The Bribe Fails, Ctd

More

A reader writes:

I certainly agree with you in theory, however, in reality I have to tell you that I am really nervous.  I am 64 and am currently employed and have insurance.  I am retiring in January and will continue with my current insurance until April when I turn 65 at which time Medicare kicks in.  Here’s the rub.  I wanted to change docs and guess what the first question was when I gave them my date of birth.  You got it – what insurance do you have?  Hmmmm wonder if they would have taken me as a new patient (or will keep me) when I am on Medicare.  Asking the docs to take a 20% hit on Medicare patients is not exactly incentive to take anyone over 64.  Do you have an alternative suggestion?

Another writes:

The Medicare bill that failed yesterday was far from a bribe. It was an attempt to fix an accounting error that could cripple the primary care system for seniors.

The Sustainable Growth Rate formula that determines payments to physicians (but not to hospitals) has required physician payments cuts for the last several years. The formula is complicated, but one of its biggest flaws is its failure to account for the rapid rise in the costs of providing care. Congress has understood this for the most part and voted to stop smaller scheduled cuts many times before. Many physicians are small business owners, and when their costs are rapidly rising out of their control and their payment is being forced downward, they often stop taking Medicare patients or adjust their practice styles in other ways.

The difference between yesterday’s bill and previous interventions was that instead of just passing a one-year fix, Congress was finally trying to find a long-term solution. The can has been kicked down the road so long that physicians are facing a 21% cut in Medicare payments in January. That won’t happen because it would be disastrous to the healthcare system. The shock of such a financial hit alone would be disruptive, plus you’d probably have a lot of physicians dropping Medicare. Instead, once again Congress will slap a Band-Aid on the SGR, freeze payments for one year to avoid a 21% cut, and have to address the problem again and again and again until a long-term solution is found.

The politics of it were indeed sketchy, and you’re right in calling for pay-go funding, but I thought you might be interested in some in-the-weeds details about why the bill mattered in terms of policy.

Just find a way to pay for it, that's all.

Jump to comments

2006-2011 archives for The Daily Dish, featuring Andrew Sullivan

Get Today's Top Stories in Your Inbox (preview)

What's the Number One Thing We Could Do to Improve City Life?

A group of journalists, professors, and non-profit leaders predict the future of livable, walkable cities


Elsewhere on the web

Join the Discussion

After you comment, click Post. If you’re not already logged in you will be asked to log in or register. blog comments powered by Disqus

Video

Adventures in Legal Weed

Colorado is now well into its first year as the first state to legalize recreational marijuana. How's it going? James Hamblin visits Aspen.

Video

What Makes a Story Great?

The storytellers behind House of CardsandThis American Life reflect on the creative process.

Video

Tracing Sriracha's Origin to Thailand

Ever wonder how the wildly popular hot sauce got its name? It all started in Si Racha.

Video

Where Confiscated Wildlife Ends Up

A government facility outside of Denver houses more than a million products of the illegal wildlife trade, from tigers and bears to bald eagles.

Video

Is Wine Healthy?

James Hamblin prepares to impress his date with knowledge about the health benefits of wine.

Video

The World's Largest Balloon Festival

Nine days, more than 700 balloons, and a whole lot of hot air

Writers

Up
Down