HCCD Report Alaska 99516

Comments for Obama/Daschle’s Health Care Community Discussion
for “Be Part of the Solution: Informing the President-elect”
Held Dec. 21, 2008, Rabbit Creek Neighborhood, Anchorage, AK

Fixing Medicare without Adding Cost

The small discussion group dealt mainly with Medicare, the AARP lobbying efforts that thwart finding low/no cost solutions, the difficulty finding doctors who will accept Medicare clients, and needed changes to the Medicare rules that would actually reduce Medicare costs.

Despite rumors to the contrary, Alaska is far from being the only place where Medicare doctors are scarce. With our economic crisis, it’s imperative we think outside the box to make Medicare efficient and available.

Problem Situation 1. My husband pays nearly $100 a month for Medicare but can’t use it because his doctor has opted out. He can’t even get reimbursed the little bit that Medicare would normally pay had his doctor not opted out.

My doctor can’t keep the doors open if her Medicare clients comprise more than about 20% of her clientele. Yet I am not allowed to pay the full fee she normally charges, thus removing myself from essentially being a Medicare client within that 20% category which would open up another spot for Medicare patients who do not or cannot pay the full fee. Neither can I get reimbursed for the small amount Medicare would normally pay should I have remained a Medicare client.

Solution 1: Allow Medicare clients who elect to pay the full doctor’s bill, to get reimbursed from Medicare for the amount they’d normally pay. The diagnosis and procedure codes are put on all medical receipts and this is the information that is needed for reimbursement.

AARP alleges that this would in effect make Medicare for ‘the rich.’ This thinking misses the whole point of allowing a person to be ‘removed’ as a Medicare client, and thus open more of that critical 20% clientele for other Medicare clients. The client would still be paying into Medicare.

Some say this would be contrary to the purpose of Medicare, which is a tax-supported health access program designed to ensure access to medical care for older Americans. The discussion group says it is a critical change needed in order to be able to provide health care for seniors, because the system is not able to do so now.

Problem Situation 2: Medicare’s rules actually increase costs by insisting that all tests--laboratory and radiology--be separated out. Realize that with today's technology, many labs can (and do) run many tests on the same tube of blood for about the price of one test. Should it matter that the doctor may not need all of these multi-test reports to treat a chronic condition if in the end it will save Medicare money? A local radiologist gave the example of whole skeletal scans that were once below $400. The cost now approaches $1,000 due to Medicare’s rules.

Solution 2: Review all Medicare rules, as above, that end up costing the system more and revise accordingly for better economic outcomes.

Problem Situation 3: Fixing Medicare by throwing more money at it, is shortsighted and ineffective.

Solution 3: Adding money to Medicare is a never-ending battle that must be addressed by thinking ‘outside the box’ such as revising Medicare rules to allow for the solutions proposed above. This would ensure more doctors would accept Medicare clients and reduce over all costs.