Tag: "Medicare"

The Government is Already Rationing Health Care

This is Scott Gottlieb, writing in the Wall Street Journal:

Take the agency’s tortured decisions concerning the use of implantable defibrillators that jump-start stopped hearts during cardiac arrest. Medicare sharply restricted their use in the 1990s. Mounting research proved that the $30,000 devices could be saving many more lives. So in 2003 Medicare adopted a novel theory to expand coverage to some, but not everyone, who needed one. The agency said only patients with certain measures on their electrocardiograms (called “wide QRS”) seemed to benefit.

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Oct 07, 2009 | 5 comments | by

“These changes need to see the light of day.”

Sen. Chuck Grassley on rejected Republican amendments to the Baucus health care bill:

Americans considering what this health care proposal means for them deserve to know that Medicare prescription drug premiums would probably go up, veterans’ access to health care would be diminished, and workers’ wages could be garnished in the midst of growing unemployment and a prolonged recession, in order to pay for other spending in the health reform bill.

Oct 06, 2009 | 6 comments | by

Policy Update – 2009/9/28

House leadership fights measure to allow Americans a three day window to read important bills (think: health bill) before Congress votes.

Baucus bill: play or pay or go to jail.

Medicare scare-mongering: That’s what The New York Times says you’re doing if you point out that the Baucus bill would pay for health insurance for the young with $400 billion in cuts for seniors.

Sep 28, 2009 | 4 comments | by

Extending the Emergency Room Rules to the Entire Health Care System

Hospitals run by government used to be the place where people who could not afford other health care were supposed to go for treatment. In 1986, EMTALA, the Emergency Medical Treatment and Active Labor Act, turned this system on its head. It required hospitals to provide the same kind of emergency treatment to everyone, whether or not an individual had made provisions for payment.

The problems created by EMTALA are severe. They illustrate a crucial problem in health care policy: can a health care system be stable if it requires that people who do not pay be treated in the same facilities and to the same standard as those who do?

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Sep 25, 2009 | 5 comments | by

Does Hospice Care Reduce Medicare’s Cost for End-of-Life Care? No.

This is Jason Shafrin, writing at the Healthcare Economist blog:

Medicare recipients in their final year of life generate about six times the expenditures of the average surviving Medicare enrollee and account for almost 30 percent of total program spending. Can hospices decrease Medicare’s end-of-life expenditures? A paper by Garber, MaCurdy and McClellan find that the answer is no.

In summary, although hospice utilization increased and inpatient hospital care decreased, “the simultaneous rise in the use of hospice and other services, however, meant that the number of days that patients received Medicare-covered services rose between 1988 and 1995.” the net effect of these changes in utilization was an increase in monthly Medicare expenditures before death, rising from about $5,500 in 1988 to more than $7,000 in 1995 (in 1995 dollars).

Sep 22, 2009 | 3 comments | by

Hits & Misses – 2009/9/21

Medicare will pay $8,000 for a computer that will turn typed words into speech for the speech-impaired. It will not pay $450 for an iPhone that will do the same thing.

The pancreas. Gone awry, it is the source of diabetes, affecting 23 million people and it is at the front lines of our expanding waist lines.

Sixty percent of adults can’t digest milk, including most of Asia, half of Africa and 3/4 of Mediterranean.

One FDA bureaucrat is holding up many new cancer treatments.

salt-and-pressure-cuff

Sep 21, 2009 | 3 comments | by

Which Seniors Will Be Hurt the Most if President Obama Succeeds in Cutting Payments to Medicare Advantage Programs to Subsidize Health Insurance for Young People?

Surprisingly, they are low-income and minority seniors, the ones most likely to be Democratic Party voters. Seniors enrolled in MA have lower incomes than the average senior in Medicare:  

  • 47% of MA enrollees have incomes below $20,000.
  • Only 6% of MA enrollees have incomes above $50,000.

Hispanic and African-American seniors are most likely to choose MA over the traditional Medicare program:  

  • 1 in 3 Hispanic seniors are enrolled in MA.
  • 1 in 4 African-Americans seniors are enrolled in MA.
  • 1 in 5 White seniors are enrolled in MA.
  • 1 in 6 Asian-Americans are enrolled in MA.
Sep 21, 2009 | 5 comments | by

Just How Low-Cost is the Mayo Clinic?

The idea that putting everyone into something like a Mayo Clinic will save oodles of money underlies almost everything being discussed in Washington. But it is based more on wishful thinking than on any real evidence. Now Peter Nelson at the Center of the American Experiment offers a paper that should put this fantasy to rest for a while.

Mr. Nelson agrees that the Mayo Clinic provides very high quality care. But he says if you look beyond the price controls of the Medicare program, it is by no means low cost. He writes, “In Medicare, the government sets prices and, as a result, the prices in the Dartmouth data reflect national Medicare policies and do not reflect the price of health care services negotiated between private health plans and providers more generally.” Indeed, “Relative to other Minnesota providers, most evidence pegs the Mayo Clinic as a high-cost provider.”

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Sep 21, 2009 | 3 comments | by

Doctors Seven Times More Satisfied with Payments from Private Insurance as Medicare

With all the polls of Americans on health reform, one group’s members are rarely surveyed about their preferences: physicians. Although medical societies are lobbying for special privileges, the views of actual physicians have remained largely unexamined. Two physicians recently sought to remedy this by surveying a random sample of 6,000 physicians (of which 43% responded) and publishing the results in the New England Journal of Medicine.

Funded by the Robert Wood Johnson (RWJ) Foundation, the survey’s results were promoted with a different headline than you see above.

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Sep 18, 2009 | 4 comments | by

The Medicare Advantage Plans Obama Wants to Defund: More Evidence on their Performance

Almost one in every four seniors is enrolled in a Medicare Advantage (MA) plan. These plans are run by private insurers. They receive a risk-adjusted annual fee for each enrollee from Medicare; and they tend to provide comprehensive benefits, similar to what nonseniors typically have. President Obama says the government is overpaying and wants to cut revenues to these plans by $177 billion over ten years. Industry sources say 5 million seniors would lose their coverage as a result. The Congressional Budget Office (CBO) says that under House Bill (H.R. 3200) 3 million current enrollees would lose coverage, rising to 6 million by 2019.

I previously reported on the relative performance of eight major MA plans vis-a-vis conventional Medicare. Now there is new data for all MA plans versus all standard Medicare in two states: California and Nevada. Assembled by the Agency for Health Care Research and Quality the data shows:

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Sep 17, 2009 | 21 comments | by
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