Congress is on the Move for the Medicare Makeover

Medicare is a health insurance system which caters mostly to senior citizens, persons with disabilities, and especially those who happen to have terminal illnesses. So congress is now making sensible changes regarding its Medicare system specifically its old way of paying medical practitioners commonly called, doctors. Anybody could sense that the old system is nothing but just a political scheme that only matters the most to the doctors who are rendering services to Medicare beneficiaries, but with little or no effect to other concerned individuals.

Congress is saying that the old formula is no longer workable and is ineffective so it is working on a new system which aims on improving the quality and at the same time reducing the cost of the beneficiaries of health care.

Back in 1997, a health insurance system was created.  It all started because the government  was trying  to curb the increasing cost of Medicare’s payments to doctors, thus, resulting to an option that their salaries would be directly proportional to the broadening economic growth at that time. This formula has put the doctors to a great advantage but is only good while the economy is growing and expanding at its peak. But when the economy got worse, however, the system called for a pay cut, making the doctors unhappy and started to rebel against the system.

The revolt opted the congress to respond quickly by passing what has come to be called the “doc fix” — a temporary relief from the mandated pay cuts. This thing has been around for years now, the first was for 2003, and since then, there’s been one happening every year.

Congress should not waste their time on this kind of act, but mistakes are committed time and again, while losing an opportunity at the same time. Because Medicare accounts for such a big share of health-care spending, its payment policies influence practices in the rest of the system.

Traditionally, Medicare has worked on a fee-for-service model, where doctors are encouraged to do the greatest possible number of services they could provide. If its payments could be repackaged instead to push doctors toward a service focused on good results and efficiency — to make the quality of treatment matter more than quantity — that could reduce costs and improve care.

This latest Medicare makeover is set to expire April 1, it is a hopeful development, Republicans and Democrats in the House seem close to agreeing on a new quality-oriented payment system for Medicare. So doctors who partake in groups that coordinate care, for example, would get extra money. The deal reportedly includes a two-year extension of the Children’s Health Insurance Program, which is a brilliant idea in its own right.

The barrier that still remains is cost– an expected $200 billion over 10 years. About $70 billion of that will be covered by making other cuts to Medicare payments, and by demanding an increase on the contributions from beneficiaries who have bigger income. There are plenty of ways to save more money if congress would really want to. One of which is, to put an end to overpayments to hospitals for training doctors; another is to prohibit doctors to refer patients to their own businesses. And there are still a lot of options out there to choose from that depends on the willingness and eagerness of congress.

Altering the way Medicare pays doctors is, somehow, worth some deficit spending — especially if it does not change the formula, and relying on more short-term fixes, is also likely to result in deficit spending. If only there is a new payment system that can change the way doctors deliver their services, the long-term savings and the improvement in public health care maybe worth the while.



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