Thursday, December 10, 2009

Hospitals and Doctors - Surprise! Surprise! Doctors, Hospitals, Health Plans Resist Medicare at 55

Preface: In their desperation to pass a Medicare bill, Democrats have dropped the public option and proposed starting Medicare at 55 rather than 65. As indicated in a recent Wall Street Journal Health Blog, doctors, hospitals, and health plan resist Medicare expansion to the 55 to 64 year old cohort. No doubt, the reasons are philosophical, i.e., a government takeover. But they are also practical, Medicare tends to cut fees arbitrary and capriciously without warning. And Medicare fees often do not meet the cost of doing business. Hospitals say Medicare only covers 91 percent of costs, and doctors estimate Medicare pays 20 percent to 30 percent less than private plans. There is another reason as well. Medicare is going broke because of fraud, lack of cost controls, and rampant bureaucratic inefficiencies. Extension of Medicare to the 55 to 64 year group is almost certain to add to the national debt.

Docs, Hospitals, Insurers Oppose Medicare at 55. WSJ Health Blog, December 8

By Jacob Goldstein

The details of the Senate Dems’ health-care deal won’t be revealed for a few days, until after the CBO crunches the numbers. But the broad outlines are already clear — a move away from a new government-run health plan, coupled with a Medicare expansion that would allow people between 55 and 64 to buy into the program if they can’t find insurance elsewhere.

Medicare typically pays lower rates than private insurance, and big groups representing doctors, hospitals and health-insurance companies are lining up against the Medicare expansion:

Insurers: “This would add millions of new people to a program everyone agrees is going broke,” said a spokesman for America’s Health Insurance Plans, according to Kaiser Health News.

Hospitals: “Adding millions of people to [Medicare and Medicaid] at a time when they already severely underfund hospitals is unwise and should be opposed,” the American Hospital Association said in an alert sent to members and quoted by Politico.
Doctors: The AMA said it opposes the expansion because doctors face Medicare pay cuts, and because some patients already struggle to find a doctor who accepts Medicare, the WSJ reports.

Dr. Richard Reece is author, blogger, speaker, and innovation and reform commentator. Dr. Reece’s latest book, Obama, Doctors, and Health Reform ( is available at and other book websites. For information on speaking fees and arrangements, call 860-395-1501.

No comments: