Wednesday, April 14, 2010

Time to fix Medicare Funding - Permanently!

It is bad enough that in this country people have to scramble furiously to claim benefits that are supposed to assist them. But what else would one really expect in a nation that worships the "hollow law"? (Hollow law, originally defined by William Greider: A law that is so riddled with loopholes and/ or loose language it is impossible to enforce).

In the case of Medicare, we've already beheld the Part D circus that was passed back in 2003, and which offered a smoke-and-mirrors benefit not even administered by the government per se, but by more than 900 private insurers with whom the potential beneficiary had to interact to obtain the best deal. Most seniors, when they did finally climb through the bureaucratic jungle, found a "benefit" so rife with loopholes that it was almost not worth the trouble, far less cost. (And many millions of seniors soon ended up the proverbial "doughnut hole" because their prescription drug costs kept increasing and no provision existed within the law for the government to bargain for the best prices - as could the VA).

The latest travesty to unfold is that since April 1 (coincidentally, April Fool's Day) a 21% across the board cut in Medicare reimbursments has been effected, leaving many seniors without doctors. In fact, as noted in today's Denver Post, these seniors have been "fired" by their doctors because the latter weren't prepared to make do with 21% cuts in patient reimbursement. Those seniors now must desperately search for either free care facilities (which have hitherto mainly been for the indigent or immigrants) or for urgent care facilities (which - like ERs- have typically been for extreme medical crises, not nominal care).

Now, while another pathetic "midnight fix" seems likely by the Senate( a vote for a temporary "patch" is to occur sometime this week) it should never have come to this, and also it may be too late for those seniors already dropped. They will still see hell trying to find new primary care physicians.

As opposed to these yearly, stupid "patches" why not just fix the reimbursement problem permanently? It will save seniors' nerves and not have them biting their nails to the quick every year- squirming to see whether the new fix will come or whether their doctors will drop them like hot potatoes because the government is too cheap to hold its end of the deal on delivering a critical benefit. As one medical staffer put it ('Medicare Patients Get the Gate', Denver Post, p. 5A):

"Creating a permanent fix would eliminate a lot of the frustration".

A medical society chief executive, Alfred Gilchrist said:

"We need a permanent fix so that patients and their doctors don't have to continue to worry about whether the federal government is going to be a good business partner or not".

Well, that's one way to put it, but how about a senior on Medicare not having to worry whether the American government (which can afford to piss endless billions on occupations and invasions) will be an Indian Giver or not? Offering a benefit with one hand, then de facto making a mockery of it with the other (by only paying doctors - scarce enough as it is for geriatrics- a fraction of the value of their time).

Why does the Senate (in which the Dems now hold a 59-41 advantage) continue with this stupid game? Well, one guess would be the cost. As the same Denver Post article observed, a "permanent fix" (at least lasting the next decade) would come to around $220 billion. Very likely the pusillanimous Dems (who seem to lack the brainpower to craft powerful verbal counter attacks and arguments) are petrified of the tea baggers raising hell if this much is added to the debt. (Never mind the recent Afghan "surge" added that in one month!)

But to me, it's time the Democrats stop acting like DINOS and act in the true tradition of Franklin Delano Roosevelt for once. That means paying for the benefit (Medicare) that you have offered to seniors! Not half way, and not three fourths of the way, but the whole way! It's bad enough that a 65 year old retiring this year will need $250,000 (over the 25 years or so he can expect to live) to pay for all the medical costs Medicare doesn't cover. Then to add to that financial stress not being certain if one will even have a doctor, because the country is too damned cheap to cough up the moola for the benefit, is beyond the pale.

Get off your keysters, Senators, and pass a damned permanent fix for Medicare reimbursements, and do it NOW! This is definitely a budget -related issue so can come under the reconciliation modus operandi, which needs only 51 votes.

Don't worry about the tea baggers, they will yelp like stuck pigs anyway. Worry about the seniors over 65 who form the largest, consistent voting bloc in the nation. Diss or dismiss them at your own peril.


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