Month: July 2011

Medicare at 67: The next big change?

By Jennifer Haberkorn, Politico

President Barack Obama and House Speaker John Boehner failed to strike a “grand bargain” on the nation’s deficit, but they may have pulled off another trick: revolutionizing the debate over Medicare.

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NY Daily News editorial & my letter to the editor

From the Daily News:

You think the debt crisis is bad now? Wait until Obamacare takes its toll, By Andrea Tantaros

One of the main reasons for enacting Obamacare was to bring down health care costs – so said the President, then-House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid. But since its passage, the sweeping overhaul of one-sixth of our economy has done just the opposite. If you think the debt debate on Capitol Hill has revealed that this nation is on the road to fiscal ruin, just wait until health care reform really kicks in.

The Congressional Budget Office will tell you that we will save $143 billion between 2010 and 2019, but its assumptions were flawed from the start. Doing a close analysis of the budget office scoring, Kathryn Nix of the Heritage Foundation concludes that Obamacare “indisputably represents a massive new burden on current taxpayers and future generations.”

Those costs are evident already. “Health care costs are expected to increase by 8.5% in 2012 – slightly up from this year’s increase of 8%, according to the annual ‘Behind the Numbers’ report on medical costs recently released by [PricewaterhouseCoopers’] Health Research Institute,” says the online publication Small Business Trends.

Part of that increase has to do with the fact that many of the nation’s hospitals are buying up physician practices or consolidating with other hospitals to form conglomerates that are able to muscle insurers more than ever before for higher fees for service.
But the other factors that have contributed to the spike are the provisions in Obamacare that took effect immediately.

Insurers are now forced to cover patients despite any preexisting conditions. They are also required to provide preventive services and cover children as their parents’ dependents up to the age of 26. The health care bill also scrapped annual and lifetime cap provisions, so if you get a rare form of cancer, you’ll have unlimited coverage regardless of the cost. According to news website The Daily Caller, “the day Obamacare hit the books one year ago, 150 new regulations immediately went into effect. Since then, 125 more regulations have gone into effect.”

All of this sounds wonderful, but someone has to pay. Every American who currently has health insurance in the U.S. will be forced to shell out higher premiums.

The danger to insurance companies, and thus to patients, is similar to what happened with Romneycare (a blueprint for Obamacare) in Massachusetts, where the new health mandates ruined the few efficiencies of managed care. Sicker (and, hence, costlier) patients sign up for coverage, which weighs down on the healthy population, whose premiums rise so drastically that they cannot afford coverage anymore. They figure, why pay expensive premiums when I can instead sign up for insurance when and if I do get sick and pay the penalty for not being covered (which is much less, anyway)?

It’s just like car insurance: You need safe drivers paying their insurance to balance out the reckless drivers with shoddy driving records. Without just about all responsible drivers purchasing coverage, the system doesn’t work.

That is why Obamacare is so poorly crafted. There is no incentive for healthy people to sign up. However, had the bill included a provision that opened up insurance markets over state lines, the competition among insurers for customers would have naturally kept costs in check.

In fact, if Obamacare isn’t repealed, today’s national debt will be far worse tomorrow because of exploding costs.

The National Federation of Independent Businesses released a report this week that revealed that “one in eight small businesses have had or expect to have their health insurance plans terminated since the passage of President Obama’s health care reform,” according to The Daily Caller. The findings echoed a report from consultants McKinsey & Co. last month that stated that 30% of employers will “definitely or probably” stop offering health insurance coverage to employees after 2014.

Think about it: If you own a business that has fewer than 50 employees, why would you continue to pay for their insurance when you can force them into the government exchanges? Not only does that mean you won’t get to keep your doctor, as Democrats promised you would, it also means that Obamacare could drive us into fiscal ruin.

According to a Washington Post Op-Ed by Sen. Ron Johnson (R-Wis.) and former Congressional Budget Office Director Douglas Holtz-Eakin, “If half of the 180 million workers who enjoy employer-provided care wind up in the exchanges, the annual cost of Obamacare would increase by $400 billion by 2021. If the other half eventually follows suit, and all American employees wind up in the exchanges – which we believe is a goal of Obamacare – then the annual cost of the exchanges would increase by more than $800 billion.”

That means that far too much of the private-sector health care balance sheet would be transferred over to taxpayers to foot the tab. Over 10 years, the costs would be in the trillions.

Wasn’t the whole point of Obamacare to bring costs down – and not break the back of the federal budget?

That’s why it must be repealed. The debt fight in Washington will be small potatoes today when you think about what it will be after health care reform goes into full effect. But by then, Obama will conveniently be out of office, and we’ll be stuck with the bill.

To the Editor:

I am writing in response to the opinion piece written by Andrea Tantaros  on healthcare reform entitled “You think the debt crisis is bad now? Wait until Obamacare takes its toll.”  I have no problem with those who object to the many provisions included in the Patient Protection and Affordable Care Act (healthcare reform law) and I also agree it will end up being more expensive to implement than planned.  However, virtually every issue raised by Ms. Tantaros was faulty in its conclusion as to why healthcare reform will be more expensive than the Congressional Budget Office predicted.  I think it’s irresponsible to use incorrect facts when you are trying to make a point.  That is exactly what happened in this piece and let me explain why:

1.       It is true healthcare costs continue to rise at alarmingly high rates (8% predicted for 2012).  What is untrue is this growth is related to “Obamacare.”   Healthcare costs were rising well before healthcare reform was presented to the American public.  In fact, some of the very reasons behind the reform legislation originate with the concerns over the explosive growth in costs over the past decade.  Healthcare reform, while imperfect, is designed to bring those costs down.  It is true that hospital systems are buying medical practices and it is also true these organizations will use their newly found market clout to negotiate better reimbursement rates.  However, Medicare does not negotiate.  So these networks will not increase the federal burden on healthcare costs.  Secondly, the primary purpose of forming these hospital/physician networks is to better integrate care for the patient, and thereby, the healthcare system in general.  There is no question, when you better organize and manage a patient’s healthcare, you will save the healthcare system money by keeping people out of the hospital and lowering readmission rates.

2.       The healthcare reform provisions that have kicked in so far, such as requiring health insurers to cover dependent age children up to age 26, are estimated to increase the costs to the healthcare system by approximately 1%.  A fraction of the overall spending growth projected for 2012.  To suggest these few immediate provisions, intended provide instant relief for many and generate public support behind healthcare reform  are breaking the bank, is simply not true.  Neither is the claim that insurers are currently not allowed to deny applicants because they have preexisting medical conditions.  That provision does not start until 2014.

3.       I am truly dumfounded by Ms. Tantaros suggestion that only sick people  would sign up for healthcare insurance.  Perhaps the single most controversial component of the legislation requires all Americans to sign up for healthcare insurance.  Sick and healthy alike.  Everyone is in – plain and simple.  While unpopular to many, it is the underpinning of balancing the healthcare insurance markets. Without it, healthcare reform as written will fail.  However, as of today, the individual mandate is included, so Ms. Tantaros’ argument is not only irrelevant, but makes no sense. 

4.       Finally, and I could go on with more, it is still very unclear whether large group employers will stop providing healthcare insurance to their employees.  Healthcare insurance is a benefit that is not currently required to be offered today yet approximately 180 million Americans get their healthcare insurance this way.  It is true some employers will stop offering insurance and force employees into buying insurance on the state exchanges and the penalty the employer pays the government will be less than the cost for providing the insurance.  However, the impact and magnitude is still very unknown.  While this issue is complex and there is no data to accurately project the ultimate outcome, I think it is inappropriate to suggest employers will stop providing this benefit. Further, this has nothing to do with whether you would be able to see your existing physician. 

You may find this hard to believe, but I actually have concerns over the ultimate costs of healthcare reform on the government and society in general.  While there are new payment mechanisms in place to hopefully lower costs,  I do not believe the American public fully understands the real reasons behind the explosive growth in healthcare costs.  We are living longer and using more expensive healthcare every day.  Drugs, technology, multiple doctor visits, home care, etc.  One needs to look no further than the new late stage prostate cancer treatment drugs that prolong life for patients on average between 4-6 months at an estimated cost of $90,000.  While there may be no limit to the price we want to pay when we get sick and want to fight for survival, you cannot ignore the costs associated with these new treatments.  And since it is the insurance company or the government that pays the bill, we are not even aware of how much it costs.  Until we are all willing to accept the actual facts, the more we will let people like Ms. Tantaros distort the truth about why healthcare in this country is so expensive.

Andrew Rubin

Host, Healthcare Connect on Sirius/XM Doctor Radio


You think the debt crisis is bad now? Wait until Obamacare takes its toll

By Andrea Tantaros, The Daily News

One of the main reasons for enacting Obamacare was to bring down health care costs – so said the President, then-House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid. But since its passage, the sweeping overhaul of one-sixth of our economy has done just the opposite. If you think the debt debate on Capitol Hill has revealed that this nation is on the road to fiscal ruin, just wait until health care reform really kicks in.

Read article


At Age 46, Is Medicare Ripe For A Change?

By Mary Agnes Carey and Shefali S. Kulkarni, Kaiser Heatlh News

Medicare, the federal entitlement program for the elderly and disabled, was signed into law by President Lyndon Johnson 46 years ago this week. Changes to the program, such as raising its eligibility age or requiring wealthier seniors to pay more for coverage, have been discussed in the debate over raising the federal debt ceiling and also by several commissions charged with finding ways to reduce federal spending, including on entitlement programs.

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Debt ceiling plan would repeal CLASS Act

By Brett Norman, Politico

The deficit-reduction proposal released Tuesday by the reconvened Gang of Six would repeal the Community Living Assistance Services and Supports Act, a move that would be a major setback to advocates for improving access to long-term care.

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Bipartisan Plan for Budget Deal Buoys President

By Jackie Calmes and Jennifer Steinhauer, The New York Times

WASHINGTON — President Obama seized on the re-emergence of an ambitious bipartisan budget plan in the Senate on Tuesday to invigorate his push for a big debt-reduction deal, and he summoned Congressional leaders back to the bargaining table this week to “start talking turkey.”

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Coburn deficit plan offers $9 trillion in savings

By Felicia Sonmez, The Washington Post

Sen. Tom Coburn (R-Okla.) on Monday released a plan that he says would achieve $9 trillion in deficit savings over the next decade through a combination of far-reaching spending cuts, entitlement reform and increased tax revenue.

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Pre-existing Conditions Exclusions

When HealthCare Reform goes into full effect starting January 1, 2014 no healthplan, either sold privately or through the …

Health Insurance Exchange Markets: What You Need To Know

By Susan E. Matthews, Everyday Health Staff Writer MONDAY, September 30, 2013 — Congress may still be debating particulars …

Important healthcare benefit information for federal employees

  Federal Employee Health Benefits and Healthcare Reform As it stands today only those federal employees who are members …