What Does Super Committee Failure Mean For Healthcare?
The medical community is buzzing with concern this afternoon over what the failure of the Joint Select Committee on Deficit Reduction means for healthcare providers and recipients.
Under the ‘trigger’ provisions agreed upon during the August debt default crisis, were the super-committee to fail to arrive at their own formula for getting rid of $1.2 trillion in deficit – a circumstance that has now become reality – Medicare would find itself facing an annual cut of 2 percent each year for a ten year period beginning in 2013.
Should this actually occur it would be disastrous for health of the nation’s senior citizens. Properly configured, the cuts could be made without biting into benefits for the elderly who depend upon the program, but the trigger mechanism does not point to specific areas of the federal health program where the cuts could be targeted in a way that would reduce spending while protecting benefits. Thus, everything would have be cut by the 2% amount, including medical benefits.
Personally, I don’t believe for a moment that the sequester provisions that were the penalty for failure of the deficit committee will ever see the light of day. There are thirteen months to go before these provisions kick in and Congress is already planning way to work around the cuts – particularly with respect to the defense budget. As a result, we can fully expect that the lame-duck session that will take place immediately following next November’s elections will either do away with or drastically modify the anticipated cuts.
It should also be noted that there are many policy experts who believe that had the panel reached an agreement, the damage to Medicare may have been far more serious than the planned 2 percent annual cuts.
There is, however, some real potential for immediate damage as a result of this Congressional failure.
The physician community had hoped that a deal would have brought resolution to the Medicare payment reductions doctors face each and every year as a result of the sustainable growth rate (SGR) formula. While Congress has traditionally delayed the cuts each year, the current decrease scheduled – should it actually happen – would hit physicians with a 27% pay cut for caring for Medicare patients starting January, 2012.
Given the tenor of Congress these days, there seems to be some chance that the Republicans might wish to make their point by allowing the payment reduction to take place. Should this happen, we’ve got a very big problem on our hands.
Physicians are already unable to make much-if any-profit on what Medicare pays them to treat our nation’s elderly. A near 30% cut would cause many-far too many-doctors to close up shop to seniors who are unable to cover the fees doctors require to stay in business out of their own pockets. The disastrous result this would lead to is obvious.
Says American Medical Association president, Peter Carmel:
The failure of the deficit committee forces our nation to continue on an unsustainable path that puts current and future generations of Americans at risk for harsh consequences The deficit committee had a unique opportunity to stabilize the Medicare program for America’s seniors now and for generations to come.
Once again, Congress failed to stop the annual charade of scheduled Medicare physician payment cuts and short-term patches, which spends more taxpayer money to perpetuate a policy everyone agrees is fatally flawed.
As I often point out, doctors are the one element of our healthcare system that are irreplaceable. Having hospitals are of little value when there are no physicians walking the halls to care for us. Drugs aren’t going to reach those who need them if there are no doctors to write the prescriptions.
Let’s hope that Congress is not so foolish as to make their point by hurting physicians and the seniors who depend upon them.
By: Rick Ungar, Forbes, November 21, 2011
New Study: Raising Medicare Eligibility Age Erodes Social Security Benefits
A proposal to increase the Medicare eligibility age, which the Super Committee is considering, would drive up health care costs to the point where they would consume almost half of the Social Security check of a middle-class retiree, according to a new analysis by Social Security Works.
In his testimony before the Super Committee yesterday, Erskine Bowles, a Morgan Stanley executive and co-chair of the President’s Fiscal Commission, recommended raising the Medicare eligibility age to 67 as a way to bridge the differences between Democrats and Republicans on the Super Committee.
Bowles explained his support for the policy on the grounds that the Affordable Care Act (ACA) made “other coverage available” to 65- and 66-year-olds, by providing subsidies to purchase health care in the private sector.
Bowles’ testimony in favor of raising the age comes on the heels of public endorsements by the American Hospital Association, the leading trade association for the nation’s for-profit hospitals, and the Healthcare Leadership Consortium, a consortium of health insurance companies, pharmaceutical companies, and other medical providers.
The Center on Budget & Policy Priorities, a center-left think tank, criticized Bowles’ compromise for being “to the right of Boehner’s offer to Obama in July.” They dismissed, in particular, Bowles’ reliance on the ACA to justify raising the Medicare eligibility age. Robert Greenstein, the Center’s President, wrote that without assurance that ACA will withstand overwhelming Republican political and legal opposition, Bowles’ proposal to raise the Medicare eligibility age “would risk leaving many 65- and 66-year-olds with no insurance at all at the very time of life when they are developing more medical conditions and problems due to their age.”
Even if ACA is successfully implemented, however, many experts believe raising the Medicare eligibility age would be poor policy. A study by the Kaiser Family Foundation found that raising the Medicare eligibility age to 67 would increase health care costs across the economy, saving the government little money. What money the government would save, the Kaiser study found, would come from shifting the costs of care onto patients — especially, but not only, individuals aged 65 and 66, who would no longer be eligible for Medicare.
A new analysis of the Kaiser study by Social Security Works shows that the increase in out-of-pocket costs for 3.3 million people aged 65 and 66 would take a large bite out of affected seniors’ already modest Social Security checks.
From Social Security Works’ analysis:
Of the 3.3 million people aged 65 and 66 who would pay more out-of-pocket for health care if they were no longer eligible for Medicare, the following two groups would be hit especially hard:
- Out-of-pocket health care costs would increase, on average, by $4,300 in 2014 for 960,000 people aged 65 and 66 who purchase coverage through a health insurance exchange and have incomes exceeding 400 percent of the federal poverty level ($43,560), making them ineligible for subsidies available to exchange participants with lower incomes.
- Under current law, these 65- and 66-year-old retirees’ average out-of-pocket costs would be $6,800 in 2014, out of a total Social Security benefit of $24,469. If forced out of Medicare and onto the health insurance exchanges, their average out-of-pocket health care costs would grow to $11,100, out of a total Social Security benefit of $24,469. [Figure 1] As a result, if the Medicare eligibility age is raised, out-of-pocket health care costs would go from consuming 28 percent to 45 percent of those 65- and 66-year-old retirees’ Social Security check.
Sources: Social Security Works analysis of estimates from Social Security Trustees, 2011, and Kaiser Family Foundation, 2011.
- Out-of-pocket costs would increase, on average, by $1,200 for 240,000 people aged 65 and 66 who purchase coverage through a health insurance exchange and have incomes between 300 and 400 percent of the federal poverty level ($32,670-$43,560). Under current law, these 65- and 66-year-old retirees’ average out-of-pocket costs would be $4,800 in 2014, out of a total Social Security benefit of $18,464. If forced out of Medicare and onto the health insurance exchanges, their average out-of-pocket health care costs would grow to $6,000, out of a total Social Security benefit of $18,464. As a result, if the Medicare eligibility age is raised, out-of-pocket health care costs would go from consuming 26 percent to 32 percent of those 65- and 66-year-old retirees’ Social Security check.
Costs to Social Security beneficiaries could be substantially higher than estimated here. The out-of-pocket costs discussed in Social Security Works’ analysis do not include the cost of medical services that are not covered by Medicare at all, including dental care and most kinds of long-term care, such as permanent residency in a nursing home. Accounting for these medical services would not have any bearing on the amount that out-of-pocket costs would increase if the Medicare eligibility were raised to 67. It would, however, show average out-of-pocket costs to be considerably larger under both current law and if the Medicare eligibility were raised to 67.
By: Daniel Marans, Policy Director, Social Security Works, Published in Huffington Post, November 4, 2011
Women, Watch Your Back: Anti-Choicers Are Gambling With Your Life
In a medical emergency, the last thing we should be worried about is whether a hospital is going to put ideology ahead of the care we need to protect our lives and health. But if anti-choice lawmakers get their way, women and their loved ones will have to watch their backs.
Yesterday the House passed an unprecedented bill that would allow hospitals to let women die at their doorsteps. It sounds almost unbelievable — but utter disregard for the well-being of women who need abortion care has tragically reached new levels in the House.
The bill, the so-called “Protect Life Act” does anything but. Indeed, it gambles with women’s lives. It could allow hospitals to ignore the Emergency Medical Treatment and Active Labor Act (EMTALA) which requires that patients in medical emergencies receive appropriate medical treatment, including abortion care if that’s what’s medically indicated.
The bill’s proponents will first tell you that this is necessary to protect religiously affiliated hospitals, and then claim that there’s no such thing as emergency abortion care (which begs the question of why they’re so intent on overriding it). They’re wrong on both fronts.
First, the denial of appropriate medical care to a woman suffering from emergency pregnancy complications can be devastating. The following story recorded in the American Journal of Public Health is just one example:
A woman with a condition that prevented her blood from clotting was in the process of miscarrying at a Catholic-owned hospital. According to her doctor, she was dying before his eyes, her eyes filling with blood. But even though her life was in danger, and the fetus had no chance of survival, the hospital wouldn’t let the doctor treat her by terminating the pregnancy until the fetal heartbeat ceased of its own accord. She ended up in the I.C.U.
Second, even the Catholic Health Association, the leadership organization for Catholic hospitals — hardly an anti-religious or pro-choice lobby — has told Congress that they don’t “believe that there is a need for the [refusal] section to apply to EMTALA.” The very institutions on whose behalf this heinous provision has been proposed are saying “don’t do this.” But so far, the bill’s sponsors remain unmoved.
Every representative who voted for this bill should hear from you and be made to think about the woman, mid-miscarriage, bleeding and scared out of her wits, who rushes to the nearest hospital only to be told by her doctor that he’s not allowed to treat her. Think about that woman, and then tell us — what are you going to do?
By: Sarah Lipton-Lubet, Policy Counsel, ACLU Legislative Office, Published in RH Reality Check, October 14, 2011
With HPV Vaccine Rumors, Michele Bachmann Is The New Joe McCarthy
Joe McCarthy knew how to rile up the base. He knew his political hot buttons. He knew how to stoke fear and create a movement. He knew how to build a following by ratcheting up the rhetoric, the facts be damned.
Sadly, Rep. Michele Bachmann has followed in his mold: questioning the patriotism of members of Congress, fanning the flames of hatred of gays and lesbians and, now, attacking the vaccine to prevent cervical cancer.
This HPV political maneuver may be her last. This should be her “have you no sense of decency” moment, just as the Army-McCarthy hearing was in the 1950s.
Somehow, the anti-vaccine movement has gained steam in the United States. Rumors that traditional vaccines caused autism began to spread. They were disproved but not before many parents declined to vaccinate their children.
A Science Times article in the New York Times (“Remark on Vaccine Could Ripple for Years”) points to a three to four year drop in vaccination rates after such publicity. Diseases such as measles and whooping cough, supposedly under control, have seen outbreaks. According to the Times, “measles cases in the United States reached a 15-year high last spring. ”
The HPV virus is, unfortunately, far too common. More than 25 percent of women 14 to 49 have been infected, 44 percent in the 20 to 24 age range. Not only can HPV cause cervical cancer but it can cause other cancers as well.
Last year only 32 percent of teenage girls had been given the vaccine.
If Michele Bachmann’s scare tactics prove true to form, there will be a drop in the number of girls and women protected. By putting out false information, by repeating the statement of someone at the debate that the vaccine caused mental retardation, she set back the effort to save women’s lives. Hardly a pro-life position.
In fact, the vaccine can prevent unnecessary surgery for several hundred thousand women a year and even allow women to successfully carry a pregnancy to term.
Over 35 million doses have been distributed without any serious side effects. Thank goodness doctors and clinics and reputable research organizations moved quickly to take on Michele Bachmann.
But, make no mistake, she even stayed on the issue in Thursday’s debate. This woman won’t quit, no matter the facts or the implications of her actions.
She sees a political opening and she takes it, she sees a chance to rile the base and she seizes it, she sees a good sound bite and off she goes.
If, in fact, the experts are correct and this will set back vaccinations for years, Bachmann will need to do more than apologize for her McCarthy-like tactics. As he ruined innocent lives, she may responsible for doing the same. She will have to look herself in the mirror and know that her actions led to more women losing their lives.
By: Peter Fenn, U. S. News and World Report, September 23, 2011
The GOP’s Lies And ‘Monstrous’ Lies
In politics these days, there are lies, “monstrous lies,” and statistics. By lies I mean the mundane nonsense that dribbles out of politicians’ mouths when the facts don’t suit them or they just don’t know any better. By “monstrous lies,” if I can borrow the phrase of the moment, I refer to the grander deceptions swallowed by whole political movements, delusions and deceptions that infect larger issues of policy and worldview.
Statistics in this case, along with pesky facts, help expose and distinguish the two species of falsehood—both of which have been on dramatic display during the GOP presidential primary campaign.
Take, for example, Michele Bachmann, who is practically a walking, talking full-employment plan for journalistic fact-checkers. Appearing at last week’s Republican debate (sponsored by CNN and the Tea Party Express—does that mean that the Tea Party is now part of the lamestream media?), Bachmann repeated a favorite talking point, that the Constitution forbids states to mandate that their citizens buy health insurance, Romneycare-style. “If you believe that states can have it and that it’s constitutional, you’re not committed” to repealing the Affordable Care Act, she argued. But the conservative case against the healthcare law rests on the notion that because the Constitution does not explicitly authorize such a law, the federal government is barred from instituting one. Since the 10th Amendment reserves powers not delegated to the federal government back to the states, it is constitutional for, say, Massachusetts to require its citizens to purchase health insurance (or car insurance, for that matter). Bachmann’s stance, one blogger at the influential conservative blog Red State argued, is “either ignorance on display or dishonest pandering.”
Bachmann was even more egregious after the debate, when she went on Fox News Channel, and later the Today show, and asserted that Gardasil, the vaccine that Texas Gov. Rick Perry had tried to mandate for Texas schoolgirls, caused “mental retardation.” It’s such whole-cloth twaddle that even the likes of Rush Limbaugh (“she might have jumped the shark”) and the Weekly Standard (“Bachmann seemed to go off the deep end”) blasted her for it.
But Bachmann is literally and figuratively small potatoes, Perry’s arrival having returned her to the lower tier of GOP contenders. And she is minor league compared to Perry in the “monstrous lie” department.
The phrase of course comes from his memorable description of Social Security. “It is a Ponzi scheme to tell our kids that are 25 or 30 years old today, you’ve paid into a program that’s going to be there,” Perry said at his first presidential debate. “Anybody that’s for the status quo with Social Security today is involved with a monstrous lie to our kids, and that’s not right.” Elsewhere he has called the program “by any measure … a failure” and cited it as “by far the best example” of an extra-constitutional program “violently tossing aside any respect for our founding principles.”
It’s a catchy turn of argument, but one monstrously divorced from reality. His “failure” kept nearly 14 million seniors and 1.1 million children out of poverty last year, according to Census Bureau data. Here are the facts about Social Security: Without any modification, it will pay out full benefits for the next 24 years. Starting in 2035, its trust fund will no longer be able to pay full benefits. Instead it will pay roughly three quarters benefits through 2084, which is as foreseeable a future as anyone can peer into in these matters—a problematic future, but hardly a monstrous one and certainly not an impossible one.
Indeed, the Congressional Budget Office has produced 30 policy recommendations, some combination of which could fix the Social Security shortfall. Here’s one: Remove the payroll tax cap so that more wages are subject to the payroll tax. That would make the program solvent for the 75-year window—again, hardly a monstrous situation. (To put it another way, the Social Security shortfall figures to be roughly 0.8 percent of GDP—roughly the same as the cost of extending the Bush tax cuts over the same period.)
Social Security wasn’t the only topic this week of Texas-size Perry misinformation. Obama “had $800 billion worth of stimulus in the first round of stimulus,” Perry said. “It created zero jobs.”
This gem—a staple of GOP talking points—earned a “Pants on Fire” rating from PolitiFact, which pointed to several independent analyses that came to quite different conclusions. The Congressional Budget Office has estimated that the first round of stimulus created or saved between 1.3 million and 3.6 million jobs; HIS/Global Insight put the number at 2.45 million, Macroeconomic Advisers at 2.3 million, and Moody’s Economy.com at 2.5 million. The GOP may disdain jobs that come from public spending (recall Speaker John Boehner’s “so be it” comment when asked about budget cuts leading to fewer jobs), but they cannot seriously argue that the economy would be better off if the ranks of the unemployed were 2.5 million persons more swollen. So instead forgo the inconvenient truth in favor of the monstrous lie.
These lies are monstrous because they are not one-offs, but are central to the GOP case—that Social Security (except, they are quick to add, for those currently on it) and the stimulus plan don’t work. So they have real-world policy consequences—see the emerging conservative line of attack against Obama’s American Jobs Act, that it is a stimulus retread. “Four hundred-plus billion dollars in this package,” Perry concluded at the debate. “And I can do the math on that one. Half of zero jobs is going to be zero jobs.”
He may be able to do math, but his grasp on the facts is tenuous at best.
By: Robert Schlesinger, U. S. News and World Report, September 22, 2011
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