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A Suspicious Assertion
I am highly suspicious of any assertion that the government can achieve significant cost savings by scaling back the Medicare Advantage program without harming patients. There are only a handful of levers that will produce significant cost savings and all of them have negative consequences, either directly or indirectly, for patients:
· Cost savings can be effected by making patients pay more for their coverage, but that option makes the benefits more expensive for senior citizens.
· The government can choose to pay doctors and hospitals less. Any effort to pay less to doctors can backfire by causing some percentage of them to stop accepting Medicare Advantage patients. Those seniors who want to retain their physicians will find themselves unable to do so.
· The government can pay pharmaceutical companies and insurance plans less, but that simply shifts the burden to the remaining insurance plan policy holders, which means that seniors and others who are receiving insurance through a program other than Medicare Advantage will pay more.
There is no free lunch here. The ways to reduce the cost of Medicare Advantage for the government are to design health insurance plans to reward:
· Cost-effective care by doctors and other providers; and
· Patients who take better care of themselves to avoid illness and injury, to get screenings and immunizations and to follow their treatment plans when they have chronic diseases like diabetes and heart disease.
I am deeply concerned that our elected officials will not have the political will to redesign Medicare Advantage or Medicare to drive cost-saving behaviors. While they clearly have some level of understanding of the value of prevention, they tend not to connect the dots between health insurance plan design that drives prevention and the resulting cost savings.
By
Michael Critelli
|
October 2, 2009; 3:14 PM ET
| Category:
Health Care Reform
,
Insurance
,
Medicare
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Posted by: web650stlaw | October 3, 2009 10:59 PM
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I believe that the quickest and surest way to a responsible health care bill which will benefit all citizens is to require all legislators to have the same coverages available to the average citizen. Because our federal legislators do not participate in the health legislation they are proposing for Joe Citizen they lack the incentive to construct cost effective plan. If our Sentor's and Congressmen were to face the same choices we will after the bill is past maybe they would stop listening to the special interest groups, insurance and pharmaceutical industries, and pass a bill we all could afford.