ObamaCare's Rationing Board Spells Doom for Medicare

town hall ^ | 7/12/2011 | Hadley Heath

[tobyhill]

This summer, most of the public's political attention is focused on the tug-of-war over the debt ceiling and government budget. Yet another important drama is also unfolding in Washington.

This week, Congressional leaders will hold a hearing on the IPAB: the Independent Payment Advisory Board, which could be a first step to the board's repeal This board, created by the Affordable Care Act (“ObamaCare”), is one of the lesser-understood provisions in the 2000-page law, but it is a critical aspect, exemplifying how ObamaCare would control Medicare costs. If the public learns more about IPAB, the movement to fully repeal ObamaCare will gain important momentum.

Lawmakers created the IPAB in the Affordable Care Act to help solve Medicare's significant financial problems. The average couple will pay $140,000 into Medicare during their working years, but will get nearly three times that amount back in health care services through Medicare. This pattern has led the program to a $79.4 trillion “unfunded liability” or budget hole, and that figure grows each year.

[Notary Sojac]

There is some real fraud, but much of what the government is calling "fraud" these days is just part of the covert rationing plan.

Medicare's coding and billing rules are incredibly complex and poorly defined - ask your doctor if you don't want to take my word for it.

And the government is threatening physicians and hospitals with massive fines and possible jail time if they don't follow the vague rules in the way Medicare thinks they ought to be followed.

So the end result will be that the doctor decides not to take the risk, not seeing the patient, not doing the procedure...

[Semperfiwife]

And an entire generation of those third persons has been aborted by the very generation that needs them now the most.

[unkus]

SOP for the nomenklatura is to insulate themselves from the consequences of the policies they enforce on others.

---

You’re right. Now we have our own nomenklatura in America.

[kaila]

Decreasing payments to providers will not help the problem. Medicare payments are so low, providers will continue to reject Medicare patients.
I read a few years ago the highest amount of money spent by Medicare is in the last year of life of the patient. We have to take a look at this. I recall recently that there is a new prostate cancer drug that costs aout $90,000. It extends life for terminal prostate cancer patients for 3 months. I cannot remember the name of the drug, but Medicare approved it for their formulary.

[LibsRJerks]

I’m an RN and I like your ideas. I’m pretty sick of seeing welfare queens put up in private rooms w/ all the hotel amenities, and their demanding little attitudes, while I, a military wife, was put up on a “quad” room, had to get up and make my own bed, didn’t even get escorted out in a wheelchair, etc, etc ...

If you are on the “low” run, you fly no-frills. It’s not fair to those who pay.

Then again, these commies want equal benefits in everything, except in WHO PAYS.

[LibsRJerks]

This is also the unspoken issue. We keep people alive for SO long ...and sometimes for only a short time — yet we want all of this treatment to be available — we desperately want it. If we want it, we have to resign ourselves to the fact that it HAS to be paid for ... or something. I don’t know the answer ...but it’s true.

On a daily basis we keep people alive who normally, naturally, would have died in earlier times. A simple heart med allows someone to lay in a bed alive, for weeks at a time ...

[ilovesarah2012]

What is the average annual payout of Medicare per recepient?

[Lou L]

Thanks LRJ...

I've been in the military, and while I can't say I've ever been in a military hospital for any major treatments, I know that many in the military receive "practitioner-style" care for their basic, non-life threatening healthcare needs. If that's good enough for those that serve in harm's way, it's certainly good enough for those who don't contribute.

[musicman]

"ObamaCare's Rationing Board Spells Doom for Medicare"

[LibsRJerks]

I’ll say. And I want to say it again. Our clinics are plain, bare bones. We see whatever doc happens to be in that day ...not our own “private” doctor ...although we do get kept in groups and the same docs go over our cases.

Hospital stays are adequate, but no frills. I don’t remember nurses rounding every single hour, and I dont’ remember them coming within 2 minutes of me calling as I am MANDATED to do in our civilian hospital. There is no “room service” w/ meals ...no “order taking” like I’ve seen lately in our hosptial. Meal tray comes ..and if you don’t like it, too bad.

Most of all ...you can ask the docs questions, but there is no chewing out the docs and nurses to your satisfaction ...if you have a problem, you take it up w/ TRICARE and some bureaucrat somewhere.

I’m still alive and healthy ...but our care would definitely NOT satisfy the majority of civilians I encounter in my work now. I dont’ think they even know what they have coming w/ an obamacare type of service.

[kaila]

It used to be that doctors and nurses would tell patients if their demands are unreasonable- asking for treatments and medication they do not need.
Now, a lot of the doctors practices are being swallowed up by big entities who now call the shots. Care in the hospital is being given by hospitalists who never ran a business of a private practice.
In order not to get complaints which could cause them to get in trouble with administration, they will usually order up things to keep up patient satisfaction, but cost money in the long run. The same with oupatient clinics owned by corporations.When you have physicians who have no sense of the cost of healthcare( because they are owned and have never run a private practice), they will prescribe treatments until the country goes bankrupt. They also need to train physicians to be able to talk with families when continuing care is futile. I have seen physicians avoid this conversation, although lately there has been a slight increase in discussion of end of life care. Sometimes, you have to be blunt.
There is a huge entitlement mentality of Medicaid patients, who tend in my experience to be the most demanding because they do not have to pay anything.
If I ran the healthcare world- I would do these things:
1. Make Medicare means tested. Pay more if you have more income. If you want to pursue futile care- then you need to pay for it yourself.
2. Medicaid patients must pay a copay on every non emergency service they receive. I do not care if it is only a buck, but they need to have skin in the game.
3. Prioritize the care that is given. The new thing in healthcare is sleep studies for sleep apnea. That is not a healthcare priority. We should emphasize conditions that can endanger life , and limb. Buy a separate luxury policy if you want your acne treated.
4. All illegals seeking healthcare must be reported to INS for immediate deportation once their condition is stable in the hospital.
5. Reduce the paperwork demand on hospitals and clinics tht the government has mandated.
6.Chronic treatment of conditions such as- never ending physical therapy for back pain- needs to be limited. PT is good in some aspects of care, but way overused.
7.Malpractice reform. A lot of tests that are ordered for patients is defensive medicine.
I could go on.....

[DrC]

“If you invested that $140 K across your work span you would hope to get more than that back after 30+ years of working. “

The figures are in present dollar terms, taking into account past inflation and discounting future benefits at 2% a year.
http://www.urban.org/publications/412281.html. It’s a conservative estimate of the mismatch between contributions and payouts since it only includes those who survive to age 65 and ignores all those who died prior to that year, i.e., contributing taxes but receiving no benefits.

In contrast, Social Security is much less of a “deal” with at least some non-negligible fraction of recipients paying in more than they get etc.

There’s little question we need to adjust the age for Medicare eligibility if we ever wish to make this program financially viable over the long haul. Moreover, there isn’t any particularly good reason for Uncle Sam to bankroll Warren Buffett’s health care in retirement etc. Means-testing Medicare would make much more sense.

[LibsRJerks]

Agree with all of it ..but one thing is missing ...eliminate ALL lawyering and lawsuits ..it’s the reason also WHY docs order all those tests, and we have all this crazy pricing.

Agree about medicaid recipients ...as a nurse, they are also the ones crying foul the most, threatening to sue. Really gets me, as they aren’t paying a FREAKING DIME for any of their care.