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Reform advocates challenge gov't. report on Medicare impacts of health-care bill

By Lori Montgomery
A plan to slice $500 billion from Medicare over the next decade -- one of the most significant sources of funding for President Obama's health care overhaul -- would not jeopardize services for Medicare patients, reform advocates argued Monday, challenging a government report suggesting that the cuts could prompt hospitals and other providers to stop participating in the program.

"A memorandum recently issued by the CMS Actuary analyzing the effects of 'America's Affordable Health Choices Act of 2009' (H.R. 3962) concludes that some providers may end their participation in the Medicare program. Hospitals always will stand by senior citizens," Charles "Chip" Kahn, president of the Federation of American Hospitals, said in a statement.

Added Sister Carol Keehan, president of the Catholic Health Association of the United States: "Clearly, the Catholic Health Association thinks the possibility that hospitals might pull out of Medicare because of the deal that was struck to be very, very unfounded.... Catholic hospitals would never give up on Medicare patients."

The comments came in reaction to the release over the weekend of a 31-page report by Richard Foster, chief actuary for the Centers for Medicare and Medicaid, the federal agency that administers both programs. In an analysis of the House bill requested by GOP lawmakers, Foster, who serves as an independent technical adviser to the administration and Congress, questioned the sustainability of about $282 billion Medicare cuts, which would sharply lower projected payments to institutional providers. He also noted that an additional $200 billion in proposed cuts to the Medicare Advantage program is likely to reduce enrollment in the program by 64 percent in 2014, causing more than 8 million seniors to lose access to the program's more generous benefits packages.

Overall, the cuts would require spending per beneficiary to grow at roughly half the rate of the past two decades, according to the Congressional Budget Office, a dramatic reduction many budget and health care experts consider unrealistic. In his report, Foster said the cuts could prompt some providers to stop accepting Medicare patients, potentially jeopardizing access to care for millions of patients. Alternatively, Foster wrote, the providers could implore Congress to restore some of the funds, blowing a hole in the financing for House's $1.05 trillion expansion of health coverage.

Democrats and hospital officials on Monday disputed that assertion, arguing that providers had agreed to the cuts in exchange for legislation that would bring them millions of newly-insured customers. Moreover, they said, hospitals, nursing homes and other institutional providers -- unlike doctors -- are heavily dependent on public health recipients and would never pull out of the programs.

In an interview, Foster said it's possible that the deal could hold through 2019, but said that at some point, providers are unlikely to be able to absorb the cuts. "The question is at what point would it become unworkable," he said. "If it's within the 10 years, then some portion of those savings would not be realized."

Democrats also challenged another of Foster's points: That adding more than 34 million people to the rolls of the insured, as the House bill is projected to do, would overwhelm the existing health care system, causing providers to raise fees or take privately-insured patients over the newly-expanded pool of Medicaid patients that would be created under the legislation. A House Democratic aide said Foster had not taken into account an entire section of the House bill that calls for new investments in community health centers and incentives to expand the supply of physicians and other providers.

Foster acknowledged that he had not estimated the impact of those provisions. But, he said, "The key issue is, if you add 34 million people with insurance, can the supply of providers expand quickly enough? And that's not obvious. Even if the well-intentioned and well-designed" provisions in the House bill were enacted, Foster said, he remains convinced that the system's ability to rapidly absorb the increased demand for services "is worth worrying about."

By Web Politics Editor  |  November 16, 2009; 5:57 PM ET
Categories:  44 Native , Health Care  
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Comments

Its not so much that providers will stop taking Medicare, its what services will remain. As an example, for inpatient mental health services, our hospital gets paid about 50 cents on the dollar of what it costs to care for a patient. Hospitals cross subsidize services like this. As reimbursements fall, some of these services will be reduced or eliminated by various hospitals as we will be unable to subsidize any longer. As services get cut or eliminated, access gets reduced and that is where the impact is felt by both Medicare and non-Medicare patients. This will be a certainty as reform happens.

Posted by: chuckgijanto | November 18, 2009 7:55 AM | Report abuse

Rich393, the "Catholic" Health Association of the United States seems to be one of the many "Catholic" groups FUNDED and MANIPULATED by George Soros, a U.S. enemy bent on destroying our health care and our country. http://www.rightsidenews.com/200911127274/editorial/atheist-soros-funds-catholic-groups.html

As a Catholic, I'm insulted by Sister Carol Keehan's ridiculous propaganda. Those receiving medicare already have problems because many doctors CAN'T AFFORD to treat Medicare patients. The plan to slice $500 billion from Medicare will make it almost impossible for seniors to receive health care.

Additionally, thousands of doctors are already considering getting out of the health care business if the Obamacare SCAM is imposed on us. Imagine the scarcity that will result from the addition of 35 million new patients with fewer doctors or nurses!

Don't believe the PROPAGANDA of "Catholics" funded and manipulated by U.S. enemies like George Soros.

Posted by: AntonioSosa | November 17, 2009 2:29 PM | Report abuse

"Added Sister Carol Keehan, president of the Catholic Health Association of the United States: "'Clearly, the Catholic Health Association thinks the possibility that hospitals might pull out of Medicare because of the deal that was struck to be very, very unfounded.... Catholic hospitals would never give up on Medicare patients.'"

What? On one hand the Catholic Church would deny basic services to 68,000 needy Washingtonians if the city passes a same sex marriage bill. Then the Catholic Church says the above.

Why should we believe either statement?

Posted by: Rich393 | November 17, 2009 2:14 PM | Report abuse

Congratulations to the WashPo staff for covering the CMS report and the reaction to it. The NY Times decided not to run any story of the report, further convincing critics that the paper has continued to blur the line between its editorial and news operations.
Thom 714

Posted by: thom714 | November 17, 2009 12:26 PM | Report abuse

Many average Americans have accepted wage cuts and no increases to save their jobs. The healthcare industry can do the same though this is probably more smoke. Medicare advantage accounts should be for low income seniors who need them. That is not the case now and those screaming the loudest are probably the many well off seniors soaking us for a perk we can not afford and that won't be available to those of us now paying for them to have it.

Posted by: Falmouth1 | November 17, 2009 12:10 PM | Report abuse

Posted by: scrivener50 said "WHAT GOOD IS HEALTH CARE REFORM...AND SILENT, INJURY- AND ILLNESS-INDUCING, MOOD-ALTERING MICROWAVE / LASER RADIATION WEAPONS SYSTEMS USED TO IMPAIR THE PHYSICAL AND NEUROLOGICAL FUNCTIONING AND WELL-BEING OF MANY AMERICAN CITIZENS".

Just because you are paranoid doesn't mean someone isn't out to get you. I hope that mental health care reform will be included in the bill. America REALLY needs it.

Posted by: littlepaws | November 17, 2009 10:39 AM | Report abuse

Anyone who thinks 500 billion can be reduced in Medicare spending over ten years without detrimentally affecting health care for seniors in this country seems very deluded. They seem to think hospitals and medical care providers will simply accept lower payments, salaries, etc.
Posted by: Aprogressiveindependent ====================
I URGE YOU, progressive independent to do some research. Most of that 500b comes from the Advantage Plans which I consider as welfare plans. These people do not even pay the Medicare monthly premium. If one is that poor he/she should be on Medicaid. They are not poor people on these plans. My friends tell me how they renovated their homes and are now going on a cruise with the money they saved. Please. Educate yourself! The Advnatage Care programs are provided by for profit insurance companies who charge the government on an average of $849 a month for each enrollee(cost depends on whether or not you have a chronic condition). For this the enrollee gets insurance for glasses, hearing aids, dentist visits, and health club payments. These perks are practically free to the insurance company - paid for by you and me and the Medicare Trust Fund. The reason some do not join these plans is because we need to keep our specialists - usually heart doctors. These plans are OK if you are relatively healthy and have few or no chronic conditions. They are PPOs and HMOs with lists of doctors and hospitals, copays and high deductibles. Wait until one of the participants has a lengthy hospital stay. The copay will knock them out! One participant told me that at the beginning of this year the entire doctor list she had to choose from had changed - new doctor every year? Many of us can't do that. BTW hospital payments and provider payments have already been negotiated. Read and learn.

Posted by: littlepaws | November 17, 2009 10:28 AM | Report abuse

On the one hand he's saying people are not going to get care because of cuts in benefits, and on the other hand he's saying people are not going to get care because of increases in benefits. Sheesh! Doesn't anyone every say, Of course, it's going to work? Universal health care is a commonplace in developed countries. Of course, it's going to work.

Posted by: cmckeonjr | November 17, 2009 7:09 AM | Report abuse

WHAT GOOD IS HEALTH CARE REFORM WHEN A FEDERAL-LOCAL 'MULTI-AGENCY COORDINATED ACTION PROGRAM' IS DESTROYING THE LIVES AND LIVELIHOODS OF UNJUSTLY 'TARGETED' AMERICANS...

BY MEANS OF A GPS-ACTIVATED NATIONWIDE VIGILANTE ARMY;

CO-OPTED LOCAL POLICE;

COVERT PROGRAMS OF FINANCIAL SABOTAGE;

AND SILENT, INJURY- AND ILLNESS-INDUCING, MOOD-ALTERING MICROWAVE / LASER RADIATION WEAPONS SYSTEMS USED TO IMPAIR THE PHYSICAL AND NEUROLOGICAL FUNCTIONING AND WELL-BEING OF MANY AMERICAN CITIZENS.

President Obama, AG Holder, SecHomeland Napolitano, SecDef Gates, DNI Blair must dismantle the nationwide, federal-local GPS-activated extrajudicial targeting and punishment matrix and the covert microwave/laser attack system and remove from power the secretive executive branch officials who continue to oversee it.

http://nowpublic.com/world/gestapo-usa-govt-funded-vigilante-network-terrorizes-america

OR (if link is corrupted / disabled):

See "GESTAPO USA" at http://NowPublic.com/scrivener ("stream" or "stories" list).

***

U.S. CENSORS THE NET AS OBAMA LECTURES CHINA ON NET CENSORSHIP

http://nowpublic.com/u-s-censors-net-obama-lectures-china-net-censorship

Posted by: scrivener50 | November 16, 2009 11:57 PM | Report abuse

* If you go with the public option, it is not a free option. You still have to pay for it.
* If you like your current option, you can't keep it. It's going to be discontinued.
* If you need care and can't afford it, there are free clinics and Medicaid.
* If you have preexisting conditions, you can still get insurance; you just have to wait a bit.
* If you are an insurance company, you have to pay politicians for their favors.
* If the proposed plan is passed, premiums will become unaffordable, and care will decrease.

Posted by: ReginaldJackman | November 16, 2009 9:45 PM | Report abuse

you are asking me to believe a nun? man i wore their hands across my face as do generals medals upon their chests. i had to switch providers here in San Diego because the waiting rooms were filled with tons of illegals and now you are telling me 34 million are not going to make a difference? this is not health care it is new taxes, raising premiums and giving the government more power over my life. i left Minnesota and Medicare because it is cheaper here in Southern California for medical care and rent....and it is sunny, what a trade

Posted by: Timray18 | November 16, 2009 9:05 PM | Report abuse

My father was a health actuary for the international consulting firm Milliman, Inc. He was testifying before congressional committees on health care financing back in the late 1960's.

He has recently created an online book at http://29thday.org to help people solve the problems we all face.

Chapter 8 of that book is on health care reform. He proposes solutions that not only save 6.4 trillion over 10 years but empower individuals rather than institutions. He does a good job explaining complicated issues in layman's terms.

Check it out. It's free. And he wants to know what you think about all this as well. Here is the link.

http://29thday.org/book/chapter.php?chapter=8

Pete

Posted by: pberry1_98 | November 16, 2009 8:44 PM | Report abuse

Wouldn't it be a GREAT and WONDERFUL miracle if JUST ONCE Congress would LISTEN and vote according to the vast MAJORITY of United States Citizens who OBVIOUSLY want Single-Payer Public Health Care - - - instead of being MORE ATTUNED TO THE BAST___RS who finance their re-elections??????

Posted by: lufrank1 | November 16, 2009 8:35 PM | Report abuse

Anyone who thinks 500 billion can be reduced in Medicare spending over ten years without detrimentally affecting health care for seniors in this country seems very deluded. They seem to think hospitals and medical care providers will simply accept lower payments, salaries, etc.

Posted by: Aprogressiveindependent | November 16, 2009 6:20 PM | Report abuse

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