Why Medicare cuts pose such headaches for Fiscal Cliff negotiators
POLITICO offers a masterful summary of proposed cuts in Medicare - from upping the eligibility age from 65 to 67, for example, to other reductions -- together with the projected savings but also some of ramifications, not always immediately evident...
As I've said repeatedly, cut all the other stuff first, THEN cut the safety net. Yes, I know, it won't be enough, but by cutting all the other stuff first, then would need less to be cut from the social safety net, but Republicans prefer to stick it to the little guy FIRST and protect their wealthy pals.
Tue, Dec 4, 2012 9:12am
Four years ago we crunched the numbers on this, and determined that by switching Medicare to a fee scale, where visits were reimbursed by a single fee amount no matter whether it was for back pain or a stuffy nose, and that 100% of the fee was paid for a first visit, and 50% was paid for the follow-up, and zero for visits thereafter for the same cause.
The idea was to reward keeping patients well, and not reward for every single little test that could be thought up to milk the system.
Our target was to get medical costs per GDP down under 13.7%. Still it was the world's highest, but was 4% of GDP lower than before....
We also put on the table the idea of having regional boards of physicians deciding the pricing structure. If prices were standard, then competition between doctors would be based on "which one got me well the faster" and not on price.
Having prices standardized would create a faster turnaround on payments, because unlike today where every single test requires reams of paperwork to prove such a test is necessary.... standardized visit fees would make it possible for doctors to work this week, and get paid the next.
Our goal back then was that by guaranteeing payment, a physician could run his office without two or three people who simply are there to navigate the medical insurance labyrinth. So even if the physician received less on top by a reduced pricing structure, he could net the same amount off the bottom by having 80% reduction in office costs.
Our cost for this was an average assessment of $11.48 a week on every American employee.
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