Building on a Wall Street Journal editorial I wrote last summer, Tom Saving and I have proposed nine small scale reforms for Medicare at the Health Affairs Blog. [See previous commentary and comments.] Most of these are relatively easy fixes. They are relatively easy to implement and should save the system significant dollars. I’ll do a Health Alert on this on Monday.
In a parody playing on the Medicare handbook that the Centers for Medicare & Medicaid (CMS) publishes each year that gives seniors information about changes to the program, U.S. Senators and doctors Tom Coburn, M.D. (R-OK) and John Barrasso, M.D. (R-WY) released their own “Medicare and You 2012” handbook that provides a doctors’ perspective about the real challenges facing the Medicare program under President Obama’s health care law.
Which members of Congress are in the top 1%? Nancy Pelosi and Dianne Feinstein are among them.
1 in 5 Americans have eaten an entire pie by themselves. See Parade Magazine’s history of pie here.
Money saving idea: Model Medicare after Vet care. That’s as in Veteran, not Veterinarian.
A 2003 law fixes the price Medicare will pay for injected drugs to an “average sales price” that is at least six months old at any given time. This flawed concept means even if a generic firm raises its price to reflect increased production costs, the new price won’t get paid by Medicare—meaning purchasers would be losing money for months at a time. The result is that generic prices can’t rise to reflect changing demand or the need for bigger investments in manufacturing.
To fix this, we should lift existing price controls when it comes to critical injectable drugs that are generic. First, Medicare can be directed to ditch the flawed “average sales price” and reimburse manufacturers for these drugs according to the price that is paid by wholesalers on the open market and already reported to Medicare. Then generic firms could adjust prices to match rising production costs and meet demand.
These drugs should also get a holiday from other Medicaid price-control schemes that serve to distort market prices…. Better still, Medicare can move the reimbursement of these drugs from its price-controlled “Part B” scheme and into its “Part D” drug program, which already pays for the pills that senior citizens get from pharmacies….
Allowing generic injectables to be priced competitively would allow manufacturers to recoup the costs of production and bring shortages to an end.
See Scott Gottleib WSJ editorial. See also our previous posts here, here, here and here.
A study in the journal Cancer that found people with private health insurance fared better after prostate surgery that either patients with Medicare or Medicaid. According to Fox News:
Researchers determined that among more than 61,000 men who had their prostates removed to treat cancer, those with private insurance had fewer complications from surgery and were less likely to die in the hospital.
Men covered by Medicare or Medicaid were more likely to need a blood transfusion to treat blood loss: almost eight percent and 11 percent, respectively, had a transfusion, compared with just over five percent of men with private insurance.
A similar study by some of the same researchers also found privately insured patients who had a kidney removed also had better outcomes than those covered by Medicare and Medicaid.
Only three weeks remain before the Joint Select Committee on Deficit Reduction, popularly known as the “Super Committee,” must submit a bill to Congress that will cut the deficit by at least $1.2 trillion in ten years. By design, everything is on the table. The Super Committee only has one chance: It can bring forth only one bill, and must do so by November 23.
Although details are murky, it was reported that the Super Committee’s Democrats have proposed $600 billion in savings from Medicare, Medicaid, and other health spending, while Republicans have proposed $800 billion of cuts to health spending, as well as increased revenue of $640, some of which is scheduled to come from higher health-care premiums. Each side rejects the other’s proposal.
And the Super Committee is not just about health spending. It’s about everything, including the hot-button issue of national defense.
Note: Medicare spending for physician fee-schedule services grew by 73% — from $37 billion to $64 billion — from 2000 to 2010, more because of growth in the volume and intensity of services than because of fee increases. The Medicare Economic Index is a measure of inflation in practice costs. Data are from MedPAC.
[C]hanges included in the so-called “Affordable Care Act” drastically cut payments to Medicare Advantage plans starting in 2013, driving many MA plans out of business, and forcing the surviving plans to slash benefits. According to a recent study I wrote with Michael Ramlet, these cuts will cause the beneficiaries in the average county (MA plans are offered on a county-level basis) to lose two-thirds of their MA plan choices by the time the new payment formula is fully phased in in 2017….
The average beneficiary — considering both those who stay in the stripped-down MA program, and those who transition out of it — will incur an average cut of more than $3,700 in benefits per year by 2017.
The decline in both plan offerings and in enrollment will vary substantially across the country. In Texas, for example, beneficiaries will face an average loss of more than three quarters of plan offerings per county by 2017….
The percentage of beneficiaries pushed out of the program ranges from 38 percent in Montana to a 67 percent in Washington, D.C., and 84 percent in Puerto Rico. Average benefit losses range from a low of $2,780 in Montana to a high of $5,092 in Louisiana.
Full Robert Book post here. See our previous posts here and here.
If ObamaCare succeeds in cutting doctor and hospital payments as planned, drug spending will become the fastest growing part of Medicare. See this report from the Bipartisan Policy Center.
Source: The Congressional Budget Office.
