Now That It’s Over…

I’m of two minds to write this post this morning, but feeling like I do, I’m inclined to let the words roll.

I know many folks might not agree with what I’m going to write, but I really want to put it out there and see what people are thinking.  Because I just can’t reconcile in my mind why the general public is O.K. with this.

The biggest topic on my mind is medicare and it should be on the top of everyone’s list.  Now I’m not at an age where I qualify for medicare, but my mother is solely dependent on medicare for healthcare.

Here is the deal:

The SGR or sustainable growth rate formula is used to calculate reimbursements to various healthcare providers.  It was designed in 1997 as a way to keep medicare spending on a certain track of outgoing expenses.  However, in 2002, it became clear that the formula for figuring the SGR was flawed, requiring a 4.5% cut in all medicare payments to providers.  So, to prevent healthcare providers from opting out of medicare, they put a hold on the 4.5% cut, vowing to address the issue in congress.

The issue has been discussed, but no act has remedied it.  Every year they have put a hold on these cuts since 2001.  This hold is set to expire at the end of 2012, which would effectively decrease medicare reimbursement by about 28%–the 716 billion dollars that has bandied about in the press.  What has been talked about even less is the full implementation of medicare cuts which are an additional 415 billion dollars between the years 2013 and 2020 which is another 10 percent.  So ask yourself, if your employer came to you and said you would have to take a cut in pay that amounted to 40% over the next ten years, would you do it?  Of course not.  You would look for another job, because while your salary is being decreased, the cost of living is increasing, and medicine is no exception.  Technology costs money, tests cost money, and office visits cost money.  In order to sustain a medical practice and pay your overhead, you have to make money, not lose money.  A point that seems foreign to the guy sitting in the White House.

His master plan to save over a trillion dollars by the end of 2020 is to make medicare worthless.  Because health care providers will start opting out of medicare very quickly when these cuts hit, it will leave many uninsured saving the government the money they would have paid out to the participating providers.

So I ask the questions, how is this O.K.?  Why doesn’t the public see this?  Do they see it and just not care?  Do they hear it and think it’s a lie?  Do they hear and believe that is the plan, but that they will come up with some other solution?

One thing is for certain.  A storm is brewing, and the election?  That was just the beginning…


This entry was posted in medicare, Opting out of medicare, Reimbursement cuts, Sustainable Growth Rate and tagged , , , , . Bookmark the permalink.

38 Responses to Now That It’s Over…

  1. Peter S says:

    A lot of things have been put off until after the election, this is just the start of it. As usual, no one wants to talk about or do anything until it is almost too late. And then, at the last minute, some kind of stop gap measure will be put in place.

    Unfortunately, most people, including Congress, are better at procrastinating than they are at taking responsibility and making the tough decisions.

    • Yeah, and if you read the articles, just like anything else, when you wait till the last minute, it costs more…

      • Peter S says:

        What frustrated me about the presidential campaign was that I saw little of substance on both sides. I guess it’s always like that, but it seems as though there are some major problems coming up that were barely talked about, like Medicare, the “Fiscal Cliff”, deficit spending, and many others. It’s as if they think the public are not smart enough to know what is going on now, or able to figure out what might happen in the future.

      • It’s funny (as in strange, not comedy) but after the first debate, I thought hey, maybe Romney is it. Then after the VP debate, I was really impressed with Ryan. But I have to say, the second and third debates, I found myself thinking, whoa, what happened? It was then I got out the worry beads… 🙂

      • Peter S says:

        They were a little too cautious, maybe they didn’t want to wreck any momentum that they had built up during debates 1 and 2. I can’t listen to the radio or watch TV for the next few days, it’s just too frustrating to see!

  2. wedelmom says:

    Great post full of great information. My parents are also dependant on medicare and I have been saying many of the same things you just pointed out. I too am in a quandry as to how the public is okay with all of this, but it would seem that they are. I hate to believe that people don’t care about anything that doesn’t directly affect them but that is the perception I have right now.

  3. Barneysday says:

    If I’m reading you correctly, your major concern is the cut to fees paid to caregivers now and in the future. I share your concern. More medical offices are now including signs that they are no longer medicare providers, and although I truly believe the days of the wealthy doctor have passed, like any professional, they deserve a comfortable living.

    Having said that, I don’t see how Medicare can be allowed to go away, now or in the future. There are still billions of $$$ wasted in fraudulent charges from fraudulent office fronts. The payments made to Medicare, like increases to Social Security are inevitable. There will also have to be OptOut provisions in both programs. Did you know you can opt out of Social Security, but still have to pay taxes on the income you would have received? How utterly stupid is that!

    And Ryan’s plans of vouchers was silly for a few reasons. 10 years, (If you were 55 or less in his plan) is nowhere near enough time to recover/save for senior medical care. We just retired, and are paying a high deductible, but still, $1800/month. How is anyone going to save for that? and secondly, his voucher plan of $5,000 a year is ridiculous against these charges.

    So, like so many things political,we will be forced as a country to await the “cliff” before anything of substance is done. Lets hope thats not too late.

    Great post

    • Yes, I’m hearing the same thing from friends, although I haven’t seen it–that medicare isn’t accepted at their doctors offices. But I remember one year the insurance we got from my husbands office wasn’t accepted by anyone in town (they were told that everyone accepts it), but when I tried to use it at the pediatricians office, they said no. Then I called around, and found no one accepted it. They eventually worked out a contract, but I remember that feeling, and absolutely freaking out at the idea that NO ONE took it. What is that like for the elderly? I can’t even imagine. I do think there is a fix. I don’t think Obama has it. They still think in terms of helping everyone, even if that means cutting your own throat (like abandoning the elderly). They haven’t (and frankly no one has) shown that they can think outside the box.

      • Barneysday says:

        I don’t think it can be done by one guy in office, nor one legislator. This will have to be a team effort of both sides, willing to fall on their swords, so that no one has to. Its a losing proposition unless everyone buys in.

      • That is true. I was thinking that maybe they need to separate duties. Foreign policy seems to be such a different animal from economy. Maybe there should be a commander in chief for each…

  4. robincoyle says:

    The whole thing scares me. The problems are so massive, it feels out of control. How can we fix the problems that seem unfixable. Thanks for putting this out there. Time for straight talk and less political posturing.

  5. I am very concerned and so dissapointed with the result.

    • I’m hearing that from so many people. I think what bothers me the most is the fact that so many people are in need, but no one wants to realize that the resources are not limitless. Take the illegal immigrant issue. How can anyone think we can take on the thousands and thousands of illegal immigrants when we don’t even have the resources for people who have actually paid into the system? It’s ludicrous. When someone is drowning, the first rule of life saving is to throw them something, not go out and try to rescue them yourself. They will pull you down with them in their desperation to survive. And what good is that if you both die in the act? Maybe that sounds cold and heartless. Maybe there are people who will say it’s even unconscionable. But there is a reason that the airplane spiel tells you to put your own air mask on first before you put one on your child. You can’t save them if you’re unconscious.

  6. Arlene says:

    Thank you for your post. It’s good to know I’m not the only one frustrated with the obsurdity.

  7. Imelda says:

    You laid it out clearly. I hope my comment is not too cynical but the solution to that problem will be one of the come-on – vote-for-me line in the next election. The government needs to have something to dangle in front of its constituents.

    However, I hope and pray that for the good of the people and the country, unrest does not set in before the problems are solved.

  8. I’m in Canada and it is so hard to understand your system because ours seems so simple in comparison…I hope that somehow things get better for you….Diane

  9. sayvan says:

    The answer lies in the system of taxation. The reality is that this crisis is a carefully constructed crisis. It doesn’t have to happen. The contribution public services make to our prosperity
    should be obvious, but it is not always properly
    appreciated and frankly the right want us to think its not sustainable because the alternative they propose means more profits for corporations. It is generally agreed that public services
    such as health care and education need to be properly
    funded and widely available. The facts prove that economies pick up and slow down with governmentment spending changes. When economies decline it is often a direct result in cuts in spending. Study after study proves that government spending on social services, infrastructure and income support raises national income by more than the dollars actually spent. Likewise the reverse occurs when we turn to austerity and cuts to those very systems. Income inequality leads to increased health care and social cost. Tax fairness is a major cause of this decline and inequality in your country and mine (Canada). Attacks on labour rights, attacks on Unions, the lack of manufacturing jobs and lack of an industrial strategy as well as a rising number of McJobs all are major contributers to the issues we are facing in North America. Countries with a strong labour movement are more democratic and more transparent. The first wave of attacks on equality are always against labour…. and why? Without a strong labour movement the Conservative ‘Think Tanks” have a clear road to implement and create rules that allow the rich to get richer and the rest of us to pay for and carry the burden of those cuts.
    The real problem is that over the last 12 years and really the previous 8 (Bush years) the total tax rate has decreased for the top 1% and increased for the bottom 10%. High income earners have not paid taxes this low since the 1920’s. Remember what happene the decade following that? In Canada, the corporate tax rate has never been so low. These types of tax cuts have not created more jobs, they have not created more investment, nor have they improved productivity. However, during this same time while seniors are seeing reduced benefits as one example, corporate profits have soared, all the while the economy has been tanking. In 1995, the average CEO made 85 times the wage of the average worker. Today, while millions are unemployed that number has risen to 219 times the pay of the average worker. Financial sectors are being bailed out by the tax payers, yet they are not paying their share. In Canada, while the top 5 banks made a combined 20 billion in profit in 2010 they also enjoyed 11 billion in tax savings. Are you starting to see why our Medicare system or the free universal health care all Canadians enjoy, is now at risk? The reality of the situation is that this is not a spending problem, the reality is this is a revenue problem. There is more than enough money to sustain these programs unfortunately this money is in the wrong hands and spent on the wrong priorities. Your President has the right idea. I am sorry if I have hijacked your post but I think part of the problem is the slanted spin that conservatives like to put on the reality on the ground. I listened to Obama make his speech last night, I felt empowered and in a strange way proud to be a supporter (even if I am a Canadian).

    • I don’t know that I agree with you wholeheartedly. And if I understand you correctly, then Obama shouldn’t be raising taxes at all, because there is more than enough money, it’s just allocated incorrectly. I think we are saying some of the same things, though. My problem is, where do you draw the line? The reason the wealthy don’t pay the same taxes is because of all the loopholes they can take advantage of, effectively lowering their tax rate. I have yet to hear Obama address the loophole issue, and like it or not, he IS one of them. He does not pay his fair share in taxes, has a diverse investment portfolio, and I’m certain he doesn’t want to give that up anymore than anyone else in congress. So it’s easy to say, tax the people who make 250,000 or more, because that guy who makes 250,000 can’t take advantage of the same loopholes as that guy who makes half a million. So in the end, the guy making 250, his tax rate will increase by 5%, while the guy who makes half a million will stay the same due to some loophole to lower his tax rate. The only way to fix this tax revenue problem is to do away with ALL loopholes period, and have a flat tax, at three different levels of income. The lower income pay less, the middle income pay a little more and the top earners pay the most. Tax is collected and that is that. There is no tax day, there’s no itemization, there’s no freebies. And his idea to take monies from medicare and shift them to a defunct medicaid is disastrous. The simple fact is, nothing in life is free. And another simple fact is, you CANNOT SAVE EVERYONE! It is the law of survival. Do we have an obligation to help others? Absolutely. But EVERYONE has to do WHAT THEY CAN. And our country has become rife with people who think of being taken care of as a right and a way of life. There is a saying, “The world needs ditch diggers too.” Not everyone can be Einstein. Not everyone can be Bill Gates. Those that are less fortunate deserve help and care. But that is a separate issue from those who refuse to work, and only take from the system without giving a single thing back, and EXPECTING IT. From where I sit, his constituency is filled with the latter, not the former. He talks the talk, but does not walk the walk. He only donated serious money to charity when he began considering running for presidency. If he has everybody’s best interest in mind, then I’ll believe it when I see it. You are right about protection of the corporation and wealthy. What I disagree with is to say that one side or the other promotes this while the other does not. Hogwash. They both do. The real problem is that congress and government is broken. And until it is overhauled, anything else is just a band aide.

      • Pat Bailey says:

        Obama did say that the tax loop-holes need to be fixed, so that people who make more pay their fair share, including himself. People who have the most power are the people who have the most money – and their sole purpose it seems is to hang onto it. I am hearing the right say that billionaires worked hard for their money and should be able to keep it. I am of the belief that anyone with a billion or more in assets, got that money because they exploited others and others worked hard for them. I believe that those with more are expected to give more to the greater good of society, My experience has been that those who need help are those who just can’t make it because of crippling mental illness or physical disability or because doors are closed to them because of discrimination. My staunch far-right friend is death on free-loaders but has a son and a sister who are getting a lot a welfare benefits because of mental illness. Her mother is also getting benefits from the VA and Medicare.
        According to the reporting by the more moderate and liberal news stations, there is evidence that the two sides are open to working together. Journalist who I have a hard time discerning their political leaning are also sounding optimistic. I’m not hearing this optimism from the more conservative news stations.

      • Yes, I did hear that now that you say it. I just think that his clever accountant like so many of the wealthy will figure a way around. Hopefully they will work together. Only time will tell.

      • sayvan says:

        fair enough on your thoughts, however what I am saying is that we need to tax the higher income as thats where the money is. Whether that be closing loop holes or simple increases. Just look at the campaigns and their fund raising. the big super packs clearly have the money to pay for the programs we all cherish. The amounts spent would put a huge dent in the defecits of many countries! A flat tax will never work. The lowest income earners will always pay more than those at the higher end when you break that down to real money, disposable income. I like the debate tho…. now lets get back to our photos and what makes are blogs tick!

      • Agreed. All the politics just makes me depressed. I much prefer the photography.

  10. To your question “why does the public not see this?” – – from what I observe, talking with others, listening to the more conservative pundits – – there are alot of people out there who just plain want “free stuff”. They don’t get that someone has to pay. I don’t think they want to see it. America has changed alot – – and although change isn’t necessarily a bad thing, I don’t feel real good about some of those changes. I’m more of a “minimal government/personal responsibility” person. It seems there are many who would rather be taken care of. It looks kind of scary to me… I worry for my children and grandchildren. Thanks for a good post 🙂

    • Thank you Brooke. It is scary. I don’t get it. And why anyone could think that the top 1% can cover the debt is beyond me. It’s mathematically impossible.

      • sayvan says:

        Arnel… it’s actually not. The 1% have more than enough to pay what is their fair share and that is the key…. what is the fair share. If it were not for the conservative agenda people would not have a need for what some commenters refer to as “Free Stuff”. If people didnt have to work 3 or 4 part time jobs just to make ends meet our communities would be much better off and much stronger and healthier. The Conservative agenda and people like MItt Romney are the very ones who attacked and destroyed our economic manufacturing base and made millions doing it while the every day person suffered the consequences.

      • Well, I think we are actually referring to two groups of people when referring to “free Stuff”. But I suspect we are going to have to agree to disagree here. I don’t think it is totally one side any more than it is totally the other side. There is more than enough blame to go around. Likewise, the solution is not completely the leftists solution, and it’s not completely the rights. Neither can fix it alone.

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