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Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
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ctipton Offline
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Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
Sunday, May 29, 2011
By Terence P. Jeffrey


[Image: aaa1_41.jpg]
(CNSNews.com/Penny Starr)
Sen. Churck Schumer (D-N.Y.)

(Commentary) - Sen. Charles Schumer (D.-N.Y.), appearing on NBC's "Meet the Press" today, proposed a reform that would ration health care for sick seniors by telling doctors the Medicare system would pay them a single flat fee for treating a particular illness as opposed to paying for the specific services needed to treat a particular patient.

The system proposed by Schumer would give health-care providers a financial incentive to withhold care from sick seniors because each and every service or treatment they provided would cut into their profit margin--or cause them to lose money.

Under the current fee-for-service Medicare system, Medicare payments are already so low that many doctors do no take new Medicare patients because it costs them too much to do so, or they transfer the costs of treating Medicare patients to private insurance holders by charging higher rates to them.

Yet Schumer sees greedy doctors as Medicare's root financial problem.





"The root of the problem is a cost-plus system," said Schumer of Medicare on "Meet the Press." "When you're sick, the doctor gets paid for each service, each prescription, each pill, each test. If you were to tell doctors you get a certain amount of money to treat Jim Smith, who has a certain form of diabetes, say $10,000, every study shows that you'd save hundreds of billions of dollars without cutting benefits to people. That's what Democrats stand for."

Schumer outlined this proposal while attacking the reform proposed by House Budget Chairman Paul Ryan (R.-Wis.), which Schumer said would "end Medicare as we know it."

In fact, the Ryan plan, included as a long-term goal in the budget approved by the Republican-controlled House of Representatives earlier this year, would not change the Medicare system at all for Americans 55 or older. Younger Americans under Ryan's plan would receive a federal subsidy to pay the premiums on a guaranteed health-insurance plan that they would choose and purchase.

Under the Ryan Medicare reform plan, decisions about what health coverage and services to buy or not buy would be in the hands of the individual American. Under the Schumer Medicare plan, decisions about what health coverage and services seniors would get would be in the hands of Medicare bureaucrats who would decide what flat fee any particular illness was worth and in the hands of health-care providers who be able to increase their income by decreasing care and who could go broke if they provided needed care to a sick patient that cost more than the Medicare bureaucracy's one-size-fits-all flat fee.

http://www.cnsnews.com/news/article/schu...ough-one-s
 
05-31-2011 12:39 PM
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QSECOFR Offline
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RE: Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
I guess Sarah Palin right all along.
 
05-31-2011 03:10 PM
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BearChatter v2.0 Offline
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RE: Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
I hear the Democrats are preparing a new bill idea called "The Logan's Run Bill".

When old people reach a certain age, we just kill them off.
 
05-31-2011 04:34 PM
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glacier_dropsy Offline
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RE: Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
Fu*k the politics and discuss the issues for a change?

This type of reimbursement strategy is already in place for dialysis patients. Medicare makes one "bundled" payment a month for all dialysis related care. It was recently implemented, so it will be interesting to track how the costs and outcomes are affected. I'm guessing we will see a shift towards peritoneal dialysis over the next few years.

Schumer sounds like a moron in his discussion of what physicians get paid for. Few physicians get reimbursed for admitting the patient, ordering labs, ordering imaging, and ordering procedures. That must be some interventional radiologist that got tired of the hours so he went into pathology, but he missed the human contact, so he decided to be a family practitioner, but he kept up on all his board requirements.
Now, if you want to discuss what hospitals get paid for, that is different.

That article is not short and sweet, it is brief and brainless. Get ready for an onslaught of such nonsense before the next election cycle. They forced you into Obamacare vs they didn't protect your medicare...FML.
 
05-31-2011 09:50 PM
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ctipton Offline
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RE: Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
(05-31-2011 09:50 PM)glacier_dropsy Wrote:  Fu*k the politics and discuss the issues for a change?

This type of reimbursement strategy is already in place for dialysis patients. Medicare makes one "bundled" payment a month for all dialysis related care. It was recently implemented, so it will be interesting to track how the costs and outcomes are affected. I'm guessing we will see a shift towards peritoneal dialysis over the next few years.

Schumer sounds like a moron in his discussion of what physicians get paid for. Few physicians get reimbursed for admitting the patient, ordering labs, ordering imaging, and ordering procedures. That must be some interventional radiologist that got tired of the hours so he went into pathology, but he missed the human contact, so he decided to be a family practitioner, but he kept up on all his board requirements.
Now, if you want to discuss what hospitals get paid for, that is different.

That article is not short and sweet, it is brief and brainless. Get ready for an onslaught of such nonsense before the next election cycle. They forced you into Obamacare vs they didn't protect your medicare...FML.

Quote:Fu*k the politics and discuss the issues for a change?

Fu*k all the doctors who have a protected, jaded view, and look at the real issues. All medicians (I just made that up, but it seemed right) receive too damn much recompense.
 
05-31-2011 10:30 PM
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glacier_dropsy Offline
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RE: Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
I enjoy the neologism, but why the parts about protected and jaded?
 
(This post was last modified: 05-31-2011 11:11 PM by glacier_dropsy.)
05-31-2011 11:10 PM
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Eastside_J Away
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RE: Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
(05-31-2011 09:50 PM)glacier_dropsy Wrote:  Fu*k the politics and discuss the issues for a change?

This type of reimbursement strategy is already in place for dialysis patients. Medicare makes one "bundled" payment a month for all dialysis related care. It was recently implemented, so it will be interesting to track how the costs and outcomes are affected. I'm guessing we will see a shift towards peritoneal dialysis over the next few years.

Schumer sounds like a moron in his discussion of what physicians get paid for. Few physicians get reimbursed for admitting the patient, ordering labs, ordering imaging, and ordering procedures. That must be some interventional radiologist that got tired of the hours so he went into pathology, but he missed the human contact, so he decided to be a family practitioner, but he kept up on all his board requirements.
Now, if you want to discuss what hospitals get paid for, that is different.

That article is not short and sweet, it is brief and brainless. Get ready for an onslaught of such nonsense before the next election cycle. They forced you into Obamacare vs they didn't protect your medicare...FML.

I actually didn't know this was tied to dialysis payments. But it sure sounds a lot like "DRG" payments that have been around for a couple decades.

I understand why the government would embrace the logic of paying a flat fee based on the diagnosis rather than an open code based fee schedule. But IMO it forces docs to treat patients in certain way (not always the best way) and leads to a whole world of unintended consequences.

Ins. companies have also been doing this for a long time, but more commonly by establishing "case rates" for common procedures.

This topic is complex and it scares people which makes it a precious political commodity. And no, I agree this will not be debated openly and rationally. - its just not going to happen.
 
06-01-2011 07:05 AM
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mlb Offline
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RE: Schumer Proposes Rationing Through One-Size-Fits-All Payments for Sick Seniors
The basis of his point is good... implementation probably not so much (but that is what the discussion is for).

Hospitals are probably more along the lines of what he was referring to, not the direct physicians, but at the end of the day there is no doubt that they love to push medical tests across the board. Whether it is for pregnant women, a person with diabetes, or a heart patient, they always order a ton of tests. There are 2 reasons for that in my estimation: 1. Worried about being sued and having their malpractice insurance canceled or raised in price. 2. More tests, more revenue for their organization - especially if they have the testing equipment on site.

A great example of this is MRI machines... they are expensive, very large, and take up a lot of room in any office. Yet, they have them everywhere. Why? They'll tell you that they can get results back faster and treat faster. Do we need that? Not generally... send someone down to the hospital if you need the answer back immediately. If you don't, have 1 or 2 outpatient centers on each side of town. I'd argue that a region the size of Dayton (where I live) doesn't truly need more than about 10 of those machines, but between the 2 main hospital groups there are probably 40-50 (I know of 5 in my small suburb alone, and who knows which ones I don't know about). How do they pay for those machines? Test baby, test.

I still think the number 1 issue to lower medical costs is tort reform. After the laws are changed to limit financial compensation for malpractice, we should start looking at specific diseases and pay treatment as a fixed price rather than the current system of test after test after test. Obviously not all illnesses can fall under that category, but I have no doubt many of them could be put under such a plan that would save people, insurance companies, and the government a ton of money a year.
 
06-01-2011 07:30 AM
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