Maybe Michael Moore’s 2007 documentary “Sicko” made an impression on the US government, or maybe the rising cost of Medicare forced them to find a better way of doing things. Regardless of what motivated the change, if all goes well, it could be a welcome one.
Physicians in the US have long lamented that they only get paid for treating patients, i.e. prescribing drugs or scheduling tests, than for just seeing them and recommending ways for them to stay healthy. With the implementation of the new Medicare law, that could all change.
Those who saw Moore’s film may recall that some European physicians get paid for preventive medicine, such as recommending a diet and exercise regimen for an overweight patient. The new Medicare law could make it more lucrative for primary care physicians to invest themselves in keeping their patients healthy rather than ill.
According to Kaiser Health News, Medicare will pay more to doctors “who provide quality care at lower cost to Medicare and reduce payments to physicians who run up Medicare’s costs without better results.”
That sounds pretty simple, but it doesn’t seem to consider patients with chronic illnesses or patients who don’t follow their doctors’ instructions. Some worry that doctors who want to receive the financial incentives may short shrift their patients or refuse to treat those with chronic or serious illnesses like asthma or Crohn’s disease. Any time the phrases “health care” and “manage costs” appear together in the same sentence, patients start to feel afraid. They naturally assume that in order to “manage costs,” their physicians will spend less time with patients, which could in turn lead to the doctors’ missing things that might have been caught during longer examinations or consultations.
Former administrator for the Centers for Medicare and Medicaid Services (CMS) Dr. Donald Berwick told Kaiser Health News, “We do have to be cautious in this case. It could lead to levels of gaming and misunderstanding and incorrect signals to physicians that might not be best for everyone.”
Hospitals will also be subject to the new Medicare law. Beginning in 2012, the law will reduce payment to hospitals with high numbers of preventable hospital readmissions. Beginning in 2015, it will reduce payment to facilities with patients suffering from hospital-acquired conditions. This could bode well for patients if it inspires health care workers to be more vigilant about preventing things like staph infections or discharging patients prematurely.
Health care spending in the United States adds up to about $2.5 trillion each year. A significant percentage of that goes to satisfy the health care needs of approximately 47 million elderly and disabled US citizens.
A new law that could reduce the government’s Medicare spending could be just what the doctor ordered. Those who proposed the change want patients to get high-quality health care at a reduced cost. But will that actually happen? And what will happen if private insurance companies follow Medicare’s lead? Would that affect patients in a positive or a negative way?
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