Mike,

Speaking of working for doctors and no profits, Lynn just got her letter from the Feds announcing the 21 percent cut in Medicare reimbursements. They are not wasting any time, are they?

It's one that's been used for years.

Re: The medicare cuts.

My mother-in-law spent 1 more day in the hospital 5 months ago than I did 2+ years ago.

Now then, I was in for surgery in which I had a disc pressed up against my spinal cord.  I ended up have C5 & C6 fused and the disc removed.  My surgery lasted 4 hours.  I spent the night in the hospital before going home.  I spent 28 hours total in the hospital.

My mother-in-law was only in to check her heart.  No surgery.  Nothing more than a couple of tests run.  She had no IV drip, no medicine given to her other than what she brought from home.  She spent 2 nights in the hospital, about 42 hours total.

Medicare was charged $1,700 LESS than what it cost for me by going through Blue Cross/Blue Shield of Illinois.

The problem is not Medicare.  It's what the hospitals charge to Medicare.  Now they won't get away with over charging any more.

Kevin,

Hospitals and Doctors are two very different animals. I cannot speak for hospital practices, but I know about the MDs because my wife is a family physician.

Under Medicare, the government sets the fee at what doctors will be reimbursed for providing services, and that fee is now being reduced 21 percent from the current level. This new fee is LESS than the cost of providing the service (eg. it costs more to purchase the vaccine than the government will reimburse you for giving the shot).

More to the point, the Center on Budget and Policy Priorities (a left wing group) released a report last week detailing Medicare savings will help reduce the deficit. Here's a link to the report: http://www.cbpp.org/cms/index.cfm?fa=view&id=3134

I draw your attention to this paragraph from that link (bold emphasis mine):

"The one significant exception to this pattern of Medicare savings taking effect (in the past) is what happened to the badly designed “sustainable growth rate” (SGR) formula, which set payments to physicians and was enacted as part of the 1997 Balanced Budget Act. Contrary to common misconceptions, the SGR provision was originally expected to produce only a small amount of savings — less than 5 percent of the total Medicare savings in the Balanced Budget Act, or only $12 billion over ten years. The SGR formula was subsequently blocked by Congress when it turned out that it would have had the unintended effect of cutting payments well below doctors’ actual costs of providing services. And even though Congress has not allowed the full cuts required under the SGR formula to take effect, it has still cut the physician reimbursement rate substantially: the current reimbursement rate in 2010 is 17 percent below the rate for 2001, adjusted for medical care inflation."

In short, the new 21 percent cut in Medicare reimbursement enacts the rates that were previously deferred by Congress. These new cuts on top of the previous cuts means everytime a doctor provides primary care to a Medicare patient they are losing money.

Mike O'Brien earlier in this very long thread stated that all here agreed that doctors should make a profit, and that Healthcare reform was only about sticking it to the insurance companies. As I predicted (from reading the legislation), here is the evidence that about $300 billion of the $500 billion on costs savings to pay for the Medicare Act are coming through reductions in fees for services in primary care.