Congress has been procrastinating on an action that is critical to protect health care access for seniors and military families in Maine and across our country. It has put off getting rid of the broken Medicare physician payment formula, which threatens access to care for millions of Medicare and TRICARE patients by frequently threatening drastic cuts. If Congress does not act now, a 27 percent cut is scheduled to hit physicians who treat seniors and military families on March 1.
The looming cut would force many physicians to limit the number of Medicare and TRICARE patients they see in their practices. We’re already seeing some signs that seniors are having trouble accessing Medicare physicians. Twenty-two percent of Medicare patients looking for a new primary care physician had trouble finding one, according to a 2010 report from Congress’ Medicare advisory committee. A 27 percent cut on March 1 would make this much worse.
Preserving access to health care for seniors and military families in Maine is critical. Close to 20 percent of Maine’s population relies on Medicare or TRICARE for health care coverage. Compared to the rest of the country, this puts Maine at an above average proportion of Medicare patients. Yet, there are only 14 practicing physicians per 1,000 Medicare patients in Maine, which is below the national average.
Instead of stabilizing Medicare and TRICARE by fixing the problem, Congress has made it worse over the past decade by passing 13 costly, short-term patches that only delay the cuts. These short-term patches have increased the cost to taxpayers for permanent elimination of the formula from $48 billion in 2005 to $300 billion today.
If Congress continues to spend more money to keep this broken system in place, the cost will double again in five years to $600 billion. The scheduled cuts are becoming steeper and the cost to taxpayers greater the longer Congress stalls. The cost for Congress to fix this problem will never be less than it is right now.
In order to permanently eliminate this problem, Congress must work in a bipartisan fashion to get rid of the broken Medicare physician payment formula. This will protect access to care for seniors and military families and stop increasing the cost to taxpayers. It is the fiscally responsible way to stabilize the Medicare and TRICARE programs that nearly 300,000 people in Maine rely on.
There is a unique opportunity right now to use projected spending for the wars in Afghanistan and Iraq to eliminate the flawed formula and protect access to care for seniors and military families. As operations in Iraq and Afghanistan wind down, projected spending that won’t be used on the wars becomes available to ensure access to care for our military and seniors — without adding to the nation’s deficit. Passing up this opportunity would leave Congress with an even more costly problem to resolve in future years, requiring even more difficult choices.
Poll results show that 94 percent of Americans believe a cut, such as the 27 percent cut scheduled for March 1, is a serious problem for those who rely on Medicare. Patients, physicians and taxpayers need to make their voices heard. This month is critical for Medicare and TRICARE patients in Maine and across the country.
Now is the time to contact Maine’s members of Congress and tell them to eliminate this broken formula and preserve access to health care for seniors and military families. By accessing the AMA’s Patients’ Action Network at www.patientsactionnetwork.com or calling 888-434-6200, you can learn more about this important issue and identify and contact your federal legislators. Please join us in telling Congress that the time for a permanent solution to this ongoing problem is now.
Peter W. Carmel, MD, a pediatric neurosurgeon who practices in Newark, N.J. is president of the American Medical Association.
The intransigent GOP members in the house refuses to act on any long term issues. The cost curve continues upwards. Candidates run on eliminating the only law that can slow the growth of health care expenses that are strangling family budgets and our broader economy. They offer no solution except saying “not that”.
Within a year of offering a public option, rates will begin to moderate if not actually start to fall. When you have protected oligopolies, there is not true competition. Free markets can be a vital part of the solution but not without a public option. The insurers will seek efficiency only when they have a competitive reason to do so. For now, the same profiteering will continue and families will have to suffer more of the premium increases that have been unrelenting for over a decade now.
Congress will not act because they do not stand up and admit the nature and extent of the problem. Our politicians have been dishonest with us and we need to demand better.
If you are sick of looming budget deficits at the state and federal level, there is only one way out in reality. That is to address the health care cost curve by bringing about a public option. We have a choice: either the insurers get a few more years of excess profits and the deficits explode or they don’t and the people get a public option that will restore free market conditions.
Not to mention raising revenue by allowing the rich and corporations to pay their fair share. They benefit from society also, let them contribute to it.
A public option will always appear cheaper than the free market. Not because it actually is cheaper, but because it will always be subsidized with taxes in one way or another. Those subsidies may be direct and open or hidden by cost shifting certain expenses either to providers or other government agencies. This cost shifting is most apparent in Medicare where the cost of collecting the “premiums” is part of the IRS expenses and also is partly paid for indirectly by employers. Cost shifting and other accounting tricks allow the administration to say that Medicare has an administrative cost of around 3 or 4 percent. If private insurers could use the same accounting tricks they would have the same numbers.
Maine’s experience with the failed Dirigo health plan shows how this works. For those receiving direct subsidies the plan looks great. Their apparent cost of insurance appears low compared to private insurance. If you are one of the few not getting a subsidy then Dirigo actually costs MORE than private insurance. Everyone getting Dirigo should get a monthly statement showing the true cost of their insurance and a line showing the amount being subsidized by taxpayers.
The real effect of a public option will be to make private insurance non-competitive and to eliminate it over a few years. Private insurers are required to play by a different set of rules that a public option is exempted from.
If it is only the GOP that is standing in the way of real Medicare reform they why wasn’t this problem handled in the first 2 years of Obama’s presidency when congress was in complete Democratic control?
The truth is that politicians in both parties recognize that Medicare is unsustainable as it now exists. They won’t tell us the truth because they know that if they did people will know that they have been lied to for years. The backlash will be extreme and politicians will be removed from office. By kicking the can down the road they keep themselves in power and hope to pass the problem on to someone else. Problem is that we are running out of road.
The real reason for premium increases is that the total cost of health care has increased. You can trace these increases to several sources. Government mandates, rules, and regulations are a major cause, usually imposed with the best of intentions and without any consideration of eventual costs. An aging population is another major cause. And the big one, advances in health care that keep people alive longer and save people who previously would have died. Take for example the costs associated with that young girl who just had the multiple organ transplants. I was told that in one recent year that fully 50% of the total cost of EMMC medical-insurance costs for it’s employees was spent on a half dozen individuals. I believe I was told that all of them involved organ transplants as well as other major health issues.
As long as you continue to paint this as a political issue with one side blaming the other the real issues will not be addressed. And that is how most of the politicians want it to stay.
Dirigo is a poor comparison because the program lacked the key to any successful insurance program, that being sufficient enrollment. If Dirigo had been open to all residents, and was supported with the subsidies that the Federal gov will offer through the Affordable Care Act, the outcome would have been entirely different.
This is not a matter of blaming one party or another. The GOP has failed to present an alternative. they simply speak in terms of repealing the ACA.
No action and repeal does not do the State or nation any good in terms of dealing with the impacts of rising costs in health care. Our deficits are the result of this rise in costs. There is no single factor with more leverage at any level of government. To ignore health care costs while claiming to be interested in reducing deficits is intellectually dishonest.
I guess you overlooked the fact that the reason enrollment was not open to all residents was because the state could not afford the massive subsidies that would have been required. Just where do you think those subsidies were going to come from? And the ACA has same problem. The promised subsidies are going to amount to billions of dollars that has been under estimated on purpose for political and ideological reasons.
Thank you for saying ” To ignore health care costs while claiming to be interested in reducing deficits is intellectually dishonest.”
Seeing that the ACA does nothing to honestly control costs. Other than the hidden bureaucracies whose whole purpose is to institute rationing.
The ACA is full of cost saving measures. This combined with increasing the number of people covered by insurance and access to exchanges are all improvements that the current system does not foster.
You still have yet to offer any alternative. You do realize that there is no way to balance budgets without making some big changes. We need alternatives, not just criticism.