GOP returns to scare tactics on 55+ Medicare
Image by Getty Images via Daylife
The GOP – and those in the blogosphere dedicated to the philosophy of just saying no – have been out in full force today making the argument that lowering the age of Medicare to those over 55 will create far more problems than it cures. Their argument centers on the alleged ‘fact’ that with many physicians already dropping Medicare patients, due to lower payment rates, there will be an expanded crisis in finding physicians to treat the equally expanding number of Medicare participants if more are allowed into the system.
I know you’ll be stunned to hear that if the research is, in any way, indicative of the truth, this claim is likely to prove out to be completely false.
Hard as it is to believe that the GOP propaganda machine would seek to mislead, lets’ go to the facts – beginning with the findings of a Robert Woods Johnson Foundation national poll of physicians, published on September 14, 2009, as reported by Ezra Klein;
Doctors overwhelmingly support either a public option or a public system. Indeed, when you add the two groups together, it’s more than 70 percent of respondents. There were some differences across specialties, but not a lot: about 75 percent of primary care doctors favored a public option or public system, while about 67 percent of surgeons felt similarly.
Next, the survey asked about opening Medicare up to individuals between 55 and 64. Support overwhelmed opposition by more than 2 to 1 (emphasis added.)
Via Washington Post
This morning, Sen. Orrin Hatch (R-UT), appearing on Dylan Ratigan’s MSNBC show, raised the spectre of 50% of America’s physicians no longer taking Medicare patients if more people were added to the system. Yet, again, the research shows that this is just not what is likely to happen.
In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 29 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them, up from 24 percent the year before. And a 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients, only 38 percent of primary care doctors did.
Via NewYork Times
It would seem to be an almost inescapable conclusion that if you lower the age of Medicare participation to 55, it is far more likely than not that physicians will find it untenable to opt out of the Medicare program. Let’s face it – the ‘young immortals’ in our society – those who don’t believe they will ever get sick – are not the ones who rush to see the doctor. In fact, they tend to avoid doctors like The Plague. Thus, one can’t help but suspect that it would become rather difficult for many physicians to keep their doors open were they to say no to the 55+ demographic.
The GOP is also failing to take note of the large number of physicians who, fed up with the process of having to clear their decisions with private insurance companies and incur the huge overhead charges involved in submitting claims, are dropping out of private insurance plans in droves, expecting their patients to pay cash for the services of their physician in the hopes that the patient will be reimbursed directly by their insurer.
In states like California, HMO participation, the least expensive form of private health care coverage, is now accepted by just over 50% of the state’s physicians, yet, Senator Hatch would have us fear the disappearance of doctors because of increased participation in Medicare? Remarkable.
There are, no doubt, a number of shoes left to drop in the discussion over lowering the age of Medicare participation. There will likely be troublesome and complicated issues to be faced if this is on track to become a reality.
But let’s not let allow this to be derailed by misstatements, quarter-truths and outright lies by those who seek only political victory with no regard for the well being of their fellow citizens.
This is much too important to allow the death panel crew have their way once again.
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Anyone know the real reason they are proposing lowering medicare age to 55?
Teachers and many other public employees retire at age 55…and in many areas are left without health insurance….this would be a big coup for public employees….
Now on the other hand many teachers are handed free health care for life when they retire such as all los angleles city teachers…and many other public employees get free health care for life when they retire…not medicare
And to be sure many public employees can retire younger, some as young as 41
“And to be sure many public employees can retire younger, some as young as 41″
In response to another comment. See in context »Source please…
Unlikely that such a source would exists as it is a ridiculous claim.
In response to another comment. See in context »Andylevinson -
In response to another comment. See in context »Wow – you actually managed to completely contradict yourself in just two paragraphs – that’s good even for you.
In fact, you would be hard pressed to find any school district in America where the teachers do not have a state-wide collective bargaining agreement calling for continued health care at the time of retirement and beyond. So – you just couldn’t be more wrong.
I didn’t contradict myself….I was saying it isn’t 100% one way or the other…..I gave a scenario why they would come up with this magic 55 number…..
Why not just include everyone in medicare and be done with it?
That could be done in a single sentence…instead of thousands of pages…
In response to another comment. See in context »Hello andylevinson,
You asked: “Why not just include everyone in medicare and be done with it?”
The answer is because political conservatives have enough clot to prevent it. Lower the age for Medical took nine months or so get to this point and it has been a helava fight. How much more so to include everyone?
In response to another comment. See in context »Last time i looked, the political liberals hold the u.s. senate, house, and white house…..they can pass any bill they have the courage to pass….
p.s.our you aware federal employees who can retire at 55, start receiving social security payments at age 55 in addition to their federal pension…while the private sector has to wait until age 62 to receive a scaled back social security check…
In response to another comment. See in context »That may be the first thing you’ve said that I can agree with. We absolutely should include everyone in Medicare. Now, tell your representatives you feel that way.
In response to another comment. See in context »Hello andylevinson,
You wrote:”Last time i looked, the political liberals hold the u.s. senate, house, and white house…..they can pass any bill they have the courage to pass….”
It is true that Democrats control both houses of Congress, but not liberals. I was careful to say “political conservatives” and not Republicans. The ability of Democrats to pass a bill is quite dependent on “Blue Dog” Democrats and “Independents”.
In response to another comment. See in context »[...] This post was mentioned on Twitter by rickungar, Tweets Tube. Tweets Tube said: GOP returns to scare tactics on new health care compromise http://bit.ly/5rIddZ [...]
Rick,
I’m not quite following you here. The statistics you are citing do show that physicians feel that they can’t make money from lower reimbursements. If Medicare provides some of the lowest payments then it does seem likely that physicians who can get away with it will refuse to take Medicare payments. What new incentives are there to keep the better physicians in the system?
I’ve always felt that we need more doctors. Medical school enrollment has held constant for the last 20 years – let’s get more doctors in the system, and let the free market solve the problem.
misterb-
In response to another comment. See in context »1. It is true that Medicare pays about 20% less however the administration costs to physicians is about 15% less, so you have the spread of 5% that doctors are losing out on. The reform bills would alter the payment approach away from pay per service and towards a result oriented schedule where doctors can earn more for good results. This could help bridge that 5% gap for the docs while producing better results for patients.
2. I completely agree we need more doctors. We also need more doctors in primary care. Right now, only about 5% of med students are going into primary care for a profession because they are paid poorly compared to specialists. There is a lot to say about how to change this situation which maybe I’ll do in a post in the next few days. But, suffice it to say for the moment that you are absolutely right about needing more doctors and we have to focus on how to make this happen.
Funny how we have come back to the proposal that seemed to make so much sense initially, let more people into Medicare with their 4% overhead vs. the insurers with 35% overhead. Medicare is the most efficient payor we currently have since you can file online and avoid rejections and receive payments as electronic funds transferred to your bank account. We would favor Medicare over any HMO and all our physicians are Republicans.
There you have it!
In response to another comment. See in context »The government can theoretically do everything cheaper because it pays no taxes, fees etc…..
….now, the san francisco chronicle reports that the middle class will be hammered with new and higher taxes to pay for government run health
…it also says 250,000 federal workers aren’t insured because they can’t afford the premiums…..now that confirms my guess that they are lowering medicare age to accommodate government employees
In response to another comment. See in context »Uh…hmmm….they want to lower Medicare age to help federal employees afford health insurance?
Interesting theory, but makes no sense on so many levels it’s hard to know where to start. So let’s just say this -
1. The federal employees who are estimated not be able to afford premiums (despite the fact that the federal gov’t., like all employers pay a substantial part of the premium, are those who earn low salaries. By way of example, a federal employee who is a janitor makes about 30K. So, they have trouble covering their premium costs.
However, it isn’t lowering medicare that is going to help them – it is the subsidies proposed for ALL Americans that will help solve this problem.
I know you are fixated on government employees, but you just can’t bend the facts to make reality fit your particular pet peeve.
In response to another comment. See in context »I am all for putting everyone in the same boat, not have yachts for some and leaky dingys for other….let’s stick everyone in the medicare boat
Nobody has forced the federal janitor to take the $30,000 job….there is only one job in America that people are forced to too….jury duty, which pays below minimum wage
Now they want to force people to buy health care from the government or go to jail
In response to another comment. See in context »Bad idea. Medicare will be broke by 2017. Medicare denies more claims than private insurers. The first year the plan will cut 1.3 billion from Medicare for heart and cancer treatments. Many employers will drop employees and pensioners over 55 thereby forcing them into the already busted Medicare program. No money for the doctors and hospitals means no treatment. Thus,”The Complete Lives System” included in the stimulus plan could be used to designate who would receive health care. The added costs to Social Security for payments for the onslaught of retirees will be 1.6 billion per year.
Any chance you might give us some citations on some of this? Particularly the 1.3 billion cuts for heart and cancer treatments. I have a feeling you are talking about the recent CMS cuts to Cardiologists for payments on in-office equipment usage charges. While this was scheduled to impact on Oncologists also, it ultimately was not extended to the cancer docs. As for the Cardiologists, thanks to some hard work by the American College of Cardiology, the CMS is having another look as the AMA survey which led to the cuts was badly flawed. Is this what you are talking about? If not, could you point out where you are getting these numbers.
As for insolvency of Medicare, this is certainly a looming problem. However, lowering the age of participation to 55 would not come at the same premium prices. While we don’t yet know what the prices will be, the estimates are running at about $500 per month vs. about $100,. Also, your statement that Medicare denies more claims than private insurance is misleading. What this statistic does not include are the requests by physicians to do procedures prior to them being done that are disapproved by private insurance companies. As a result these claims are never put in because the insurance company tells the doctor how to practice medicine – Medicare does not do so. More claims are denied because of error in claims and fraud. Also, there are more claims put in for non-covered procedures such as cosmetic. Medicare participants put these in hoping that they will be approved precisely because Medicare does not deny covered procedures like private insurance companies do.
In response to another comment. See in context »It would be helpful if you can provide data to back up claims like these as they very much tend to mislead – not a particularly helpful tactic when people are trying to legitimately work through what it all means and what is good for them.
Hello Rick,
riffenberg is right, Medicare and Social security are going broke. Consider the following stories in the Los Angeles Times.
April 6, 1992 – “The new siren is a frank and gloomy assessment that the national trust fund that pays hospital bills for 34 million Americans on Medicare will be broke in 10 years.” The would be George H.W. Bush telling us that Medicare would be broke in 2002.
January 9, 1984 – “Some adjustments are needed to head off bankruptcy in the Medicare system. The trust fund that helps pay doctor and hospital bills for 29 million Americans will run out of money by 1990 if nothing is done” That would be President Reagan saying that Medicare would be broke by 1990.
June 20, 1980 – “Unless Congress acts, the Social Security fund will run out of money to pay retirement and survivors’ benefits by late 1981 or early 1982, the funds government trustees reported Thursday.”
May 6, 1978 – “The social security trust funds that pay benefits to retired and disabled workers will be in good shape for several more decades but the fund that pays hospital insurance under Medicare will go broke by 1990, the trustees told Congress today.” That would be President Jimmy Carter again with a “go broke date of 1990.
August 30, 1960 – “That the [Medicare] bill passed was totally uninformed and almost totally irrational made no difference; the Democratic Presidential candidate can cry that he wanted to do more the old folks and the Republican candidate can say that the Congress might have done less if he hadn’t been so busy…We said that he bill was total uninformed, and it is…Nobody knows what it is right to do about medical aid to the aged because nobody has determined how many need help….Moreover, the political promoters have not had the courage to declare bluntly that everybody at age 65 receive a government health stipend, regardless of need…”
Paradoxically only ten years ago, 1999, long after it was already bankrupt, Medicare, Social Security, and the US Treasury had surpluses!
“Rep. J.C. Watts, R-Oklahoma, chairman of the House Republican Conference, said the GOP wants 90 percent of the surplus used for the debt. In a CNN interview, he said the other 10 percent should be used to “take care of a lot of priorities we have, like prescription drugs, making sure that our education needs are met, making sure some of our national security needs are met, and doing that while at the same time protecting the Social Security surplus and the Medicare surplus.”
http://archives.cnn.com/2000/ALLPOLITICS/stories/09/27/clinton.surplus/
In response to another comment. See in context »I’m well aware of the financial difficulties in both Medicare and Social Security – as is everyone. However, that was only a small part of what riffenberg was suggesting – much of it based on incorrect or misleading data.
Medicare can and will be financially turned around because there won’t be any choice but to do os. However, turing it around will require changes, many of which are being addressed in the current legislation. there is also a very good argument to be made that by expanding Medicare to take in the younger demo, the pool tilts more in the direction of helping Medicare out of some of the financial trouble rather than the other way around.
The truth is that if we are going to make changes in the way we handle health care in this country, we have to begin with the ideas based on what is the right thing to do. Challenges will certainly be presented to be solved. But the start is to do the right thing.
In response to another comment. See in context »It can not be refuted that Medicare will be bankrupt by 2017. There is article after article on the subject on the web.
In response to another comment. See in context »I don’t buy your assertion that the number of Medicare denials for health care are skewed. Many people who have Medicare have supplemental insurance. Why? Do you know anyone with a private insurer with supplemental insurance?
From what I have read the average cost for 1 person’s premium will be about $7600 or $633.00 per month. http://www.time.com/time/politics/article/0,8599,1947063,00.html
That is not cheap. Heck is Cobra any more expensive?
Look it’s worse. Reid said, In November that the Health Care Bill will add 1.6 billion dollars more in Social Security Payments. That was before this idea about extending Medicare came up. How much more will it be? Read about it here, http://74.125.47.132/search?q=cache:CzUG1qSzpeQJ:www.cbo.gov/ftpdocs/107xx/doc10731/Reid_letter_11_18_09.pdf+reid+costs+for+social+security&cd=1&hl=en&ct=clnk&gl=us
Don’t count on the good will of the state to provide you with all the health care you will need. There is rationing in other western countries for health care. People are denied life saving drugs in other countries. These drugs are administered here, freely with our private insurers. Take for example the cancer drug Herceptin, http://www.theatlantic.com/doc/200903/postrel-drugs
I worked with a woman whose 76 year old father was denied prostate cancer surgery in Holland. His doctor told him,”After all, you are 76.” She brought him to America and he got his surgery here. It’s naive to think the money will come from somewhere. Someone will pay for it. Excuse me but they don’t pay for medical care for people all over the world. Their govt.s can not afford it. England has limits on how much they will pay for medical treatment per indiv.
Obama said,
”Loading up on additional tests or additional drugs” must be curbed. “Maybe (some would be) better off not having….surgery, but taking (a) painkiller” instead.
“the chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bill out there” – Barack Obama
June 24,2009 ABC News “Questions for the President: Prescription for America”
Why do you think Rahm Emanuels brother, Ezekiel Emanuels ,”Complete Lives System” was included in the stimulus bill? For the heck of it?
CUTS IN MEDICARE HEART DISEASE
“ I am writing of the Obama Administration’s – regulatory decision – to go ahead with a massive cut in Medicare payments to cardiologists. I emphasize that this is a regulatory decision because it was not made by the Congress legislatively (not that that would be ok) but, instead, it was made by the massive Health and Human Services Department of the US Government. Given the limited resources of the Medicare budget, in order to increase payments to general practitioners (in an effort to attract more such doctors – a good idea), bureaucrats needed to gore somebody’s ox and cardiologists were chosen (a horrible idea).
The decision to do so is astonishing.”
http://biggovernment.com/2009/12/06/health-cares-coming-heart-attack-a-pre-obama-care-death-panel-2/
Second article on subject heart treatment
Medicare:
Cuts will hurt heart disease fight http://jacksonville.com/opinion/letters_from_readers/2009-12-09/story/medicare_cuts_will_hurt_heart_disease_fight
Report: Medicare cuts would threaten profitability of one in five hospitals
“In reality he legislation is deeply regressive and proposes cuts of more than $400 billion from the government-run Medicare program for the elderly and disabled. It bears no relation to a universal health care system, and would leave an estimated 25 million people without insurance coverage. It mandates individuals and families to obtain coverage or pay a penalty, and imposes a tax on higher-priced insurance premiums held by unionized and other workers.”
http://www.washingtonpost.com/wp-dyn/content/article/2009/12/11/AR2009121102792.html?hpid=topnews
Cancer treatment
“Starting in January, payment for the administration of life-saving cancer drugs will be cut by 5 percent, with further cuts increasing to almost 20 percent by 2013. A disaster in cancer-care delivery is imminent. Why? Because cuts already in place from the start of 2009 have reduced reimbursements levels to a level that most local oncologists already cannot live with.”
http://www.lohud.com/article/20091209/OPINION/912090307/1076/OPINION03/Medicare-reimbursement-cuts-mean-disaster-for-cancer-care-delivery
Hello Rick,
I was being ironic. Medicare and Social Security have been “going broke” since before they were even begun. Further, long after it was supposed to have “gone broke” it had a huge surplus (1999). Medicare and Social Security are as “broke” as the Federal Government wants them to be.
In response to another comment. See in context »Rick, I think you kinda missed the “not-so’subtle” way Davidlosangeles was showing that medicare, according to most republicans, has been going bankrupt for close to 40 years, and yet, has not gone bankrupt.
Dave
I did miss it. Sorry david. I went back and re-read it and I should have read it more carefully the first time!
In response to another comment. See in context »Riffenberg-
It is very hard to respond to your comment because, with all due respect, you are kind of all over the place. But I’ll do my best.
1. It is completely unclear that Medicare will go broke in 2017 – if no other other reason than the legislation currently on the table looks to extend the viability by at least 9 years. That aside, as David points out, Medicare and Social Security have been going broke since before they even began. I suspect these funds will survive.
2. You are confusing costs here. When you point out the price of $7600 a year for Medicare, it looks like you are referring to supplemental programs for existing Medicare beneficiaries. If you are, then your numbers are just wrong. Medigap policies cost nowhere near that much.
If you are referring to the cost of a Medicare plan for 55+ to 64, yes, it could cost this much. However, this is an OPTION for those who cannot get health insurance and, whether you get it or not, while $600 a month is indeed very expensive, its a lot less expensive than not having health care coverage at all at the age of 55+. Further, those who already have less expensive coverage through employment will continue to have it. And, when the subsidies kick in, this cost will come down dramatically for those who need the subsidies. Meantime, Senate Dems. are looking for a way to help those who would qualify fo rhe extended Medicare before the subsidies kick in.
3. Your arugment that only Mediciare requires supplemental coverage while private insurance doesn’t is just bizarre. They are two very different things. Medicare A provides everyone with a basic level of coverage for free. Medicare B is available at a very low premium costs. But here gaps in coverage and that is why people have the option to supplement it. Private health insurance is constructed in a whole different way. So, your point is just completely lost on me.
4. You seem to veer into the are of what happens in other countries on the topic of rationing. Not sure where that fits in here. I’ve written much on the pros and cons of other nations and their systems and cannot cover it here.
5. As for the CMS limiting payments to cardiologists, you appear unclear as to what this was about. First off, I too disagreed with the decision – mainly because it was the result of a flawed survey conducted by the AMA that only got a response from about 50 doctors, many of whom are on hospital staffs who are not affected by the ruling. The decision reduces what the CMS will pay for equipment useage in physician’s offices. As I say, I think they way overdid it, but other than that, I just can’t make out where you’re going with this.