ObamaCare Meltdown, Part II: Medicare Implosion

As reported by the Associated Press, “Congress agreed Monday to a one-month delay in Medicare payment cuts to doctors, giving a short-term reprieve to a looming crisis over treatment of the nation’s elderly.”  Whoa, wait a second, stop the presses.  “Looming crisis?”  I thought we solved all those with ObamaCare!

In fact, the number of crises looming over health care has increased dramatically because of this misbegotten legislation.  Congress is stumbling backward in the shadow of a Medicare crisis ObamaCare will inflate into a disaster.  They’re desperately trying to prop up the system with temporary bills, like the one they scribbled last night.  Democrats know that when Medicare finally implodes, a horde of enraged seniors will crawl from the rubble and rip them to pieces.

This particular crisis began looming back in 1997, with the adoption of the Sustainable Growth Rate formula for determining Medicare payments.  It was intended to link Medicare spending with the growth rate of the national economy.  (Say, what would happen if we did that with all federal spending?) 

The sour economic growth of the last few years was fed into this formula, and it spat a handful of stale peanuts into the hands of dismayed physicians.  The formula calls for a 25 percent rate cut in Medicare payments for next year.  Medicare reimbursement is already so threadbare, and requires so much paperwork, that an increasing number of doctors refuse to accept Medicare patients, or sharply limit the services provided to them. 

In a Washington Post story from last Friday, N.C. Aizenman relates tales of Medicare patients forced to wait from two to six months before seeing specialists – the kind of experience all non-politicians will enjoy once ObamaCare really settles in.  A top primary-care physician named Linda Yau, who won’t accept any new Medicare patients, explains, “It’s not easy, but you realize you either do this or you don’t stay in business.”

How is all this connected with ObamaCare?  Those Medicare cuts were expected to save the government over $400 billion in the next ten years.  Obama and the Democrats have already spent that money on their health-care scheme.  Billions were supposed to be siphoned into ObamaCare through the Medicare cuts.  Rate extensions like the one passed Monday night are a red LED timer ticking down on the side of an atomic deficit bomb.  It makes the same ominous beep-and-bump noise as the timer on the TV series “24.”

As the Washington Post explains, the volume of services per Medicare patient increased by 42 percent between 2000 and 2008.  Part of this is due to the rising cost of advanced, life-extending medicine, which contributes to the actuarial nightmare of Medicare and Social Security systems that were designed back when the average life expectancy was ten or fifteen years less. 

A lot of the increase comes from “defensive medicine,” extra tests and procedures designed to stave off malpractice suits.  ObamaCare does absolutely nothing to alleviate these costs.  Instead, it will make them worse, since it includes provisions that will dramatically increase the demand for medical services, such as forcing insurance companies to cover pre-existing conditions.  Much of this new demand will come from younger patients eager to use the “free” benefits from their government-mandated health insurance, shifting resources away from the elderly, who are logically the heaviest consumers of medical services.  As for malpractice reform… well, you didn’t see any trial lawyers weeping at the passage of ObamaCare.

The practical solution to an environment of rising cost and demand is to increase supply.  The political response, already well under way from Democrats and their media allies, is to demonize doctors, which will inevitably reduce supply.  “The argument that doctors literally can’t afford to feed their kids [if they take Medicare rates] is absurd.  It’s just that doctors have gotten used to a certain income and lifestyle,” sneers Robert Berenson, a fellow at the Urban Institute… a far-left outfit advocating socialized medicine, which the Washington Post absurdly describes as “non-partisan.”  Berenson also sits on the Medicare Payment Advisory Commission.  Get used to those long waits for vital services, seniors.

The Post also includes a much more illuminating quote from Dr. Yao, who stopped seeing Medicare patients altogether: “I graduated medical school $100,000 in debt. I worked 110 hours a week during my residency for $30,000 a year and sacrificed all through my 20s. And even now, you’re still seeing people all day, with meetings and paperwork at night, on top of the emotional side of worrying when the patients you care for aren’t doing well. This is life-and-death stuff. And I feel like that should be compensated.”  The supply of valuable human resources for medical care will not be increased by showing potential medical students a future filled with long hours, crushing debt, and cut-rate compensation, coupled with the absolute certainty that politicians will blame every flaw in their rickety system on doctors.

The terms of the Medicare crisis are simple: the only way Democrats could claim they were “guaranteeing access to medical care for everyone” was to pretend four hundred billion dollars would appear from thin air.  This pretense will end on the day they can’t make any more temporary emergency extensions to Medicare payment rates.  So will the fiction that doctors are lazy millionaires who could easily provide for everyone’s needs, if they were just a bit more civic-minded… and the poisonous lie that a wise State can multiply loaves and fishes, by replacing private greed with collective compassion.