Hospitals oppose Obama Medicare/Medicaid cuts

[cougarnurse]

Any thoughts or comments? Hospitals oppose Obama's Medicare, Medicaid cuts - Yahoo! News

President Barack Obama said Saturday he wants to help pay for his health care overhaul by slowing Medicare and Medicaid spending, but hospitals, medical technicians and others are resisting.

The high-stakes struggle over medical care is heating up as Obama declares the status quo unacceptable.

The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying greater efficiencies and broader insurance coverage will justify the change. Hospitals, especially those with many poor patients, say the proposed cuts are unfair and will harm the sick and elderly.

Congress ultimately will shape the new laws. Obama is urging lawmakers to be bold and to resist powerful lobbies trying to maintain their clout and profits.

"Americans are being priced out of the care they need," Obama said in his weekly radio and Internet address.

Obama said high health care costs hurt the entire economy and contribute to the nearly 50 million people who lack coverage. His address focused on payments to Medicare and Medicaid, which cover millions of elderly and low-income people and involve thousands of doctors, hospitals, nursing homes and other institutions.

He proposed cutting $313 billion from the programs over 10 years. That's in addition to the $635 billion "down payment" in tax increases and spending cuts in the health care system that he announced earlier.

Together, Obama's plans would provide $948 billion over a decade in savings and/or tax increases to help insure practically everyone and to slow the rate of soaring health care costs.

The president wants to cut $106 billion over 10 years from payments that help hospitals treat uninsured people. Spending on Medicare prescription drugs would fall by $75 billion over a decade.

And slowing projected increases in Medicare payments to hospitals and other providers — but not doctors — would save $110 billion over 10 years, the president said.

Obama called them "commonsense changes," although he acknowledged that many details must be resolved. Some powerful industry groups called the proposals unwise and unfair.

"Payment cuts are not reform," Rich Umbdenstock, president of the American Hospital Association, said even before Obama's plan was announced. His group is urging hospitals with large proportions of low-income patients "to push back on proposed cuts."

The pharmaceutical industry is wary of Obama's plan to extract $75 billion over 10 years from Medicare prescription drug spending. The White House said "there are a variety of ways to achieve this goal." For instance, it said, drug reimbursements might be reduced for people who receive both Medicare and Medicaid.

The drug manufacturers' chief trade group issued a cautious statement Saturday, saying pharmaceutical companies support health care changes, but that much work remains to be done.

An industry group that which represents makers and users of medical imaging devices, such as MRI and CT equipment, was more hostile.
Obama wants to reduce government payments for such services. He said the devices are used so frequently and efficiently that providers can spread their costs over many patients, requiring less government reimbursement.

The Access to Medical Imaging Coalition, a trade group, disagreed. It said the president's plan would "impair access to diagnostic imaging services and result in patients' delaying or forgoing life- and cost-savings imaging procedures." The group said Obama's efficiency estimates were based on a flawed survey.

Even if Obama and Congress could hit the overall goal of $948 billion in health care savings over 10 years, it still might not be enough to cover all the nation's uninsured. Outside experts say the 10-year cost could range from $1.2 trillion to $1.8 trillion, depending on factors such as how generous federal subsidies turn out to be. One Senate proposal would subsidize families making as much as $110,000.

The administration wants to hold the cost to about $1 trillion, and Obama says the plan must not add to the federal deficit.

His budget director, Peter Orszag, told reporters that $948 billion "is in the ballpark of many of the proposals floating around," and that "there may well be some additional resources that are necessary." He said the administration will work with Congress.

But the president's earlier package of $635 billion in spending cuts and tax increases has gotten a cool reception from lawmakers. And there's no clear indication the latest proposal will fare any better.

House Republican leader John Boehner of Ohio said Medicare and Medicaid need reform, "but serious changes should not be rushed through Congress as part of a new government-run program that will raise taxes and make health care more expensive."

[nursinghumor]

Surprise, suprise the pharmaceutical, hospital and medical imaging companies are opposed.

Government programs like Medicare, Medicaid and health insurance companies are their cash cows.

It's like funding a war, charge what you can, deliver what gives you the greatest profit.

It is time for some radical changes.

Time for some hefty audits to identify and put a stop to insurance fraud.

Let the government shop around for the best prices, negotiate for coverage for everyone.

Personally I could care less if the HMOs and other private insurance companies go out of business. They've been denying care to those that needed it from the start in lieu of profits.

Anyone remember the documentary "Sicko" and the plight of 911 rescue workers?

Michael Moore's "Sicko," which opened nationwide Friday, is filled with horror stories of people who are deprived of medical service because they can't afford it or haven't been able to navigate the murky waters of managed care in the United States."
http://www.cnn.com/2007/HEALTH/06/28...eck/index.html

Granted Michael Moore dramatized it, but the message is clear. Insurance companies are not providing care to those who can't pay for it. They need to be covered.

My two cents.

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
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[cougarnurse]

And yet, people ARE sicker, and all the treatments, etc., are not going to help everyone. ABT's are relatively 'new' (last century), dialysis..... I tend to think quality of life, for the most part.

Yes, education is important in managing BP, DM, etc. etc. Yet, Some listen, some won't, and some, nothing---meds, other treatments---work.

[OldSquidNewNurse]

I agree with most of what nursinghumor had to say. My company (an HMO) had its annual awards banquet last night and instead of going to a nice place with catered food and an open bar, with had it on site with coolers of beer, pop, and water. We are hurting, but still hanging on by a finger nail. Unlike the insurance companies that Mr. Moore pointed out we by law have to cover everyone. Last year we were ranked the number 4 HMO in the country US News and World Report. My company is a staff model HMO (we own and operate our own primary care offices). We are the only NCQA certified medical home in the state of Michigan and I believe only the 7th in the country.

I believe that the government needs to step in before the healthcare “system” implodes in on itself. Only 25% of medicine is evidenced base. Where is the proof that the medical provider is doing something that will have a positive outcome for the patient? This is our basis for denying care. Most providers are paid for the procedures they perform. This increases their willingness to do procedures regardless of outcomes. A notable exception to this in the Mayo Clinic whose providers a paid a salary. Because of the lack of incentive to do procedures utilization and costs have decreased.

Another issue is hospitals charging for things they are not doing. For example here in Grand Rapids there three cancer centers for four major hospitals (why a town the size of GR needs three cancer centers is beyond but) a study of one of the cancer centers who promotes itself has having a team of physician specialists, nurses, RD’s, etc. meeting with patients to develop a individualized treatment plan found that out of the 70 cases reviewed the individualized treatment plan was only developed on 11 patients, yet the cost to insurance companies were the same regardless.

As I have said many times, the sign of a healthy society is not more or bigger hospitals, but fewer.

[Teeituptom]

And yet, people ARE sicker, and all the treatments, etc., are not going to help everyone. ABT's are relatively 'new' (last century), dialysis..... I tend to think quality of life, for the most part.

Yes, education is important in managing BP, DM, etc. etc. Yet, Some listen, some won't, and some, nothing---meds, other treatments---work.

I will never go on dialysis, myself

[cougarnurse]

I will never go on dialysis, myself

They now have a 'do it at home' version. I kid you not.

[Teeituptom]

They now have a 'do it at home' version. I kid you not.

They do I know, but untill they get a golf version, not interested