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Retirees, Medicare, and the urgent "doc fix"
Old 06-12-2010, 01:48 PM   #1
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Retirees, Medicare, and the urgent "doc fix"

The President has used his weekly radio address in a most unusual way.

President's Weekly Address

If I understand him correctly, he's saying that he needs Republicans to now support another "doc fix" so that medical providers won't have their Medicare reimbursement rates cut 21% this week.

Didn't he just shepherd through a comprehensive health care reform law? I remember a lot of projections about all the cost savings from Medicare. I remember that the law would cut the deficit. This all seems incongruent with suddenly needing to pump a lot more money into Medicare.

This makes me think that maybe all the costs weren't included in those already-very-high CBO projections.

He's saying that doctors may stop seeing Medicare patients, which can't be good for retirees. I think it's possible that all this might hurt public support for his reforms. I think maybe a lot of folks assumed that a comprehensive bill wouldn't omit something important like this. I do hope people can keep their doctors.
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Old 06-12-2010, 04:45 PM   #2
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This is another example, and there are many, of the numbers fraud they played with the health care reform. Now Obama is trying to blame the republicans if this is not passed, so he can blame them going into elections when more doctors abandon medicare.

If they had included this, which they should have, the bill would have never passed as it would have easily pushed it past 1T in costs, and there would have been a negative cash flow.

When you combine this with the 115B that is considered, discretionary spending CBO was not allowed to calculate in the bill, which the congress will have to approve to keep care system afloat, the bill is really under water.

They are hoping to hide these facts past the elections, and think the electorate is stupid, so hopefully press will keep these fact upfront.

Very sad that organizations like AARP and others drank all that kool aid.

Seniors will be in for a very rough ride in the future years.
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Old 06-12-2010, 06:25 PM   #3
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I am posting to make only one point. This problem was discussed all during health care reform debates and was not hidden. Don't be so shocked that health care reform didn't solve everything. It barely passed. Attempts to change the formula as part of reform failed. The problem is complex and reading I did indicated that more study had to be done to figure out how to compensate providers. So, temporary fixes continue.

The Independent Payment Advisory Board | Health Care Reform Center

This link discusses the panel that is to look at medicare cost control.


Otherwise, healthcare reform is too hot and political a topic and too complex for me to discuss adequately on this board.
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Old 06-12-2010, 07:42 PM   #4
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Originally Posted by samclem View Post
The President has used his weekly radio address in a most unusual way.

President's Weekly Address

If I understand him correctly, he's saying that he needs Republicans to now support another "doc fix" so that medical providers won't have their Medicare reimbursement rates cut 21% this week.

Didn't he just shepherd through a comprehensive health care reform law? I remember a lot of projections about all the cost savings from Medicare. I remember that the law would cut the deficit. This all seems incongruent with suddenly needing to pump a lot more money into Medicare.

This makes me think that maybe all the costs weren't included in those already-very-high CBO projections.

He's saying that doctors may stop seeing Medicare patients, which can't be good for retirees. I think it's possible that all this might hurt public support for his reforms. I think maybe a lot of folks assumed that a comprehensive bill wouldn't omit something important like this. I do hope people can keep their doctors.
does it bother anyone that our president, when pushing for his health care bill, used this cut in drs medicare pay to make it appear that his bill was pretty much paid for even thought he knew (as witnessed by this address) that he was gonna attempt to get rid of that pay cut after his bill passed? what does that say about his integrity?
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Old 06-12-2010, 07:44 PM   #5
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does it bother anyone that our president, when pushing for his health care bill, used this cut in drs medicare pay to make it appear that his bill was pretty much paid for even thought he knew (as witnessed by this address) that he was gonna attempt to get rid of that pay cut after his bill passed? what does that say about his integrity?
Surely, you jest. This cut in physician payments was not part of the calculation on the cost of the health care bill. Reducing fraud and waste in Medicare was part of that calculation.

The cut you mention is part of the legislation created in 1998 which reduces payments to doctors on a set schedule.

Rita
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Old 06-14-2010, 05:02 PM   #6
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Discussions about health care and health insurance can be thoughtful and productive or they can be a front for a lot of partisan politic bickering, in Washington and on this site. It is easy for posters to read a thread linked to retiree health care and possible shortage of medicare docs, such as this one, and then move to pure politics. While health care and its costs may be *the* critical issue facing wannabe early retirees and is about as relevant as they come, it's only a hop, skip and a jump from a relevant and important FIRE topic to full contact politics.

The moderation teams appreciates our members keeping the above in mind. Many thanks!

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Old 06-14-2010, 05:13 PM   #7
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Otherwise, healthcare reform is too hot and political a topic and too complex for me to discuss adequately on this board.
Really? I think you are one of the most eloquent posters on this topic.

But I can understand why you don't enjoy stirring up the coals. Maybe just once in a while, OK?
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Old 06-15-2010, 05:22 AM   #8
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This makes me think that maybe all the costs weren't included in those already-very-high CBO projections.
Yes, as Martha said, this has all been discussed before. And it is just as true today, as it was then, that the need for the "doc fix" pre-dates recent health care reform. It isn't included in the CBO cost estimates, because it is, and always was, independent of the legislation that passed. Just because it is related to health care doesn't make it a cost of new legislation.
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Old 06-15-2010, 07:43 AM   #9
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This thread is a perfect example, why I am against the health insurance law. Programs already on the books aren't working like they should. Instead of passing a laws that address the problems with the programs already not functioning properly Congress passes laws that don't address the problem. When the problems in the current system are pointed out, the response is we can't fix those problems because of these other problems. The fixes for the other problems don't address the problems with the current programs and simply add more problems to the already problem ridden programs. The end result is more problems, more money spent, and nothing to address fixing any of the problems in any of the programs.
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Old 06-15-2010, 10:37 AM   #10
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Yes, as Martha said, this has all been discussed before. And it is just as true today, as it was then, that the need for the "doc fix" pre-dates recent health care reform. It isn't included in the CBO cost estimates, because it is, and always was, independent of the legislation that passed. Just because it is related to health care doesn't make it a cost of new legislation.
The doc fix was originally in the bill as part of the total cost and was later stripped out to make it look like the total cost would be lower than it really is. Explain that one.
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Old 06-15-2010, 12:01 PM   #11
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The doc fix was originally in the bill as part of the total cost and was later stripped out to make it look like the total cost would be lower than it really is. Explain that one.
Um, that is a mighty simplistic view of a complicated issue. The house bill had approved a fix, straight along party lines. The Senate did not. To say it was stripped out is disingenuous.
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Old 06-15-2010, 12:10 PM   #12
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Who would suspect, that this program would cost more than they let on ?

I am shocked ! Shocked I tell you, that costs were lowballed !
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Old 06-17-2010, 06:29 AM   #13
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Who would suspect, that this program would cost more than they let on ?

I am shocked ! Shocked I tell you, that costs were lowballed !
I'll try with a little less political sarcasm this time. I find it interesting that as the law is implemented many of the arguments made by those against the law are playing out to be true. While at the same time many of the arguments made by supporters are being found to be a bit off. For example the point that it will cost businesses a lot of money. People won't be able to keep their current health insurance. It is going to be too expensive. We are finding that more spending bills are needed to get the law implemented. I'm sure more will follow as more portions of the law are implemented.
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Old 06-17-2010, 01:31 PM   #14
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So what would you advocate?

The current system (pre-reform) is in the process of collapsing from escalating costs and the steady decline of people with insurance coverage.

The people fortunate enough to have employer provided coverage are at the mercy of whatever their company plan feels like providing. From my experience, this means that when you get health care service, the provider charges any amount they feel like as much as 6 months after the service was provided. The insurance company then negotiates a lower amount, and then pays whatever portion of that they feel like. They've both set the system up to be impossible to figure out and dispute. Costs can't be controlled because you have no knowledge of what things will cost until you get the bill 6 months later.

There really aren't a lot of viable paths out of this mess. I see three basic choices--

1. Some version of single-payer. This is done throughout Europe and Canada. There are a fair number of differences in the systems they've implemented. Some have actual government-run care, like the UK, and some have a "Medicare for all" system like France. Politically, this was determined to be unacceptable right from the start.

2. Get the government out of healthcare entirely. Get rid of Medicare, Medicaid, etc. Remove the employer tax incentive to provide healthcare and let everyone fend for themselves in a free market. I have a hard time seeing this fly, as the prevailing attitude of the largest voting block in this country is "keep the Government's hands off my Medicare."

3. Tinker with the current system to make it suck a little less. Make the insurance companies cover everyone, since they are getting better and better at weeding out the sick people. In return, make everyone get insurance to avoid the opposite problem. If you're mandating that people get insurance, you probably need to subsidize it for the poor. This looks an awful lot like the reform bill they passed.

Ultimately, we as a country are going to have to an adult conversation about health care rationing. Whether you do it with the free market via price, or by some 3rd-payer system via government or insurance provider, there is no getting around the fact that the fundamental problem we face is that the demand for a product you don't pay directly for is going to be massive. Until we can have that conversation without someone screaming "Death Panels" we will have escalating health care costs.



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This thread is a perfect example, why I am against the health insurance law. Programs already on the books aren't working like they should. Instead of passing a laws that address the problems with the programs already not functioning properly Congress passes laws that don't address the problem. When the problems in the current system are pointed out, the response is we can't fix those problems because of these other problems. The fixes for the other problems don't address the problems with the current programs and simply add more problems to the already problem ridden programs. The end result is more problems, more money spent, and nothing to address fixing any of the problems in any of the programs.
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Old 06-18-2010, 05:50 AM   #15
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There are more than enough threads where I've stated my opinion of how to fix the health care system. I don't think it really fits in this one, but you are free to do a search on the topic. Some thread wander is expected, but that is more than wander. It's more like a long hike.
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Old 06-18-2010, 08:45 AM   #16
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I'm really not that interested.

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There are more than enough threads where I've stated my opinion of how to fix the health care system. I don't think it really fits in this one, but you are free to do a search on the topic. Some thread wander is expected, but that is more than wander. It's more like a long hike.
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Old 06-18-2010, 08:48 AM   #17
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I am posting to make only one point. This problem was discussed all during health care reform debates and was not hidden.
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Yes, as Martha said, this has all been discussed before.
Agreed, it has been discussed on this forum and many other places. But... I think the more relevant question is, did Obama ever highlight this issue at the level of a weekly radio address (or even close)?

I do not know the answer to that, it is a question.

And this sure does relate to retirement - if Doctors can't afford to see Medicare patients, our options will be limited. If they raise the payments, there's that pesky deficit thingee.

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Old 06-18-2010, 12:17 PM   #18
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Um, that is a mighty simplistic view of a complicated issue. The house bill had approved a fix, straight along party lines. The Senate did not. To say it was stripped out is disingenuous.
For anyone to argue that whether the bill is passed separately or passed together with the doc fix is any different is also disingenuous. The money all comes from the same place and it is most certainly a cost to the healthcare system and taxpayers. It was removed from the bill so they could kick the can down the road another year and deal with it after the health reform commotion had passed, which ironically is when it will just be beginning as people find themselves with notices of massive rate increases for individual coverage based on the new mandates.

Almost everything that critics argued would happen if this bill was passed has already started coming to fruition. If the bill is not repealed or heavily modified, I will surely be interested to see where the market stands in 2014. $1500/month for a high deductible plan, anyone?
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They're solving the crisis!
Old 06-19-2010, 01:29 AM   #19
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They're solving the crisis!

The crisis may be close to over! The Senate passed the doc fix! Now it goes to the house.

Here's the funny part--the fix is only good for six months, then we'll face the problem again--a 21% cut in Medicare reimbursement to doctors (I guess it might be bigger by then. If this goes on long enough, doctors will have to pay Medicare patients when they treat them). If only there had been some sort of bill or law that could have addressed this in a more permanent way as a result of the more than 12 months of national debate on health care. I guess we'll just lurch along 6 months at a time. But it's important to take the positive view--we should be happy for whatever Washington decides to give us from the money they take from us or the next generation. Six months is better than nothing! Congress is very compassionate, and probably didn't want hundreds of thousands of seniors turned away by their doctors as November approached. November is a cold month, and winter is a bad time to be without a doctor.

According to the above article, the legislation was passed by voice vote, so we don't know who voted for and against it. That's too bad, as now we won't know how each senator voted. Well, this is a crisis, there's not a lot of time for bookkeeping! I guess the Senate Scribe would have to write all those names in his big parchment book using his quill pen.

Medicare, and medical care in general, is a very important topic to those on this board.


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$1500/month for a high deductible plan, anyone?
I don't think high deductible plans will be available, at least not as we know them today. They aren't comprehensive enough to "count" as insurance, so anyone with such a high-deductible plan will still have to pay the penalty tax once it is enacted. And, they won't get the subsidy/wealth-transfer payments to use in the purchase of such policies.
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