Here Come the Medicare Cuts
This became something of a standard talking point during both the 2004 and 2008 presidential elections. As the story went, Democrats cared about seniors and their particular needs. Republicans wanted to cut Medicare and were plotting to kill your grandparents. My, what a difference one election makes, eh? Check out one of the health care amendments which passed in the Senate over the weekend.
By a vote of 53 to 41, the Senate on Saturday rejected a Republican effort to block cutbacks in payments to home health agencies that provide nursing care and therapy to homebound Medicare beneficiaries.
Republicans voted against the cuts, saying they would hurt some of the nation’s most vulnerable citizens. Most Democrats supported the cutbacks, saying they would eliminate waste and inefficiency in home care.
I think everyone on both sides of this debate can at least agree that we’d like to see waste and fraud eliminated or vastly reduced in the health care system. But is home health care a place to start looking to cut out some of the costs to pay for this massive overhaul? Gary Gross at Let Freedom Ring highlights an interview by Tom Hauser with Neil Johnson, executive director of the Minnesota Home Care Association.
HAUSER: How many Minnesotans right now have home care?
JOHNSON: Well, we’re looking at…the estimates are 68,000-70,0000 people last year, in 2007 excuse me, & 28,000 received Medicare services & another 30-40,000 received medical assistance services.
HAUSER: And what’s gonna be the practical impact if these cuts were to go through?
JOHNSON: Well, certainly access is an issue & we’re certainly worried about that but the many agencies are hanging on the edge right now. Medicare has been a good payer for most providers in the state of Minnesota & combined with medical assistance & some waiver payments & some private payments & long-term care but Medicare has been a key factor in providing needed skill services to the citizens of Minnesota.
HAUSER: There seems to be a disconnect here because people look at home care as a way to bring down costs that are often associated with hospital stays. I know 60 Minutes just did a segment on this & they said it was a good way for people at the end of their lives of saving spending $5-10,000 a day so why’s that being targeted?
JOHNSON: Well, I think it’s an easy target because people don’t really understand what home care providers do. But, yeah, we think we’re the best alternative out there. It’s efficient. It’s productive & it’s where people want to spend the rest of their lives…
This looks like one of those “good news / bad news” stories. The good news is that the Democrats seem to have finally gotten the message that the country is not going to tolerate some hugely expensive boondoggle with the name “health care reform” stapled on it, and they’re going into full blown war council mode to find a way to reduce costs. The bad news, as some of us have been predicting all along, is that in order to do it they’re going to start slashing elements of the current health care system which actually work, along with sneaking in as many taxes as they can manage. (See the new proposed taxes on all manner of Class III and above medical devices and taxes on so called “Cadillac health care plans” currently used by many middle class citizens.)
The current debate in the Senate is going far past whether or not we should allow a disastrous “public option” to thrash 1/6th of the nation’s economy into a blood mess. It is also highlighting a fresh examination of exactly which portions of the current system – still one of the best in the world which finds more than 80% of Americans satisfied with it – do work and which may need some trimming.
There is potential for useful, meaningful reform out there, but the Democrats are sprinting down all the wrong roads to find it. At this point I’m not sure which would be better… massively reforming the current proposals to create something which is both useful and fiscally responsible, or just trashing the whole thing and starting over with a leaner, meaner bill from scratch.
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14 Responses to “Here Come the Medicare Cuts”
Actually the home health care industry is fraught with waste and abuse, so it's a good target. Unfortunately the Democrats solution appears to be just making the pie smaller rather than weeding out the fraud. They are acting similarly with nursing home payments, which will affect people who are even more helpless than the folks getting home health care.
Obama/Pelosi/Reid's claims that people will not lose Medicare benefits they currently enjoy are just plain false. You can't cut billions of dollars out of programs and expect them to function the same.
I think these cuts are a good first step. More needs to happen, though.
First of all, a conditional thanks to the Dems that dared to cross the partisan lines, over no-man land, to risk the gas attacks from Harry and company and to try and protect us seniors. Of course there is fraud in Medicare/Medicaid, but these areas need the weeding, as mentioned above, not the wholesale cuts. Let's not throw at grandma with the sitz bath water.
[...] Jazz Shaw notes that Democrats used to scream that Republicans wanted to kill seniors through Medicare cuts. Now … This became something of a standard talking point during both the 2004 and 2008 presidential elections. As the story went, Democrats cared about seniors and their particular needs. Republicans wanted to cut Medicare and were plotting to kill your grandparents. My, what a difference one election makes, eh? [...]
I am not for indiscriminate cuts in Medicare costs. However, I am sure there are ways to reduce costs wisely and compassionately. But, hey, why are Conservatives crying crocodile tears for a Socialist program such as Medicare?
And here is the “other side of the story::
NYT, Dec. 7
Here's the reality: we can't afford all-you-can-consume health care. Some things are going to have to be cut. It's called facing the music.
Eighty percent of Americans are satisfied with the current system, because, let's face it, most of 'em ain't paying the bills. Forty seven percent of Americans don't even pay any federal income tax.
Here is the REAL reality.
Politicians, as a group and a whole, don't give a damn either way. What they do care about is the appearance of opposing the other side and getting reelected.
They are a classic monopoly – they are one and the same group of people, constantly trading sides in various arguments and disagreements in a manner that would make George Orwell proud (two GO references in one day!), worried only about keeping all others out, and stealing what they can for themselves.
Right on AR. Appearance certainly goes along with going along. All I see are lemmings with little baseball hats that say R or D on them.
Completely agree, AR, and it's not hard to understand why the politicians behave that way.
What is remarkable though is the extent to which voters follow their lead and can so easily be gamed into the same behavior of switching sides in an argument when it suits their partisan interests.
However, I am sure there are ways to reduce costs wisely and compassionately.
Well, let's hear them. What are the wise and compassionate methods that Reid plans to use?
“Obama/Pelosi/Reid's claims that people will not lose Medicare benefits they currently enjoy are just plain false. You can't cut billions of dollars out of programs and expect them to function the same.”
Of course, and it's just ridiculous that the Dems actually have their defenders, who believe what they say!
(Oh, well. Bottom tail of the bell curve has to exist, by definition, in any population…)
“the Democrats are sprinting down all the wrong roads to find it”
It's largely fiscal gimmickry. (It's not that they relish robbing Medicare.) They are appealing to the easily manipulated new prospective class of (new) federal beneficiaries, and are (for now; they'll remedy what they're doing later, I'm sure they're thinking or hoping) robbing existing older program Peter to fund part of exciting new program Paul. It's a variant of the “Beame shuffle” (and the temporary[?]-cannibalization and redirection is also similar to Obama's wanting to shift TARP funds to all kinds of other “good” purposes, notably before next year's elections. Would it be surprising if “temporary” “one-time” spending on health care was one of these new “good” purposes, incidentally?).
In all the talk about health care reform, I don't feel like there's enough discussion about understanding the real costs of health care. Why don't we ever know the costs of health care procedures and treatments? ?” I got a kick out of this fun, short video. Check it out. It makes you wonder why our health care system is set up the way it is.
http://www.whatstherealcost.org/45secondstoshare
Cute.