McConnell Gambles on Real Medicare Cuts

May 14th, 2011 at 12:00 am | 43 Comments |

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After months of proposing symbolic actions (cuts in domestic discretionary spending), remedy decent if politically risky ideas (the Ryan Medicare reform) and one truly terrible one (we’ll default on the debt but, cialis by paying foreign bondholders ahead of Social Security beneficiaries, we’ll somehow avoid “real” default), the Republican Party is, at last, talking about serious entitlement reform.

Senator Mitch McConnell’s decision to put Medicare—the single biggest entitlement program—in the spotlight makes a lot of sense. Nearly everything McConnell has said about the program  (its out of control costs and the need for reform) is right. If he actually wants to achieve reform and is willing to take big political risks to do it, the best place would be to start in the obvious one: current Medicare benefits. Although difficult, such changes can be made in a way that doesn’t seriously harm current beneficiaries. It could get past the White House and Senate, and would make real budgetary progress.

Here’s the logic. Short-term cost savings changes—which, as a practical matter, would need to involve a return of the “capitation” (basically provider fee caps) that was key to the 1990s Medicare reforms—offer the key to saving money right away without raising taxes. Other plans, including Paul Ryan’s, would let costs continue to grow until an entirely different system kicks in a decade or so hence.  Plans to cut in the future (which both parties have made a lot of) can be changed before they take effect. Cuts now, obviously, take place now.

Capping and even cutting provider fee reimbursements is the least bad option for containing costs. Wages in the medical sector, for all job types and skill levels, are already higher than those in any other of the 11 major private employment sectors the Bureau of Labor Statistics monitors.  Since nearly all medical jobs are skilled, prestigious, and higher paid than similar ones elsewhere in the world, furthermore, providers have no place to go. Although they’ll complain mightily, cutting government payments now won’t cause an exodus from the medical field. Yes, some specialist waiting lists will probably grow and creature comforts may disappear from a few hospitals but medical care itself probably would not suffer. (I’m not sure that Medicare should be paying for the lattes, hardwood-floor private rooms, and hotel-like dinner menu the hospital closest to me offers inpatients.)

Although Democrats will surely complain and blame Republicans for any ills that result, short-term cuts to Medicare that include real deficit reductions will be hard for the Senate to ignore or the President to veto.  So long as no benefits are actually removed—pretty easy—both parties can take credit for  “protecting” the program and “preserving” its future. Anyone who would oppose such cuts, once they pass the house, can be seen as the enemy of deficit reduction.

The effects of cutting payments right away, furthermore, would happen now. Since the savings from payments would accrue every year starting immediately, future cuts and reforms could be a lot less painful and controversial. Sure, immediate cuts to Medicare aren’t the most politically popular option and would almost certainly cost Republicans a handful of House seats and perhaps a Senate seat or two. But they’re the right thing for the nation’s future.


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43 Comments so far ↓

  • rbottoms

    Talk about whistling past the graveyard.

    Understandable since all the GOP leaders look like undertakers.

    We’re going to take the Ryan plan and rhetorically beat you to death with it.

    Here we thought gay bashing, anti-science fantasy, inept war fighting, and an obsession with women’s vaginas would have done it, but apparently all selfish old white people — GOP voters — care about is their own Social Security and Medicare.

    Hey, whatever works.

  • Graychin

    But WHY do Republicans want to cut Medicare? We know that their hand-wringing over (future) deficits is fraudulent. They’re the same clowns who gave us a VERY expensive prescription drug benefit just a few years ago – and simply swiped Uncle Sugar’s credit card to pay for it.

    No, it’s not about deficits. Deficits are just a pretext for some ideological haymaking while R’s perceive that the sun is shining. The deficit “crisis” is an excuse to start dismantling all the popular “socialism” that R’s have fought bitterly since the New Deal – most of all Social Security and Medicare. And also Medicaid, which benefits no one except all those lazy poor people.

    • arvan

      The simple answer is that they don’t, they just want to use Medicare “reform” to accomplish other objectives, including, but not limited to: repealing the AHCA, giving tax cuts to the rich, and denigrating the enemies of the party (the educated, the young, union laborers, minorities).

  • hisgirlfriday

    Why is anyone supposed to care what McConnell puts on the table? He was totally irrelevant in continuing resolution debate and he’s totally irrelevant on this one as well.

    Also, did Eli miss that the Senate GOP under Toomey put out a budget that actually spends more on Medicare than Obama is proposing?

  • Hunter01

    Rather than deal with the main cost problem of Medicare (extraordinary measures at the end of life), we will now demonize physicians for earning more than some other professionals. That med students work harder and go to school longer than other students in professional schools; that they must do a three- or four-year residency on top of med school (with torturous hours for minimum wage); along with a one- , two- or three-year fellowship after residency should they want to specialize; and then carry tuition debt much larger than lawyers, dentists, accountants, or engineers, for example; and that is just the beginning of the burdens placed on physicians, but, well, you get the point. No need to mention malpractice litigation and insurance, the endless fights with HMO claims agents, etc.

    And so, my fellow Republicans, let’s drag out the pitch forks and the torches once again. Screw those docs with their fancy white coats. Lets trash their income and diminish the profession and services we all need. We are Americans and we are Republicans — we don’t need no stinking elitist professionals.

    Long live Mitch and Sarah!

  • valkayec

    While the GOP House and Senate keep repeating in budget discussions “cut Medicare expenditures”, their ads go out across America chastising Democrats for cutting wasteful corporate Medicare expenditures and attempting to rein in costs of unproven and needless expenditures.

    Somebody please explain to me why this dichotomy exists yet no one is picking up on it?

    • grayarea

      It’s based on the myth on the american dream. Note other countries embrace Culture or the wealth of their nation. The US is all about the dream of the individual, go west, son you can be president too. Other countries know that the individual can only really be wealthy if the country is. This fact or ‘socialism’ is not accepted in the US, and the cognitive dissonance that tries to weld it together is achieved in a euphoria of national pride/superiority… a dream state, or as George Carlin said, ‘they call it a dream cause you have to be asleep to believe it’

    • rbottoms

      Somebody please explain to me why this dichotomy exists yet no one is picking up on it?

      Because Republican leaders know Republican voters are stupid.

      Stupid by lifestyle (Fox News is my only source for information), stupid by inclination (Trump 2012), and stupid by design “Don’t retreat, reload.”

      As long as whatever it is the government spends doesn’t go to The Blacks, tm then it doesn’t matter to them. Slashing costs related to doctors will impact the poor and the black, so they don’t give a sh*t, and while most Republicans aren’t black, a hell of a lot of them sure are poor and they vote against their own interests every two years.

      I know why Mary Landrieu votes with the oil companies, she represents an oil state, Louisiana but try to make sense of why some idiot GOP voter in Idaho opposes stripping $21 billion dollars of their tax money going to subsidies to Exxon? Because Rush says it’s bad, so its bad.

      Stupid. Selfish. Dumb.

      Raise tax rates on people making an adjusted gross of $250,000 or more.

      Eliminate welfare for corporations.

      Eliminate welfare for mega farms.

      Add a lousy dime to the gas tax.

      If you are Republican it is an article of faith that you need to oppose those things every two years though it would fix the goddamn deficit, so you are stupid.

  • KellyRek

    The Medicare cuts involving capitation would result in healthcare providers to prefer younger patients with private insurance — more money to be made off of them. Already, the Mayo Clinic here in Glendale, Arizona rejects Medicare patients.

    A solution, to empower Medicare patients from the negative consequences of capitation, is the Medicare Patient Empowerment Act. This will allow the Medicare recipient to pay extra money out of his/her own pocket to the provider … to help boost the stingy Medicare reimbursement and equalize it to the market price levels. Otherwise, the elderly will become pariahs and viewed as indigents by the healthcare providers.

    Already, the kidney dialysis patients — under Medicare — receive horrible treatment. The Atlantic magazine did an exposé on this in the December 2010 issue. With the capping of Medicare reimbursement rates, the quality of care will only worsen.

    Below are the links:

    The Medicare Patient Empowerment Act (article) … http://www.robertsewellmd.com/About/Blog/tabid/195/PostID/42/The-Medicare-Patient-Empowerment-Act.aspx

    The Medicare Patient Empowerment Act (bill’s summary) … http://www.leecountymedicalsociety.org/MedicarePatientEmpowermentActSummary.pdf

    “God Help You. You’re on Dialysis” … http://www.theatlantic.com/magazine/archive/2010/12/-8220-god-help-you-you-39-re-on-dialysis-8221/8308/

    • ram6968

      looks like mpea is just a roundabout for ryan’s budget……push the cost onto the patient

  • KellyRek

    [@Comment is awaiting moderation ... below is the truncated version of my original post. To view the links for the related material, just click onto my name to visit my blog and search article title: "Changes to Medicare."]

    The Medicare cuts involving capitation would result in healthcare providers to prefer younger patients with private insurance — more money to be made off of them. Already, the Mayo Clinic here in Glendale, Arizona rejects Medicare patients.

    A solution, to empower Medicare patients from the negative consequences of capitation, is the Medicare Patient Empowerment Act. This will allow the Medicare recipient to pay extra money out of his/her own pocket to the provider … to help boost the stingy Medicare reimbursement and equalize it to the market price levels. Otherwise, the elderly will become pariahs and be viewed as indigents by the healthcare providers.

    Already, the kidney dialysis patients — under Medicare — receive horrible treatment. The Atlantic magazine did an exposé on this in the December 2010 issue. With the capping of Medicare reimbursement rates, the quality of care will only worsen.

  • KellyRek

    If my above post shows up later as duplicates … then my sincere apology. I was receiving this message, “Your comment is awaiting moderation.”

    Please help me out, my fellow colleagues … is posting links okay with the FrumForum administrators? (When I deleted the links in an edited version of my article, it then got posted immediately.)

    • valkayec

      Two links are okay. Three links causes a wait for moderation. It usually takes a couple of hours.

  • Stan

    McConnell may be premature in saying it, but he’s right about capping Medicare fees. I have doctors in my family. They earn, on average, about twice as much per year as their European counterparts. I’m happy that their annual income is five times the American median family income. But I don’t want it to go to ten times or twenty times, and that’s what we’re likely to see if the Affordable Care Act succeeds in increasing demand for medical services. Physician incomes and payments to hospitals and to the pharmaceutical industry have to be held down to something like the annual inflation rate if more drastic changes to Medicare are to be avoided, and the only effective way of doing this is through governmental action. So I applaud Mitch McConnell for his realism and his courage.

    • joanna

      you do realize that European doctors pay much less for their education? and they do not have to pay horrendous amounts for the malpractice insurance.?

    • ram6968

      if the healthcare plan leads to increasing demand for medical services…..an assumption on your part…doctors visit, $100…..emergency room visit $500

  • ottovbvs

    Since it’s provider costs that are at the heart of Medicare’s budget problems then McConnell is at least pointing in the right direction. As indeed does Obama’s ACA. Ryan’s proposal on the other hand was aimed in the opposite direction of restricting access by pricing out usage. There are two fundamental reasons why the US is spending roughly twice as much anyone else on healthcare and neither have anything to do with access since everyone else provides universal access and we don’t. The principal reason for our inflated expenditure is quite simply that we have a delivery system geared to increasing costs by maximising expensive paid procedures and tests. Secondly the method by which we fund much of the private sector (ie. health insurance) is a classic rent seeking mechanism. On this topic there’s an article in today’s NYT describing how insurance companies are making record profits but are still pushing for double digit increases in premiums. As Stan observes above the real income of doctors is about 2.5 times that to be found in the Euro zone. At the same time we spending roughly 2.5 times what the Euros are spending on drugs. At bottom these are the reasons why medical inflation is running at 8-10% a year while general inflation is at around 2%. There is no other explanation because the characteristics of all these other health markets are exactly the same as ours. There’s the same propensity to use healthcare and the same aging populations who tend to consume vast amounts of healthcare expenditure in their last years.

    Although McConnell is pointing in the right direction capitation is a bit of a blunt instrument and unlikely to work. We actually already have theoretical capitation of doctors reimbursement rates as it happens. Some 45 million Americans receive Medicare coverage. For doctors who accept Medicare, federal law requires that reimbursement rates be adjusted annually based on formula tied to the health of the economy. That law says rates should be cut every year to keep Medicare financially sound. But Congress has blocked those cuts from happening in eight of the last nine years and this is as much due to Republicans as Democrats . So what are the chances that any capitation scheme is likely to work? Not high. If McConnell is serious (not likely on past performance) his proposal at least means there will be focus on the cost issue.

  • Londo

    Republicans applauding government regulation to cap private sector income? Am I on Candid Camera?

  • indy

    Exactly. CBO projections are that in the absence of changes in federal law total spending on health care will rise from 16% of GDP in 2007 to 25% in 2025, 37% in 2050, and 49% in 2082.

    This problem is bigger than just changes in Medicare. Structural changes in the delivery system are crucial.

  • jg bennet

    We don’t need cuts to Grandma’s meager existence we need revenue in the trillions!

    I don’t know about you you guys but depending on the politicians who got us in this mess to get us out of it is the height of stupidity and is a lot like asking an active crack addict for advice on sobriety.

    So why is it we are broke and looking to cut off grandma?

    The following are 28 statistics about the gutting of the U.S. economy that will blow your mind….

    #1 According to the U.S. Department of Commerce, the U.S. trade deficit for the month of March was $48.2 billion. That was up from $45.4 billion in February.

    #2 The United States has had a negative trade balance every single yearsince 1976.

    #3 Between December 2000 and December 2010, the U.S. ran a total trade deficit of 6.1 trillion dollars.

    #4 The U.S. trade deficit with China in March was $18.1 billion. This is money that is not going to support U.S. businesses and U.S. workers. If that money was actually going to our businesses and to our workers it would increase tax revenues.

    #5 Since China entered the WTO in 2001, the U.S. trade deficit with China has grown by an average of 18% per year.

    #6 During 2010, we spent $365 billion on goods and services from China while they only spent $92 billion on goods and services from us.

    #7 Since 2005, Americans have gobbled up Chinese products and services totaling $1.1 trillion, but the Chinese have only spent $272 billion on American goods and services.

    #8 The U.S. trade deficit with China in 2010 was 27 times larger than it was back in 1990.

    #9 According to a recent report from the Economic Policy Institute, between 2001 and 2008 the United States lost 2.4 million jobs due to the growing trade deficit with China. Every single state in America experienced a net job loss due to our trade deficit with China during that time period.

    #10 The United States has lost an average of 50,000 manufacturing jobs per month since China joined the World Trade Organization in 2001.

    #11 The United States has lost a staggering 32 percent of its manufacturing jobs since the year 2000.

    #12 Between December 2000 and December 2010, 38 percent of the manufacturing jobs in Ohio were lost, 42 percent of the manufacturing jobs in North Carolina were lost and 48 percent of the manufacturing jobs in Michigan were lost.

    #13 Back in 1970, 25 percent of all jobs in the United States were manufacturing jobs. Today, only 9 percent of the jobs in the United States are manufacturing jobs.

    #14 China produced 19.8 percent of all the goods consumed in the world last year. The United States only produced 19.4 percent.

    #15 According to the IMF, China is going to have the largest economy in the world by 2016.

    #16 Nobel economist Robert W. Fogel of the University of Chicago is projecting that the Chinese economy will be three times larger than the U.S. economy by the year 2040 if current trends continue.

    #17 Back in 1998, the United States had 25 percent of the world’s high tech export market and China had just 10 percent. Ten years later, the United States had less than 15 percent and China’s share had soared to 20 percent.

    #18 Manufacturing employment in the U.S. computer industry was actually lower in 2010 than it was in 1975.

    #19 In 2002, the United States had a trade deficit in “advanced technology products” of $16 billion with the rest of the world. In 2010, that number skyrocketed to $82 billion.

    #20 Last year, China produced 11 times as much steel as the United States did.

    #21 Do you remember when the United States was the dominant manufacturer of automobiles and trucks on the globe? Well, in 2010 the U.S. ran a trade deficit in automobiles, trucks and parts of $110 billion.

    #22 In 2010, South Korea exported 12 times as many automobiles, trucks and parts to us as we exported to them.

    #23 According to one recent study, China could become the global leader in patent filings by next year.

    #24 China is now the number one supplier of components that are critical to the operation of U.S. defense systems.

    #25 In 2010, the number one U.S. export to China was “scrap and trash”.

    #26 Thanks to our exploding trade deficit with China, the Chinese have accumulated nearly 3 trillion dollars in foreign currency reserves. That is the largest stockpile of foreign currency reserves on the entire globe.

    #27 The amount of the trade deficit that can be attributed to foreign oil is at the highest level that we have seen since 2008.

    #28 It is being projected that for the first time ever, the OPEC nations are going to bring in over a trillion dollars from exporting oil this year. Their biggest customer is the United States………

    • ram6968

      get a copy of alvin tofflers, “the third wave” then get back to me on that trade deficit nonsense

  • bamboozer

    To quote Mr. T “You goin’ down fool! “. Ryan’s budget let the cat out of the destroy Medicare bag and just excluding todays recipients is not going to close it back up. For some reason people on Medicare seem to care for thier childrena and want them to have what they have. And one more time for the Conservatives: Until The Military Is Cut Back And The Wars Ended This Whole Thing Is Nothing More Than An Attempt To Destroy Medicare And Social Security. And we all know it, including Melting Face Mitch.

  • Stan

    I refer everybody to this article:

    http://www.huffingtonpost.com/richard-kirsch/health-care-costs-_b_860601.html

    In it, Richard Kirsch, quoting an earlier study by Uwe Reinhardt, notes that prices for medical services in the US are much higher than the corresponding prices in Canada and western Europe. That’s why our medical costs are twice theirs, even though we spend less time in contact with physicians and in hospitals. Reinhardt ascribes this to weakness by the American insurance industry in negotiating medical prices as compared to corresponding organizations in the other OECD countries and to high administrative costs in the American insurance industry. Kirsch quotes some of the eye opening differences in the prices for various medical services, starting with how much it costs for an office visit in France and the US. In a recent Economix blog, Reinhardt discusses why he thinks market forces do a poor job in containing medical costs. From all this I reach the conclusion that if we don’t use governmental action to control medical costs either a substantial chunk of the American population is going to lose access to health care or we’re going to spend an ever increasing fraction of our national income on medical services. So I again say, right on, Mitch!

  • armstp

    It blows my mind that the GOP are the same guys to campaigned in 2010 against the Democrats and “Obamacare” based on scarring seniors that the Dems were going to take away their Medicare. The ran tens of millions of dollars worth of adds about Medicare.

    Republican exaggerations about cutting Medicare
    By Angie Drobnic Holan
    Published on Monday, October 11th, 2010 at 4:38 p.m.

    During the debate over health care reform, Republicans often complained the Democratic plan would cut Medicare. They are now repeating those attacks in campaign ads against many Democratic candidates, targeting older voters who may be worried their Medicare benefits will be harmed.

    In Florida, the conservative 60-Plus Association took aim at Democratic members of Congress Allen Boyd, Alan Grayson and Suzanne Kosmas. The ad said the new health care law “will cut $500 billion from Medicare. That will hurt the quality of our care.”

    In Pennsylvania, the Republican-controlled group Crossroads GPS attacked Democratic Senate candidate Joe Sestak, saying he “voted to gut Medicare … reducing benefits for 854,489 seniors.”

    In California, Crossroads GPS said Barbara Boxer “voted to cut spending on Medicare benefits by $500 billion, cuts so costly to hospitals and nursing homes that they could stop taking Medicare altogether.”

    http://www.politifact.com/truth-o-meter/article/2010/oct/11/republican-exaggerations-about-cutting-medicare/

    .

    Will 2010 Medicare ads come back to haunt GOP?

    http://www.cbsnews.com/8301-503544_162-20050995-503544.html

  • Rob_654

    1) I think that the American people are mature enough (at least sometimes I think so) to have a serious discussion and do something about the huge costs associated with end of life medical costs.

    2) As for reducing payments – I agree that Doctors put in a huge amount of time in school and the costs associated with it, however, there are not many professions in this country that are essentially guaranteed lifetime employment at very nice salaries. I think that not just Medicare but that insurance itself needs to look at some of the costs associated with health care and are the doctor’s salaries sustainable? I don’t think that they are. If doctor’s see their salaries take a hit – and if they want to quit and find another job (good luck making the same salary with the same basic job security) – and will it make people not go into the medical field? I doubt it – again becoming a doctor will still be a profession that pays much higher than the average job out there and will ensure lifelong employment.

    • joanna

      “….will it make people not go into the medical field? …”

      yes, we already have a shortage of doctors,which is supposed to grow even more. As a disclaimer, I do manage my husband’s private practice (part-time for now). Our fees are very average in the field, but we do not accept Medicare and Medicaid at all (only through commercial insurance that we are contracted with) – their proposed fees are basically half of our fee for service charges, and about 60-70% of commercial insurance rates. And in order to deal with all the paperwork, i would have to hire extra person, and this is another cost. if you cut medicare fees, good luck with finding a doctor. These high high salaries – maybe if you are a ob-gyn or surgeon, or some other expensive specialty., and own a big practice, where other work for you too.

      • joanna

        one of the problems is, that fewer doctors now go into pivate practice now – intstead they join big hospital organization, etc, where they get to work office hours, wiht benefits, no administrative hassle, more family time. These big organizations, due to their size, have much better bargaining power wiht insurance companies. I have seen my husband’s employer contract with one of the insurance companies, – it was around 140% more than what they offered us in private practice for the same doctor’s service. Our rate was so low, it was obvious, they just do not want us in the network.

        I also think the procedures and cost of equipment are very often overcharged, much more than doctor’s visit. I have to get nebulizer for my daughter – the cost of this thing was $400 (mostly paid by insurance) – but this is nothing more than simple motor in the plastic cover, that supposed to blow air into the pipe. it it purpose wasn’t medical, it coudn’t have cost more than $50….. I’m sure this is not the only example of overpricing just because they can.

      • ottovbvs

        Obviously everyone’s circumstances are different but the fact is doctors incomes in the US are over twice those in Europe. And they are operating in a system that encourages treatment because it boosts revenue and hence income. I’ve had this conversation with a couple of doctor friends of mine and basically they agree because as you’ve just described Joanna you’re running a business, not a branch of the social services.

  • Rabiner

    Stan:

    Wouldn’t you need to reform how Doctors become Doctors if you were going to cut their pay significantly? The amount of debt a doctor incurs almost makes it necessary for them to be overpaid. If they had a reasonable debt load after their training I could see a reduction in payments for their services but until that time, it just isn’t a feasible solution. You could have Federally subsidized medical education as a short term solution but long term you’d need to change the system entirely.

    • ottovbvs

      The amount of debt a doctor incurs almost makes it necessary for them to be overpaid.

      So we have run a healthcare system at twice the cost of everyone elses so that Doctors can pay their student loans? Are you serious? I don’t dispute the cost of medical ed is a problem but it’s a stretch to use it as a justificative for the most expensive healthcare system in the world.

    • Stan

      Rabiner, I understand what you’re saying but I’d have to see some numbers before agreeing with you.

  • Frumplestiltskin

    you want to fix medicare, then institute single payer and have money from healthy people flow into the treasury instead of insurance company pockets. There, problem fixed.

    • ottovbvs

      There, problem fixed.

      Not really. The major problem is the cost of providing care. Rent seeking insurers are part of the problem but the lesser part.

  • Fozz

    Wow, even Paul Krugman is not as hellbent as “Eli Lehrer” on exclusively punishing physicians, while giving predatory insurance companies and tort lawyers a free pass.

    What a scum.

  • Fozz

    Doctor’s incomes are only 10% of health care costs, and unlike health insurance premiums, doctors’ incomes have not exactly skyrocketed in the past 20 years. There are different causes to this problem.

    I see Eli Lehrer as a one-sided demagogue who wants doctors to drown in debt while being paid peanuts.

  • Stan

    Fozz, doctors are not paid peanuts, at least by my standards, but I agree that their salaries are only part of the problem. I’m not arguing that physician salaries should be decreased. I’d just like to see some way of holding their yearly increases and the increases in hospital bills to something like the inflation rate for the Consumer Price Index.

  • Fozz

    I agree that doctors are not paid peanuts, but they will be if their reimbursements get slashed, and if they bear the brunt of the cuts that are made to save Medicare (which is what Eli Lehrer seems to be advocating). AARP doesn’t want Medicare seniors to have any costs shifted to them, DC lawyers will not support malpractice reform, the insurance industry has many, many politicians in their deep pockets, and so does the pharmaceutical industry.

    I think some specialties like Dermatology and Anesthesiology are overpaid, but most primary care doctors are underpaid given their level of education and training, and I’d hate to see their income get cut further since they will greatly be needed when the Baby Boomers retire.

  • joanna

    ….”I’d just like to see some way of holding their yearly increases and the increases in hospital bills to something like the inflation rate for the Consumer Price Index.”…

    Doctor’s pay it’s not a biggest part of hospital bills. When I looked at the bills for delivery of my two kids, doctor’s fee was between around 15% of the total cost. The epidural cost more (administered by RN) than the doctor. Ob-gyn – $1450 , epidural – $1800, the total bill: over $10,000. must be the food….

    • ottovbvs

      No one says doctor’s pay is the entire problem. Of course it’s not. But it’s part of the problem. The facts are there for all to see. Doctors collectively are making more than twice as much as their peer groups elsewhere. This doesn’t mean the distribution of income among doctors is equitable, it’s well known for example that interns don’t get paid too well and that young doctors are fleeing primary care because it’s not as well remunerated as specialisms. None of this alters the basic facts. Having a baby in this country for whatever reason costs $10-15,000 whereas it costs less than half that in France or Britain. Cat scans in the US are in the $1000-1500 range whereas in Japan it’s around $100 and in France $600. Ultimately this is a zero sum game and the only way you are going to contain Medicare and healthcare costs generally is by reducing the amount received by providers.

  • mickster99

    “Reform” is Republican-speak for elimination of a “socialist” program they have hated for decades. No one is fooled by McConnell/Ryan and “reform”.

    Medicare is not an entitlement. It is government administered health insurance plan that people pay into every pay check for life. It was passed with the approval of an body of representatives duly elected by citizens of the U.S. There is no “entitled” involved.
    No more than buying life insurance is an entitlement.

    Reducing health care cost should be about actually reducing the cost of health care.
    Eliminating Medicare will not make health care cheaper.

    Indeed the CBO says Ryan’s plan will increase the cost of health care for those 65 and over when compared with existing Medicare.

    Republicans need to just be honest.
    They want to end Medicare. Plain and simple.
    They need to stop hiding behind weasel words like “reform” and “entitlements”.
    They want to end government single-payer health care for seniors.
    Plain and simple.
    See. Very easy. No weaseling.

  • mickster99

    The Affordable Care Act has 500 billion in Medicare cuts over 10 years.
    That of course the despicable Republicans demagogued these cuts their benefit (along with “Death Panels”) to their benefit in the 2010 elections.
    Now the Teabagger Frosh are complaining to the WH about using Medicscare tactics.
    Now that the election is past, hey, we got this great idea, lets cut Medicare.
    See what guts we have discussing reform of Medicare.
    And the courageous Ryan can hide his plan’s health insurance mandates and huge taxe cuts the stinking rich and for corporations (see the Bonfire of the Vanities-like performance of big oil CEO’s on tv if your stomach can handle it)
    Pathetic and vile, they are.

  • nuser

    Sometimes at night I wake up in a cold sweat,believing McConnell is next to me , or oh’ God….