Following the Money, Doctors Ration Care

by Tyler Cowen

Unequal access to health care is hardly a new phenomenon in the United States, but the country is moving toward rationing on a scale that is unprecedented here. Wealthy people will always be able to buy most of what they want. But for everyone else, if we stay on the current course, the lines are likely to get longer and longer.

The underlying problem is that doctors are reimbursed at different rates, depending on whether they see a patient with private insurance, Medicare or Medicaid. As demand increases relative to supply, many doctors are likely to turn away patients whose coverage would pay the lower rates.

Let’s see how this works. Medicare is the major federal health program for the elderly, who vote at high rates and are politically influential, and so it is relatively well financed. Medicaid, which serves poorer people, is paid for partly by state governments, and the poor have less political clout than the elderly, so it is less well financed. Depending on the state and on the malady, it is common for Medicaid to reimburse at only 40 percent to 80 percent the rate of Medicare. Private insurance pays more than either.

A result is that physicians often make Medicaid patients wait or refuse to see them altogether. Medicare patients are also beginning to face lines, as doctors increasingly prefer patients with private insurance.

Read More...

Patients Should Pay Their Own Bills

by IBD Editorials

Big Spenders: Increases in health care costs rival the rising of the sun for inevitably. Should we blame greedy doctors and drugmakers? No, blame should be placed on the system the government has promoted.

The tax code encourages employers to buy health care insurance plans with pretax dollars. Because these plans are exempt from federal income and payroll taxes, employers salaries. Nearly 60% of American adults are covered by an employer-based plan.

For most, these plans work well. But the arrangement that so many have become accustomed to has driven health care spending ever higher. The cost of medicine increased 98% between 1992 and 2008, a period when the consumer price index rose 53%. Health care spending now makes up 17% of the economy, a far bigger slice than it did before the 1965 creation of Medicare and Medicaid, when it never went beyond 6%.

Why has this happened? Devon Herrick from the National Center for Policy Analysis has the simple answer: We have become big spenders on health care because our motivation to be thrifty has been legislated away.

"A primary reason why health care costs are soaring is that most of the time when people enter the medical marketplace, they are spending someone else's money."

Read More...

The "Repeal" Pledge

Government Hospital Comparison Website Unreliable

by Karen Kaplan


If a surgical procedure is in your future, the Centers for Medicare and Medicaid Services would like to make your life a little easier by helping you choose a hospital with a good safety record. Its Hospital Compare website allows you to search hospitals in your area and see whether they do a good job of some seemingly important things, like giving patients antibiotics when they’re supposed to and heading off dangerous blood clots.

But don’t put too much stock in the Hospital Compare ratings. According to a study being published in Tuesday’s edition of Archives of Surgery, patients who went under the knife in the lowest-scoring hospitals did just as well as patients who were treated in the best hospitals.

Read More...

ObamaCare will clog America's medical system

by Marc Siegel

A month ago, U.S. Health and Human Services Secretary Kathleen Sebelius sent a letter to the president of America's Health Insurance Plans stating that the impact on insurance premiums from "the new consumer protections and increased quality provisions" of the new health reform law "will be minimal ... no more than 1% to 2%." Sebelius warned Karen Ignagni that there would be "zero tolerance" for insurers blaming unjustified premium increases on the new law. Talk about subtle.

Sebelius' threat, though, obscures a larger problem: The new health care law mandates and extends the kind of insurance that breeds overuse, thereby driving up costs and premiums. And here I thought the reform intended to reduce costs.

As the details of this massive government-led health care overhaul begin to trickle out, let me be clear (to borrow the president's go-to phrase): The medical system is about to be overwhelmed because there are no disincentives for overuse.

Read More...

Obama murdered Medicare

by Thomas R. Saving and John C. Goodman

The health care reform law enacted in spring will have a devastating impact on elderly and disabled Medicare enrollees if its provisions are not substantially changed.

The law creates a new mechanism to reduce the rate of increase in Medicare payments to doctors and hospitals. As a result, Medicare payments will fall below Medicaid rates before the end of this decade, and they will fall increasingly behind the rates paid by all other payers in succeeding decades.

To appreciate what that means, consider that Medicare currently pays about 20 percent below what private insurance pays. At those rates, hospitals lose money on Medicare patients. Under the spending cuts called for in the Affordable Care Act (ACA), payments will get worse in the future.

Read More...

Obamacare Sticker Shock: Taxing Over 15,000 Medicines

by Connie Hair

Nancy Pelosi warned us we’d have to pass Obamacare to find out what’s in it. And what we’re finding we don’t like at all.

Higher insurance premiums are hitting families hard. Medicare Advantage has been decimated. Millions will be forced into government-run Medicaid where long lines and rationing await.

If we like our insurance -- too bad.

Beginning January 1, 2011, more than 15,000 over-the-counter (OTC) health care items will require a prescription (and that means a doctor’s visit) for tax-free reimbursement.

Read More...

Medicare actuary: Reform will cost some seniors

by Jennifer Haberkorn

A Medicare official concedes that seniors may have to dig deeper into their wallets next year thanks to the health care law.

The new analysis finds the health care overhaul will result in increased out-of-pocket costs for seniors on Medicare Advantage plans.

Richard Foster, the actuary for the Centers for Medicare and Medicaid, also tells Senate Republicans that the overhaul will result in “less generous benefit packages” for Medicare Advantage plans next year. Foster is independent from the administration and non-partisan.

Read More...

Medicare Czar Flees ‘Rationing’ Query

States fight Obamacare

 by Sally C. Pipes

Opposition to the new health reform law is continuing to grow in the states - just as Congress prepares for its final pre-election legislative session.

Colorado, for instance, just placed an initiative on the ballot that would, if passed, block many aspects of Obamacare - including the requirement that individuals purchase health insurance. A similar measure was overwhelmingly approved by voters in Missouri last month. And several states recently announced that they don't believe they have the authority to enforce the new law.

With actions like these, the message to Washington is clear: If Congress doesn't repeal Obamacare, the states just might do it themselves.

Read More...