Friday, October 30, 2009

Pelosi and House Democrats stick it to seniors with health care "reform" bill that will slash Medicare by $400 billion

Nancy Pelosi announces a bill to strip millions of seniors of their quality care

The House health care plan unveiled yesterday by Speaker Nancy Pelosi has a lot that is commendable in its 2000 pages. But it's not at all commendable that the bill, which will cost $894 billion over 10 years, is "deficit neutral" only because it slashes more than $400 billion from Medicare in that period. Senior citizens are to see a significant decrease in the accessibility and quality of their health care, in order to pay for nearly half the cost of extending coverage to others.

The Congressional Budget Office's scoring of H.R. 3962, the Affordable Health Care for America Act -- which might as well be named the Medicare Reduction Act -- cites these "savings" to be achieved in the Medicare program:

Permanent reductions in the annual updates to Medicare’s payment rates for most services in the fee-for-service sector (other than physicians’ services), yielding budgetary savings of $229 billion over 10 years...

Setting payment rates in the Medicare Advantage program on the basis of Medicare spending per beneficiary in the fee-for-service sector and changing the way that payments to Medicare Advantage plans reflect differences in the health status of enrolees, yielding savings of an estimated $170 billion...over the 2010–2019 period.

The massive $229-billion reduction would drive hoards of doctors to refuse to participate in Medicare -- and there are already far too many who don't, due to reimbursement rates far below those of private health plans.

Oh, but Democrats are saying in stage whispers that no one should worry about the reduced fee-for-service payments, because they'll "fix" that in a separate bill. Of course, that makes the claim of deficit neutrality for H.R. 3962 duplicitous. But seniors also need to worry that the Democrats may not be able to keep their promise of a sly "fix." If the bill passes, as is, it becomes the law of the land, period. By the time that happens, who knows what the political environment will be like. How many people predicted early last summer that we'd be into November with no health care bill passed by either the House or the Senate? Seniors would be foolhardy in the extreme not to worry that H.R. 3962 will set the terms of their health care for a long time to come.

The Medicare Advantage plans from which $170 billion would be cut currently enroll 11 or 12 million seniors. These plans have been cast by Democrats as too generous to the insurance companies that offer them, because the companies get as much as 14% more from the feds than providers under the regular Medicare program. There are two things wrong with that argument: first, as indicated above, the regular Medicare reimbursement rates are lower than they should be to ensure that providers accept Medicare patients; and second, the whole point of the Advantage programs was to pay insurers more to induce them to offer managed-care (HMO) plans that would provide better overall quality of care for patients with multiple health problems, emphasize wellness and prevention, and eliminate the need for seniors to navigate through mountains of Part A, Part B and Part D insurance paper work. That's why a quarter of all Medicare enrolees prefer Advantage plans.

Anyway, didn't President Obama and other Democrats say over and over about health care reform that if you like your current plan and your current doctors, you won't have to change? Well, if this bill passes, Medicare Advantage plans will disappear and millions of seniors will be thrown into regular Medicare. Not incidentally, these millions will be chasing many of the same doctors and other providers who might opt out of Medicare anyway.

Medicare arguably is one of the signal achievements of the Democratic Party of the last 50 years. Why would Democrats want to eviscerate one of their great successes? Republicans may exploit the huge negative impact on Medicare of the House bill as a talking point -- but Republicans are not going to stand up for Medicare in the long run.

Democrats who support the House bill may think they can bob and weave around the issue of Medicare cuts and hope that seniors remain in the dark or confused about the impact of the bill (or distracted by minor additional benefits for Medicare recipients in the bill, such as an increase in drug coverage). If so, they would be wise to think again. Seniors are already well aware of the fact that they will get the short end of the stick under health care "reform." That's why only 36% of people over 65 support the proposal in a recent poll. Seniors are by far the most reliable voters. It will be tough to conceal the impact of the cuts when they actually happen, and seniors will be really, really pissed when they go to the polls.

What do you think? Post a comment.

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