The Medicare trust fund has been extended to 2030, 4 years longer than projections made just one year ago. This sounds like wonderful news until you take a closer look. The fine print reveals that this is little more than campaign rhetoric. Four years in the grand scheme means little when you look at the real numbers.
More baby boomers approach eligibility age every day. In 2012, there were 50.8 million people on Medicare. That number is expected to increase to 57 million by 2020. Will Medicare be there when our seniors need it most?
Regulatory changes this past year have put hospital stays in the crosshairs. Medicare Part A pays for hospital services but only if someone is labeled as an inpatient. To cut costs, Medicare has made it harder to get inpatient status, even if a patient stays in the hospital overnight.
The two-midnight rule went into effect in October 2013 and has seniors baffled by what it means. To be honest, it has many health care professionals equally confused. It states that a doctor must expect a patient to be in the hospital for a stay spanning at least two midnights to be considered for inpatient coverage. To give perspective, many emergency surgeries do not require stays of more than two midnights. That is a lot of money Medicare Part A is not paying towards medically necessary costs.
The Obama administration notes that spending under Medicare Part B (outpatient services) and Part D (prescription coverage) has not changed in recent years. Overall spending, however, has decreased under Part A for two years in a row. Part of this may be attributable to pressure put on doctors and hospitals to improve patient care and avoid hospital readmissions. This is beneficial to patients on all fronts unlike the outright cost shifting that comes with the two-midnight Rule. That degree of cost shifting can only harm seniors who end up paying more for the same level of care.
The problem is that politicians in Washington are patting themselves on the back for adding four years to the Medicare trust fund, as if this alone will solve a crisis. Medicare is stronger, they claim. Medicare provides more services. When it comes at the expense of cost shifting thousands of dollars to our seniors for each hospital stay, four years is not all that impressive; it is only a presidential term.
I would be more impressed if my Medicare patients were able to pay for food, shelter, and medication while getting the medical coverage they had before the two-midnight Rule. It is not surprising the American Hospital Association is suing the government over the legislation.
There is no question health care will be the pulse of the 2016 presidential election with Medicare flashing in neon lights. Until then, our seniors still need to access care and services. Can they afford it? Our seniors need more resources to guide them through the Medicare maze.
Tanya Feke is founder, Diagnosis Life.