Doctors and Medicare
Many concerns about Medicare and doctors can be traced to provisions of the Affordable Care Act—specifically to those calling for cuts in Medicare funding.
Those cuts are not insubstantial. They total over $700 billion—or over $14,000 for each person currently on Medicare.
According to Pres. Obama, ACA cuts to Medicare funding will not have a negative impact on Medicare recipients. Speaking out during last year’s presidential candidate debates, Pres. Obama declared the cuts were the result of “no longer overpaying insurance companies” and “making sure we weren’t overpaying providers.” Defending the cuts, the President said, “We were actually able to lower prescription drug costs for seniors by an average of $600, and we were also able to make a significant dent in providing them the kind of preventive care that will ultimately save money throughout the system.”
Opponent Mitt Romney and many Romney supporters viewed the cuts another way, however. Offering a rebuttal similar to the position put forth earlier in the campaign by his running mate Paul Ryan, Romney said, “Some 15 percent of hospitals and nursing homes say they won’t take any more Medicare patients. We also have 50 percent of doctors who say they won’t take Medicare patients.”
Many opponents of Obamacare, including Ryan, see cuts to Medicare as the inevitable result of shortcomings of the Affordable Care Act. In short, their position is that the ACA is not financially viable, and requires funding from another source if the President’s vision of government-mandated health coverage is to come true.
And what is that source?
As Ryan described it last year, “The planners in Washington didn’t have enough money. They needed more. They needed hundreds of billions more, so they just took it all away from Medicare. $716 billion funneled out of Medicare by Pres. Obama.”
During the first of last year’s three televised presidential debates, Romney attacked “the idea of cutting $716 billion from Medicare to be able to balance the additional cost of Obamacare.”
Wherever you stand on Obamacare, the cuts to Medicare are real. Whether you agree or disagree with the President about the need to be on guard against overpaying insurers and providers, it seems hard to argue with his opponents’ view that those cuts are in fact putting increased stress on Medicare recipients across the country.
Many doctors—already frustrated in their dealings with health insurers—report that they find it doubly frustrating to deal with Medicare.
Much of that frustration dates back to 1988, when Congress introduced a system of price controls called the Resource-Based Relative Value Scale (RBRVS). According to Forbes, the RBRVS did not achieve its aims of controlling Medicare spending largely because “doctors, especially specialists, compensated for being paid less per-service by performing more services.”
Hoping to establish a more effective way to control Medicare spending, Congress in 1997 passed a balanced-budget law which included a new payment formula for Medicare. According to Forbes, the new formula, called Sustainable Growth Rate (SGR), sought to tie “growth in physician fees to growth in the size of the nation’s economy, as measured by GDP.” However, the Houston Chronicle reports “the formula assumed low growth rates, and cuts expected to be modest turned out to be large.” The SGR has guided Medicare payments ever since, and the result is that many doctors feel they are grossly underpaid for the services they provide Medicare recipients.
The number of persons without health insurance coverage in the United States is one of the primary concerns raised by advocates of health care reform . A person without health insurance is commonly termed uninsured (regardless of insurance of objects unrelated to health), and this article uses the term in this sense as well. According to the United States Census Bureau , in 2009 there were 50.7 million people in the US (16.7% of the population) who were without health insurance.
It determined that the proportion of Americans who were underinsured, uninsured, or whose health insurance had gaps had been growing steadily from the year 2003 through 2010. During that time, the number of people who were underinsured exploded to a point that it almost doubled. In 2003, there were 16 million underinsured people in the United States, but that figure rose considerably to 29 million by 2010.
The ACA addresses barriers to acquiring insurance coverage through expanded access to Medicaid, subsidies for private insurance, and health insurance market reforms. The majority of the coverage expansions in the ACA will take effect in 2014, at which point, there will be a requirement that individuals have health insurance coverage. The law will also prevent insurers from rejecting individuals or charging higher premiums based on health status. By 2016, the ACA is estimated to decrease the number of uninsured by nearly half, leaving far fewer individuals facing the health and financial risks that come with being uninsured.
This information comes from a new survey, conducted on behalf of InsuranceQuotes.com by Princeton Survey Research Associates International. The survey reveals that 64 percent of the uninsured say they haven’t decided whether they will buy health insurance by Jan. 1, 2014, as required by the Affordable Care Act (ACA), which is also known as Obamacare .
Having no health insurance also often means that people will postpone necessary care and forego preventive care – such as childhood immunizations and routine check-ups-completely. Because the uninsured usually have no regular doctor and limited access to prescription medications, they are more likely to be hospitalized for health conditions that could have been avoided.