Here’s a depressing thought. Vince Ventimiglia of B&D Consulting thinks we’re still in the early stages of the healthcare reform debate. Ventimiglia, who spoke on a conference call Sept. 18 hosted by Wells Fargo Securities, noted:
I think we’re still on the first wave, and that wave is the wave of intense committee effort to develop something that gets pretty close to universal coverage–a universal access bill to ensure that the uninsured are covered and that the health system is improved….I do have a belief that this first wave is not going to be successful – that it’ll be difficult to get consensus around a broad universal coverage bill, and that the Democrats will look at two other options.
The second is reconciliation, a wave that will start being considered, I think, in the next few weeks. And if it is pulled, if they decide to act on that wave, [then it] would happen middle/end of October.
Ultimately, I believe there will be a third wave (I don’t believe they’ll go with reconciliation…) late in the year –sometime in December — that will essentially be a Medicare package with some incremental insurance provisions in it that will be driven by the need to ultimately have a doc fix…so that docs can avoid their 21% cut.
FYI, he’s referring to the 21% cut to physician Medicare payments scheduled for 2010….See you at the next Town Hall meeting.
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If medicare reimbursement is cut by 21% to physicians, it will be virtually impossible for them to stay in business!! How embarrasing! Do you realize how long they train? I already see how much their reimbursement is being axed everytime I recieve an invoice for payment when I visit the doctor and it is not 21%, yet. Terrible
Three Changes that will pass: may be held together with bubble gum
Three major changes will be passed by December:only time will tell if they are held together with bubble gum.
1-Covering the uninsured and the elimination of pre existing conditions for individual and small business coverage is going to get thru…and this alone is a huge accomplishment for this round of health care reform. Our emergency rooms and government-commercial programs were covering many of these individual’s costs. Commercial insurance programs subsidize many of the costs incurred by government programs…ask any hospital administrator about this and you’ll hear this consistent theme.
2-Medicare Advantage surplus will be eliminated in payment methodology. Whether you are a fan of Medicare Advantage PFFS or Managemed Care Plans…one thing is clear; consumers love them. Over 10 million consumers voted with their feet and chose them because of their comprehensive coverage with typically includes drugs….with low or no premiums in most markets.
Whats all the fuss about with these plans? Why are insurance companies blamed for offering them when congress approved them and higher reimbursements? Congress never thought Private Fee For Service Plans would be a solution for expanded access in rural care; they never thought these plans would be offered outside of rural areas. Why not when they act like PPO’s with no networks and richer benefits? Is it possible that insurance companies were the scapegoats here since they were playing by the rules and made very large profits until MIPAA was created to change the rules?
3-Medicare fee schedule reduction for physicians will be eliminated; and Medicaid system will be significantly expanded though the current Medicaid system is held together with bubble gum. Issues around access to care, financing, and financial viability are voluminous. Also…Coverage for kids healthcare programs should be at the same level as medicare for reimbursements to providers.
While the top three big ideas will get thru…bubble gum wont work with this one:
4-The cooperative idea doesn’t make my big three list since it is significantly flawed as a national strategy for local competitive offerings. It poses little threat to insurance companies market share…it will likely live on. How will these cooperatives been administratively efficient and offer cost effective-competitive in and out of network care competing with the Blues, United and Aetna, Cigna….is another matter. It wont.