Struggling to make it through in the midst of an ever-worsening budget impasse over Medicare reimbursement, the Center for Medicare & Medicaid Services (CMS) couldn’t wait any longer. CMS is now implementing a 21% cut in physician payments, which will affect an estimated 50 million claims. Claims that were held back since June 1 will be the first to feel the effects of the cuts.

In the late 1990’s the funding formula for Medicare reimbursements was first enacted in conjunction with the Balanced Budget Act. However, even at that time it was thought by some to be flawed. Today the formula is thought to be seriously flawed, and is growing more and more out of sync with its original intended purposes with each passing year.

Medicare Cuts Could Affect Quality of Care

Even though Medicare has instituted this drastic cut it too may stand to be on the losing side of the board as well, considering there are already a huge number of medical practices that currently do not take on Medicare’s elderly patient population.

Participating physicians will see a direct impact of the 21% cut with the average office visit now being reimbursed at about $8.00 less than what they were in 2007. Medicare may also feel the brunt of this unresolved state of affairs.

If a resolution is indeed reached, and the cuts reversed, they are looking at having to swallow about .30 cents per claim that is reprocessed. This translates out to a staggering potential of $15 million dollars for the first 50 million claims alone.

Only time will tell how it will all play out in the end, if there ever will be an end. In the meantime, there is no way for anyone, including physicians, patients and even Medicare to avoid the huge impact of this monumental move.

President-elect Barack Obama should take note – health reform is about the little things just as much as it is sweeping changes to the system.

Information gathered from a batch of more than 8,500 meetings held around the country in December will be compiled and used to help design the healthcare proposal that has been in the news as of late. Obama’s transition team plans to post some of the material at change.gov.

One particular meeting took place late December 2008, between newly appointed secretary of health and human services, the former Senate Majority Leader Tom Daschle, and more than two dozen seniors During this meeting, seniors told Daschle that they placed more importance on certain things such as waiting times to see their doctor, the increasing cost of prescription drugs, and the narrow range of Medicare coverage for certain medical procedures, equipment, and treatments.

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Universal healthcare could be useful in more ways than one. With more than half a million jobs lost in America in November (the biggest decline in a single month in more than thirty years), the country is in dire straights. Nearly 7% of the nation is wholly unemployed, and a total of 12.5% are either unemployed or barely working. That’s 19.3 million Americans who have little or no work.

The incoming administration is preparing a stimulus package to be introduced in the New Year, intended to get the economy ticking over again by investing billions in infrastructure. The package may include upgrading school buildings, upgrading public buildings to improve energy efficiency, building of bridges and roads, extending the reach of broadband internet, and improving electronic record keeping for medical billing.

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AARP (formerly the American Association of Retired Persons, but now known more commonly by its acronym) is a non-profit, non-government interest group which, according to its web site mission statement, is “dedicated to enhancing quality of life for all as we age,” by providing “a wide range of unique benefits, special products, and services for our members.” AARP acts as a member advocate, and is a powerful lobbying group. It also sells insurance, investment products, and endorses certain insurance companies.

Sounds good, yes? But by virtue of its habit of endorsing insurance companies, AARP has recently come under fire. The Kaiser Family Network recently revealed that AARP’s endorsements don’t come cheaply – 43% of the revenue the supposedly non-profit, independent advocacy group collected in 2007 came from royalties and fees the organization took from insurance companies – as payment for endorsements.

Doesn’t sound too much like consumer advocacy, does it.

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Many of us rarely ponder what our health and life are worth. It’s often assumed that life is priceless, but that doesn’t do justice to the stratospherically rising health care and insurance costs; in fact health bills are now the leading cause of bankruptcy.

One common way to calculate the value of our life is to use the same equation used by many health care providers. That cost was once $50,000 per year of quality life, according to the international standard for government-run health insurance plans across the globe. This number has been disputed by economists at Stanford and they were able to calculate that a year of quality life is actually $129,000! That is a lot of money for a year of life, but of course: life is priceless!

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