Back in 2007, I wrote about how the Bush administration was attempting to create a public climate opposed to universal single payer health care---the only sensible model---by waging war against Medicare. Here is a link to the journal I wrote then.
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x1571349Why jeopardize a social program near and dear to the hearts of so many registered voters? Proponents of single payer point to Medicare as a model of efficiency. With its low overhead, Medicare challenges the private insurers who claim that they have to tack on 20, 25 even 30% “to cover expenses.” By its very existence, Medicare reveals that claim to be a self serving lie.
In the above journal, I outlined the steps which the Republican Congress and Bush had taken to weaken Medicare. They included 1. funneling Medicare money to private managed care plans that have high overhead and which cherry pick only healthy seniors, 2. paying doctors to reduce their Medicare spending 3. draining the Medicare coffers through Medicare Part D and 4. making it next to impossible to get care under Medicare through across the board fee cuts designed to force physicians to limit the number of Medicare patients they treat.
When Junior sees Grandma being denied care under Medicare, then he will think twice about joining a single payer government sponsored insurance plan…or so the strategy goes. So far, it has not been very successful. Here is a study which analyzes public opinion about Medicare for All. When those surveyed are given more information, the number in favor approaches 70%. (Presumably the other 30% are the same folks that continued to support Dick Cheney the War Profiteer and GeorgeW. Bush the Torturer)
http://pnhp.org/blog/2009/12/09/two-thirds-support-3/Republicans may not rule in Washington anymore, but they are still up to their old tricks. Today, one of their Senators, Jim Bunning has managed to cut Medicare fees by a whopping 21%.
http://www.google.com/hostednews/ap/article/ALeqM5gC_JUxACvC2mi0yR_N2APmvp19lAD9E63FBO0Funding to temporarily stave off the cuts was part of a bill passed last week by the House. But the Senate failed to act on the one-month fix because Republican Sen. Jim Bunning of Kentucky objected that the $10 billion measure would add to the deficit.
Since this is the Associated Press, the title of the piece blames “gridlock”, but the truth is there for all to see. A
Republican who voted “yes” to fund Bush’s $3 trillion War of Choice thinks that $10 billion to keep America’s seniors from dying on the streets is too much.
Bush froze the scheduled 2008 10% fee cut. Apparently his handlers thought that this issue was too hot to handle. But a lot has changed since then. A new president and a new Congress were sent to Washington in 2008 with a mandate to fix health care. The insurance industry is growing nervous, as Democrats start to listen to the voters instead of their lobbyists. They need to find a quick way to undermine the public’s support for the most popular health care plan in the country.
In one loose cannon Republican Senator, they have found their answer. Convince Americans that their health insurance can be snatched away from them at any moment based upon the whim of one elected fruitcake, and they will begin to doubt single payer.
Ever wonder how much money Sen. Bunning has received from the health and insurance sectors? Wonder no more.
http://www.sunlightfoundation.com/projects/2009/healthcare_lobbyist_complex/This is not Sen. Bunning’s first attempt to kill Americans. Since he is from Kentucky, he has abused his power to protect the tobacco industry’s good given right to addict minors.
One of those finally approved was Miriam Sapiro, who had become the Obama administration’s prime example of stalled nominations since being chosen in April to be a deputy United States trade representative. Senator Jim Bunning, Republican of Kentucky, put a hold on the confirmation of Ms. Sapiro, an Internet policy consultant, to try to pressure the trade representative’s office to file a complaint with the World Trade Organization against Canada over a law that bans cigarettes with candy flavors.
http://www.nytimes.com/2009/12/28/us/politics/28nominees.html?_r=1Quick, how much money does the nation waste each year paying for the direct health costs of tobacco addiction and the indirect costs of lost wages? If you answered
almost $200 billion, give yourself a gold star.
Hmm. How can a man who has done everything in his power to make this country waste $200 billion a year---and recall that half of all medical spending is government spending--- get so bent out of shape over $10 billion? Seems to me this is more about rewarding his lobbyist buddies in the insurance industry than it is about reining in government spending.
What are the nation’s health insurer’s getting for their money? If the fee cuts go through, doctors in primary care (PCPs) will quickly stop accepting new Medicare patients, the way that most of them do not accept Medicaid patients. By quickly, I mean tomorrow. If you consider that an office based physician’s overhead is 50% or more, a flat cut in fees equals a much greater cut in take home pay. While doctors will hesitate to dump the elderly patients that they know, they will feel no need to keep their practices open to new Medicare enrollees. Worse yet, as older doctors retire, their elderly patient will have a hell of a time finding new PCPs. Many of them may be forced to seek care at the local indigent clinic, which will be more than happy to accept 80 cents on the dollar. Depending upon where you live, that may be a good thing for Grandma---or it may be a nightmare. And of course, many counties have no safety net for those who can not get care in the private medical community.
If Grandpa starts bitching and moaning about how worthless his Medicare coverage is, the younger generations will notice. If they see him go into a diabetic coma and die, because he could not get an appointment with an internist to follow up on his sugar, they will blame the federal government and Medicare. Suddenly, single payer government run will look like a very bad idea.
Things the fee cut will not accomplish? It will not persuade more medical school graduates to go into the primary care specialties that emphasis disease prevention which could actually cut health spending. The across the board cuts do nothing to correct the payment imbalances that favor surgeons and specialists. Cardiologists will not stop seeing Medicare. They will just start inserting more stents. Orthopedists will find time to put in more artificial hips. They will grumble about the extra hours, but Medicare spending will not decrease. The $10 billion savings that Bunning promises to deliver will not materialize. Instead, more Medicare beneficiaries will end up in the hospital in with congestive heart failure, kidney failure and other preventable diseases. Because you can legislate a cut in fees but you can not legislate against sickness.
Very likely, some compromise will be reached. Bunning will be given a concession for his tobacco buddies so that the Medicare system is not thrown into chaos. But the damage has already been done. A few more members of the public have been lead to believe that putting their health care security in the hands of Washington politicians---some of them clearly insane---is a dumb idea.
And what about last month, when the Mayo Clinic announced (and the WSJ publicizied):
Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors.
snip
Mayo is probably a leading indicator of where other hospitals and doctors are headed. Physicians on average earn 20% to 30% less from Medicare than they do from private patients, and many are dropping out of the program. While about 92% of family physicians participate in Medicare, only about 73% of those are now accepting new patients. In some specialties—neurology, oncology, gynecology—in places like Manhattan and Washington, patients can struggle to find any doctor who'll accept Medicare.
The $500 billion in Medicare cuts planned as part of ObamaCare won't help this trend. The hospital industry agreed earlier this year to chip in $100 billion over the next decade in lower annual payment increases for Medicare. The chief Medicare actuary estimates that up to 20% of hospitals could become unprofitable as a result of the scheme.
http://online.wsj.com/article/SB10001424052748703436504574640711655886136.htmlThere goes another nail in single payer's coffin.
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