Obama's Medicare Liposuction

The financial meltdown crushing the US - already triggered the stimulus package and bailing out of the banks, AIG and the auto companies. As we all know this will not be the end. Obama is calling from the tightening up of our collective fiscal belt, which must bring changes in Medicare and Social Security.

President Obama has no choice but to address Social Security and Medicare. Medicare does have many nasty problems and one was addressed in a New York Times story today

Physicians who take kickbacks from drug and device comprise are now being investigated by the feds. These doctors have had consulting agreements with device makers and Pharmas. These heavy hitter providers pay these doctors, (many of whom are surgeons) handsomely for using their products.

This looks and smells like kickbacks. The Department of Health and Human Services ‘s chief counsel is leading the investigation into these “ consulting agreements”. The point is not only are kickbacks but these “ consulting contracts” increase the cost of health care, and endanger patients This investigation into physicians who enter into these fraudulent contracts may end their participation in Medicare This will severely affect their practice since the elderly over 65 consume the bulk of our national health care dollar.

In order to deter health care fraud the story says, the feds are looking into criminal wrongdoing by doctors that may end in jail time and fines on top of losing all Medicare patients. This is an example of some of the liposuction that needs to be done on this huge entitlement.


Another recent Times stout on fatty Medicare tissue, (2/29/09) says Obama would also increase premiums charged to Medicare beneficiaries with higher incomes for prescription drug coverage.

Obama will make drug makers do what they do with the huge VA health care system, discount drugs. President Bush left this out of his prescription drug plan, helping create that disastrous donut hole. The result is taxpayers and the elderly pay more for drugs than VA recipients who get at a reasonable discount. The government knew how to low bid this contact. Bush just forgot that.

Mr. Obama said he would cut $176 billion over the next decade by cutting Medicare payments to health insurance companies that provide comprehensive care to more than 10 million of the 44 million Medicare beneficiaries.

Medicare pays private insurers an average of 14 percent more than it would cost to care for the same people in the traditional fee-for-service Medicare program. “It’s time to stop this waste,” the White House said, quoted I the New York Times story.

Our bulging Medicare budget would be lighter on the scale with another proposed cut. The president projected cutting Medicare payments to hospitals that re-admit a large proportion of patients within 30 days after they are discharged. Such re-admissions sometimes indicate that hospitals provided poor care or did not properly coordinate care.

Under the proposal, hospitals would receive “bundled payments” that cover not only their own services, but also any care provided by nursing homes and home health agencies in the month after patients left the hospital.
Geriatric patients now get out the hospital sicker and quicker. The are scooped into the trembling arms of unpaid family care providers who are made to be pseudo nurses and doctors for very ill relatives. These tremulous family members are asked to manage Hoyer lifts, give injections, transfer the non-ambulatory (talk about breaking your back) and a whole raft of medical jobs they have absolutely no training to do. This causes older patients to end up back in the hospital sicker and very quick.

Hospitals now do little training of family care providers and do not include them in plans for discharge. Discharge planners are so overwhelmed by their huge caseloads they barely have time to educate and train family care providers to care for these very ill older relatives. So older patient cycle quickly back through the ER before 30 days, costing the health care system and Medicare tons for this insane gap.

The White House said this proposal would save $26 billion over 10 years.

Mr. Obama also proposed squeezing $37 billion out of the payments to home health agencies over the next decade.
There is more to come but the patient is morbidly obese. That fat is mostly, high calorie physicians, insurance carriers, pharmas, device makers stuffing the Medicare body with cheap junk food that the tax payer and both Medicare patient and family, has to absorb .