Medicare solvency: A matter of opinion?
The cost of U.S. healthcare spending has become one of the most hotly debated issues of our time. Each side is constantly looking for proof that their solution to the healthcare crisis will keep costs down, yet neither side has a tried and true method.
On August 5, Health and Human Services Secretary Kathleen Sebelius announced that Medicare would remain solvent through 2029, an extension of 12 years from projections made last summer. Proponents of the new healthcare reform law, the Affordable Care Act, are quick to say that measures in the law are behind the extended solvency projection.
According to the new Medicare Trustees' report, the largest amount of projected savings under the Affordable Care Act would come from Medicare budget cuts to hospitals, skilled nursing facilities, home health agencies and most other providers. The report also projects lower payments to private Medicare Advantage health plans.
Donald Berwick, MD, the new chief of the Centers for Medicare and Medicaid Services, said the decrease in reimbursement shouldn't pose a problem. Providers will be able to find more efficient ways to cut costs and improve care, he thinks, especially with the host of federal incentives available to them.
Many doctors disagree.
J. James Rohack, MD, past president of the American Medical Association, said the new report reinforces that steep Medicare physician payment cuts "are right around the corner," with a 23 percent cut this December and another 6 percent cut on top of that the following month.
"This report is just the latest warning bell for members of Congress who know the Medicare physician payment system is broken," he said.
According to Rohack, one in five physicians overall, and nearly one-third of all primary care physicians, say they are limiting the number of Medicare patients in their practices due to the threat of future cuts and inadequate Medicare rates.
This situation is not new. It has been a long time coming, under presidents and Congressional majorities of both parties.
One thing is for certain. While Republicans and Democrats keep finger-pointing in Washington, healthcare costs will continue to gobble up our Gross Domestic Product. We will continue to be outpaced by nations that have cheaper healthcare, and the poor and uninsured will continue to go to hospital emergency rooms for "free" healthcare, paid for by our taxes.
The Medicare trustees conclude that the United States needs to find longer-term solutions than those it has thus far relied upon. I don't think anyone could disagree with that.
