Republican/conservative healthcare alternative still MIA 5 yrs later

[woolfe9998]

From your own first link:

Ask a doctor and most will tell you that they lose money on Medicare patients. They continue taking them because these people are long time patients and the doctors feel a responsibility toward them. Note also that your articles are mute on doctors accepting new Medicare patients (i.e. patients who are new to the doctor rather than existing patients who transition to Medicare.)

Look, you guys can cut Medicare as much as you wish as long as you can sell 50.1% of voters that cuts on other people are good for them. Just please pick a lane, don't pat yourselves on the back that your cuts have only caused less than 2% of doctors to stop taking Medicare patients whilst simultaneously arguing that there were no cuts - even though the guy at the top not only agrees he cut Medicare by $718 but promises to veto any bill restoring those cuts. And for the love of G-d, please stop accusing Republicans of WANTING to cut Medicare when you ARE cutting Medicare - even if you can argue that the number of physicians dropping Medicare patients is acceptable.

http://www.wsj.com/articles/SB10001424127887323971204578626151017241898

They aren't mute on the issue of docs taking new Medicare patients. You should have looked at the second link. There is plenty of data which bears directly on that issue. For example:

A small share of Medicare beneficiaries say they looked for a new physician in the past year, and only 2 percent of seniors with Medicare report problems finding one when needed—comparable to rates reported by privately insured adults age 50-64.

If there is a decline in docs accepting new Medicare patients, then by definition those who are looking for docs within the past year should be having trouble finding them, but only 2% reported having trouble.

But hey, if that isn't enough, here the issue is addressed directly:

According to recently-released physician survey data, the majority (91%) of non-pediatric physicians accept new Medicare patients—the same rate that accept new patients with private non-capitated insurance. This correlation persists generally across states, indicating that physician acceptance of new Medicare patients may be more related to local market factors than issues unique to Medicare overall.

Doesn't seem like what you're suggesting is correct.

So far as "most doctors" saying that they lose money from Medicare patients, you're going to have to back that one up because it doesn't make sense in light of these stats. If it was a loss, no chance would you see 90% participation rates.

The bottom line in this entire discussion of "cuts in spending" vs. "cuts in benefits" is, are Medicare recipients in general being hurt in some way because of the ACA? I see no evidence of this and while I shouldn't need to even say this, evidence, not opinions and bald assertions, is required to make a case.

 

[BonzaiDuck]

Just scanning through the thread, and noticed someone had quoted this:

"Meanwhile, the proportion of family doctors who accepted new Medicare patients last year, 81%, was down from 83% in 2010, according to a survey by the American Academy of Family Physicians of 800 members. The same study found that 4% of family physicians are now in cash-only or concierge practices, where patients pay a monthly or yearly fee for special access to doctors, up from 3% in 2010."

A SURVEY [statistical sample] . . . of 800 members of the AAFP . . . shows a 2% drop in family doctors accepting Medicare patients.

Recently, my local right-wing newspaper published a "survey" of likely voters in California who supported the Tea Party. The paper was guilty of nothing in this: they correctly reported the sample size and sampling error.

The local Tea Party Chairman fired off a letter to the paper, insisting that the low support of the Tea Party shown by the sample HAD to be incorrect.

He argued that in a state with 24 million eligible and 17 million registered voters, a sample of 1,000 could NOT reflect the population with any accuracy. But the simple mathematical statistics of the sample design was undeniable: a random sample would give percentage results with an error of +/- 3%.

Now there is a slight difference in sampling from a finite population and an infinite population -- of little consequence to the sample of voters.

And the correction factor "N-n" wouldn't amount to a hill-of-beans difference in this sample of doctors, either.

You might as well say there is no significant change in what doctors are doing with Medicare patients: One sample might show 81%; another might show 82%; another might show 83%.

Perhaps I might have collected statistics on my own observations of nonsense I've seen in political dialogue over the last 15 years, but I didn't. However, this is a typical Republican pattern: Use selective choices of facts to buttress your argument. And ignore mathematical reality and common sense. After all, voters are primarily stupid, and it's your mission to sway them with more nonsense, since you're right about everything, winning is everything, and the truth doesn't matter.

 

[werepossum]

They aren't mute on the issue of docs taking new Medicare patients. You should have looked at the second link. There is plenty of data which bears directly on that issue. For example:

If there is a decline in docs accepting new Medicare patients, then by definition those who are looking for docs within the past year should be having trouble finding them, but only 2% reported having trouble.

But hey, if that isn't enough, here the issue is addressed directly:

Doesn't seem like what you're suggesting is correct.

So far as "most doctors" saying that they lose money from Medicare patients, you're going to have to back that one up because it doesn't make sense in light of these stats. If it was a loss, no chance would you see 90% participation rates.

The bottom line in this entire discussion of "cuts in spending" vs. "cuts in benefits" is, are Medicare recipients in general being hurt in some way because of the ACA? I see no evidence of this and while I shouldn't need to even say this, evidence, not opinions and bald assertions, is required to make a case.

Two things here. First, this is conflating all physicians with primary care physicians. Specialists may be crying the most, but they still make out much better than do primary care physicians. It's also conflating Medicare and Medicaid, which though the same basic fund pay substantially different amounts for office visits. For example, the 2014 Merritt Hawkins study found that across all markets studied and all specialties, Medicare acceptance was 76% (not necessary accepting new Medicare patients but accepting some Medicare patients) whereas Medicaid acceptance was merely 45.7%, down from 55.4% in 2009 and 49.9 in 2004. As to why this might be, look at Bloomberg's article covering this situation. UnitedHealthGroup pays $119 per office visit, Medicare pays $73, Medicaid pays $52.

About 46 percent of physicians accept Medicaid, according to a 15-city survey last year by staffing firm Merritt Hawkins. That’s down about 10 percent from four years before. To encourage primary-care doctors to take Medicaid patients, the Affordable Care Act has temporarily increased the program’s payments to doctors, matching Medicare’s higher rates through 2014. But the boost doesn’t apply to specialists such as cardiologists and oncologists. “What they pay doesn’t even come close to covering expenses,” says Pat Howery, the administrator at Colorado West Otolaryngologists, an ear, nose, and throat clinic in Grand Junction. For a basic office visit, Howery says, UnitedHealth Group (UNH) pays $119 and Medicare $73; Medicaid comes in at $52. “You can’t make this up in volume,” he says. In January the clinic began limiting each doctor to two Medicaid appointments a day.​

Again, please note that seeing two only Medicaid appointments a day is still participation in your numbers, putting this practice squarely in the 46 percent of physicians who accept Medicaid.

http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2014waitsurvPDF.pdf
http://www.bloomberg.com/bw/articles/2014-04-10/doctors-shun-patients-who-pay-with-medicaid

Second, we're getting a bit far afield from my comment that Obama took $718 billion out of programmed Medicare/Medicaid spending. Since you are arguing that the issue is whether "Medicare recipients in general being hurt", I take it that you agree my statement is correct, no? If for instance Bernie Madoff stole $100 million from Bill Gates and yet Bill Gates has no particular reduction in lifestyle, would you argue that Madoff stole nothing? Same principle, yet I highly doubt you'd take that logic to the bench.

 

[ivwshane]

You are certainly giving Jhhnn a good run for title of Stupidest Person on the Internet.

And yet you are miles ahead of us in that run

 

[werepossum]

And yet you are miles ahead of us in that run

Ah, you only feel I am miles ahead because you cannot see me. If you were to look back -

Well, okay, you still couldn't see me. But I'm back there, somewhere, in the pack.

 

[Jhhnn]

From your own first link:

Ask a doctor and most will tell you that they lose money on Medicare patients. They continue taking them because these people are long time patients and the doctors feel a responsibility toward them. Note also that your articles are mute on doctors accepting new Medicare patients (i.e. patients who are new to the doctor rather than existing patients who transition to Medicare.)

Nice setup in the first sentence, aimed at the truly gullible, of course. Before you can use such a claim you need to authenticate it. Good luck with that. You can't possibly authenticate the rest of it, either, given that HMO's like Kaiser will take all the seniors they can get. It really doesn't get any less personal than that. They're in it for the money.

Look, you guys can cut Medicare as much as you wish as long as you can sell 50.1% of voters that cuts on other people are good for them. Just please pick a lane, don't pat yourselves on the back that your cuts have only caused less than 2% of doctors to stop taking Medicare patients whilst simultaneously arguing that there were no cuts - even though the guy at the top not only agrees he cut Medicare by $718 but promises to veto any bill restoring those cuts. And for the love of G-d, please stop accusing Republicans of WANTING to cut Medicare when you ARE cutting Medicare - even if you can argue that the number of physicians dropping Medicare patients is acceptable.

http://www.wsj.com/articles/SB10001424127887323971204578626151017241898

As has been pointed out, high end physicians with strong practices will get more from private insurers so some will turn away Medicare patients because they can.Some will do it just to get all political & "make a point" as if their importance is the equal of their egos. It's not like this will leave any of them hurting for money. If it did, it'd be a lot more than 2%.

Your fake piety is duly noted when we compare your shit to what Repubs want-

http://www.huffingtonpost.com/rep-john-b-larson/medicare-cuts_b_888639.html

 

[werepossum]

Gotta love this thread. Republicans don't have a plan - and look how horrible it is!

For the record, as I noted above Republicans don't have a plan intentionally. This isn't because they are waiting to spring some grand design on us, it's because they are unable to craft anything that is substantially different without pissing off some potential voters. This is their Hope and Change, and they are Hoping that you'll believe they have some great Change. They do not, of course, and will not. There is no miracle theory that will suddenly make the free market want to insure people who can't afford insurance.

And since it needs to be said because politics is a team sport, the only Pubby running who could possibly get my vote (minus some horrendous Dem candidate) is Kasich, who accepted Obamacare and expanded his state's Medicaid program. Yet Kasich will get nowhere because the most important quality in a Big Two candidate is an unwavering opposition to whatever the other team does. This is why I usually vote Libertarian.

 

[Jhhnn]

Gotta love this thread. Republicans don't have a plan - and look how horrible it is!

For the record, as I noted above Republicans don't have a plan intentionally. This isn't because they are waiting to spring some grand design on us, it's because they are unable to craft anything that is substantially different without pissing off some potential voters. This is their Hope and Change, and they are Hoping that you'll believe they have some great Change. They do not, of course, and will not. There is no miracle theory that will suddenly make the free market want to insure people who can't afford insurance.

And since it needs to be said because politics is a team sport, the only Pubby running who could possibly get my vote (minus some horrendous Dem candidate) is Kasich, who accepted Obamacare and expanded his state's Medicaid program. Yet Kasich will get nowhere because the most important quality in a Big Two candidate is an unwavering opposition to whatever the other team does. This is why I usually vote Libertarian.

They really don't have a plan for healthcare, just a plan to pander to the base, such as it is.

And, uhh, what difference does it make who Dems run if you vote Libertopian, anyway?

How does whining about subsidy cuts to well heeled healthcare providers fit into Libertopian ideology, anyway? Aren't you supposed to be engaging in some free market Rah-rah?

 

[werepossum]

They really don't have a plan for healthcare, just a plan to pander to the base, such as it is.

And, uhh, what difference does it make who Dems run if you vote Libertopian, anyway?

How does whining about subsidy cuts to well heeled healthcare providers fit into Libertopian ideology, anyway? Aren't you supposed to be engaging in some free market Rah-rah?

It matters because the Dem nominee may well get elected. And I started this not by complaining about the cuts, just by pointing them out.