Monday, January 16, 2017

Medicare: Proposed Changes to the Plan - Part One

Now, I know that some seniors are adamant:


While it might be nice to stand, line in the dirt, opposed to ANY changes in Medicare, I'm afraid that is NOT a realistic scenario.

Medical care - particularly for seniors - is expensive. Insisting that doctors and other medical providers just suck it up, and take less money for services, has led to difficulty getting doctors to agree to see you. NO medical care is worse than pricey medical care.

It's the remedy of choice for politicians - there are fewer doctors than seniors, and seniors are the most reliable voting segment. Better to starve a doctor, than to tell a senior that he has to accept more expensive visits.

I've been investigating this for a few weeks. Like it or not, almost every senior will be affected by this issue.  I've read some of the available proposals, and have summarized a few below. I'll be posting more on this in the coming weeks; it's likely to be tackled early in the new administration's term, perhaps as early as this summer.
  • The AARP presentation lays out some of proposed changes, from the perspective of the Right (Heritage  Foundation) and Left (Brookings Institution), as well as from Avalere Health, a consulting firm on Health Issues. The presentation provides viewpoints from a variety of stakeholders, clearly identified.
  • Changes to Part D only - the ultimate cost of the Part D (medication part) of the Medicare plan was not known when the coverage was implemented by President GW Bush. This paper discusses ways of limiting costs to the providers.
    • Some limits on medication may be necessary. There are a few patients that will use meds that are quite expensive. Some of these are transplant patients; others are fighting chronic illnesses, such as AIDS, liver/kidney/heart disease, and may reasonably be expected to continue using those pricy meds for some time.
    • It may be necessary to adjust co-pays. Like it or not, most of us are sensitive to cost. If the cost of using a particular medication increases, we might be open to a generic or other substitute.
    • Lifetime limits might be a part of this equation. At some point, we might have to weigh the cost of staying alive against the cost of bankrupting ourselves and leaving nothing but bills to our estate.
  • Changes in Medicaid affect not only seniors, but other groups - Workers Comp, government workers, etc. Their plans shift when Medicare does. SOME of the 'concern' for retirees is really concern for their OWN plans.
  • Keep in mind just how much of the federal budget is affected by changes in Medicare.
    • " Taken together, Medicare, Medicaid, and the Children’s Health Insurance Programs are an estimated 21% of the federal budget while Social Security is approximately 20%" - emphasis mine.
    • Failure to reduce runaway costs may cause TAXES to increase - and, not just those that primarily affect wage-earners, but consumer costs, as well.
  • What is a "peverse incentive"?
That's all for now - I'll be updating this in Part Two later.

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