"We have to reform Medicare to strengthen it."

[unkachuck]

"Now, I realize there are some in my party who don't think we should make any changes at all to Medicare and Medicaid, and I understand their concerns. But here's the truth. Millions of Americans rely on Medicare in their retirement. And millions more will do so in the future. They pay for this benefit during their working years. They earn it. But with an aging population and rising health care costs, we are spending too fast to sustain the program. And if we don't gradually reform the system while protecting current beneficiaries, it won't be there when future retirees need it. We have to reform Medicare to strengthen it."

....reforming Medicare and Medicaid instead of reforming the healthcare system to contain outlandish costs and with the bulk of the Boomers more-than-likely passing in 10-15 years, do you believe the President when he makes the argument that we need to reform Medicare to strengthen it?

[EFerrari]

1. The president's use of "reform" is very loose. n/t

[leftstreet]

2. Who said this? Bush? McCain?

:shrug:

[Pirate Smile]

3. He isn't for cutting benefits. He is for changes within the Health Care System re how they pay, etc.

The Affordable Care Act has already had a big impact on the growth of health care inflation before most of it has even gone into effect - just by hospitals & Doctors getting ready.

A drop from almost 10% to around 3% is massive.

edit to add:

Medicare Spending Slows Sharply; Zeke Emanuel Is Not Surprised

While our elected representatives wrangle over slicing entitlements, virtually no one seems to be paying attention to an eye-popping fact: Medicare reimbursements are no longer accelerating at a break neck-pace. The new numbers should be factored into any discussion about healthcare spending: From 2000 through 2009, Medicare’s outlays climbed by an average of 9.7 percent a year. By contrast, since the beginning of 2010, Medicare spending has been rising by less than 4 percent a year. On this, both Standard Poor’s Index Committee and the Congressional Budget Office (CBO) agree. (S&P tracks healthcare spending with the help of Milliman Inc., an independent actuarial and consulting firm.)

What explains the 18-month slow-down? No one is entirely certain. But at the end of July David Blitzer, the chairman of Standard &Poor’s Index Committee, told me: “I’m hesitant to say that this is a clear long-term trend. But it’s more than a blip on the screen."

Since then, I have talked to an analyst at the Congressional Budget Office who is involved in putting together numbers on Medicare payments for CBO’s Monthly Budget Review. He confirmed that they, too, have seen a dramatic slow-down in Medicare spending.

When I asked, “Why?, he replied: “We have some theories.”

Would he share those theories?

“No,” he responded. “You would quote me.”

This is true.

Probably he was reluctant to see his name in print because these days, news that Medicare spending is beginning to level off --without Draconian cuts--could create political waves in Washington.

Standard & Poor’s Blitzer was more forthcoming. In the S&P report on healthcare spending released on July 21, he wrote: “many participants in the healthcare system have indicated that providers are trying to address health care reform and are looking for ways to control costs. If true, this combination certainly would be a contributory factor to the moderation in cost we have witnessed since early 2010.”

Zeke Emanuel, an oncologist and former special adviser for health policy to White House Office of Management and Budget director Peter Orszag, is certain that this is what is happening. When I spoke to him last week, Emanuel, said: “This is not mere chance: this is directly related to the initiation of health care reform.” It is not the result of reform, Emmanuel emphasized. The reform measures that will rein in Medicare inflation have not yet been implemented. But, he explained, providers are “anticipating the Affordable Care Act kicking in.” They can’t wait until the end of 2013: “They have to act today. Everywhere I go,” Emanuel, added, “medical schools and hospitals are asking me, ‘How can we cut our costs by 10 to 15 percent?’

“This is doable, since there is so much fat in the system” said Emanuel, a doctor who is well aware of just how often unnecessary tests and procedures hike medical bills, while exposing patients to needless risks. It is worth noting that Emanuel is far from cavalier about cutting Medicare benefits that could help patients. A medical ethicist, he has recently been chosen to lead the medical ethics department at the University of Pennsylvania’s Perelman School of Medicine. But Emanuel understands that patients do not benefit from waste, and that today, our medical culture encourages health care providers to "do more," without always considering whether medical evidence justifies another test or treatment.

Meanwhile, thanks in part to the heathcare debate, combined with spiraling insurance premiums, the majority of Americans realize that we cannot afford out of control healthcare spending. There is now a nationwide mandate to rein in health care inflation, not just in the public sector, but in the private sector. “Either we get volume under control, or prices paid both by private insurers and by Medicare will drop,” says Emanuel. “Hospitals know this. They is why they want to make their systems more efficient.”

http://www.healthbeatblog.com/2011/08/medicare-spending-slows-sharply-few-seem-to-notice-part-1.html

[Marrah_G]

12. I'd love to se the specifics on exactly what he is proposing.

I'd bet my bottom dollar in comes in the form of cuts, raising the qualifying age, etc etc.

Now if it comes in the form of actual reforms of waste or negotiation with drug companies etc. THEN I would be very surprised but in a positive manner.

[Pirate Smile]

22. I wouldn't be shocked to see some changes that are more like nibbling around the edges but

not actually changing the basic system - which is what Republicans want to do.

I summarized it like this the other day: If you can't tell the difference between people who want to privatize SS & voucherize Medicare and people who are willing to make some modifications around the edges so the programs can last longer then you are truly not paying attention to details and are losing the forest for the trees.

[me b zola]

46. Oh, I see

Cuts are fine as long as they are not as big as the cuts that republicans will make. Yeah, but fuck no. I prefer when people piss on me that I don't accept that as acceptable humidity.

[SugarShack]

72. Soc Sec needs reform too and he wants to slash it in half via payroll tax cut? So many not work?

gads....a fourth grader could have done better.

[humbled_opinion]

15. You can't have it both ways....

Health care costs are rising, everyone knows this.... If you don't somehow lower the costs than in fact you are faced with a 70 Trillion dollar unfunded liability in Medicare. Now how you deal with the 70 Trillion is crucial. Cons want Privitization, I fear Obama is following this path.

Even the PPAA is going to come at significant insurance costs to individuals, its the curse of the Private sector being able to negotiate and set the rates.

When all is said and done everyone is going to feel the Healthcare pinch, I just hope I can still afford to feed my family, because healthcare is useless if you die from starvation first.

[Pirate Smile]

25. While you were responding to my comment, I was editing it to add some information that I've seen

recently but really hasn't been reported on very much. It has to do with the rising costs. If you haven't seen it, you might want to read it.

One thing about Medicare is that it is so HUGE that even small changes in increases/inflation can cause very big changes in what the years out costs look like.

[demwing]

57. Are you sure "He isn't for cutting benefits"???

Please explain this quote from last night's "Jobs" speech?

"And if we don't gradually reform the system while protecting current beneficiaries, it won't be there when future retirees need it

Current beneficiaries? Why just "current" ???

[NorthCarolina]

75. If that was the exact case, wouldn't he simply say so in clear, unmistakable language

and put everyone's fears and suspicions to rest once and for all?

[SmileyRose]

4. I agree with him.

We need to reform it so everyone is in and no one is out.

Yeah, I know, that's not what he meant. But a girl can dream can't she?

[Dragonfli]

19. Ah, the dreams of a smart girl, if only they would listen to a smart woman like you, I would be :-)

[Blue_In_AK]

5. It reminds me of Vietnam.

It became necessary to destroy the village to save it.

[humbled_opinion]

6. WOW how dare you...

Accuse the President of saying what he said about medicare, thats just not right....

:eyes:

[midnight]

7. Let's vote on what strengths those of us who are going to be using it, want....

[Lasher]

8. Makes it sound so wonderful.

What did he say about reforming our unsustainable military expenditures?

[ThomCat]

38. Yeah, about that...

Not a damned thing.

Fun how that goes. Meanwhile, he's also proposing 3 more Free Trade Agreements. As if NAFTA didn't teach us enough of a lesson the first time. x(

[DJ13]

9. If I read a politician had said that I would have sworn it was a Republican

When I heard Obama say it I was shocked.

That is straight out of the GOP talking points.

[amborin]

10. as many of his statements and policies are....

[spartan61]

18. Come on, there is room to reform Medicare.

What about negotiating for Rx like the Veterans Admin does. That's a reform and it would save money. I see waste in my own case. I have to wear a CPAP mask at night and I am sent a new one every three months. I don't need a new mask every three months but I'm told I have to because Medicare is paying for that. I tried to tell them I don't need a new one that often but I'm told I have to take it. Now if you multiply the number of people in the country who receive a new CPAP every three months, we're talking a HUGE number. Make that a new mask every six months instead and look at the savings just on that. I'm sure there is much more waste in Medicare costs that could be reformed without having to raise the Medicare age

[ThomCat]

39. You know damned well he isn't going to allow that kind of a reform.

He's talking about limiting the number of people who are allowed to enroll, and the maximum reimbursement rates for services, even though they already pay such ridiculously low rates that many doctors refuse to accept medicare.

If he was talking about allowing negotiation of Rx costs, the drug industry would have a collective heart attack and their lobbyists would be attacking him publicly. He would back down immediately. He doesn't have the spine to try any reform that challenges the corporations. He'll only hurt the people he's supposed to be helping.

[COLGATE4]

60. You're (unfortunattely) all too right. The only 'reform' Obama is

interested in is directly related to limiting accessability to Medicare, either now or more likely for future beneficiaries. He hasn't got the spine to address major issues like Rx costs (which he has already given away) or any other type of reform which the Insurance companies oppose. I'm afraid this is just one more in the now boring "Audacity of Hope" lecture series.

[Lint Head]

11. Medicare for all would be a start.

[white_wolf]

13. I posted this here before, but it deserves reposting. "Let me warn you":

http://www.youtube.com/watch?v=S3RHnKYNvx8

[NYC_SKP]

14. He's right. We need to reform it to strengthen it, to keep it viable, or it will die under it's own

weight and ineptitude.

It's like a lumbering and poorly designed and built 1984 Oldsmobile.

We need it to be like a 2012 Camry, or, better still, a 2014 Tesla.

Yes, damn straight, that will take REFORM and more.

:patriot:

[still_one]

17. We are in 2 wars. Get out of those wars and there will be plenty of money. /nt

[area51]

21. Damn right. n/t

[NYC_SKP]

28. No. One has NOTHING to do with the other. We should stop the fucking wars in any case.

And, we will have to reform Medicare in any case.

Because the way it exists is dangerous, unhealthy, wasteful.

Ending the wars won't change a thing.

Both need to change.

[Lasher]

48. We could save money by ending the wars in Iraq and Afghanistan.

Would you rather save money that way, or by cutting Medicare and Medicaid? I would rather save it by ending the wars.

[NYC_SKP]

53. Why not BOTH?

There's use of a false argument in there somewhere, these two things aren't mutually exclusive, much as politicians like to play one against the other.

The idea that we should quit wars to pay for a dysfunctional medical system that could itself be redesigned is like saying:

If mom quits drinking she can afford to continue shopping where the prices are 2X as much.

:shrug:

[Lasher]

65. Well OK Skip, I'm in favor of improvement.

You say that Medicare is dangerous, unhealthy, and wasteful. Specifically how is this so, and what would you do to improve it without degrading its benefit for current and future beneficiaries?

[NYC_SKP]

68. For one thing, SKP stands for escapee, not "Skip" ;^) And I'll give examples.

Doctor A paid by Medicare prescribes med X and then Doctor B prescribes med Y, and a drug interaction kills grandpa because there's no modern shared information tool in effect.

Doctor C prescribes Warfarin/Coumadin/Rat Poison to Uncle Billy because Medicare pays for it whether it's deadly or not, Uncle Billy could take Aspirin instead but doesn't because doctor tells him he may suffer a stroke.


Acme Scooter provides Mom a scooter which, after 4 years, needs a new joystick. Joysticks aren't available, mom MUST by a whole new scooter- cost to taxpayer, $4,500. Making matters worse, mom hates the new style scooter, returns it, yada yada yada...

Want more examples, I got a million of em.

:patriot:

[Lasher]

70. None of these is a Medicare problem.

In the first example, it is not Medicare's place to prevent drug interaction. Doctors should ask the patient what they are taking before they prescribe anything else. Further, as a second line of defense, the patient's pharmacy should detect such a problem and alert the patient.

In your second example you are talking about something else a doctor did wrong. Medicare is not going to dictate to my doctor when he should give me Aspirin instead of a prescription medication, and I don't want them to. I think you're exaggerating when you characterize a drug approved by Medicare as a deadly rat poison.

So what's with this last example? This is a problem with the Scooter supplier. What is Medicare supposed to do, shit a joystick? They're just supposed to pay the bills, which they do efficiently.

Traditional Medicare is more efficient than private sector health care insurance. This is the biggest reason why the government pays a 14% higher per-capita subsidy for Medicare Advantage beneficiaries. If Medicare is 'dangerous, unhealthy, and wasteful' it is no more so than any private sector alternative.

What would you do to improve Medicare without degrading its benefit for current and future beneficiaries?

[NYC_SKP]

71. Nice try, but Medicare perpetuates these problems, all of them, clearly.

Medicare is not just supposed to "pay the bills" or to do so "efficiently".

That's so sad.

They are the ones who need to regulate, make sure the money is well spend, no fraud.

If they don't do it who will????

Shit a joystick, what?

It's their fucking rules about not repairing that make people have to get a new one whether or not they like it.

Look, the system is a fucking wasteful deadly mess and if if dies it will be because it WASN'T fixed, and it died under it's own weight.

:patriot:

[Lasher]

73. Your doctor is not responsible for drugs he prescribes, and Medicare is?

Sorry, I just can't buy that.

I thought you meant to say that scooter parts (joysticks) were not available. Now I think you're saying the parts might be available but Medicare won't pay for repairs. I'm confused so I checked out the Medicare website:

If you own Medicare-covered durable medical equipment (scooters) and other devices, Medicare may also cover repairs and replacement parts. Medicare will pay 80% of the Medicare-approved amount for purchase of the item. Medicare will also pay 80% of the Medicare-approved amount (up to the cost of replacing the item)for repairs. You pay the other 20%. Your costs may be higher if the supplier doesn’t accept assignment.

Note: The equipment you buy may be replaced if it’s lost,stolen, damaged beyond repair, or used for more than the reasonable useful lifetime of the equipment.

http://www.medicare.gov/Publications/Pubs/pdf/11045.pdf

Seems pretty reasonable to me. Can you square your claim about scooter repairs with this Medicare policy?

[NYC_SKP]

74. So who's responsibility is it to make sure vendors don't take advantage of old timers.

Maybe my parents were victims of deceptive practices.

Who is supposed to police these things?

I don't have to square shit, Lasher.

The fact remains that the system is fucked up.

It's bloated, it's outdated, and it's easy to be gamed.

Sad that so many people say "don't fuck with it"... yeah right, just let it keep fucking with people's lives.

I may not have solutions, but something needs to be done.

[Lasher]

76. I'm sorry you have had a hard time handling medical care for your parents.

Thanks for volunteering to be a moderator. I respect that.

Lasher

[still_one]

67. If you stop "waste" that is one thing, if you increase the age, because people are living longer,

that is unacceptable, and one of the ideas floated about

[unkachuck]

24. what I don't understand....

....with our current expensive healthcare system, if we are going to PROTECT the current beneficiaries which are numerically the financial problem, then all that reforming Medicare is going do is chump those who come behind us Boomers out of their full share of Medicare.

[NYC_SKP]

27. Unfortunately, those in power are likely to use "reform" to give us a horse and buggy...

...a significant step back from the Olds.

But leaving it alone, with all of its waste and fraud and archaic manner of delivery of care (and miscare) will, I think, lead to its end.

[EFerrari]

41. Bulleria. Medicare is the most cost effective medical care delivery system we have. n/t

[NYC_SKP]

56. Tell me that after you've been the representative of both parents in working w the system...

And apologies if you have that experience.

It's wasteful and stupid and I estimate that it could deliver much better service at half the cost.

And with fewer deaths and injuries.

Fact.

[whatchamacallit]

47. Kool-Aid. n/t

[Bluebear]

16. "some in my party" -- yes, the real democrats

[Skip Intro]

20. I don't believe it from repubs, don't believe it from Obama. Especially when corp bailouts and wars

go on unimpeded.

BS detector beeping like crazy.

[madamesilverspurs]

23. I'm a Democrat. I'm a senior citizen, and disabled.

Medicare has been part of my experience for many years. There are, I've found, many inefficiencies within the program. Fixing them would save millions. There are many redundancies, overlaps that could be corrected, also saving millions. There's also that old idea about prevention costing much less than cure. A good 'reform' would be the addition of dental coverage; my doctors tell me that in our country there are numerous major health events that started with unaddressed dental problems, events that could have been precluded with adequate dental care. Let's not assume that 'reform' won't include improvements.

Bring your ideas to your congresscritter. If he's a teabagger (like mine, dammit), tell him anyway; then go down the road to a district with a rep who actually listens to constituents. Don't stop talking about it just because some people want to go negative.

[Bluebear]

26. Hands off Medicare. Tax the rich & cut defense

[Telly Savalas]

37. Agreed. Medicare is perfect in every respect.

If we're going to add dental coverage, we might as well just cancel it altogether.

[andlor]

51. +1

[NYC_SKP]

55. Right. If dad quits gambling then mom can afford to keep drinking and playing Lotto.

End wars.

Fix fucking Medicare.

Win-win.

:patriot:

[Pirate Smile]

29. Thanks. I don't quite get this "you can't touch it at all" mindset. Things can be improved. There is

massive fraud and the Feds are making huge busts quite frequently now of the fraudsters.

It feels way too close to the irrationality of the NRA & gun nuts regarding even the most rational gun laws.

This is from within the past 24 hours of so:

Feds land historic Medicare fraud bust

September 7, 2011 4:04 PM

A coordinated strike by federal law enforcement resulted in the largest Medicare fraud bust in U.S. history. Eight cities were involved, stretching from New York to Los Angeles, and more than 90 people were arrested. Armen Keteyian reports.



Read more: http://www.cbsnews.com/video/watch/?id=7380129n#ixzz1XQ8xBlSU

And I've seen them repeatedly over the past year.

Ha - I had googled it - and before yesterday's "biggest ever Medicare Fraud bust", February had the Biggest ever Medicare Fraud bust - and the October before that was "the biggest Medicare Fraud bust".

February 2011 - In 'Largest-Ever' Bust, Medicare Fraud Task Force Arrests 111

http://www.kaiserhealthnews.org/Daily-Reports/2011/February/18/medicare-fraud.aspx

October 2010 - Feds Arrest 44 in 'Largest-Ever' Medicare Fraud Bust

http://www.aolnews.com/2010/10/14/feds-arrest-44-in-largest-ever-medicare-fraud-bust/

[Dragonfli]

31. That does not explain the distinction between protecting CURRENT beneficiaries

It implies to me that FUTURE beneficiaries will get cuts, why else use the word CURRENT? Can you explain that please?

[Pirate Smile]

32. They changed some things in 1983. Were those horrific changes agreed to between

Tip O'Neil and Reagan? They were phased in over time.

I assume they would do something like that.

I don't think that would be the end of the world.

[Dragonfli]

35. Not for guys that wear white shirts and ties to work I suppose, they can afford extra insurance. /nt

[spartan61]

49. Did any of these "Largest Ever" Medicare Fraud cases

include the one when Rick Scott was CEO? He took the 5th seventy five times. What did the citizens of Florida do? They elected him Governor!!! Is there any way at all to fix stupidity?

[Pirate Smile]

62. I still absolutely can NOT believe Florida elected him Governor.

:wtf: :wow:

[NYC_SKP]

30. You're absolutely right. There's so much that needs improvement here, it can be MUCH better.

Those who say don't touch it probably haven't experienced it, and are being foolish, IMHO.

And sure, we need to stop the wars- that has nothing to do with the FACT that Medicare is poorly run and needs to be reformed to stay viable and effective, more effective than it is now.

:hi:

[Dragonfli]

33. Does Current then mean those that collect it now won't get "improvements" but the future

beneficiaries will get improved benefits rather than cuts or a higher age of enrollment? is that why he used that word?

That word is usually code for generational warfare wherein the grandparents will vote for it because only their children will be sacrificed, I guess he is re-inventing the political use of that particular wiggle word.

Thank you for knowing what he means and that it is actually the opposite of what that has meant in the past, you must know people in the administration because he never gave the details of how much better you know they want to make it rather than saving money at the expense of the most incapable of defending themselves.

[Mojeoux]

44. I am a disabled elder too and I agree whole heartedly.

Thank you Madam Silverspoons. Everybody's got their knickers in a knot and they don't think this stuff through. There are plenty of places to streamline and make Medicare work BETTER!
And Dental care, Oh my God, it's an infection inside of someone's head!

[FarLeftFist]

34. CUT WASTE FRAUD AND ABUSE!

[Dragonfli]

36. I wish he would have said that rather than threaten FUTURE recipients (protecting only the current)

[ThomCat]

40. Start with the Defense budget,

then the intelligence budget.

The Social Security and Medicare budgets have been examined and cut so many times there is very little there that could possibly be waste, fraud or abuse inside the administration.

The fraud that does exist comes from health care corporations that take advantage of the lack of auditors. There aren't enough auditors finding organized medicare fraud because of the constant cuts. Stop cutting the budget and let them hire people! Then they'd be able to find the fraud and save money that bleeding-out from the outside.

Medicare has always been consistently Much more cost efficient than any private health insurance. What more do they want? x(

[EFerrari]

42. Weasel words. n/t

[FarLeftFist]

69. Really?! Considering fraud waste and abuse takes up a HUGE chunk of the money.

Do you know how many scams there are?!

[gkhouston]

43. Burning the village in order to save it. n/t

[flamingdem]

45. They need to say - we will not raise the age for eligibility

I think they think their message is so much better than the repukes but they need to say no age raising at least not for many decades.

One of the cruelest things is the idea of getting close to being out from under and getting the football pulled away.

Though.. the more I learn it looks like the payments are at least half of what I pay now anyway for gap coverage..

[Vinca]

50. Did he blow a kiss to Paul Ryan from the podium?

Democrats across the country can now destroy their "Republicans want to kill Medicare" campaign ads.

[Inuca]

59. Maybe you should wait

for some actual proposals before you say that? NOTHING that the Ds are likely to agree with, even raising the eligibility age, which would IMHO be very bad, would not come even close to what Ryan proposed and the R lemmings in the House voted on. There may be changes that would be painful, I don't know. But they would not KILL Medicare.

[mmonk]

52. Of course not. It is the same rhetoric used for decades by Republicans.

No constraints on private sector health care costs will just mean rationing of care in regards to Medicare to America's most vulnerable.

[tsuki]

54. We have to pollute to make the air cleaner. nt

[soryang]

58. Obama's putting medicare on the table cratered the economy

The largest demographic is counting on medicare at 65. When Obama put medicare benefits "on the table" consumer spending, employment, and commerce cratered.

Way to go, "democrat!" These people understand nothing about economics. Consumer confidence fell through the basement with this talk of reform. Americans can spend nothing. They can only save to compensate for the benefits being taken away.

[Inuca]

61. This is one of the most irrational posts I read around here

and I read quite a few. Putting Medicare on the table, in other words, unconfirmed reports about what may have been going on behind closed doors, and as a result "consumer spending, employment, and commerce cratered". If you are serious, and I hope you are not, that's a stunning statement.

[soryang]

63. It's a fact

Deal with it. People with discretionary cash waiting for retirement and medicare at age 65 are terrified by these democratic concessions to the austerity nuts. The economy slowed palpably after Obama promoted the sequestration budget reform act of 2011 which cuts medicare two percent a year in real terms, as opposed to reductions from hypothetical increased budgets pertaining to defense and other budget sectors. The Obama administration also agreed to back door reductions in social security disability awards which also appear in the Budget Reform Act.

Economic activity is neither rational nor irrational. It is what it is. Tell people you're cutting disability and medicare benefits, they respond economically. If you haven't perceived the economic meltdown since the "everything is on the table" Budget Reform Act of 2011, you're living a sheltered existence.

"Let them eat cake."

[Pirate Smile]

64. It is NOT a fact.

It is your opinion. There is a big difference.

[JoeyT]

66. Fear not, we're going to improve it.

By cutting waste. The same way we improved welfare. And it's being sold with the same talking points.