According to the New York Times, Medicare payment has been shifted to paying doctors for the overall quality of their care, and away from reimbursement for specific services and in proportion to numbers of services provided. This is a counter-revolution in Medicare away from providing the best care for the individual patient based upon the patient’s choices as informed by the doctor’s recommendations. Now we are in rationed care territory. Doctors will get an implicit raise every time a Medicare patient is shunted away from receiving a test or procedure paid for by Medicare. That’s how managed care works, by increasing profits by denying care. Unable to link so I am providing a copy of the article link below.
A more accurate version of the savagery of this shift is available in the following link.
In the above linked article, the authors explain how means-testing, and rationing will reduce the quality of medical services for Medicare recipients and make it more of a ‘poverty’ program. Throwing people into managed care is rationing: It is very much a neoliberal ‘We are going to break your neck’ to old people from lawmakers and from this Hooverite President.
Disclaimer: My experience with managed care is that old people will be given aspirin and a sonogram when their growing tumors start to bleed and ache. Reports will be sent to the wrong places, and patients who are very ill will be sent home with words of false reassurance. Friends will drive the nearly dying to ‘out of network’ hospitals where their real diagnosis will be discovered and then they will die.
After reflecting on how quickly this bill passed and how little information was made available prior to its passage, this appears to be another fast-tracked, somewhat secretive process. The American media totally failed to warn citizens before hand that this was being sped through and what its implications were for older patients. When I reviewed Robert Pear’s article in the New York Times, the shift to managed care was not revealed, even though cost shifting was described in some detail: http://wp.me/p1hj2G-eZ
Robert Pear’s description of the changes here:
The Center for Medicare Advocacy looks at the straight up rip offs in the bill for Medicare recipients in terms of additional costs and reduced care.
If Kaiser Foundation objected to this bill, I could not locate their description of their response to the bill at their site.
Finally, the experimental program which is supposed to prove that this new form of managed care will save Medicare, and the taxpayers, and the patients, money, has proved to save only 1%. And why is that true? Because the money saved is given back to hospitals and doctors as bonuses, and that is why they like it and have no complaints about it, even though they are stealing from patients by rationing care.