21% Medicare and tricare cuts effective April 1 2010

[PrincessFiona]

As our VP would say, this is a big effing deal. This will affect seniors and military folks too, as apparently tricare ties its payment structure to medicare (according to the military officers association anyway). Private insurance companies will eventually follow and lower pay scales.

How will this affect access to care for seniors and military families in the months to come? This seems like a travesty...particularly for the families of people serving overseas, etc. I grew up with tricare and remember then that tricare was a problem because of low payments and taking forever to reimburse.

The fact that this was not stopped is too bad for a lot of people...patients and doctors alike.

Kris

[Sheherezade]

They need a permanent fix -- but I'd take a temporary one, too. I hope people are clear that this is in no way part of the health care bill. It wasn't "fixed" by the health care bill, either. It wasn't addressed. Now, Senate Republicans are blocking the extension bill. It has been passed by the House. I'm not sure if this was once again a "hold" by a senator. Those gentlemen rules need to go away --- until we have gentlemen again in the Congress. They are being used to avoid debate and decisions.

http://blogs.wsj.com/health/2010/03/...s/tab/article/ (House passes extension, blocked by Senate)

http://www.healthcarefinancenews.com...pushed-april-1 (Extension expires April 1st, Senate has still not passed bill to extend to September)

[DCJenn]

Most people that I know in the military don't use civilian doctors so I'm not sure how much it will impact. The issue would likely be for those people in areas like where Sally's husband was stationed where they jettisoned a lot of the military care to the civilian hospitals since it was cheaper than maintaining a fully functioning hospital w/ so few personnel.

Jenn

[PrincessFiona]

I wonder why our dem and repub representatives can't get their shit together on this? I read that when they come back on April 12th they will do another "stall until September" maneuver.

I hope they stall and then come up with a permanent fix that does not hurt everyone involved.

Jenn, I grew up on military bases and had tri-care. Many bases had clinics, but were only good for so much. I remember climbinbg over the barbed wire fence one day (hello Darwin! LOL), getting stuck on a barb and of course needing stitches. LOL Our clinic didn't do stitches after 5pm. My mom had to drive me 2 hours to a military base that did. (That'll teach me to climb over barbed wire fences! LOL Actually, it didn't! ) Tri-care was tough to have accepted by outside providers and that was an issue. Dropping reimbursement to health care providers is a bad idea, i think. It's just my opinion though. It will make access more difficult for people that are in the position Sally was....and I think military families make enough sacrifices. I know you and I can agree on that!

Kris

[Sheherezade]

I worry that this is just a way to leave the 21% cut in effect and appear to be negligent instead of mindful about the decision. I'm probably just paranoid - but I know they need to make cuts eventually and no one wants to be the one to pull that trigger.

[DCJenn]

Kris-

I completely agree- there are some military bases that have minimal coverage. It's bad enough that the personnel have to schlep to the civilian providers- let alone having to shell out $ to do it.

Angie- I'm not sure that your paranoia is misplaced- They said that it's Coburn who is holding it up this time- and he's a physician so I wonder what his motivation really is?

Jenn

[PrincessFiona]

I wonder why the govt can't look at other ways to save money? Imagine if we weren't paying companies like Halliburton in the middle east instead of allowing true market competition.... What if we eliminated tax loopholes for offshore companies? It just seems to me that instead of considering payment cuts they should figure out how to bring in and waste less money.

Also (death squad alert) maybe we have to look in general at the fact that most medicare dollars are spent in the last 6 weeks of someone's life with heroics when they are clearly dying. If 85 yr old grandpa has end stage cancer and dementia....well....maybe pneumonia is his friend....and not the vents in the ICU. It sounds harsh, but it will have to come. That's how it works in countries with govt. healthcare. I mean that not in the sense that the elderly should be denied care but in the sense that we sometimes overdo it.

Kris

[DCJenn]

It's true- both of my grandmothers have made it explicitly clear that they don't want ANY sort of intervention if that should happen. That said, no one is there in either case to insist that be the case. They both have living wills but unless someone is with it enough to contact my parents or their siblings then it's entirely likely that my 93 year old grandmother could end up on a vent and tied to machines. (and in the state of Pennsylvania once they're on machines it's VERY hard to get them off)

We DO need to have these conversations on the family level as well as on the national policy level but with everyone screaming murder and socialism, it's going to be hard for people to be heard.

Jenn

[PrincessFiona]

I think you're right, Jenn!

ETA: I had this conversation with my dad and he completely freaked and told me he was glad the decision wouldn't be mine!

Me: You would want to be kept alive on a vent in that circumstance?
Him: Yes. You just stay away from me.
Me: Bummer....you mean I couldn't pull the plug myself?
Him: hahaha <sarcasm>

Those gentlemen rules need to go away --- until we have gentlemen again in the Congress.

This can be on one of the signs we carry in the "Be Reasonable" March on Washington .