Action For Better Healthcare

By Ed Howe
Retired president and CEO, Aurora Health Care 

While Washington is still hammering out the details to potentially expand Medicare coverage to individuals as young as 55, I feel it is important to explain why I feel this is not a good idea. 

So here is my "Top 3 reasons not to expand Medicare coverage" list for you.

1. The Medicare population will become larger and sicker

The individuals who would "buy in" to the Medicare benefit plan will likely have pre-existing conditions and will be patients who cannot obtain regular private insurance on their own. This will cause tremendous financial implications for hospitals and for people paying for private insurance.

2. Medicare reimbursement will suffer

Medicare reimbursement rates differ from state to state and from hospital to hospital. It is a complex payment model that typically does not pay hospitals and doctors a fair reimbursement rate for services rendered. Because of this, hospitals and doctors have to charge patients with private insurance more to make up the costs. This situation will only get worse if access to Medicare coverage is opened up to people ages 55 to 64.

3. The plan fails to save Americans money

The entire point of this debate in Washington has been to bend the cost curve down when it comes to healthcare. Expanding Medicare coverage and allowing more people to access a poorly run and poorly administered plan will make healthcare costs worse.

To put it simply, expanding Medicare coverage does not accomplish the goal!

Join the conversation and post your comments below.

gehowe | Cost reduction, Government, Legislation, Not For Profit, Not For Profit hospitals, best practices, healthcare costs, healthcare reform, hospitals, insurers, medicare, reimbursement | 12 10th, 2009 |

5 Responses

1. kester freeman Says:
   December 11th, 2009 at 11:05 am
   [+]

   Your top 3 reasons make sense from a hospitals perspective. They are also correctly identifying the hugh hold in this reform, that... ...

   [Open ↓]
   [-]

   Your top 3 reasons make sense from a hospitals perspective. They are also correctly identifying the hugh hold in this reform, that is the lack of cost controls. i.e. continuation of fee for service medcine. But from a consumers perspective it’s a very attractive idea depending on the premium rates. Hospitals need to get used to the idea of less commercial reimbursement and gov payment.

   [Close ↑]

2. Ed Howe Says:
   December 11th, 2009 at 2:20 pm
   [+]

   Kester, I believe that providers, hospitals, doctors, and others must and can get by with less money. But they need a different pa... ...

   [Open ↓]
   [-]

   Kester, I believe that providers, hospitals, doctors, and others must and can get by with less money. But they need a different payment system. Bundled pricing, incentives to create accountable care organizations that integrate care, a system that forces patients to make some economic decisions on what care to get.
   The reason I think this proposal is wrong headed, is it does not bend the cost curve and is unaffordable to the government.

   [Close ↑]

3. kester freeman Says:
   December 11th, 2009 at 9:19 pm
   [+]

   Ed - You are dead on. But I don't believe we have the political will or guts to reform the cost side without a crisis. This covera... ...

   [Open ↓]
   [-]

   Ed – You are dead on. But I don’t believe we have the political will or guts to reform the cost side without a crisis. This coverage reform will create that crisis as you and Mike Daly predict.

   [Close ↑]

4. Michael stephens Says:
   December 15th, 2009 at 3:44 am
   [+]

   There have already been too many variables introduced into the health reform legislation. Expanding Medicare to this segment of t... ...

   [Open ↓]
   [-]

   There have already been too many variables introduced into the health reform legislation. Expanding Medicare to this segment of the population simply introduces more risk and uncertainty. I predict that if a health reform bill eventually passed by Congress and signed by the President, it will simply mark the beginning of the debate is this country as we come face to face with the reality that no expansion of coverage will be politically or economically viable unless there is a dramatic reduction in healthcare costs. If the rate of increase in costs is reduced, even as a result of health system change, many providers will receive less in payment than they are receiving now. That is the reality of our future.

   [Close ↑]

5. Don Ammon Says:
   December 15th, 2009 at 10:54 am
   [+]

   Ed has identified some of the serious issues and as we see the changes that the Senate makes daily to get enough votes, it continu... ...

   [Open ↓]
   [-]

   Ed has identified some of the serious issues and as we see the changes that the Senate makes daily to get enough votes, it continues to show the objective of change at any cost. Unforunately we cannot afford that. Reform yes but in a way that this country can handle.

   [Close ↑]

Post a comment