[Marxism] Health care bill will reduce health care for seniors

Louis Proyect lnp3 at panix.com
Sun Nov 15 18:19:05 MST 2009

Report: Bill would reduce senior care
Medicare cuts approved by House may affect access to providers

By Lori Montgomery
Washington Post Staff Writer
Sunday, November 15, 2009

A plan to slash more than $500 billion from future Medicare spending -- 
one of the biggest sources of funding for President Obama's proposed 
overhaul of the nation's health-care system -- would sharply reduce 
benefits for some senior citizens and could jeopardize access to care 
for millions of others, according to a government evaluation released 

The report, requested by House Republicans, found that Medicare cuts 
contained in the health package approved by the House on Nov. 7 are 
likely to prove so costly to hospitals and nursing homes that they could 
stop taking Medicare altogether.

Congress could intervene to avoid such an outcome, but "so doing would 
likely result in significantly smaller actual savings" than is currently 
projected, according to the analysis by the chief actuary for the agency 
that administers Medicare and Medicaid. That would wipe out a big chunk 
of the financing for the health-care reform package, which is projected 
to cost $1.05 trillion over the next decade.

More generally, the report questions whether the country's network of 
doctors and hospitals would be able to cope with the effects of a reform 
package expected to add more than 30 million people to the ranks of the 
insured, many of them through Medicaid, the public health program for 
the poor.

In the face of greatly increased demand for services, providers are 
likely to charge higher fees or take patients with better-paying private 
insurance over Medicaid recipients, "exacerbating existing access 
problems" in that program, according to the report from Richard S. 
Foster of the Centers for Medicare and Medicaid Services.

Though the report does not attempt to quantify that impact, Foster 
writes: "It is reasonable to expect that a significant portion of the 
increased demand for Medicaid would not be realized."

The report offers the clearest and most authoritative assessment to date 
of the effect that Democratic health reform proposals would have on 
Medicare and Medicaid, the nation's largest public health programs. It 
analyzes the House bill, but the Senate is also expected to rely on 
hundreds of billions of dollars in Medicare cuts to finance the package 
that Majority Leader Harry M. Reid (D-Nev.) hopes to take to the floor 
this week. Like the House, the Senate is expected to propose adding 
millions of people to Medicaid.

The Centers for Medicare and Medicaid Services administers the two 
health-care programs. Foster's office acts as an independent technical 
adviser, serving both the administration and Congress. In that sense, it 
is similar to the nonpartisan Congressional Budget Office, which also 
has questioned the sustainability of proposed Medicare cuts.

In its most recent analysis of the House bill, the CBO noted that 
Medicare spending per beneficiary would have to grow at roughly half the 
rate it has over the past two decades to meet the measure's savings 
targets, a dramatic reduction that many budget and health policy experts 
consider unrealistic.

"This report confirms what virtually every independent expert has been 
saying: [House] Speaker [Nancy] Pelosi's health-care bill will increase 
costs, not decrease them," said Rep. Dave Camp (Mich.), the senior 
Republican on the House Ways and Means Committee. "This is a stark 
warning to every Republican, Democrat and independent worried about the 
financial future of this nation."

Democrats focused Saturday on the positive aspects of the report, noting 
that Foster concludes that overall national spending on health care 
would increase by a little more than 1 percent over the next decade, 
even though millions of additional people would gain insurance. 
Out-of-pocket spending would decline more than $200 billion by 2019, 
with the government picking up much of that. The Medicare savings, if 
they materialized, would extend the life of that program by five years, 
meaning it would not begin to require cash infusions until 2022.

"The president has made it clear that health insurance reform will 
protect and strengthen Medicare," said White House spokeswoman Linda 
Douglass. "And he has also made clear that no guaranteed Medicare 
benefits will be cut."

Republicans argued that the report forecasts an increase in total 
health-care spending of more than $289 billion.

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