The poll results show that residents with incomes below $30,000 — the bracket that would probably make them eligible for state-subsidized care — were the most likely to say the law is helping to control the cost of their care.
The law expanded eligibility for subsidized coverage to thousands more residents, and state figures a year after the law went into effect showed that more than 200,000 residents were added to state-run coverage.
The poll results also showed that the highest income group, those whose income exceeds $75,000, were more likely than the lowest income group to say the law is hurting their health costs.
Kay Lazar can be reached at klazar@globe.com.
Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts
Sunday, June 5, 2011
Wednesday, May 5, 2010
Medicare Savings over time Health Care Reform
The new health reform law wrings $390 billion in savings from Medicare over the next decade to help pay for health care reforms—but spending on the program will continue to rise.
How can the new legislation reduce Medicare costs and still spend millions more dollars on improvements like closing the gap in drug coverage and offering free preventive care? Here’s a quick lesson in Medicare math.
These are cuts in future increases, not cuts in services, experts explain.
Medicare spending has grown about 8 percent annually over 20 years, according to the Congressional Budget Office, an independent arm of Congress. The law could slow down the annual increase in spending to about 6 percent over the next 20 years, the CBO has reported.
For example, of the projected $390 billion in savings—the latest estimate from Congressional Research Service—$196 billion comes from smaller increases in payments to hospitals, nursing homes, home health workers and other medical providers. But physicians who work in primary care will be rewarded with a 10 percent bonus. Hospitals that prevent readmissions or hospital-acquired infections will be paid more than those that do not. The American Hospital Association and the American Medical Association were among the many health care organizations that backed the legislation, along with advocacy groups.
Medicare Advantage Another piece of the $390 billion savings, about $136 billion, comes from reductions in subsidies paid to private health insurance plans, called Medicare Advantage, that provide medical and drug coverage to about one of four people in Medicare. Currently, Medicare pays the private plans an average of 14 percent more to care for a member than it would cost if that person remained in traditional Medicare.
In 2012, the government will start lowering these overpayments to Medicare Advantage plans. Insurers contend they will be forced to cut benefits. But the law prohibits plans from reducing or eliminating essential guaranteed Medicare benefits. It also protects plan members by requiring that at least 85 cents of every dollar insurers receive is spent on benefits.
Guarantees The law also requires Medicare to spend more wisely. For example, a new independent Medicare advisory board is expected to save the program $16 billion over 10 years. Cracking down on fraud and waste will save an estimated $7 billion. Even bonus payments and innovations aimed at improving patient care are intended to produce a long-term payoff: People who get more effective treatment can recover more quickly from medical setbacks, and that saves Medicare money, too.
Finally, the law comes with a Medicare warranty in Section 3601: Nothing in the law can cut current Medicare benefits, and the Medicare savings it achieves “shall extend the solvency of the Medicare trust funds, reduce Medicare premiums and other cost-sharing for beneficiaries, and improve or expand guaranteed Medicare benefits and protect access to Medicare providers.”
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Other Insurance Situations
How can the new legislation reduce Medicare costs and still spend millions more dollars on improvements like closing the gap in drug coverage and offering free preventive care? Here’s a quick lesson in Medicare math.
These are cuts in future increases, not cuts in services, experts explain.
Medicare spending has grown about 8 percent annually over 20 years, according to the Congressional Budget Office, an independent arm of Congress. The law could slow down the annual increase in spending to about 6 percent over the next 20 years, the CBO has reported.
For example, of the projected $390 billion in savings—the latest estimate from Congressional Research Service—$196 billion comes from smaller increases in payments to hospitals, nursing homes, home health workers and other medical providers. But physicians who work in primary care will be rewarded with a 10 percent bonus. Hospitals that prevent readmissions or hospital-acquired infections will be paid more than those that do not. The American Hospital Association and the American Medical Association were among the many health care organizations that backed the legislation, along with advocacy groups.
Medicare Advantage Another piece of the $390 billion savings, about $136 billion, comes from reductions in subsidies paid to private health insurance plans, called Medicare Advantage, that provide medical and drug coverage to about one of four people in Medicare. Currently, Medicare pays the private plans an average of 14 percent more to care for a member than it would cost if that person remained in traditional Medicare.
In 2012, the government will start lowering these overpayments to Medicare Advantage plans. Insurers contend they will be forced to cut benefits. But the law prohibits plans from reducing or eliminating essential guaranteed Medicare benefits. It also protects plan members by requiring that at least 85 cents of every dollar insurers receive is spent on benefits.
Guarantees The law also requires Medicare to spend more wisely. For example, a new independent Medicare advisory board is expected to save the program $16 billion over 10 years. Cracking down on fraud and waste will save an estimated $7 billion. Even bonus payments and innovations aimed at improving patient care are intended to produce a long-term payoff: People who get more effective treatment can recover more quickly from medical setbacks, and that saves Medicare money, too.
Finally, the law comes with a Medicare warranty in Section 3601: Nothing in the law can cut current Medicare benefits, and the Medicare savings it achieves “shall extend the solvency of the Medicare trust funds, reduce Medicare premiums and other cost-sharing for beneficiaries, and improve or expand guaranteed Medicare benefits and protect access to Medicare providers.”
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Other Insurance Situations
Health Care Cost Increase Is Projected
By ROBERT PEAR
WASHINGTON — A government analysis of the new health care law says it will not slow the overall growth of health spending because the expansion of insurance and services to 34 million people will offset cost reductions in Medicare and other programs.
The study, by the chief Medicare actuary, Richard S. Foster, provides a detailed, rigorous analysis of the law.
In signing the measure last month, President Obama said it would “bring down health care costs for families and businesses and governments.”
But Mr. Foster said, “Overall national health expenditures under the health reform act would increase by a total of $311 billion,” or nine-tenths of 1 percent, compared with the amounts that would otherwise be spent from 2010 to 2019.
In his report, sent to Congress Thursday night, Mr. Foster said that some provisions of the law, including cutbacks in Medicare payments to health care providers and a tax on high-cost employer-sponsored coverage, would slow the growth of health costs. But he said the savings “would be more than offset through 2019 by the higher health expenditures resulting from the coverage expansions.”
The report says that 34 million uninsured people will gain coverage under the law, but that 23 million people, including 5 million illegal immigrants, will still be uninsured in 2019.
Republicans said the report vindicated their concerns about the law, which was approved without a single Republican vote. The White House pointed to bright spots in the report and insisted that the law would help bring down costs. In 2004, when Mr. Foster raised questions about cost estimates by the Bush administration, Democrats lionized him as a paragon of integrity.
Mr. Foster says the law will save Medicare more than $500 billion in the coming decade and will postpone exhaustion of the Medicare trust fund by 12 years, so it would run out of money in 2029, rather than 2017. In addition, he said, the reduction in the growth of Medicare will lead to lower premiums and co-payments for Medicare beneficiaries.
But, Mr. Foster said, these savings assume that the law will be carried out as written, and that may be an unrealistic assumption. The cuts, he said, “could become unsustainable” because they may drive some hospitals and nursing homes into the red, “possibly jeopardizing access to care for beneficiaries.”
Nancy-Ann DeParle, director of the White House Office of Health Reform, said that fear was unfounded.
Mr. Foster’s report, which analyzes the effect of the law on national health spending of all types, has a different focus from studies by the Congressional Budget Office, which concentrated on federal spending and revenues and concluded that the law would reduce budget deficits by a total of $143 billion over 10 years.
In his report, Mr. Foster made these points:
¶The government will spend $828 billion to expand insurance coverage over the next 10 years. Expansion of Medicaid accounts for about half of the cost. The number of Medicaid recipients will increase by 20 million, to a total of 84 million in 2019.
¶People who go without insurance and employers who do not provide coverage meeting federal standards will pay $120 billion in penalties from 2014 to 2019. Individuals will pay $33 billion of that amount, while employers pay $87 billion.
¶The law will reduce consumers’ out-of-pocket spending on health care by $237 billion over 10 years, to a total of $3.3 trillion.
Cuts in federal payments to private Medicare Advantage plans will “result in less generous benefit packages,” the report said. By 2017, it said, “enrollment in Medicare Advantage plans will be lower by about 50 percent, from its projected level of 14.8 million under the prior law to 7.4 million under the new law.”
More in Money & Policy (19 of 50 articles)
Senate Bill Sets a Plan to Regulate Premiums
Read More »
Close
WASHINGTON — A government analysis of the new health care law says it will not slow the overall growth of health spending because the expansion of insurance and services to 34 million people will offset cost reductions in Medicare and other programs.
The study, by the chief Medicare actuary, Richard S. Foster, provides a detailed, rigorous analysis of the law.
In signing the measure last month, President Obama said it would “bring down health care costs for families and businesses and governments.”
But Mr. Foster said, “Overall national health expenditures under the health reform act would increase by a total of $311 billion,” or nine-tenths of 1 percent, compared with the amounts that would otherwise be spent from 2010 to 2019.
In his report, sent to Congress Thursday night, Mr. Foster said that some provisions of the law, including cutbacks in Medicare payments to health care providers and a tax on high-cost employer-sponsored coverage, would slow the growth of health costs. But he said the savings “would be more than offset through 2019 by the higher health expenditures resulting from the coverage expansions.”
The report says that 34 million uninsured people will gain coverage under the law, but that 23 million people, including 5 million illegal immigrants, will still be uninsured in 2019.
Republicans said the report vindicated their concerns about the law, which was approved without a single Republican vote. The White House pointed to bright spots in the report and insisted that the law would help bring down costs. In 2004, when Mr. Foster raised questions about cost estimates by the Bush administration, Democrats lionized him as a paragon of integrity.
Mr. Foster says the law will save Medicare more than $500 billion in the coming decade and will postpone exhaustion of the Medicare trust fund by 12 years, so it would run out of money in 2029, rather than 2017. In addition, he said, the reduction in the growth of Medicare will lead to lower premiums and co-payments for Medicare beneficiaries.
But, Mr. Foster said, these savings assume that the law will be carried out as written, and that may be an unrealistic assumption. The cuts, he said, “could become unsustainable” because they may drive some hospitals and nursing homes into the red, “possibly jeopardizing access to care for beneficiaries.”
Nancy-Ann DeParle, director of the White House Office of Health Reform, said that fear was unfounded.
Mr. Foster’s report, which analyzes the effect of the law on national health spending of all types, has a different focus from studies by the Congressional Budget Office, which concentrated on federal spending and revenues and concluded that the law would reduce budget deficits by a total of $143 billion over 10 years.
In his report, Mr. Foster made these points:
¶The government will spend $828 billion to expand insurance coverage over the next 10 years. Expansion of Medicaid accounts for about half of the cost. The number of Medicaid recipients will increase by 20 million, to a total of 84 million in 2019.
¶People who go without insurance and employers who do not provide coverage meeting federal standards will pay $120 billion in penalties from 2014 to 2019. Individuals will pay $33 billion of that amount, while employers pay $87 billion.
¶The law will reduce consumers’ out-of-pocket spending on health care by $237 billion over 10 years, to a total of $3.3 trillion.
Cuts in federal payments to private Medicare Advantage plans will “result in less generous benefit packages,” the report said. By 2017, it said, “enrollment in Medicare Advantage plans will be lower by about 50 percent, from its projected level of 14.8 million under the prior law to 7.4 million under the new law.”
More in Money & Policy (19 of 50 articles)
Senate Bill Sets a Plan to Regulate Premiums
Read More »
Close
Friday, February 19, 2010
Cost of Health Care Reform
First, Congress is debating how to cover the uninsured, as if that is the principal
problem of our health system.
Should we have a public plan option? Should we expand Medicare? Medicaid?
Should there be a mandate to buy health insurance? Obama believes that health
system reform will require a massive infusion of tax money to cover the uninsured,
also his primary issue.
Both Congress and Obama are wrong. The issue is not coverage, it is cost control,
or more specifically, waste elimination. Per-capita taxation for health care is higher
in the U.S. than anywhere else in the world. More than one-third of the $4 trillion
collected in state and federal taxes this year will go to health care.
If we limited health spending to just those tax dollars we would be spending more
than any other nation on health care. Yet we add another $1 trillion to our health
spending through private payment of employer premiums and family co-payments
. Per-capita health spending is twice as high as it is in any other nation, and rising faster,
because we waste half our health spending on inefficiency and poor quality.
problem of our health system.
Should we have a public plan option? Should we expand Medicare? Medicaid?
Should there be a mandate to buy health insurance? Obama believes that health
system reform will require a massive infusion of tax money to cover the uninsured,
also his primary issue.
Both Congress and Obama are wrong. The issue is not coverage, it is cost control,
or more specifically, waste elimination. Per-capita taxation for health care is higher
in the U.S. than anywhere else in the world. More than one-third of the $4 trillion
collected in state and federal taxes this year will go to health care.
If we limited health spending to just those tax dollars we would be spending more
than any other nation on health care. Yet we add another $1 trillion to our health
spending through private payment of employer premiums and family co-payments
. Per-capita health spending is twice as high as it is in any other nation, and rising faster,
because we waste half our health spending on inefficiency and poor quality.
Wednesday, December 2, 2009
Mass Health Care for all
What penalty will uninsured residents of Massacgusetts face if the don.t buy health Insurance after July 1, 2008?
They will lose your personal deduction for your state inme tax return
They will lose your personal deduction for your state inme tax return
Tuesday, October 6, 2009
Health Care Reform hold Insurance Companies Accountable
If Congress now creates new exchanges, as seems increasingly likely, it must prevent this phenomenon by setting two national rules: Insurers have to accept everyone and have to charge everyone the same rates regardless of health status.
Such rules would force insurers to spread risk. But enforcement would also be difficult. Every aspect of health insurance — from the rules for underwriting and setting premiums to the marketing of policies — would need to be monitored stringently to prevent companies from steering all bad risks to the exchanges.
It would be smarter for Congress to revisit the idea of creating a public plan that could provide an attractive choice for consumers and real competition for private insurers, to give them the incentive to offer good coverage at affordable prices.
But without a public plan, tough rules and restrictions on insurance companies will be essential. Otherwise, Americans will never be able to count on good, affordable health care.
Such rules would force insurers to spread risk. But enforcement would also be difficult. Every aspect of health insurance — from the rules for underwriting and setting premiums to the marketing of policies — would need to be monitored stringently to prevent companies from steering all bad risks to the exchanges.
It would be smarter for Congress to revisit the idea of creating a public plan that could provide an attractive choice for consumers and real competition for private insurers, to give them the incentive to offer good coverage at affordable prices.
But without a public plan, tough rules and restrictions on insurance companies will be essential. Otherwise, Americans will never be able to count on good, affordable health care.
Thursday, September 10, 2009
Tort Refom 0n Health Insurance Reform
If a so-called "reform" bill comes up with these elements - no employer mandate, strong individual mandate, market rates for everything, no real insurance reform - there is no reason to vote for it. It is worse than no bill at all.
I reviewed your comments closely and what I have not seen or heard is anything that includes tort reform. We know that this bilks out billions of dollars that could be used toward delivery of care. Among the issues are costs for repetitive tests, astronomical premiums for malpractice insurance to all providers, not just doctors. All nurses, therapists, hospitals,outpatient service entities must pay these premiums BEFORE the FIRST patient receives any services. In the mix of all those to be paid in the health care delivery/provider cycle is the amount of money that is frittered away to cover litigation costs for this very sophisticated system we call health care. YES, DEFINITELY, we NEED a way to protect patients from unscrupulous practices. BUT, let us LOOK how this present system of "protection" is SUCKING the life out of the costs reduction efforts. A better approach is to put before PEER review entities outside local care to look at complaints, rather than to allow juries that are not knowledgeable about health care practices to make decisions that are just. It could require practitioners to participate on a fair rotation so that no one gains too much power over this entity. And it also has the benefit of being a continuing educational tool for those serving on it. I can tell you that I learn as much from my journals in the review of cases as I do in reading dry research projects. It puts a human face on the case at hand. This takes litigation OUT of the third parties with the possibility of great financial gain! Claims looked at for Buffalo, NY could be reviewed by a PEER Panel in Omaha. Omaha's claims could be reviewed by PEER review panel in Miami. Miami could be reviewed by PEERS in Denver. If all these claims were done ANONYMOUSLY and without monetary gain by the reviewers, but the insurer would have to pay for the costs of helping the patient pay for his health care that was required for "fixing" the error and an award for pain and suffering that could be reasonable for both, we would see very few of these "jackpot" awards going to attorneys and little to the clients. Frivolous suits would be kept to a minimum, especially if appeals were allowed a LIMIT in terms of restitution. This is a huge part of costs and it could be a substantial reduction in pay outs by insurance companies, dollars that would go to payments of real services. Third party rewards for health care that they do not deliver is like a leach sucking the blood out of the host. It did take a while for health care to document this, my God George Washington even used leeches in times of illness, but we have come a long way since then! It is time for the health care system to document this for the health of patients, the delivery system and the economy so that we can use those dollars to deliver health care to the people, who need it and not dollars to those who stand by watch to see if a mistake is made. That is a diagnosis we can make and we can cure it. Other suggestions we have been hearing are not conclusive. Let us get STARTED on the problem we know we can help.
There are needs that require insurance reform, those have a whole host of problems that ARE being talked about, but the tort reform issue seems totally neglected. A neglected patient can not get well, nay the patient who is neglected, has no hope of surviving.
When a very sick patient comes to the hospital with many illnesses, the most manageable problems are tackled first, so that the others CAN be addressed. Let us NOT obfuscate the whole system, when there are AREAS to BEGIN the process. This is a journey, this not parking lot.
Posted by: Lauragail
I reviewed your comments closely and what I have not seen or heard is anything that includes tort reform. We know that this bilks out billions of dollars that could be used toward delivery of care. Among the issues are costs for repetitive tests, astronomical premiums for malpractice insurance to all providers, not just doctors. All nurses, therapists, hospitals,outpatient service entities must pay these premiums BEFORE the FIRST patient receives any services. In the mix of all those to be paid in the health care delivery/provider cycle is the amount of money that is frittered away to cover litigation costs for this very sophisticated system we call health care. YES, DEFINITELY, we NEED a way to protect patients from unscrupulous practices. BUT, let us LOOK how this present system of "protection" is SUCKING the life out of the costs reduction efforts. A better approach is to put before PEER review entities outside local care to look at complaints, rather than to allow juries that are not knowledgeable about health care practices to make decisions that are just. It could require practitioners to participate on a fair rotation so that no one gains too much power over this entity. And it also has the benefit of being a continuing educational tool for those serving on it. I can tell you that I learn as much from my journals in the review of cases as I do in reading dry research projects. It puts a human face on the case at hand. This takes litigation OUT of the third parties with the possibility of great financial gain! Claims looked at for Buffalo, NY could be reviewed by a PEER Panel in Omaha. Omaha's claims could be reviewed by PEER review panel in Miami. Miami could be reviewed by PEERS in Denver. If all these claims were done ANONYMOUSLY and without monetary gain by the reviewers, but the insurer would have to pay for the costs of helping the patient pay for his health care that was required for "fixing" the error and an award for pain and suffering that could be reasonable for both, we would see very few of these "jackpot" awards going to attorneys and little to the clients. Frivolous suits would be kept to a minimum, especially if appeals were allowed a LIMIT in terms of restitution. This is a huge part of costs and it could be a substantial reduction in pay outs by insurance companies, dollars that would go to payments of real services. Third party rewards for health care that they do not deliver is like a leach sucking the blood out of the host. It did take a while for health care to document this, my God George Washington even used leeches in times of illness, but we have come a long way since then! It is time for the health care system to document this for the health of patients, the delivery system and the economy so that we can use those dollars to deliver health care to the people, who need it and not dollars to those who stand by watch to see if a mistake is made. That is a diagnosis we can make and we can cure it. Other suggestions we have been hearing are not conclusive. Let us get STARTED on the problem we know we can help.
There are needs that require insurance reform, those have a whole host of problems that ARE being talked about, but the tort reform issue seems totally neglected. A neglected patient can not get well, nay the patient who is neglected, has no hope of surviving.
When a very sick patient comes to the hospital with many illnesses, the most manageable problems are tackled first, so that the others CAN be addressed. Let us NOT obfuscate the whole system, when there are AREAS to BEGIN the process. This is a journey, this not parking lot.
Posted by: Lauragail
Wednesday, September 9, 2009
SEE THE CONECTION WITH AARP HEALTH CARE PLAN
The truth: Daschle is cashing in mightily on his role as "the architect of President Obama's health care plan" in the private sector — and evading lobbyist disclosure by reinventing himself as a highly paid "senior adviser" to D.C.-based law firm/influence-peddling shop Alston & Bird.
Daschle represents mega-insurer UnitedHealth, which opposes the pure public option, and Alston & Bird represents a total of 31 clients from the health care sector. According to D.C. watchdog OpenSecrets.org, "Of the $2,730,000 reported income received from clients, nearly 50 percent of that, $1,070,000, comes from these 31 health care clients."
Daschle represents mega-insurer UnitedHealth, which opposes the pure public option, and Alston & Bird represents a total of 31 clients from the health care sector. According to D.C. watchdog OpenSecrets.org, "Of the $2,730,000 reported income received from clients, nearly 50 percent of that, $1,070,000, comes from these 31 health care clients."
Sunday, September 6, 2009
Medicare Hospital Discharge
Pinpoint another serious problen confronted by members of Mass Senior Action.
Hospitals discharging older patients without any follow up or "transitional" services.
One of every five Medicare beneficiaries is readmitted within 30 days of discharge and one of every three, within 90 days--often becuase of poor communication between patients, care givers, and health care providers.
We need a benefit in Medicare to help people safely transition to home or another setting to prevent costly and unnecessary hospital re-admissions
Hospitals discharging older patients without any follow up or "transitional" services.
One of every five Medicare beneficiaries is readmitted within 30 days of discharge and one of every three, within 90 days--often becuase of poor communication between patients, care givers, and health care providers.
We need a benefit in Medicare to help people safely transition to home or another setting to prevent costly and unnecessary hospital re-admissions
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