Medicare, Freedom and the Road to Financial Hell

If anything is the opposite of an unexpected event, it is the aging process. Yet our government continues to ignore the obvious solution for its fiscal ills: freedom. Here is the NYT editorializing in The Doctor Payment Follies:

The formula that is used to pay doctors who treat Medicare patients is producing increasingly absurd results. If it were to be followed this year, doctors would face a 21 percent cut in payments for the tests, procedures, office visits and other services they provide to elderly Americans.

That would be a disaster, driving many doctors to stop accepting Medicare patients. Luckily, nobody is seriously contemplating that. As it has done repeatedly in recent years, Congress is readying a short-term fix that would provide a modest increase in physician fees for the next 19 months.

Please consider reading the entire, brief editorial, though that is not necessary to understand my points.

Let us pick a nit. Why does the Times use the word "luckily"?

Of course this is not a chance decision as implied by "luck". The entire Obamacare premise involved false accounting, in this case that the "doc fix" would actually occur. But of course the "fix" was "in". So, billions of unfunded dollars later, the government comes to the rescue of doctors and patients. But what about the interests of the $10/hour 40 year old clerk at Wal-Mart? Why is government always picking winners?

The answer is truly simple. The government can cut its payments 21% and doctors can regain the freedom to charge fairly for their services. All the government has to do is eliminate the fee controls. What will happen is that doctors will accept as full payment the lower fee schedule for those patients who can not afford to see them at the higher rates. The better-off patients will pay more out of pocket.

And the Wal-Mart clerk will then also be treated fairly. And the government will be serving notice that it is finally going to get its own financial house in order.

Till that happens (don't hold your breath), more downside economic "surprises" are likely.

Copyright (C) Long Lake LLC 2010

Health Care "Reform" is Already Here and is Already a Mess

The news keeps on coming. The WSJ is reporting on a fiasco involving home oxygen therapy. My medical advice is: don't get old. In Medicare Rule on Paying for Oxygen Vexes Patients, the Journal reports (click on insert for better image, and please think about it):

More than one million people rely on Medicare to pay for home-oxygen therapy. Now some patients are running into problems switching their suppliers because of complex new rules the federal insurer uses to pay for the services.
Under the new rules, which began to affect patients on Jan. 1, Medicare will pay suppliers at its prevailing rate for the first three years after a patient begins coverage. Suppliers are then required to continue providing oxygen services to patients for another two years, but at a sharply reduced payment rate. . .

Donna Miller of Lancaster, Ohio, uses an oxygen concentrator and a CPAP machine at night to help her breathe. The 71-year-old says she is planning to move into senior housing located in another town and that she contacted a nearby supplier that she heard provides good service. But because Medicare cut the payment for her oxygen when she reached the three-year cap this year, Ms. Miller says she is still trying to work out a transition plan with the new supplier. "I don't think it's fair that I have to go through all this red tape," she says.

Yours truly dealt with Medicare for many years. The only good thing about it is that the HMOs are worse.

If things are this bad now (and they are), just wait till the whole country is Medicare-ized AND costs are cut more in the name of efficiency and prevention.

Copyright (C) Long Lake LLC 2009

I Second That Evasion: Follow-Up You Could Not Make Up

The repeated ironies and hypocrisies are too delicious to resist, so herewith follows a brief post on the Daschle tax holiday flap. From Bloomberg.com's Daschle Raised Tax Question in June, Finance Report Says comes the detail that one could not invent:

Medicare Payments Due

The former senator has agreed that he will have to adjust again his 2005, 2006 and 2007 tax returns because he didn’t pay Medicare taxes on the additional taxable income he incurred with the use of the car, the Finance Committee staff reported.

As Health and Human Services secretary, Daschle would oversee Medicare, the insurance program for the elderly and disabled.

As a reminder, Mr. Daschle apparently consulted with his accountant in June 2007 because the former Senator suspected that the private use of a chauffered limo was in fact a taxable service, paid back taxes and interest in January 2008 after being nominated for Secretary of Health and Human Services, but no one noticed the continued underpayment (!?).

There is a wild and crazy pattern here. Mr. Obama feels that only a tax evader, Mr. Timothy Geithner, is the right person to run the Treasury Department; by far the greatest number of Treasury employees work for the Internal Revenue Service. Now, Mr. Obama feels that despite having no special expertise in healthcare policy, the right person to run HHS is Mr. Daschle, a lawyer who, despite having an accountant, was apparently unaware that there is a 2.9% surtax on earned income allegedly to finance Medicare.

Not to forget, but the new Secretary of State famously shot her Presidential candidacy in the foot when she repeatedly told the untrue story about landing in Bosnia under sniper fire as First Lady.

Next, to replace Mr. Gates as Defense Secretary, a draft dodger?

Copyright (C) Long Lake LLC 2009