D.) and I knew this charge was way over the top. I asked for an itemized bill. There were many examples of excesses. To me, the most outstanding was $48 for one 100mg dose of Zoloft. At the local pharmacy, a generic form of the drug costs well under $1. The hospital does have legitimate extra charges, but nowhere near $47. It went on and on. I wanted a second opinion. Another cardiologist came to WVU, relieving the shortage well after my procedure was done. He had been in private practice. I asked what the charge of my procedure would have been in the area of West Virginia where he had practiced. He said it would have been around $10,000. In my case, Medicare paid $8,318.33.
Had I been a private-pay patient, I’m sure the $53,000 plus would have been what I had to pay.
Around 1980 and since, Managed care groups (Health Maintenance Organizations — HMOs) became very popular. We were told that they would save money. HMOs built on venture capital, saw health care as a low-risk, highprofit industry. We have seen medical care turn into a profit making business — mostly privatized with shareholders and highly paid CEOs.
Getting old has some advantages, but one disadvantage is recalling the government stepping in to establish price controls and fighting against price fixing when confronted with outlandish charges
“…insured patients began to request that the [medical offices] bill their health insurance before making payments on their accounts. [The patient] agreed to pay the balance due after the carriers determined the insurance portion of the claim. Each insurance company had a unique set of billing requirements. The complexity of the new billing procedures greatly increased paperwork and practices had to, therefore, increase the size of their billing staff [or add a billing staff which had heretofore never existed in the medical practice]”These changes dramatically affected how Americans viewed health care. First, by not paying the premium, they no longer had the knowledge of the true cost of those premiums. Secondly, by not paying for the medical care at the time of service, they no longer had the knowledge of the true cost of health care. The organizational culture of healthcare changed and the organizational memory has been lost by the American populace.
“We are in the midst of an economic crisis and efforts to reform the health care system have centered on controlling spiraling costs. To that end, many economists and policy makers have proposed that patient care should be industrialized and standardized.”Patient care became standardized when insurance companies began telling physicians how much their services are worth. No longer is a physician paid based on the financial needs of the physician’s business, but instead on a government produced fee schedule based on a formula called RVU’s. Physicians have not had a raise in their fee schedule from Medicare in over a decade, and the docs are so appreciative that each year the fee is not cut that they don't realize that they did not receive any increase.
“The problem ... is that the special knowledge that doctors and nurses possess and use to help patients understand the reason for and remedies to their illness get lost in a system that values prepackaged, off-the-shelf solutions that substitute "evidence-based practice" for "clinical judgment."What Hartzband and Groopman do not understand is that the patient does not want to pay for the physician to develop an evidence-based plan of care. Today’s exam averages 15 minutes. A physician cannot do the type of work that Hartzband and Groopman want in 15 minutes. That is the reason that more and more medicine is pre-packaged, and it works for the majority of the population. For the minority of patients that need the more protracted appointment and care, there is resentment that they should have to pay more for their care than someone else.
“Even more troubling ... is the impact of the new vocabulary on future doctors, nurses, therapists and social workers who care for patients. Recasting their roles as providers who merely implement prefabricated practices diminishes their professionalism.Here, Hartzband and Groopman are correct: individuals who desire to make a contribution to society, and to be rewarded for this contribution financially, will steer away from medicine. Since insurance companies pay the inadequate physician the exact same as the extraordinary physician, what is the incentive to become a physician?
Reconfiguring medicine in economic and industrial terms is unlikely to attract creative and independent thinkers with not only expertise in science and biology but also an authentic focus on humanism and caring.”
Much has been said about Medicare fraud and abuse, and cutting wasteful spending, but this story has me at a loss for words.An Illinois man accused of shipping unwanted "penis enlargers" to diabetes patients as part of a Medicare fraud scheme has pleaded not guilty in an arraignment in federal court in Providence.
Under an agreement with prosecutors, Gary Winner plans to change his plea in a second hearing later Thursday. The deal calls for the 49-year-old Winner to admit he bought $26 penis enlargers from an adult website, repackaged them and shipped them to patients with information claiming the "erectile pumps" helped "bladder control, urinary flow and prostate comfort."
Prosecutors say Winner billed Medicare an average of $284 for each item, claiming they were used to treat erectile dysfunction.
The Northbrook, Ill.-resident has also agreed to forfeit $2 million.
Winner could face up to 33 years in prison.
At least give the guy points for creativity.
Is it just me, or is Washington sending a message that they want to RATION our health care? The Obama administration seems to favor placing those people who want bigger government and less access to health care in charge of our senior population.
Consider this.
During a Congressional recess Obama appointed Donald Berwick, a socialist that adores nationalized health care such as exists in Great Britain, to head the Center for Medicare Services. The timing of the appointment to a position that had been vacant for over a year is suspicious.
By making the move while Congress was not in session the appointment avoided the normal scrutiny of a Senate committee.
In essence, Mr. Berwick was appointed to a powerful government position without the normal vetting process.
Now the president wants to place Henry Aaron (no, not THAT Henry Aaron) as head of the Social Security Advisory Board.
Let's look at this in more detail.
Berwick, to whom Obama issued a dubious recess appointment to circumvent the usual Senate confirmation, has become notorious for statements like, “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open” — and, in progressive-speak, “The social budget is limited.”
Aaron, a recent Obama nominee, has expressed similar views. He wrote a piece earlier this year called, “The Independent Payment Advisory Board — Congress's ‘Good Deed.’” The grisly IPAB, one of the most underreported of Obamacare’s myriad of liberty-sapping features, would have the power to cut Medicare spending each year — if Obamacare isn’t repealed first. The dictates of its 15 unelected members would effectively become law. In fact, Congress couldn’t even overturn the IPAB’s decrees with a majority vote in each house and the President’s signature.
Power to CUT MEDICARE SPENDING.
Even Congress cannot overturn their decisions.
How much power does Washington need over our lives?
Aaron praises the IPAB, although he does admit to having a few problems with it. He thinks that its largely unchecked power isn’t unchecked enough, as the board should be able to order payment reductions for other aspects of medical care that have so far escaped its statutory grant of power. He writes,
“I admit that the provisions governing the IPAB are less than optimal. For example, recommendations regarding payments to acute and long-term care hospitals, hospices and inpatient rehabilitation and psychiatric facilities are off-limits until 2020; and those to clinical laboratories are off-limits until 2016. These politically motivated restrictions should be repealed as early as possible so the IPAB’s recommendations can comprehend the delivery system as a whole.”
In other words, Mr. Aaron wants more power sooner rather than later.
“If Americans are serious about curbing medical costs, they’ll have to face up to a much tougher issue than merely cutting waste, says Brookings Institution economist Henry J. Aaron.
“They’ll have to do what the British have done: ration some types of costly medical care — which means turning away patients from proven treatments.
Yes, we all know how well the British health care system works . . .
