Merry Christmas from the Senate via Your Grandparents

The United States Senate passing a bill on Christmas Eve for the first time since 1895 took final action on their version of a national health care bill. The proponents celebrated that the bill would not increase but actually lower the deficit. Sound like good news, but where does the money come from? MSNBC online was very clear in reporting the source of the fiscal soundness of the bill:

“The Congressional Budget Office predicts the bill will reduce deficits by $130 billion over the next 10 years, an estimate that assumes lawmakers carry through on hundreds of billions of dollars in planned cuts to insurance companies and doctors, hospitals and others who treat Medicare patients.

“… The legislation costs nearly $1 trillion over 10 years and is paid for by a combination of taxes, fees and cuts to Medicare.”

So health care for others will be financed through reducing benefits to seniors on the government provided health plan. Question: have you ever heard of a doctor not accepting a new senior citizen patient because of the low Medicare reimbursement rate? Since the majority of cost shifting in medical care is due to Medicare and Medicaid reimbursement rate how will this work? Will the government force doctors as a condition of their ability to practice medicine to accept Medicare patients the reimbursement rate that goes with the program? If that happens what will happen to the supply of doctors and other health care providers if the cost of providing care exceeds the payment for that care?

It is obvious the ramifications of this approach will, over time, have an unknown and significant impact on the future of health care and the individual lives of our seniors, which by the way are growing in numbers.

The next step in this journey is to reconcile the Senate version of health care with the House version. These bills have significant differences and it will be interesting to watch the Democrats work out the differences between the two chambers.

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