Comments on: Why doctors and hospitals oppose expanding Medicare http://www.kevinmd.com/blog/2009/12/doctors-hospitals-oppose-expanding-medicare.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: alexhttp://www.kevinmd.com/blog/2009/12/doctors-hospitals-oppose-expanding-medicare.html#comment-121795 alex Tue, 15 Dec 2009 20:24:04 +0000 http://www.kevinmd.com/blog/?p=41801#comment-121795 "Giving CMS even more market power would mean even further reimbursement cuts, something for which we all know CMS has shown a new affinity. Reimbursement cuts are the only reason physicians and hospitals are spooked. All of the above is just rationalization. What’s bad for them is good for the patient and taxpayer."By this logic if Medicare covered everyone then they could cut reimbursements by 90% and it would be great for patients and taxpayers. You don't see the slightest flaw with this logic?Further unilateral cuts by CMS in the name of cost saving are going to harm patient care. There are a great deal of unreimbursed activities that doctors do just because they take pride in what they do. Having CMS tell you every year that what you did this year is worth even less than what it was last year is a great recipe for a demoralized, unhappy workforce. Just ask the general surgeons... if you can find one. “Giving CMS even more market power would mean even further reimbursement cuts, something for which we all know CMS has shown a new affinity. Reimbursement cuts are the only reason physicians and hospitals are spooked. All of the above is just rationalization. What’s bad for them is good for the patient and taxpayer.”

By this logic if Medicare covered everyone then they could cut reimbursements by 90% and it would be great for patients and taxpayers. You don’t see the slightest flaw with this logic?

Further unilateral cuts by CMS in the name of cost saving are going to harm patient care. There are a great deal of unreimbursed activities that doctors do just because they take pride in what they do. Having CMS tell you every year that what you did this year is worth even less than what it was last year is a great recipe for a demoralized, unhappy workforce. Just ask the general surgeons… if you can find one.

]]> By: Anonhttp://www.kevinmd.com/blog/2009/12/doctors-hospitals-oppose-expanding-medicare.html#comment-121789 Anon Tue, 15 Dec 2009 19:32:27 +0000 http://www.kevinmd.com/blog/?p=41801#comment-121789 Other payers became FFS because Medicare created it. Essentially anything Medicare does is used as a baseline by the private insurers with the thinking, "if this is what the government does, why should we do much more?" Because of this, there is not that as much difference between Medicare and the private insurers as people think. So yes, Medicare did create that problem.The problem with Medicare over the private insurers is that Medicare decided sometime ago that because it can't sustain itself and balance its own budget, it solved its problems by paying hospitals and physicians less. So in a world where the senior population is growing, Medicare wants to pay even less. So, physicians and hospitals will be even busier, but paid less. Expanding Medicare to even more people will just make the bottom fall out faster. Other payers became FFS because Medicare created it. Essentially anything Medicare does is used as a baseline by the private insurers with the thinking, “if this is what the government does, why should we do much more?” Because of this, there is not that as much difference between Medicare and the private insurers as people think. So yes, Medicare did create that problem.

The problem with Medicare over the private insurers is that Medicare decided sometime ago that because it can’t sustain itself and balance its own budget, it solved its problems by paying hospitals and physicians less. So in a world where the senior population is growing, Medicare wants to pay even less. So, physicians and hospitals will be even busier, but paid less. Expanding Medicare to even more people will just make the bottom fall out faster.

]]> By: ZMDhttp://www.kevinmd.com/blog/2009/12/doctors-hospitals-oppose-expanding-medicare.html#comment-121787 ZMD Tue, 15 Dec 2009 19:17:08 +0000 http://www.kevinmd.com/blog/?p=41801#comment-121787 How does Congress expect doctors and hospitals to support expanding Medicare when they can't be bothered to prevent a 21% cut in reimbursement next month? And with further cuts threatened every year based on the SGR, who in their right mind would support this? How does Congress expect doctors and hospitals to support expanding Medicare when they can’t be bothered to prevent a 21% cut in reimbursement next month? And with further cuts threatened every year based on the SGR, who in their right mind would support this?

]]> By: KGhttp://www.kevinmd.com/blog/2009/12/doctors-hospitals-oppose-expanding-medicare.html#comment-121786 KG Tue, 15 Dec 2009 18:18:47 +0000 http://www.kevinmd.com/blog/?p=41801#comment-121786 Almost every payer is FFS, so that's not really an argument against Medicare expansion, but rather the entire system. I'm with you on the ridiculousness of that model, but the political realities today preclude such a huge paradigm shift. (Everyone still remembers capitation.) Within the FFS system, Medicare has the least overhead, most experience, and market clout to lower cost. Almost every payer is FFS, so that’s not really an argument against Medicare expansion, but rather the entire system. I’m with you on the ridiculousness of that model, but the political realities today preclude such a huge paradigm shift. (Everyone still remembers capitation.) Within the FFS system, Medicare has the least overhead, most experience, and market clout to lower cost.

]]> By: Anonhttp://www.kevinmd.com/blog/2009/12/doctors-hospitals-oppose-expanding-medicare.html#comment-121785 Anon Tue, 15 Dec 2009 18:00:50 +0000 http://www.kevinmd.com/blog/?p=41801#comment-121785 Medicare works well for the seniors who use it, but it is based on a broken system that is at least partly responsible, through its fee-for-service model, for the healthcare inflation we see now. It hasn't broken even in decades and contributed vastly to our debt. Why in the world would we want to expand something that is broken? Medicare works well for the seniors who use it, but it is based on a broken system that is at least partly responsible, through its fee-for-service model, for the healthcare inflation we see now. It hasn’t broken even in decades and contributed vastly to our debt. Why in the world would we want to expand something that is broken?

]]> By: KGhttp://www.kevinmd.com/blog/2009/12/doctors-hospitals-oppose-expanding-medicare.html#comment-121781 KG Tue, 15 Dec 2009 16:55:15 +0000 http://www.kevinmd.com/blog/?p=41801#comment-121781 Medicare reimburses less than the potential public option, which would likely behave like another private insurer. Giving CMS even more market power would mean even further reimbursement cuts, something for which we all know CMS has shown a new affinity. Reimbursement cuts are the only reason physicians and hospitals are spooked. All of the above is just rationalization. What's bad for them is good for the patient and taxpayer. Medicare reimburses less than the potential public option, which would likely behave like another private insurer. Giving CMS even more market power would mean even further reimbursement cuts, something for which we all know CMS has shown a new affinity. Reimbursement cuts are the only reason physicians and hospitals are spooked. All of the above is just rationalization. What’s bad for them is good for the patient and taxpayer.

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