Medicare Maneuvers, Part 3: The Insurer Showdown
July 16, 2008
It seems that Harry Reid gambled and won. In our previous two posts we described the battle being waged in Congress over the proposed 11% paycuts to Medicare physicians. After the Independence Day recess, the Senate Majority Leader and advocacy groups working on behalf of doctors and seniors - as well as informed and angry constituents - were able to put enough pressure on Senate Republicans to finally cross the aisle.
But party lines weren’t the real issue. The two sides squaring off in this debate were private insurers versus the average American. Why? Two words: Medicare Advantage.
As discussed in our July 2 post, Medicare Advantage came about when insurers convinced government that they were getting good at cutting spending on health care, and that maybe the government should learn from some of their tactics. Heck, they said, let’s just let insurers do the job themselves!
Medicare Maneuvers, Part 2: The Solution?
July 3, 2008
As we wrote about yesterday, payment cuts for doctors who treat Medicare patients finally went into effect July 1. Unfortunately, the first legislative attempt to block the looming doctor payment cuts didn’t come until the end of 2007, and was part of the doomed legislation to improve public funding for children’s health care (see WhatIf’s piece on SCHIP). With the competing SCHIP bills finally all defeated this spring by Presidential vetoes and Republican opposition, there was little time left to deal with doctor payment cuts before the July deadline.
Medicare Maneuvers, Part 1: The Problem
July 2, 2008
Payment cuts for doctors who treat Medicare patients - which have been looming for about a year - finally went into effect yesterday. The payment cuts of 10.6% will affect the 600,000 doctors who treat Medicare patients, and thus millions of elderly and disabled Medicare enrollees who rely on them.
Maybe if you’re under 65 and/or not relying on government health care benefits you think this isn’t your problem. You’re wrong.
A little history (based on the writings of Jonathan Cohn):
Can You Profit from Health Care? Part 2
May 21, 2008
A couple weeks ago WhatIf explored whether the U.S.’ largest industry – health care – is recession-proof. It seems health insurance companies’ profits are starting to slip. Rising health care costs means that insurers must pay out more to cover health services, which means they raise the price of their policies to recoup these costs. As a result, the number of employers purchasing insurance is decreasing.
Even so, the nation’s largest publicly-traded health plans say they will continue to raise premium prices and reduce provider payments in order to please Wall Street. “We will not sacrifice profitability for membership,” WellPoint President and CEO Angela Braly said recently.
When Insurers Take Their Toys and Go Home
May 10, 2008
For the past few years there has been work in cities and states across the country to improve our citizens’ access to health care. From San Francisco to Vermont, 39 states and a number of cities are in the process of creating legislation that would help address their numbers of uninsured.
Washington, D.C. is one of these. A look at the trouble our nation’s capital is facing on this issue may shed a light on why the words “health care reform” are often greeted with less than a smile.
Dialysis Treatment – A Punch in the Kidneys
April 2, 2008
Here’s a fact that may surprise you: kidney failure is the one disease that you can get coverage for – from the Federal Government - no matter what.
For this reason, after 30 months of treatment by a private insurer, dialysis facilities bill Medicare regardless of whether the patient is over 65 or financially stable. For those with kidney failure (End Stage Renal Disease) due to diabetes or other causes, having a machine take over the complicated (and therefore expensive) task of cleaning their blood several times a week allows them to live.
Cancer Without Coverage
February 26, 2008
The number of uninsured Americans rose by more than 20% to 47 million from 2000 to 2006. Children and employees at every income level lost coverage during this time. With cancer as the number one cause of death in the U.S. one wonders how the uninsured fight this merciless killer.
The answer? Not so well. A recent study – the first to chart a dozen major cancer types using nationwide data - shows that those with private insurance fare better in the war against cancer than those without. The uninsured are twice as likely (and those covered by Medicaid 80% more likely) to receive a diagnosis of cancer in its late stages when it’s difficult to combat the disease. Typically, the under-insured don’t get screened for cancer as often or as thoroughly so the diagnosis is delayed, as is follow-up treatment.
Kids Get Worse Care
February 19, 2008
A study of children in a dozen metropolitan areas found that they got the recommended medical care from their doctors less than half of the time. This means that kids are doing worse than adults in this country when it comes to getting good doctor care. “Doctors did best with acute problems, such as upper-respiratory-tract infections, treating them correctly about two-thirds of the time. But with chronic conditions such as asthma and diabetes, they gave the right care 53% of the time. The worst showing was in preventive care: 41%.”
Better Website for Medicare RX Plans
October 18, 2007
The Federal Government has launched a more user-friendly website that lets Medicare enrollees compare the various prescription drug plans and benefits options offered in their communities. A new five-star rating system lets users compare Medicare prescription drug plans based on access to care, quality of care, customer satisfaction and other measures. Website users can also compare and sort plans by annual costs - including prescriptions, monthly premiums, coverage levels in the so-called “doughnut hole” and other factors - and view the information in one chart.
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