Another Medicare Premium Increase Ahead

WASHINGTON -- Senior citizens can expect at least a 12 percent increase in their Medicare premiums for doctor visits next year, and that could rise even higher if physician reimbursements aren't reduced.

Richard Foster, the chief actuary at the Centers for Medicare and Medicaid Services, said Friday that physicians who treat Medicare beneficiaries are slated to see a 5 percent cut in their reimbursement rates beginning Jan. 1. But, Foster said, he would be surprised if lawmakers allow such a cut to occur.
...
John Rother, policy director for the older citizens' lobby AARP, said next year's Social Security cost-of-living increase will likely be heavily offset by the premium increase.

"This puts real pressure on the incomes of seniors, particularly those with modest income and those who get most of their income from Social Security," Rother said.

Last year, the average cost-of-living increase for Social Security recipients went up about $25 a month, and about 40 percent of that went to pay for the increase in Part B premiums, Rother said.

"What it means is a declining standard of living for most American retirees," he said.

http://www.newsday.com/news/politics/wire/sns-ap-medicare-premiums,0,2390898.story?coll=sns-ap-politics-headlines

Everyone, understandably, wants the latest treatments, but the technologies and equipment supporting them can be extraordinarily expensive.

Another problem is that a lot of treatment isn't treatment at all, but rather, prevention against possible lawsuits. The waste in tests, X-rays, ER visits, etc. - not to mention the unnecessary paperwork - is unbelievable unless you've seen it with your own eyes.

I won't go into the greedy corporation trope because we can just take that for granted. :-)

Oh how I wish we spent more on preventing disease in the first place....

I hadn't realized that until last year when my mother complained about the rise in Medicare. Her monthly SS amount was lowered to cover the Medicare increase.

Hell what a damn scam from hell!

:kick:

fan for sure.

may get only 20% of the cost of living increase, the rest goes to medacare raises... and she only gets about 600 dollars

http://www.cnn.com/2005/HEALTH/03/25/medicare.premiums.ap/index.html

Friday, March 25, 2005 Posted: 11:04 PM EST (0404 GMT)

WASHINGTON (AP) -- Senior citizens can expect at least a 12 percent increase in their Medicare premiums for doctor visits next year, and that could rise even higher, if physician reimbursements aren't reduced.

Richard Foster, the chief actuary at the Centers for Medicare and Medicaid Services, said Friday that physicians who treat Medicare beneficiaries are slated to see a 5 percent cut in their reimbursement rates beginning January 1. But, Foster said, he would be surprised if lawmakers allow such a cut to occur.

"In real life, I don't think that's going to happen," Foster said at a forum on Medicare at the American Enterprise Institute, a conservative think tank.

Over the past two years, physician reimbursement rates have increased by 1.5 percent annually. If that were to continue, then Medicare beneficiaries can expect to see a 14 percent to 15 percent increase in their premiums, Foster said.

Medicare patients??

my former employer which,as averyone knows,could be dropped anytime my former employer decideds to do it.

There is no security anymore and I feel that I one of the lucky ones.

I grew up with just the word/term: "Medicare". It sounded good.

Having had to cross that bridge sooner than expected, I had no idea that not all doctors accept Medicare. I assumed it was universal.

Even some who accept Medicare patients limit the number of Medicare patients taken (quota).

It was bad enough to learn upon being accepted into the SSDI program that there's a 24, it might be 30-month wait, before Medicare even kicks-in. Consider: losing one's job; losing income; losing medical coverage (that is if the employer had such coverage) ... being disabled ... with no medical insurance.

Americans seem to be gifted in building stress, anxiety, and fear into our institutions and systems.

The bridge yet to be crossed, which is a really scary one, is Medicaid. I have a friend currently crossing that bridge with a parent, and the general opinion is: rude awakening. Had to consult with a lawyer, etc.

This country can and must do better.

Seems we've been drifting along with do-nothing politicians concerned mostly with corporations vs. people ... elected officials not being truly public servants at all. A couple of decades of political gridlock hasn't helped. As a Society, we've been fairly complacent and negligent in improving the processes in place. Our government really hasn't done much of anything progressive in decades.
```````````````````````````````````````````````````````````````````
from "Statement of the American College of Surgeons"

~snip~

As more and more doctors curtail the time they devote to Medicare patients, seniors and disabled patients will wait even longer to visit a specialist. Moreover, like Medicaid providers, they will struggle to find physicians available for referrals for follow-up chronic care.

One problem associated with decreasing reimbursements is especially acute within the surgical community. The number of physicians who elect to practice surgery is declining. Many variables enter into a medical student’s choice of specialty. Among these factors is the viability of maintaining a practice. As reimbursements fail to keep pace with inflation, so too do the number of applicants interested in pursuing surgery. For example, following the most recent residency match, 15 percent of the positions in thoracic surgery went unfilled. Similarly, a significant number of openings in general surgery and neurosurgery remained unsatisfied.

Underserved communities that traditionally struggle to recruit and retain physicians are particularly hard hit. Expanding the number of patients seen is one of the most common means to bolstering a beleaguered practice—an option that often cannot be exercised in sparsely populated communities. Rural areas find it particularly challenging to attract young specialists, again because they cannot supply a sufficient patient base. Never are the consequences more dire than for trauma patients in underserved areas. The inability to sufficiently staff hospitals in emergency situations is one of the ripple effects of cost-cutting in physician reimbursement.

Not only are we seeing a decline in the number of young surgeons, the ranks of older surgeons are beginning to diminish as well. Faced with lagging reimbursement rates and dramatically increasing liability premiums, many of our most experienced surgeons are pursuing early retirement. As the number of Medicare patients continues to increase in our aging population, conversely the number of seasoned surgeons is decreasing, further exacerbating all of the problems associated with access to care.

~snip~

http://waysandmeans.house.gov/hearings.asp?formmode=view&id=800

There isn't any other way.

Medicaidf is an even bigger trainwreck than medicare.

Discounts to Seniors are almost non-existent. A basic 'Elderly' prescription like Actonel, costs about $70 for one month (4 pills). How can any elderly afford that...and still afford food?

something is seriously not right when an abled-body employed and medically covered citizen gets a month's supply of lipitor for a co-pay of (what is it these days?), say, $15 ... and, someone on Medicare (senior or disabled person) has to pay $120 for the same Rx ... and, then, of course, dear ol'Pfizer, throws all kinds of roadblocks to prevent buying it and other meds from Canada.

Unfortunately many doctors, hospitals, laboratories,
file fradulent bills to medicare, and get paid.

Doctors and hospitals have huge liability insurance
bills. In addition, doctors order all kinds of tests
to protect them from malpractice suits.

Add to that the expensive new machines which every one
wants for tests.

Medicare will go broke in 10-20 years anyways. So why
worry.

is there a link to statistics on such lawsuits?

http://www.google.com/search?hl=en&q=the+myth+about+lawsuits+and+medical+costs

I'm not sure about the fraud part. The Frist (HCA) family have first hand knowledge.

If by fraud, you imply that some of it may be linked to doctors raising their fees to off-set what insurance companies are willing to pay over and beyond reasonableness ... I think that contributes ... but, it's multi-faceted for sure.

Certainly, the insurance companies have done their part.

Jim Hightower starts his book, 'There's Nothing in the Middle of the Road but Yellow Stripes and Dead Armadillos', by asking who decided one day that our health care system would be assumed by corporate employers ... amongst many issues, we woke up one day, and found that our employers, now, had our medical history ... knowing what doctors we see ... what medicines we take, etc. That's another issue (privacy).

I, however, believe that that corporate takeover of managing and administering the medical system has had a great deal of effect on the costs of things. They complicate things by turning around and outsourcing the various aspects of the coverage: medical, dental, vision, and Rx to other corporations (which further spreads our private matters, too).

We all know the system needs fixing. Instead of pointing blame ... let's level it all and employ a corporate-free universal health care plan; and, make it the shining example for the world.

I have worked for a couple of insurance companies, and would never work for them again. Here is a true personal story to illustrate the lack of checks and balances in the insurance companies.

I had the misfortune of most driver's, the stone that chipped the windshield in the driver t-zone (at least in Jersey, if it is on the driver's side, no matter how small, it has to be replaced to pass inspection).

So, I wanted to claim it on my comprehensive, because I had no other previous claims. Call the first glass co., quote $239.99 less $20.00 coupon in the phone book, second quote $259.99, but they would come to where you work and replace the windshield while you worked, the third, company, asked who my insurance co. was and came back with a $540.00. price, based on what the insurance company would would pay, (kinda like an inflated blue book price. I confirmed that this was the exact same windshield.

I worked in a manufacturing environment in the systems dept. When I was on break (smoking), I discussed this with the mfg. supervisors, and they concluded that I should use the $540.00 replacement company, because otherwise the insurance company, would lose $9.00, with the a $250.00 deductible. They don't get that the insurance company would just raise everyone's premiums based on the rip off scam and make even more more money. I don't know who ticked me off more, the non restrained insurance company or the ignorant fellow employees who would raise my premiums. (Note NJ has like the highest car insurance rates in the country). I went with the lowest quote, by the way.

There is no mechanism in our corporate/governmental structure, to insure that the best value is indeed what is paid. I sent the three estimates in to the insurance company, knowing full well, it wouldn't matter.
edit:

Our local news just did an expose on the varying costs of dental work. The pricing was so completely diverse, it boggled the mind. Some of the more qualified dentists were charging like 1/3 to 1/2 less than the less qualified dentists. The story reported that most dental offices will quote their prices over the phone, now, if we weren't working such long hours, we could actually pay alot less then we need to.

I would bet the less qualified, over-charging dentists accepted your insurance plan, if you get my drift.

and that is to get away from the corporate issued health
insurance. And the best way to do that is to let the employer
put the money in YOUR medical IRA and then YOU can shop for
the best insurance. That will surely increase competition,
the heart and soul of capitalism.

Recently we had a hospital bill for $65,000 which was printed
on 86 pages of 8-1/2 x 11 sheets. This was for a stay in the
hospital for 31 days. No surgery was involved, just ICU for 10
days followed by semi-private 21 days. There were aprox 45
billable items on each page. So that is 86 x 45 = 3870 items!
Almost all of them were one line items with a code number.

I called the hospital and asked for an explanation of these
codes, and they had the gall to tell me to ask my doctor! Yeah,
my doctor has the time to sit down and explain 3870 items!!
I told the hospital there was not enough time in 24 hours to
administer 125 different items to the patient each day. The
nurse would have to walk in every 12 minutes, 24 hours a day
to deliver that many service items.

Then I called the insurance company and they said there was no
problem with the bill, they would pay it all except for the
deductible out of pocket maximum of $4000.

What I think is that the insurance company wants the hospital
bills to be high so that you are forced to do business with
them. The hospitals sock the insured patients to pay for the
indigent. The whole system is screwed up.