Reflex: September 21, 2011

Cutting payments to Medicare and Medicaid providers may harm patients, reports Robert Pear (NYT). “Experience, [experts] say, shows that some cuts in payments to providers hurt beneficiaries, as more doctors refuse to take Medicaid patients or limit the number of new Medicare patients they will accept. Hospitals curtail services. Beneficiaries may have more difficulty getting therapy services after a stroke, traumatic brain injury or hip fracture. By contrast, the experts say, other cuts force health care providers to become more efficient, saving money for beneficiaries, taxpayers and the government.” Austin’s comment: There is an easy way to cut spending: just trim payment rates. There is an easy way to cut wasteful care and spending: stop paying for things shown not to work and force entities to compete on price. The problem is the latter takes time and is resisted by interest groups as strongly as the former. One thing nearly all agree on is that spending must be cut. There’s no avoiding a fundamental truth: somebody must lose.

Don’s comment: Austin is correct and the blind spot for both political parties is that the last step if we succeed in slowing cost inflation in health care is that someone will get less care and/or someone will be paid less for providing care. Hard stuff.

Hospital workers outspend others on medical care, reports Debra Sherman “Healthcare workers and their dependents were more likely to be diagnosed and hospitalized to treat asthma, diabetes, congestive heart failure, HIV, hypertension and mental illness. It found that the average cost of healthcare for hospital employees and their dependents was $4,662 per year — $538 higher than that of the general population.” Aaron’s Comment: Are they really sicker, or do they just have better access? 

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