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View Diary: The political vulnerability of subsidies (226 comments)

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  •  But there are two issues (0+ / 0-)

    First -

    We really need to accept that as great a program Medicare is for beneficiaries - it's really a prime mover in a lot of our health care problems that extend beyond insurance (or the concept of insurance... etc).

    Medicare reimbursement rates are pretty much the benchmark everyone starts from... This just logically follows from the fact that Medicare - even Medicare limited to over-65 Americans - is the single biggest player in health care payments.  Bigger than any insurer, but a wide distance.  It funds more than just senior care - it's the basic funding mechanism for residency programs.  It funds - until this bill passes - 'charity care'.

    Private insurers use the Medicare rates to negotiate their rates with providers.  Hospitals use these rates as their rate setting benchmark.

    ... it's more than just rates in a vacuum - the over-specialization conundrum (too many medical specialists, too few primary care/family docs) can also be traced back to Medicare, as it's Medicare that is "to blame", so to speak, for this since it pays procedures by specialists handsomely - while family docs grumble....

    I'm not saying this addresses the basic issue of subsidies being at risk - but it does speak to the underlying problem of costs.

    Simply lopping out private insurance - however you do it - certainly brings that number down, but it in no way solves it.

    I guess everyone's got their own blog now.

    by zonk on Wed Dec 16, 2009 at 01:30:51 PM PST

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