Medicare 1965-2012 - Democratic Underground

McCamy Taylor

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Sat Sep-10-11 09:31 PM
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Medicare 1965-2012

Medicare is not just in danger. Medicare is in the ICU on a ventilator----and your Congress is ready to pull the plug. All the GOP has to do is do nothing, one of their favorite pastimes in recent months, and universal healthcare for the elderly will go the way of the dodo. If the debt committee comes to no agreement, Medicare payments to providers and hospitals will be cut by 2%. Worse yet, if no legislation is passed by both houses of Congress this fall, all Medicare providers will see an additional 30% cut in their reimbursements in January, 2012.

http://www.medpagetoday.com/Washington-Watch/Washington-Watch/28025

http://www.medpagetoday.com/PublicHealthPolicy/Medicare/27430

Will never happen, you say? The AMA will flex its political muscle, as it has done year after year and Congress will kick that can on down the road once again? Pardon me, but it takes two legs to kick a can, one to do the kicking and one for the standing. Right now in Washington the two legs of Congress---the Republican House and the Democratic Senate and White House can not see eye to eye on anything. When one legs goes to kick, the other will try to run away. The result will be a nation in which seniors will not be able to get care (except in dire emergencies) after January 1, because providers will lose money when they treat them.

You say doctors can afford to take a 32% pay cut? So what if they have to downsize from Porsche to Lexus? So what if they have to vacation in South Florida rather than the Bahamas? Gather round children, as we discuss the facts of (medical) life.

The New York Times recently wrote an article about a family physician who is being driven out of business by sky high overhead and low reimbursements. Dr. Sroka is currently paying out 75 cents on every dollar he brings in to pay employee salaries, rent, malpractice insurance and other miscellaneous expenses. What happens to Dr. Sroka if Medicare cuts its reimbursements by 32%? For the math impaired, here is a hint: he starts losing money every time he sees granny for her diabetes.

http://www.nytimes.com/2011/04/23/health/23doctor.html?pagewanted=3&_r=1

Remember the chaos caused by the federal government shutdown in the 1990s? This will be the same, except targeted at the nation’s old folks. The elderly who need acute care will still get it. If Uncle Bob has an MI, they will go in and stent him. But if Uncle Bob is having leg pain and recurring ankle ulcers because the arteries that lead to his legs are clogged up---he will have to wait on that fem-pop bypass. If he is forced to wait too long, he could lose a leg. Aunt Jenny will probably get her acutely infected appendix out, but she may have to look around to find someone to do laser surgery on her diabetic retinopathy. If she has to wait long enough, she could go blind. Both Uncle Bob and Aunt Jenny will find themselves driving a lot farther to find someone to monitor their hypertension and diabetes---but first they will have to be on a waiting list, since everyone else will be looking for a doctor who still accepts Medicare. Those who can afford it will pay out of their own pocket to see nonparticipating providers. Can your Aunt Jenny and Uncle Bob afford to pay cash for all their medical expenses? If so, good for you. You will hardly notice the change. But, if your relatives are like a lot of folks, living on a fixed income, they will find themselves between a rock and the GOP---and the GOP has been pretty hard on old folks lately, calling them welfare queens and deadbeats.

Ordinarily, there is no way in hell that the Republicans would risk alienating the AARP. The elderly are part of their base. They count upon little old men and women flocking to the polls to cast votes based upon concern for national security. So, why am I concerned?

There is a Big Lie going around, one the Washington Post started in July and which folks all over the internet---including some at DU---keep repeating. Obama wants to rape, mutilate, annihilate and then destroy Medicare! Never mind that the Republican House voted to end Medicare—and life as we know it---for American seniors last spring, while Obama has only suggested making some changes. A whole lot of folks---including some at DU---are convinced that Obama’s change will be made with a chainsaw. What about the Paul Ryan Bill that would have eliminated Medicare and which all the House GOPers except four (but none of the Dems) and 40 Senate Republicans approved? Oh, the Republicans didn’t really mean that. Honest. Because we all know that Republicans and Democrats are exactly the same when it comes to Medicare, only the Democrats are much, much worse.

Illogical? Don’t blame me. I don’t make this shit up, I just gag over it.

So, anyway, with a whole army of Tea Baggers and a fair number of self styled Democrats willing to say that anything Congress does to Medicare is Obama’s fault, why should the House even hesitate to slash Medicare payments? The private insurance industry will be so delighted they will given millions to GOP Super Pacs. You see, the privates have figured out something that the rest of us seem to have missed. 75% of Medicare recipients pay an average of $3000/year in premiums---and spend an average of $3000 for health care. So, if United Health or Blue Cross can write policies for these 30 million folks for $4000/year, they will make 25% profit. The 25% of Medicare recipients who account for 85% of Medicare spending? Their high out of pocket will qualify them for Medicaid, which is going to do wonders for the budgets of states like Florida and Arizona.

The other benefit to private insurers will come from the seeds of doubt that are cast about by the GOP House. People who now want a government sponsored single payer option will begin to think twice. Damn! You can’t trust the federal government? What if I pay my $3000/year and can’t find a doctor to treat me? I better stick with Blue Cross. The premiums may be higher, the deductibles and copayments may put me into debt up to my eyeballs, but at least Congress will never allow Blue Cross to go under. If my private insurer is ever short of money, they’ll do a bailout…

Sort of feel like I am pissing in the wind with this one. I expect a whole lot of “It will never happen.” I hope you guys are right. Maybe House Republicans will go home this Thanksgivings and look at their own Uncle Bobs and Aunt Jennys and think, I could never do that to them.

But then I remember that just last spring ever single Congressional Republican except 11 voted to destroy Medicare. And I start worrying all over again. Because, you see, the future of Medicare is in the hands of Eric Cantor and John Boehner, and there isn't a whole lot that you or I can do about it.