Seniors throughout he country are extremely concerned and worried about their Medicare benefits. Everytime they hear the words "healthcare reform" they cringe, worried that as money continues to get tighter and cuts are made to many programs, they will lose critical and essential benefits that in many cases keep them alive and out of the hospital.
At a telephone town meeting Tuesday, President Obama answered questions from mostly seniors. One of the things that he said to reassure these older Americans regarding their Medicare benefits was, “Nobody’s trying to change what does work in the system,” Obama told the estimated 180,000 listeners. “We are trying to change what doesn’t work in the system.” There have been many delays when it comes to the healthcare issues, people are getting quite nervous and confused. “Nobody is talking about cutting Medicare benefits. I just want to make that absolutely clear,” the President said emphatically. When he introduced President Obama, AARP CEO A. Barry Rand said: “There’s a lot of misinformation about health care reform—even on what AARP stands for, and what AARP supports. This town hall is part of our ongoing effort to debunk myths and provide accurate information.” He added: “I want to make it clear that AARP has not endorsed any particular bill or any of the bills being debated in Congress today. We continue to work with members of Congress on both sides of the aisle and with the administration to achieve what is right for health care reform.” AARP president Jennie Chin Hansen also cited confusion expressed in questions that have come from thousands of members who have participated in previous AARP town halls. “Like, will the government tell my doctor how to practice medicine?” The idea behind this unique town hall meeting was to calm the fears of individuals - particularly seniors - who are nervous, or downright frightened, about what will happen to their Medicare and Medicaid benefits and ultimately to their health. The president said that overhauling the healthcare system is a high priority, however it is not an easy task and he wants to make certain that it is done right. “I know there are folks who will oppose any kind of reform because they profit from the way the system is right now. They’ll run all sorts of ads that will make people scared.” He pointed to the past and reminded people that this has all happened before, it is not just unique to our time or the current situation. “Back when President Kennedy and then President Johnson were trying to pass Medicare, opponents claimed it was socialized medicine,” he said. “When you look at the Medicare debate, it is almost exactly the same as the debate we’re having right now. Everybody who was in favor of the status quo was trying to scare the American people saying that government is going to take over your health care, you won’t be able to choose your own doctor, they’re going to ration care.” He also added this thought: “You know what? Medicare has been extraordinarily popular. It has worked. It has made people a lot healthier, given them security. And we can do the same this time.”
There have been discussions about how to make Medicare work better since the beginning of time, or at least since the beginning of Medicare. There are always at least two types of people when it comes to any situation - optimists and pessimists. Somewhere in the middle lie the realists, and somewhere in another part of the middle lie the critics.
These days, with a new president and congress left with billions, no, make that trillions of dollars in debt to unscramble, there are some major, essential programs that are being looked at under the proverbial microscope. One of those programs is Medicare.
Trying to balance trillions of dollars in debt while keeping as many essential programs in tact is basically a difficult, if not impossible, task. However, the attempt is being made.
In fact, the situation is so important and so serious that week after week since before this president took office, there have been new proposals on his desk, new meetings, new debates and new issues regarding Medicare and the cuts that will surely have to happen to keep the program solvent.
One of the problems is that for as many individual lawmakers that there are working on this, there are just as many opinions as to what should stay, what should go, and what could be reshaped and trimmed a little but not deleted from the program. Then there's the factor of who's on the right, who's on the left and who is trying to be bipartisan.
The biggest issue with Medicare is that some of the cuts being suggested involve ongoing care for those who are seniors and those who are disabled. This may not sound too bad, except that ongoing care is the backbone of health care. If a senior on Medicare is able to have ongoing care through the same doctor, statistics show that they will usually stay out of the hospital or, at least, they will be in the hospital less often. Statistics also show that if seniors are able to access as many outpatient opportunities as possible, this will also prevent serious health issues that would land them in the emergency room or the hospital - possibly for a long, expensive stay.
Some of the smaller things that are being considered to be cut and not just trimmed could be the difference between the continual care that seniors and individuals with disabilities need and having to more frequently go to the emergency room or have a hospital stay. Instead of saving money, this would end up costing more in the long run - and maybe even in the short run. Most outpatient procedures and services are nowhere near as costly as even one trip to the emergency room, much less a stay in the hospital for a few days or weeks. Outpatient care has proven to be preventative in most cases, and it is important for lawmakers to really look at the long term consequences as to what they are or are not cutting.
This, as lawmakers and the president know, is an urgent situation. That is why they are working on it day and night and will most likely not pass any new legislation until after the August break. They know that they have to get this right, and it is good to know that they are working hard to try to do so. Let's just hope they don't miss the forest for the trees.
With the economy in a mess these days and the presidential elections only a few weeks away, candidates and lawmakers are saying all sorts of things about what they will be doing to fix the problem. They are “debating” about raising and lowering taxes, bailing out insurance companies and banks, and a thousand other ways to help the economy get straightened out.
One question that is continually asked by the public – especially seniors – is: What is going to happen to Medicare? We know that Medicare has its own financial struggles and needs support to stay solvent. The candidates say that they will continue to support Medicare.
The reality, however, is that there may be support for Medicare in the beginning – to get elected – but over time, there could be problems. For instance, John McCain has a record of trying to cut Medicare benefits and has stated that if he becomes president, he will cut $1.3 trillion from Medicare during the next 10 years to fund his healthcare plan. $1.3 trillion is a ton of money!
With Medicare struggling as it is, cutting this amount of money would severely limit the amount of new enrollees to the program and would create the need for extensive changes in coverage in order to save money. With the system running slim right now, how much more could we cut?
This would also cause individuals with private insurance to pay for many things out of their own pocket. Individuals who are retired and on limited incomes and who rely on Medicare are not usually in a position to do so. There would also be ramifications to individual states and to their Medicaid and CHIP programs.
In addition to all of this, there are hidden taxes that we don’t see. Besides shifting the cost of many types of care and procedures to the private insurance companies, the public would end up with the tax burden of funding the shortfall.
This may or may not be a good plan. It is not for the writers of this column to decide. It is important, however, before you vote, that you determine what the candidates propose to do regarding Medicare. They have finally laid out their plans to rescue the economy and somewhat deal with Medicare. Do your research so that you know what you will be voting for.
There is good news today for doctors who treat Medicare recipients, and for those recipients who are their patients.
Congress and the Bush Administration have been playing tug of war regarding proposed 10.6% cuts in payments to doctors treating patients on Medicare. Doctors have said that they might have to stop treating these particular patients if the cuts went into effect, because it would just be too costly for them. As Congress went into recess for the 4th of July break, it looked like those predictions would have to come true, because a block of the cut had not been achieved.
Today, however, is a different day. The Senate voted over 2 to 1 to pass the bill which halts the cuts, giving enough time to explore the situation further and try to come up with a solution that will work for all involved.
The bill called “The Medicare Improvements for Patients and Providers Act of 2008” not only halts these cuts to doctors, ensuring that for the next 18 months or more, patients and doctors can continue their relationships, but also institutes a small pay increase of 1.1% to doctors in 2009 and bolsters preventative and mental health care benefits, as well.
This has been a bitterly contested issue, and the House already passed the measure. The vote on this issue is so important that Barak Obama came off the campaign trail to be present for it, and Senator Edward Kennedy, who has been very ill battling brain cancer, was also present for the vote.
The passing of this legislation will help millions of Medicare recipients and thousands of doctors who treat them from having to eliminate their treatment. It is essential since there are not enough doctors who treat Medicare recipients as is, and the potential loss of thousands more would leave some of the most vulnerable patients without a personal physician.
For now, at least, everyone can breath a sigh of relief. Given enough time to work with the situation, Congress may be able to create a long-term solution to keep doctors on board and help patients keep the quality of care they need.
We’ve been hearing about it in the news for months and it has become a critical issue waiting for a last minute pre-fourth of July solution for the crisis with Medicare fees for doctors. The country – especially the seniors in this country – has been holding its breath waiting for Congress to put a stop to the cuts in Medicare payments to doctors.
The unfortunate thing is that Democrats and Republicans have been having heated arguments during the past week leading up to the of July holiday, the idea was that they were supposed to come to an agreement to help seniors to be able to continue their care through their primary care physicians that they are familiar with.
If Congress does not pass a bill reversing the situation and postponing the 10% cut in doctors’ Medicare payments, many doctors have already said that they won’t be able to afford to treat Medicare patients if the cut goes into effect.
It is possible for Congress to reverse the fee cut, making the reversal retroactive and reimbursing the doctors for any losses they suffered during the time that the decrease was in effect. The vote on Friday was so close that one more vote would have stopped the pay cuts to doctors and kept seniors protected. 600,000 doctors are along with millions of Medicare recipients.
With both sides in a tug of war over details, there are promises of another round starting immediately after the break when Congress reconvenes. Mike Leavitt, Director of the Department of Health and Human Services has said that the department will do everything possible to minimize the impact on doctor and beneficiaries, and when the higher fee schedule is restored they will reprocess claims at the higher rates as soon as possible.
We will all be watching to see what Congress comes up with next week.
We have all been hearing about he Bush Administration’s idea to cut payments to doctors seeing patients covered by Medicare. The issue on the table has been to cut payments to doctors by 10%. This would create a huge problem for Medicare recipients because many doctors would not be able to afford to continue seeing these most vulnerable patients. As a result, more and more individuals on Medicare would be without a personal physician, leaving them in a situation where they would be open to the increase of health problems – especially if they had chronic health issues such as diabetes or high blood pressure.
With too few doctors accepting Medicare at current rates, a cut in their payments would be devastating. This would be a case of saving pennies to spend dollars. A lot of dollars. If individuals who had their ongoing health issues monitored and under control and care by a personal physician, lost that relationship, they would very likely end up doing their best to take care of themselves, however, they would probably end up at the emergency room due to lack of proper ongoing care.
Which makes more sense – paying for a doctor’s visit and some generic medicine or paying for an emergency room visit, hospital visit or hospital stay? Most of us – including Congress – understand the answer to this. Congress is trying to find a solution to help doctors and Medicare recipients continue caring for their ongoing needs.
The Bush Administration has given Congress some extra time after the 4th of July break to process this information further and work toward a solution. At the same time, however, the administration has halted all Medicare payments of claims for the first 10 days of the month, which will only add to the back log of claims that already exists.
We will all have to wait and tune in after the 4th of July to see how the rest of the situation develops. Hopefully the extra time will make it possible for Congress to continue working toward a workable solution to this complex problem.
With deadlines looming, there has been much discussion between members of Congress, CMS, physicians groups, Medicare and Medicaid beneficiaries and others trying to sort out a decent bill that would be fair to all in light of the Bush Medicare cuts that are proposed.
One of the latest situations to crop up is that Senate Majority Leader Harry Reid, a Democrat from Nevada is warning that he will try to stop the debate about the proposed bill to delay the 10.6% cut in pay to physicians for 18 months. To stop the debate, he will invoke “cloture” and do what he can to let the bill pass.
There is legislation that has been introduced by Senate Finance Committee Chair Max Baucus, a Democrat from Montana that would delay the cuts from going through. The Baucus legislation would cost $20 million dollars, but would include some positive provisions including promoting electronic prescribing by physicians, expand some other services and require Medicare to pay pharmacies that provide for Medicare recipients with prompt payment. In addition, recipients who pay for Mental Health Services would have their copays lowered from 50% to 20%.
Some funding would be decreased, such as funding for certain education and marketing programs to get physicians and private health insurance to participate in or to accept Medicare, as these are not as essential as many of the provisions that the proposed legislation is trying to save or enhance.
It is no secret that Medicare and as a result, Medicaid are experiencing difficulties and that, from all reports – Republican and Democrat, alike – the outgoing administration has not made it better, but have weakened it substantially. To be fair, we can’ blame everything on this administration, and there are many things that have happened over the past decade or more that have weakened many services that should be available to the vulnerable individuals and families that need such services.
The debate may have many points of view, but there is little time left to enact some legislation to avoid eliminating even more benefits. It is important for us to watch what is happening to the benefits and services at stake and how Congress works to block these proposed cuts from going through. Keep on the watch.
Every day we hear more and more information about Bush tax cuts, Medicare and Medicaid cuts and all sorts of issues that will confront the most vulnerable individuals in the country.
There are members of Congress on both sides of the aisle who are not at all happy with the fact that Alzheimer’s patients and nursing home/long term care patients may lose their care, but now, let’s add physical therapy to the mix.
Members of Congress are not happy. Healthcare advocates are upset. Individuals with disabilities that need the services, and disability advocates are, well, almost livid.
To their credit, Congress is doing all they can to stop this situation from happening. What will happen if Congress is not successful is that after July 1st, a large number of patients will learn that they have exceeded their cap on their therapy benefits and will have to start paying – sometimes very high amounts – out of their own pockets or find hospitals that will treat them.
All courtesy of the Bush Administration’s Medicare plans for the future. The very near future. It is possible that over 650,000 beneficiaries could lose their therapy benefits by the end of this year. Congress is against this happening and both Democrats and Republicans have ideas on how to stop this. Regardless, both sides are trying to do what they can to prevent these regulations from going through, protecting those that need this care the most.
The Medicare Rights Center has stated that it will be perilous for beneficiaries if the deadline passes without Congressional action stopping this. Patents with these benefits can be in therapy for everything from broken bones to strokes to traumatic brain injury. Those with more minor issues can choose to wait, address their issues in a different way or, if possible, they can make arrangements (possibly by negotiating block or discount prices) to pay the costs themselves if they can.
However, those with severe issues may have a much more difficult time. For instance, when dealing with long term therapy, if the person needs to stop because of these provisions, their condition could digress and they could get worse, reversing progress they have made.
The catch is that current regulations allow about $1,800 for physical therapy for year in a doctor’s or therapist’s office; however there is no cap for receiving these services as an outpatient in a hospital. Though patients can choose to go to a hospital for treatment, there are not enough hospitals or therapists available at those hospitals to treat them.
This is a quandary for those who need these benefits. It is important and notable that Congress is trying to act in time to overcome the July 1st deadline to block the Bush Administration from allowing these services to be curtailed for people who truly need and depend on them.
As President Bush’s administration winds down, you would think he would give a few folks a break at home. After all, all the candidates running to take Bush’s job are addressing issues such as the billions being spent on the war vs. the millions of dollars needed for programs at home, such as Medicare.
Even members of Bush’s party have flatly told him that regardless of the war, cutting benefits to the most vulnerable individuals in society is just not OK. Bush’s answer to the pleadings of both parties: let’s cut doctors payments and make sure that insurance companies continue to get theirs. So, it’s fine to take money from doctors who are already underpaid by Medicare and Medicaid, deducting their Medicare payments by 10%. Since there is a shortage of doctors who are willing or able to provide services to elderly individuals on Medicare, what an idea: let’s penalize the ones that are – and have been- willing to keep providing necessary medical care to our most vulnerable individuals.
Since some of these doctors are operating on a slim margin that makes it difficult to pay malpractice insurance premiums, it seems unimaginable that Bush is not at least leaving their payments alone. Instead, this 10.6% payment reduction to doctors is scheduled to begin on July 1.
Congress – on both sides of the aisle - is working feverishly to find $9 billion in other Medicare programs over the next five years to keep Bush’s plan/veto from going through. The other hope is getting enough votes on a workable program that will keep Bush from vetoing or doing anything else that will further jeopardize healthcare for those who need it most.
This is an issue to keep an eye on – especially in the coming days and weeks, as the outcome will affect many individuals, families and physicians dramatically.
