Seniors more vulnerable under Obamacare

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:

Here Comes The Boom

…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.

10 responses to “Seniors more vulnerable under Obamacare

  1. The AARP run insurance company pushed the Medicare Advantage policies about 3-4 years ago apparently with the knowledge all these policies would have to be converted to Medigap policies; a change that would bring them billions of new dollars.

  2. Erg! I wish this would have gotten repealed! I can’t stand Obamacare!

    • Westchester Bill

      I remember the Saturday afternoon in the 1970’s when I happened upon a report showing the GAD of Social Security. The Gad is the present value of future benefits less the present value of future FICA payments for those currently in the system. It was close to the value of the United States. Had Social Security been fully funded at that time, all houses, cars, companies would be owned by the Social Security trust. Thus a Social Security system like the one we now have is forced by principals of economic. Similarly for medicare. Since the expected earned income of retirees, especially those with severe dementia is limited, Medical care has to be financed outside the pay at the counter market mechanism.

      My ex-wife and I were billed over $800 a month for health insurance in the 1990s when my coverage through employment was lost. The individual health insurance market collapsed when only sick people were willing to pay premiums at advanced ages and younger people were unwilling to pay the greater than actuarial costas to support community ratings. Thus some government coercion (taxes) are required for a health system.

      What causes your aversion to Obama Care? Something close to it is required by economics. Had Senator Grassley not walked out of the negotiations, we could have had a better plan. But Republicans were more interested in party than country.

        • Westchester Bill

          The one and only claim I made about Obamacare is that it would extract the community rating tax. That was it. Chief Justice Roberts said exactly that.

          As to cost, one has to differentiate costs to individuals, including individual business, and societal costs. The Unions, God bless them, took advantage of tax breaks for health care coverage to maximize social transfer to their overpaid members. The tax breaks reduced costs for individual companies but increased total societal costs by subsidizing over use by union members. Obamacare moves some ER costs to Primary Care Costs. While it will not decrease societal costs by as much as claimed, obamacare will not necessarily increase societal costs. The benefits of preventative care advantages are day dreams. So far some bending of the health care cost curve has been observed. Please join me in praying that the bending persists.

          • You said, “Something close to it is required by economics.”

            Absolutely wrong. Obamacare is massively destructive.

            • Westchester Bill

              The experience with burial societies shows that the life insurance market requires actuarial ratings. Otherwise you get death spirals. As a particular burial society aged, its burial fees increased and potential new entrants signed up with younger burial societies. Similarly for health insurance. Community ratings drive relatively healthy people out of the market as happened in New York State. Heath plans require some form of community rating tax. The alternative of single payer eliminates a market altogether and makes the entire premium a tax.. It is simple economics.

              I don”t see obamacare as massively destructive. There is undue influence by radicals. That is why I am so angry with Senator Grassley. But many of our agencies are infected with Naderites. A Naderite drove the Toyota debacle.

              There are many smart good people to keep the Naderites in check, I hope. The old fashion Blue Cross worked beautifully in the Genesee Val;ey when I was a kid, then Naderites destroyed it for a while.

  3. I’ve been on Medicair and Tricare for Life for the past year or so with no problems. I have no particular health issues, so I don’t use it for more than checkups. I really wonder how long the “good times” will last. The Feds are going after both.

  4. Sadly, people will not wake up to the reality of Obamacare until it is too late. The medical profession has been warning about it for years — on the unsoundness of it financially, the unsoundness of the clinical guidelines and quality of care (corrupted by special interests, not based on good science), and the medical ethics. Just this week, the US Justice Dept said that doctors are not allowed to refuse to do what the government says under Obamacare if it violates their conscience. [http://cnsnews.com/news/article/doj-federal-judge-we-can-force-your-wife-violate-her-religion]. A piece in today’s American Thinker may have been written a bit hysterically, but it was accurate. [http://www.americanthinker.com/…rl=http://www.americanthinker.com/articles/../2013/02/cutting_healthcare_costs_by_killing_patients.html] This is a frightening trend that we’ve been seeing in the US for years. Doctors are already given financial bonuses by the NHS for referring elderly patients for hospice, rather than providing them medical care.

    The article in the Catholic magazine and the comments are worth reading. [http://www.catholicherald.co.uk/news/2013/01/30/peer-calls-for-liverpool-care-pathway-to-be-abolished/]

    And that’s just this week.

  5. Westchester Bill

    98% of women use birth control at some time and end of life care is important for its cost and humanity. Catholic people realize these facts, but some Catholic zealots who tilt at windmills.are best ignored.

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