Tuesday, March 01, 2011

One of the ways Obamacare was to "save money" was to cut Medicare Advantage but now..

But now HHS announces that , at least for the short term- that is until the 2012 elections, payments will increase for Medicare Advantage Programs. See here.

It was a decrease in the Medicare Advantage Payments ,along with cuts to hospitals and other providers, that was to provide about half of the funding for the expanded insurance coverage to low income folks. It was projected that some 137 billion would be saved from cuts to Medicare Advantage programs. The alleged savings was touted to also extend the solvency of the Medicare Part A Trust fund.

The actions of HHS in this regard is typical of what George Will references as the "administrative state" which the United States have (has?) morphed into. In the "administrative state", Congress passes "sentiments" not laws, and delegates to the administrative tentacles of the Executive Branch the authorship and administration of the various rules that make the Congressional sentiments operational.See here for Will's comments.

Woodrow Wilson envisioned a government that would be run by experts who would be unencumbered by the messy give and take of politicians who would stray from what was right and good for the people by the actions of various interest groups and their own selfish urges. Somehow the only PhD to occupy the White House did not realize that the experts of the various agencies might themselves posses human characteristics that steer them to act for political reasons. It is hard to consider the recent actions of HHS other than being politically motivated.

1 comment:

Anonymous said...

I sort of got stuck on the statement, Woodrow Wilson envisioned a government that would be run by experts who would be unencumbered by the messy give and take of politicians who would stray from what was right and good for the people by the actions of various interest groups and their own selfish urges.I also read that, per capita Medicare Advantage payments will increase by 1.6% on average. My problem is not so much by the cost, rather, what is more bothersome, by the level of responsibility:
Once or twice a year, the insurance companies connected with Advantage plans hold meetings for the doctors servicing the patients on the plans. They pay the doctors to attend the conference, and they update them on the most profitable use of the ICD-9 coding system. They explain the value attached to each patient on their plan, and why this value increases with the severity or morbidity of each patient’s medical status.
The insurance company receives a fee, which depends upon the ICD-9 or ICD-9s in that patient’s medical record. The more complicated, the more the insurance company receives for that patient’s overall care. It is completely understandable, therefore, why the insurance company should pay its doctors to attend these meetings and then bonus the doctors depending on their diligence in coding. The insurance company is in the medical care business to make money, and in this case the payer is CMS. The insurance company is diligently pursuing those dollars to which it is entitled, those dollars, which CMS are only too willing to pay. It is also easy to understand why doctors working for the insurance company would want to attend a handsomely compensated gathering where they learn how to earn a few extra dollars from the government for the work they are already doing. What may be difficult to fully comprehend is why the government is willing to pay so heavily for the coded description of patients’ health. That they want the information is apparent; that they are prepared to pay for the information is a reality; why they need this depth of information about patients’ health is the question I pose, especially considering the current financial woes. No one in the CMS actually physically treats patients. The added depth of coding does nothing for the patients’ wellbeing, yet it does much to increase government cost.
Dr. Mannie