Hospitals oppose Obama's Medicare, Medicaid cuts

June 14, 2009 By CHARLES BABINGTON , Associated Press Writer
Hospitals oppose Obama's Medicare, Medicaid cuts (AP)
President Barack Obama runs back to the microphone after he was ask a question about Iran as he was leaving, after delivering remarks in the Rose Garden of the White House in Washington, Friday, June 12, 2009, about passage of the tobacco legislation (AP Photo/Ron Edmonds)

(AP) -- President Barack Obama said Saturday he wants to help pay for his health care overhaul by slowing Medicare and Medicaid spending, but hospitals, medical technicians and others are resisting.

The high-stakes struggle over medical care is heating up as Obama declares the status quo unacceptable.

The president suggests trimming federal payments to hospitals by about $200 billion over the next 10 years, saying greater efficiencies and broader insurance coverage will justify the change. Hospitals, especially those with many poor patients, say the proposed cuts are unfair and will harm the sick and elderly.

Congress ultimately will shape the new laws. Obama is urging lawmakers to be bold and to resist powerful lobbies trying to maintain their clout and profits.

"Americans are being priced out of the care they need," Obama said in his weekly radio and Internet address.

Obama said high health care costs hurt the entire economy and contribute to the nearly 50 million people who lack coverage. His address focused on payments to Medicare and Medicaid, which cover millions of elderly and low-income people and involve thousands of doctors, hospitals, nursing homes and other institutions.

He proposed cutting $313 billion from the programs over 10 years. That's in addition to the $635 billion "down payment" in tax increases and spending cuts in the health care system that he announced earlier.

Together, Obama's plans would provide $948 billion over a decade in savings and/or tax increases to help insure practically everyone and to slow the rate of soaring health care costs.

The president wants to cut $106 billion over 10 years from payments that help hospitals treat uninsured people. Spending on Medicare prescription drugs would fall by $75 billion over a decade.

And slowing projected increases in Medicare payments to hospitals and other providers - but not doctors - would save $110 billion over 10 years, the president said.

Obama called them "commonsense changes," although he acknowledged that many details must be resolved. Some powerful industry groups called the proposals unwise and unfair.

"Payment cuts are not reform," Rich Umbdenstock, president of the American Hospital Association, said even before Obama's plan was announced. His group is urging hospitals with large proportions of low-income patients "to push back on proposed cuts."

The pharmaceutical industry is wary of Obama's plan to extract $75 billion over 10 years from Medicare prescription drug spending. The White House said "there are a variety of ways to achieve this goal." For instance, it said, drug reimbursements might be reduced for people who receive both Medicare and Medicaid.

The drug manufacturers' chief trade group issued a cautious statement Saturday, saying pharmaceutical companies support health care changes, but that much work remains to be done.

An industry group that which represents makers and users of medical imaging devices, such as MRI and CT equipment, was more hostile.

Obama wants to reduce government payments for such services. He said the devices are used so frequently and efficiently that providers can spread their costs over many patients, requiring less government reimbursement.

The Access to Medical Imaging Coalition, a trade group, disagreed. It said the president's plan would "impair access to diagnostic imaging services and result in patients' delaying or forgoing life- and cost-savings imaging procedures." The group said Obama's efficiency estimates were based on a flawed survey.

Even if Obama and Congress could hit the overall goal of $948 billion in health care savings over 10 years, it still might not be enough to cover all the nation's uninsured. Outside experts say the 10-year cost could range from $1.2 trillion to $1.8 trillion, depending on factors such as how generous federal subsidies turn out to be. One Senate proposal would subsidize families making as much as $110,000.

The administration wants to hold the cost to about $1 trillion, and Obama says the plan must not add to the federal deficit.

His budget director, Peter Orszag, told reporters that $948 billion "is in the ballpark of many of the proposals floating around," and that "there may well be some additional resources that are necessary." He said the administration will work with Congress.

But the president's earlier package of $635 billion in spending cuts and tax increases has gotten a cool reception from lawmakers. And there's no clear indication the latest proposal will fare any better.

House Republican leader John Boehner of Ohio said Medicare and Medicaid need reform, "but serious changes should not be rushed through Congress as part of a new government-run program that will raise taxes and make more expensive."

On the Net:

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©2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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not rated yet Jun 14, 2009
No one will be untouched by the necessary changes in health care. I hope Congress and the President understand that the reason for high costs isn't from physicians 'over testing' or patients 'over using'. The breaking point came from these very same lobbyists who have near monopolies in their respective corners of health care, insurers who have abused their contracts including overcharging government along with out and out fraud and denial of services/overcharging to individuals.

Medicare part D is a perfect example. Large insurers for the elderly sold their 'supplemental packages' marketed as 'simple' coverage. Two large insurers in the South recently were slapped on the wrist by government when it was found they were indeed overcharging the government, overcharging the insured and denying them critical, standard medications. They were prohibited from taking on any more clients as their punishment which seems to this reader a very anemic response to them.

The cart is before the horse. Trillions in a plethora of programs beyond TARP to support a failed shadow banking and an abundance of businesses will result in higher taxation at the state, local and federal levels eventually. The destruction/transfer of wealth from individuals left with no place to stay up with that invisible inflation except to become a Day trader on Wall Street means there must be a TANGIBLE return to the taxpayer/individuals in exchange which lessens individuals burdens from that massive transfer of wealth to fewer and fewer.

The only way to heal health care is to take out what has eroded into counterproductive business interests which have become vampires. Returning to a patient centric approach vs profit centric will save money. Standardizing billing ALONE will save an estimated $300 billion/year-without denial of service as a means of funding. (I suspect that number will be much higher) HR676 written with broad bi-partisan support in 2007 provides the framework to restore some sanity into health care.

Currently there are more billing agents in hospitals than hands on providers of care in this ad-hoc system of "care". MBA's and the Harvard Business School economic models do not include "first do no harm" in their curriculum. Their models and philosophy are false. Those educated and experienced in health care can save costs and provide better care without those who arrogantly injected themselves. Public health and public interest have long been left out of the equation as the 'free market' for profit system of health care was executed in its extreme but in fact is a 'captured' market. Over 50 million have zero coverage, tens of millions of others are under insured.

Missing from the the debate on health care reform on Capitol Hill are those hands on providers of care who deal every day with the disparities of this system leaving countless people in its wake and financially ruined for life and not because they ate too many twinkies. Too many people are one accident, one health problem away from bankruptcy. Still others are voiceless and powerless. The AMA's interest, pharma's interest, etc., etc. all want their cake and eat it too while the rest of us are told 'let them eat cake'. Insurers are attempting to 'save money' by dictating care to physicians and providing 'services' themselves. This cannot stand any longer.

Profits aren't evil however, a 450% profit on an infant sole source medication per dose for acute respiratory distress is just one small example of how abusive and really sick/twisted this current system is, how priorities are totally lost now. Dissertations could be written on the various and plentiful examples.

Patient rights, and in particular PRIVACY when seeking care is tantamount to the physician/nurse/patient relationship. If that is foiled in addition to serving business rather than patient, we can expect costs to continue to rise as that trust will be destroyed and people will withdraw and wait until they require critical/long term/expensive care rather than early care and management. IT spending is no substitute for hands-on, feet on the ground and the TIME to provide care to sick and injured people by professionals; that is if we are to call ourselves a civilized society that includes compassion and care to our most vulnerable.

The answer to the health care conundrum is a single-payer system to negotiate with these fine businessmen. Margins on profits aren't evil either. The USA pays more, gets less and fewer are served than any nation on the planet.

One can hope the CHANGE President Obama pledged to Main Street will include denials of service in the right places, not the same places as that has proved itself without a shadow of doubt to be ineffective and unsustainable. Small business cannot hope to provide coverage in this twisted system, those without full-time work cannot possibly pay thousands/mo for coverage and still put food on the table. The elderly cannot navigate a confusing/uncoordinated system that preys on them and forces them to choose between eating protein or a critical medication. It is time for change and not ad-hoc change for favors and campaign contributions or an insider trade on a yet to be announced new drug application.
not rated yet Jun 14, 2009
Many doctors and hospitals are padding patients' bills. See this article:
Too many MDs have become businessmen first & physicians second. Investing in shopping malls, imaging clinics, etc. (conflict of interest). The above article mentions "Access to Medical Imaging Coalition", obviously a lobbying group. Too many leeches in the healthcare industry.

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