Posted on 09/10/2011 12:08:56 PM PDT by TruthHound
Last month, I was invited to make a presentation to the Peninsula Seniors Organization at the Hesse Park auditorium in Rancho Palos Verdes. The subject was "How the Patient Protection and Affordable Care Act (ObamaCare) Will Affect Seniors on Medicare." It was standing room only and the crowd spilled into the hallway.
Preparation for that talk involved a lot of study. I had served on the Los Angeles County Medical Association's subcommittee charged with reviewing all of the "reform" bills before they became law. Since then, many regulations have been written and a clearer picture has emerged of how the law will affect current and future Medicare enrollees.
The Patient Protection and Affordable Care Act is not about helping seniors. It is about providing new health insurance for 50 million uninsured younger Americans and preventive medicine coverage for 100 million currently uncovered younger people. Funding comes partly from new taxes, but mostly by stripping $523 billion from Medicare members. That's more than $11,000 per current Medicare enrollee over the next 10 years.
Some benefits were added to Medicare, such as paying a small amount for annual checkups, eliminating deductibles and copays on a few things like colonoscopies and mammograms, and closing the donut hole in Medicare Part D in 2019. But that's about it. There were $10 in cuts for every dollar in new benefits.
The law creates no new doctors or nurses. In fact, it cuts funding for some training programs. But it does add 100 million people looking to collect on their mandated, prepaid annual checkups and preventive care benefits. Unlike Medicare patients, most of these people are well. This is a huge supply problem. No one knows from where the doctors and nurses to deliver on this demand will come.
Thus the pressure on the system will be overwhelming. The Congressional Budget Office and others have estimated that if all these people get their mandated free checkups, primary care doctors will spend seven-and-a-half hours a day doing only that, with little time remaining to care for the actually ill. Look for longer lines, less time with your doctor and more trips to the emergency room for delayed care as has happened in Massachusetts under a similar plan adopted five years ago in that state.
Even worse, the only way the law allows the new federal Independent Payment Advisory Board, tasked with controlling the growth of Medicare, to cut Medicare is to cut fees to doctors and hospitals, not specific allowed services. Congress could act to cut services, but would have to eliminate as much in services as the IPAB would have mandated in fee cuts. Otherwise, IPAB's cuts take place automatically. It will be much easier for Congress to let the IPAB do the dirty work.
Within a few years the fees paid for Medicare patients are projected to be lower than those paid by Medi-Cal, California's insurance for the indigent. Those rates are so low that 80 percent of private doctors cannot afford to accept Medi-Cal. And current law prohibits Medicare patients from paying extra for any Medicare-covered service no matter how willing they might be to do so. However, it does not prohibit younger patients from doing so.
Thus, Medicare patients will be beneath the indigent in the pecking order of who gets seen preferentially if the office overhead is to be paid. When doctors are paid more to quickly see a 30-year-old with a sore throat or do a wellness checkup than to see a 75-year-old with 25 complex medical problems who needs help to get on an exam table, Medicare patients may be crowded out.
Furthermore, ObamaCare eliminates tax credits and almost $700 in annual subsidies per retiree to employers who now offer their retirees prescription drug coverage. AT&T alone will lose a billion dollars in such subsidies and credits. The CBO projects 90percent of employers will probably drop their senior prescription service. These retirees will then have to go bare or purchase ever more expensive and restrictive Medicare Part D policies.
The funding cuts for Medicare Advantage are in the order of $200 billion. Fourteen million seniors belong to MA plans that include Kaiser and other HMOs, Medicare fee-for-service plans and Medicare Medical Savings plans. About 7.5 million such seniors are projected to lose their MA plan and be forced back into traditional Medicare and its draconian funding cuts. Others will see sharp increases in their premiums.
A district federal court in Atlanta has ruled that critical parts of ObamaCare are unconstitutional while a Cincinnati district court has ruled the opposite. The case is headed for the Supreme Court probably in 2013. The Republicans who now control the House of Representatives passed a repeal act this year. It failed in the Senate by four votes.
But Republicans have committed to repeal and replace ObamaCare in 2013 if they win control of the Senate and White House. If seniors are serious about protecting Medicare, then candidates who support that repeal should be attractive.
Thomas LaGrelius is a Torrance-based geriatrician and a fellow of the American Academy of Family Physicians.
Logans Run the cutoff was 30 years old. The black spot in the palm of your hand turned black and that was the cue to die.
What other color would a "black spot" be?
I'll stipulate, it was 30, although that sounds too much like "Don't trust anyone over thirty..." for my liking.
Regards,
GtG
GtG
Haha and I watched it thinking 30 wow that’s kind of old!
Logan’s run or Soylent Green take your pick.
Probably Logan’s Run. A great movie.
Logan’s Run - that’s it. Knew it was something Run. Thanks.
Logan’s Run - that’s it. Knew it was something Run. Thanks.
nobamacare = Stay healthy or die.
Great...just great.
LOL me too! I was 16 I think when it was on and remember thinking how old I’d be when I made it to 30...now I’d love to be 30 again.....
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