Cut Medicare, Help Patients - NYT

[cbayer]

There are many needed changes to be made in this system that will not only not harm patients, but will help them. Help keep Dr. Don Berwick in place as the administrator of CMS by lobbying Congress. The Republicans are going to try and have him removed.


By EZEKIEL J. EMANUEL and JEFFREY B. LIEBMAN
Published: August 22, 2011


MEDICARE is going to be cut. That is inevitable. There is no way to solve the nation’s long-term debt problem without reducing the growth rate of federal health care spending. The only question is whether the cuts will be smart ones.
Related

Smart cuts eliminate spending on medical tests, treatments and procedures that don’t work — or that cost significantly more than other treatments while delivering no better health outcomes. And they can be made without shortchanging patients. There are plenty of examples; here are three.

Late last year, the Food and Drug Administration determined that the drug Avastin, which has serious side effects, is not effective for treating breast cancer. Astonishingly, Medicare declared it will still pay for Avastin — at a cost of about $88,000 per year for each patient.

Consider colonoscopies. The United States Preventive Services Task Force recommends not doing colonoscopies for most people over 75 because there is no evidence that they save lives in this population. Moreover, the risk of perforating the intestines rises with age. Yet Medicare pays for the procedure regardless of the patient’s age.

More at link:

http://www.nytimes.com/2011/08/23/opinion/cut-medicare-help-patients.html

[madfloridian]

1. Zeke again. He wants to phase out Medicare.

Why not let doctors decide what is right or wrong for the patient?? Unique thought I guess.

Zeke might want to phase out Medicare and Medicaid

[cbayer]

3. He doesn't say anything remotely like that in this article. Actually, quite the opposite.

And he agrees that health care providers need to be in charge of these changes:


"The responsibility for ending unnecessary medical spending needs to be placed in the hands of doctors and hospitals."

[madfloridian]

4. Here's the quote I referenced.

"No one (I think he means to say "anyone") receiving Medicare, Medicaid, or any other government program will not be forced out, but there will be no new enrollees. People who turn 65 will simply stay in the Guaranteed Healthcare Access Plan. The special tax benefits related to employer based coverage will be eliminated and most employers will stop offering health insurance."

I was referring to the "no new enrollees." I am not aware of the plan he mentions, not sure it made it through the health care talks.

[cbayer]

6. Is there anything in this particular piece that you object to?

[denverbill]

2. I can't argue with these kinds of changes.

This kind of stuff needs to be done before we talk about increasing the eligibility age to 67.

[madfloridian]

5. I disagree about denying anything across the board. Lives are saved after 75.

[cbayer]

7. Tests/procedures, etc. need to be based on evidence.

If the evidence shows no benefit and increased risk in certain populations then why should it's continued use be sanctioned?

While there is no question that lives are saved by many procedures and treatments for patients over 75, the amount of money spent for things that have no evidence of doing that are astronomical.

[madfloridian]

8. So they talk about how much longer folks are living, but they want to deny procedures?

So seniors don't need that much spent on them?

[cbayer]

9. Does it not make sense to eliminate procedures that have shown no evidence of helping

a patient and have, in fact, shown evidence that the risks far outweigh any potential benefit?

That's just bad medicine.