Cutting Medicare to Save It--and this from the Current Administration

[SorellaLaBefana]

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups...

“The Medicare physician payment final rule continues our work to strengthen primary care while also supporting preventive care and promoting better access to behavioral health care. In addition, the final rule codifies and builds on guidance to continue our ability to use rebates from drug manufacturers to strengthen Medicare...”

Under the rule, which is 3,088 pages long, the average payment rates will be reduced by 2.93% in 2025, compared to the average amount these services were paid for most of calendar year 2024...

...Bruce Scott, M.D., president of the American Medical Association, pointed out that that while physicians are receiving a 2.8% payment cut next year, medical practice costs for physicians will increase by 3.5% in 2025. After adjusted for inflation Medicare reimbursement to physicians has decreased 29% since 2001...

https://www.fiercehealthcare.com/providers/doctors-facing-29-pay-cut-2025-call-permanent-medicare-payment-reform

Cutting payments to "strengthen Medicare” reminds one of the (possibly apocryphal) quote from a reporter during what the Vietnamese call the "American War" (Which followed the French War, which followed the Japanese War) that "It became necessary to destroy the village in order to save it"

If you are a person-of-a-certain-age you know how difficult it currently is to find practices which accept Medicare patients. This is not going to improve things.

However, one might speculate that by next autumn, a 3% cut might well look GOOD. If there is any Medicare (or any economic stability) left at all.

Oh, and in passing, Tolstoy's "War and Peace" is (depending upon edition and translation) between 1,200 and 1,500 pages long—whilst this doubtless easier? to read and understand Medicare Rule is 3,088 pages!

[gab13by13]

1. I have zero trouble finding doctors

I am transitioning to move 100 miles and I have been switching doctors with zero problem. Going from Penn Highlands to UPMC with zero problem. The people at the hospitals who deal with the billing tell me they have much less problems with Medicare patients.

[SCantiGOP]

2. Me too

I haven’t encountered a practice that doesn’t take Medicare for the 5 years I’ve been under the program.
I think it is medicaid that is having a problem with the number of providers that participate.

[Silent Type]

3. The government has been cutting physician reimbursement rates for years. But still, the average physician

makes a pretty good living.

Nowadays with bigger medical practices, docs aren't covering for others like they used to have to. Larger hospitals have Hospitalists who handle most patient needs at night.

What's really bad is Medicaid payment rates and the number of physicians who accept Medicaid patients.

[Lonestarblue]

4. The better way to cut Medicare costs is to get rid of Advantage programs that cost the government more per person.

A large part if the extra costs is insurers gaming the system and their profits. I would like to see a comparison of what per capita costs would be if original Medicare added dental and vision coverage versus the Advantage costs delivering huge profits to insurance companies instead of healthcare providers.

[Silent Type]

5. Unfortunately, the only significant upgrades to our healthcare finance system since 1990s -- ACA, drug plans, Medicaid

expansion, disease care, etc. — involve private insurers who debatably “manage care.”

I know many people don't see the Clinton era Part C -- now called Medicare Advantage -- as an "improvement." But it is an improvement to people who can't afford $250 to $400 a month in premiums to stay in original Medicare, while giving up a $1000 to $2000 in annual dental care, etc.

Maybe someday we will get a truly fair/affordable system, but we aren't close for forseeable future, IMO.

So, I'm not for taking something away from 30 million Medicare beneficiaries because some don't think it’s right or best for them. Taking something that half Medicare beneficiaries voluntarily chose — until the government makes original Medicare meet their needs — would be wrong.

I’m on original Medicare, but I foresee being forced into MA to get rid of MediGap, Part D, and get $2000 or so in useful benefits like dental.

[SorellaLaBefana]

6. We are the only (overly)Developed Nation without a functional System of National Health Care

Our existing 'healthcare system' costs MORE than any other in the world (significant percentage going to bureaucrats, and to dealing with submitting health insurance claims) and, looking at many diseases, our outcomes are WORSE.

The coming Administration has quite clearly stated what their plans are for healthcare, and they are not reassuring.

Am thinking that now ARE the Good Old Days

[Silent Type]

7. I get it, but we'll be sitting here 20 years from debating the same thing with no progress.

I hope for MFA someday, but don’t see it happening in this country unless there are several choices to appease those who vote for GOPers.