Sunday, November 29, 2009
Medicare as Godfather and Grandmother; Quote and Note
As I tell my students, Medicare is the Godfather when it comes to setting payment rates ( “I have an offer you can’t refuse.), but like my Grandmother serving lunch when it comes to what care a patient can receive (Whatever you would like, dear).”
Donald Taylor, Jr, assistant professor of public policy at Duke University, clarifying factors at work in the national debate over health care reform in an op-ed in Raleigh’s News and Observer.
Paul Grundy, MD, Director of Healthcare, Technology and Strategic Initiatives at IBM Global, pointed out to me the U.S already has, in effect, a single payer system - Medicare sets the rates for the codes and health plans follow. Unfortunately, Medicare has no fraud or cost controls, as evidenced by the $60 billion in annual fraud and the $50 billion spent annually in the last two years of life. Obamacare promises delayed savings – prevention, EMRs, and coordinated care - and $500 billion in cuts over the next 10 years – but observers doubt Medicare has the political will to make savings and cuts stick. Health reform must start with Medicare reform. Medicare is the Devil not the Saint in runaway spending rather than the other way around. If past is prologue, grandma is unlikely to pull the plug on anyone.