The problem with Medicare is it's fee-for-service reimbursement model. This leads providers to providing unnecessary services in order to increase the amount of money they get from Medicare. It's not necessarily malicious, Medicare's reimbursement rates are lower than private insurance, however it is waste...and basically fraud. There is a supply and demand problem as well. For example, in an area where there are limited MRI machines, the cost for the average Medicare patient is significantly lower (up to over 50%
than in an area where there are a surplus of them. This isn't because people who need MRIs aren't getting them, but because there is an excess availability of medical equipment doctors are less hesitant to order this expensive test. The result is a lot of people end up getting very expensive procedures that they simply do not need.
You can achieve significant Medicare savings by altering this model. I'm not sure if this bill did that, but I do believe it setup a commission with the power to review Medicare spending and change it.
In addition, about $200 billion of the Medicare "cuts" are by eliminating Medicare Advantage, and moving those patients back onto the regular Medicare Rolls. Medicare Advantage is basically a government handout to insurance companies, they enroll senior citizens and the government pays the premiums. This middle man has been empirically shown to cost around 15% more per dollar than if the customers were just on regular Medicare, with no changes in quality of service.
Finally, Paul Ryan mentions the Doc Fix as adding "$200 billion" to the costs. The Doc Fix is something that Congress has passed every single year (except this one so far) that increases Medicare reimbursement rates. It was never meant to be a permanent solution, as the problem is what I discussed above. Ideally, this bill should have addressed this issue. However, given the fact that this bill was about reforming the entire health care system, and not just Medicare, I don't really have a problem with them pushing it off until they find a better, more permanent, solution. And in reality that is what the commission is designed to find. As far as I know, it will be composed of medical experts who will report recommendations to Congress.
I don't really know how you can sit back and slam this bill for hurting Medicare, as the CBO analysis says it will extend the live of the Medicare trust fund by another 9 years.
than in an area where there are a surplus of them. This isn't because people who need MRIs aren't getting them, but because there is an excess availability of medical equipment doctors are less hesitant to order this expensive test. The result is a lot of people end up getting very expensive procedures that they simply do not need.You can achieve significant Medicare savings by altering this model. I'm not sure if this bill did that, but I do believe it setup a commission with the power to review Medicare spending and change it.
In addition, about $200 billion of the Medicare "cuts" are by eliminating Medicare Advantage, and moving those patients back onto the regular Medicare Rolls. Medicare Advantage is basically a government handout to insurance companies, they enroll senior citizens and the government pays the premiums. This middle man has been empirically shown to cost around 15% more per dollar than if the customers were just on regular Medicare, with no changes in quality of service.
Finally, Paul Ryan mentions the Doc Fix as adding "$200 billion" to the costs. The Doc Fix is something that Congress has passed every single year (except this one so far) that increases Medicare reimbursement rates. It was never meant to be a permanent solution, as the problem is what I discussed above. Ideally, this bill should have addressed this issue. However, given the fact that this bill was about reforming the entire health care system, and not just Medicare, I don't really have a problem with them pushing it off until they find a better, more permanent, solution. And in reality that is what the commission is designed to find. As far as I know, it will be composed of medical experts who will report recommendations to Congress.
I don't really know how you can sit back and slam this bill for hurting Medicare, as the CBO analysis says it will extend the live of the Medicare trust fund by another 9 years.
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