Here are two stories the mainstream media isn’t jumping all over themselves to report. Both demonstrate the ultimate agendas behind Obamacare and what it will mean for babyboomers and older generations.
Last Friday, Obama cut Medicare by $716 BILLION in order to partially fund $1.9 trillion in new entitlement spending over the next ten years. As Forbes reported:
…A big chunk of those Medicare cuts came from the market-oriented Medicare Advantage program. Cleverly, the Obama administration postponed the Medicare Advantage cuts until after the election, so as to persuade seniors that everything would be just fine. But… Obama’s proposal, according to one analyst, “would turn almost every plan in the industry unprofitable.”
Today, more than a quarter of retirees get their coverage through Medicare Advantage, and the program has experienced rapid growth over the past decade. Richard Foster, the recently-retired chief actuary of the Medicare program, has projected that Obamacare’s cuts to Medicare Advantage would force half of its current enrollees to switch back to the old, 1965-vintage Medicare program. Robert Book and James Capretta estimate that this will cost enrollees an average of $3,714 in 2017 alone.
The new rates proposed by the Centers for Medicare and Medicaid Services, a.k.a. CMS, will have the net effect of reducing payments to Medicare Advantage plans by 7 to 8 percent in 2014…
Just reported in the journal Cancer was a new study by researchers at Case Western in Cleveland Ohio who found “underutilization of follow-up colonoscopies” among Medicare beneficiaries. Among elderly patients on Medicare, fewer than half are getting follow-up colonoscopies, in accordance with clinical guidelines, after having had a positive colonoscopy requiring a polyp removal. And the problem has become increasingly significant in more recent years.
What does this mean? As researchers reported in the Annals of Internal Medicine last summer, incomplete polyp removal or failure to have a follow-up colonoscopy within five years after the detection of the first polyp, as recommended, is strongly associated with an increased risk of developing colorectal cancer. “The results indicated that patients who had incomplete removal of polyps were four times as likely to develop colorectal cancer and those who did not have a follow-up colonoscopy within five years were nearly three times as likely to develop cancer,” said UNM Cancer Center.
Even before Obamacare’s recent siphoning of Medicare, Medicare has been cutting doctor reimbursements for specialists such as gastroenterologists, as well as for procedures such as colonoscopies, affecting quality of care. Two consequences are were recently discussed in the medical literature.
One result of reduced reimbursements for Medicare patients is that specialists, such as gastroenterologists, will see fewer Medicare patients and healthcare plans (paid by the Federal government to provide care for Medicare patients) will allow fewer specialist referrals and care.
Despite all the government’s talk of “preventive care,” for seniors getting colonoscopies, who performs their colonoscopies may matter. A Toronto study found that chances of dying from colon cancer appear to be lower when the test is done by a more highly trained gastroenterologist, compared to a primary care doctor or general surgeon.
For surgery centers to survive under lower Medicare reimbursements, doctors have to see more patients per hour. Surgical centers have to aim for full utilization of their operating rooms, meaning allotting 30 minutes per case, according to ASC Review — Practical Business, Legal and Clinical Guidance for Ambulatory Surgery Centers.
Another unintended consequence will be higher healthcare costs. As ASC Review reported, reimbursements for colonoscopies and other gastroenterological procedures have decreased over the last few years, with ambulatory surgical centers getting about half the reimbursement rates of hospital based centers. This discrepancy held true with the final 2013 Medicare payment rates. As a result, more patients are driven into the hospital setting, said Dr. Stephen Sears, MD, who added: “By doing so the procedural cost will double and in the end healthcare costs will increase.”
Primary care doctors are also increasingly being employed by hospitals, but the same can’t be said for specialists, ASC Review reported. In other words, it points to another reason Medicare patients may be increasingly less likely to get colonoscopies from a gastroenterologist.
Another 2012 study of nearly half of all gastroenterologists employed in the VA system found that 15% didn’t even know that a follow-up colonoscopy is generally recommended 3 years after removing polyps. The study suggested that underuse was occurring in these government-run, federally-employed settings, as well. They found that even gastroenterologists who knew the guidelines reported that their practice was to recommend a longer interval and they were less concerned about legal and financial ramifications.
In our country, at age 65 you are forced onto government-run medical care, Medicare, and don’t have the option of opting out and choosing private medical coverage —unless you forfeit all of your Social Security benefits (even though you’ve paid into Social Security your entire working life with the promise of a guaranteed return upon retirement). Obamacare brings plenty more for seniors to look forward to.