While Rome Burns, Nero Fiddles – Health Care Edition
by Tom aka Rusty Rustbelt
While Rome Burns, Nero Fiddles – Health Care Edition
While the House and Senate were trying to overhaul the entire health care system, key Medicare regulations were left in limbo. Those provisions are still in limbo.
Medicare physician reimbursement based on Sustainable Growth Rate (SGR) have been controversial and generally considered unworkable since being passed. The solution has been an annual fix rather than a permanent fix. The House bill had a permanent fix, but went nowhere.
As a result of not being fixed, some physicians will see draconian cuts in Medicare reimbursements as of March 1. Primary care docs will see a small increase in rates. Or there may be a fix, or maybe not.
Physical therapists who provide Medicare services are now subject to a cap, amounting to rationing, for elderly patients. This capping system was instituted in 1997 but an annual fix has prevented implementation. Now that too is in limbo, and therapists may be “donating” services in 2010, while waiting on an answer. If the cap remains, services will have to be rationed..
Seniors are very dependent on various forms of therapy to regain mobility and self-sufficiency after fractures, surgeries and strokes. Would we prefer nursing home placement instead?
If health care reform enlarges the role of the federal government, and this is how the feds do business, this could prove interesting.
Newsflash: Apparently Obama’s 2011 budget assumes a fix for physician SGR. 2010? In limbo.
Tom aka Rusty Rustbelt
Just another confirmation of how badly this administration has taken its eyes off the ball.
Tell us why this administration took on health care reform without also focusing on jobs, jobs, jobs?
It may be time to have a list of things that this administration has done to improve you and/or your family’s well being.
Was it not the GOP that has been filibustering a Senate SGR patch and insisted on a long term SGR fix be pulled out of the health reform bill? Because the GOP refuses to advance this legislation we should be blaming Obama for taking his eye off the ball?
Just curious — has the GOP actually done a filibuster yet in the Obama administration? I don’t think so… it seems like an imaginary filibustier is more effective than a real one.
Jay22, put on your thinking hat, please. A super-majority requires what number of minority votes? I’ll sit over on the sidelines awaiting your answer.
Jay22, you also missed the main point. Why did he/the Dems focus on the HC reformation instead of pursuing a jobs bill? Why did he/the Dems ignore the pain and suffering caused by extending and deepening unemployment for a political gain?
BTW, Rahm was correct re: wasting a crisis (for political gain), but forgot about wasting an opportunity for alleviating pain and suffering. BTW, unemployment went up again. Further deepening the pain and suffering.
How much longer are we supposed to wait for the impact of that pivot?
Noni, filibusters don’t occur any more. A call for cloture has replaced it.
I have been trying to imagine LBJ sitting around whining because the mean old GOP will not cooperate with him. Hmmm.
***I have been trying to imagine LBJ sitting around whining because the mean old GOP will not cooperate with him. Hmmm.***
Good point. If LBJ were around, I imagine that all Republican members of Congress would find that their offices required fumigating, and they have been assigned temporary office space in an unheated tent in the Capitol Mall. Also that their names have mysteriously appeared on the No-Fly List, that the 2011 budget includes no funding for any project in their state/district and that all their office phone and internet traffic is being routed through a manually operated switchboard in the Cook Islands.
At any rate, thanks for pointing out that legislation is required quickly. Perhaps Obama should put the guys who shut down the old GM in charge of all operations. They managed to pull off a job that many observers thought was impossible, and others thought would take years neatly and smartly. Those folks really need to move on to other projects.
Here is the problem I have with this particular slant, eventhough jobs could have been part of the deal.
1. It appears to be the idea of the day for politics….Stormy has been writing about jobs and policy for several years, and in 2008 was quite specific. That is a solid claim to the idea. Google stormy in AB archives.
2, Few economists and no politician of any stripe was loudly calling for job creation, trade policy changes, and helping workers when the need was obvious to some, and written about the last few years.
3. The goings on at Davos have to have had some planning for the last year…the politics of the last decade have kept it off the table as a ‘no prob’ even in 2006, the last time the free traders noticed mercantile policies trumped any notion of the impact of tariffs and such.
4. Hence, for me, this kind of claim is very hollow.
Same reason the Republicans did I presume.
***Tell us why this administration took on health care reform without also focusing on jobs, jobs, jobs? ***
Because they passed a 787B stimulus bill a year ago? Would you prefer that it had been bigger? That it had focused more on jobs and less on tax cuts (282B)?
If we were to go back and look at your posts at the time, would we find that you criticized the bill for being too small and not including more jobs programs? Be honest.
If Obama had listened to Krugman … http://krugman.blogs.nytimes.com/2009/02/07/what-the-centrists-have-wrought/ would you be happier?
I’m not cure that this fits into the discussion, but it is a bit of Medicare news and yes it is anecdotal. My dear old mom, 88 and counting, is covered by Medicare, but is signed with a PPO, GHI. I’ve never had an issue. Any doctor and her costs are covered. She gets a letter recently from GHI indication that her coverage has just changed and a co-pay system has been added. The co-pays are $20 per visit for primary care physician and $40 per visit for specialists.
No explanation, just a notice of the institution of a new co-pay policy. That’s a dramatic increase in her health care costs.
***BTW, unemployment went up again.***
Somebody over at Calculated Risk predicted that based on last year. What happens is that state unemployment bureaus are minimatlly staffed compared to current levels of unemployment. Throw in the holidays and there is a backlog of unprocessed unemployment applications in December that doesn’t get worked off for a number of weeks. Hopefully, we will start to see clean data this week or next assuming that we aren’t already.
Jack: My mother just went through something similar.
Does your mom qualify for Medicaid in her state? it would act as a supplement plan.
Codger, I do not remember EVER saying the stimulus was tto small. Now, 2lugs, yup! me? Doubt it. What I have consistently said is that the stimulus bill has been more politically oriented and less economically oriented. I have said for many years spending on infrastructure was a less efficient approach for stimulating the economy. My earliest comments re: the stimulus bill had to do with why did they back load the spending to election years.
If you look at my more recent coments re: the stimulus you would find I have some specific concerns and suggestions for a better directed stimulus.
Liberal policies have been on display for three years. I think you can read the voters’ reactions. Worse, no one has yet answered the questions: What has this administration done for you and your family? And, why did this administration focus on health care reform instead of jobs which extended the pain and suffering for those unemployed?
Jack and Rusty, medicare should cover the co-pays. I have BC/BS with co-pays and medicare payment of them is the only benefit I have seen to date. I am not altogether sure that the co-pays are just waived under MC, but next visit I will ask.
The Senate rules have not changed recently. But filibusters have become much more common. Actually, a filibuster is onerous for both sides, which is why you do not see the marathon speeches now. Both sides agree to an overnight recess, and other accommodations, like getting other business done. But if the supporters of a bill wanted badly enough to enforce the marathons, they could.
I guess the rules havn’t changed much, but their implementation of them has. from Wiki we have: “Today, the minority just advises the majority leader that the filibuster is on. All debate on the bill is stopped until either cloture is voted by three-fifths (now 60 votes) of the Senate. Some modern Senate critics have called for a return to the old dramatic endurance contest but that would inconvenience all senators who would have to stay in session 24/7 until the filibuster is broken.“
No MC will not cover all of the co-pays, either in the traditional plan or in one of the contract PPOs. Thus a booming business in Medigap plans, such as AARP.
Some PPO plans may be different, they all are.
I loved your article – it was some great information. I think you and your readers might be interested in another article I found on Medical and Dry Eyes.