Tonight’s Debate: What Joe Won’t Tell You

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Obama’s medicare cuts: real & deadly
By: Betsy McCaughey October 11, 2012

Expect Joe Biden to tee up Medicare in tonight’s debate against Paul Ryan. In campaign stops this week, the vice president repeatedly harangued that the Romney/Ryan ticket “says that we’re cutting Medicare. Nothing could be further from the truth.”

Sorry, Joe: It’s exactly the truth.

The Congressional Budget Office confirms that the Obama health law cuts $716 billion from Medicare’s future funding over the next decade. That will result in less money to pay hospitals, doctors, hospice care, dialysis centers and Advantage plans that care for seniors.

Hospitals will have $247 billion less to care for the same number of seniors than if the law had not been enacted.

Guaranteed benefits only mean something if there is money to pay for them – and it won’t be under ObamaCare. The cuts will force hospitals to reduce care, diminishing survival rates for elderly patients.

President Obama tried to pull the same fast one in last week’s presidential debate, saying the Medicare cuts will merely stop “overpaying” providers.

That’s a whopper. Medicare already pays hospitals less than cost, on average about 91 cents for a dollar of care, according to federal data. Further slashing payments to hospitals isn’t about trimming profit margins.

Richard Foster, chief actuary of Medicare and Medicaid Services, has warned Congress that ObamaCare’s cuts in hospital payments are so severe that 15 percent of hospitals may stop accepting Medicare. Many more will respond by spreading nurses thinner and reducing care.

History proves it. When Medicare cut payment rates to hospitals in the Balanced Budget Act of 1997, hospitals hit with the largest reductions in Medicare revenue (over $1,000 per patient) trimmed nursing staff to make ends meet. Eventually, patients at these hospitals had a 6 percent to 8 percent worsechance of surviving a heart attack than patients at hospitals hit less hard by theMedicare cuts,according to the National Bureau of Economic Research.

And even the largest cuts to hospitals in 1997 are small compared with what’s coming under ObamaCare.

Last week, Obama said that cutting what hospitals are paid is “savings.” Not true: His cuts will cost lives, not save them.

Elderly patients treated at low-spending hospitals get less care and are at higher risk of dying. Research sponsored by the National Institute on Aging and RAND and published in 2011 (Annals of Internal Medicine) shows that heart-attack patients at low-spending hospitals (bottom quintile) are 19 percent more likely to die than patients of the same age at higher-spending hospitals (top quintile).

Similarly, patients with pneumonia, congestive heart failure and stroke had worse chances of dying at the low-spending hospitals than patients of the same age and illness at hospitals that spend more per senior.

Yet the authors of the Obama health law decided to compel hospitals in all 50 states to imitate low-spending hospitals, where death rates are higher. On top of the across-the-board cuts in hospital payments, the administration just started awarding bonuses to hospitals that spend the least per senior.

Cutting hospital payments is a sneaky way to control Medicare spending. Politicians can claim they’re not changing benefits; more seniors will suffer more and die prematurely, but their loved ones will be none the wiser about why.

Our health-insurance system needs reform. An estimated 18,000 Americans a year die because they lack insurance. That tragedy needs to be fixed. But the Obama/Biden remedy – slashing funds from what hospitals would spend on seniors – will cost more lives.

It’s not reform, it’s murder.

Betsy McCaughey is the author of “The Obama Health Law: What It Says and How to Overturn It.”

Obama Administration Dooms Seniors To The Ravages Of Aging
By: Betsy McCaughey October 11, 2012

On October 1, the Obama administration started awarding bonus points to hospitals that spend the least on elderly patients It will result in fewer knee replacements, hip replacements, angioplasty, bypass surgery, and cataract operations. These are the five procedures that have transformed aging for older Americans. They used to languish in wheel chairs and nursing homes due to arthritis, cataracts, and heart disease. Now they lead active lives. But the Obama administration is undoing that progress. By cutting $716 billion from future Medicare funding over the next decade and rewarding the hospitals that spend the least on seniors, the Obama health law will make these procedures hard to get and less safe.

The Obama health law creates two new entitlements for people under age 65 – subsidies to buy private health plans and a vast expansion of Medicaid. More than half the cost of these entitlements is paid for by cutting what hospitals, doctors, hospice care, home care, and Advantage plans are paid to care for seniors.

Astoundingly , doctors will be paid less to treat a senior than to treat someone on Medicaid, and only about one third of what a doctor will be paid to treat a patient with private insurance. On July 13, 2011, Richard Foster, chief actuary for Medicare, warned Congress that seniors will have difficulty finding doctors and hospitals to accept Medicare. Doctors who do continue to take it will not want to spend time doing procedures such as knee replacements when the pay is so low. Yet the law bars them from providing care their patients need for an extra fee. You’re trapped.

President Obama seems to think too many seniors are getting these procedures. At a town hall debate in 2009, he told a woman “maybe you’re better off not having the surgery but taking the pain killer.” Science proves the president is wrong. Knee replacements, for example, not only relieve pain but also save lives. Seniors with severe osteo-arthritis who opt for knee replacement are less apt to succumb to heart failure and have a 50% higher chance of being alive five years later than arthritic seniors who don’t undergo the procedure, according to peer reviewed scientific research.

Yet Foster warned Congress that 15% of hospitals may stop treating seniors once the Obamacare cuts go into effect. The rest will have to lower the standard of care. Hospitals will have $247 billion less over the next decade to care for the same number of seniors as if the health law had not been enacted.

President Obama claims his Medicare cuts will knock out waste and excessive profits. Untrue. Medicare already pays hospitals less than the actual cost of caring for a senior, on average 91 cents for every dollar of care. No profit there. Pushing down rates will force hospitals to spread nursing staff thinner.

Elderly patients will have a worse chance of surviving their stay and going home. When Medicare reduced payment rates to hospitals as part of the Balanced Budget Act of 1997, hospitals incurring the largest cuts laid off nurses. Eventually patients at these hospitals had a 6-8% worse chance of surviving a heart attack, according to a National Bureau of Economic Research report (March 2011)

In addition to the across the board cuts, starting this week the Obama administration will impose a new measure on hospitals, “Medicare spending per beneficiary.” Hospitals that spend the least on seniors get bonus points, and higher spending hospitals get demerits. Hospitals will even be penalized for care consumed up to thirty days after patients are discharged, for example, for out-patient physical therapy following a hip or knee replacement.

There are ways to control Medicare spending, such as inching up the eligibility age or asking well off seniors to pay more. Forcing hospitals to skimp on care is deadly. Research sponsored by the National Institute on Aging (Annals of Internal Medicine, February 2011) shows that heart attack patients at the lowest spending hospitals are 19% more likely to die than patients of the same age at higher spending hospitals. . Yet the Obama health law pushes all hospitals to imitate the lowest spending ones.

Ignore the political rhetoric and look at the scientific evidence. The Medicare cuts in the Obama health law will end Medicare as we’ve known it and doom seniors to painful aging and shorter lives.

Bazzo 10/11/12


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