"Obamacare’s tinkering with the current program will essentially end Medicare as we know it by replacing the existing fee-for-service (FFS) payment system, the heart of traditional Medicare, with top-down payment and delivery schemes independent of the consumer choice and competition that would enable them to prove their value. Worse, new layers of bureaucracy and compliance will discourage physicians who are already wrestling with reams of paperwork and will undermine their professional independence in the practice of medicine."
"Programs designed to cut Medicare spending and improve the quality of healthcare have mostly failed, according to the Congressional Budget Office. The findings are a blow to existing Medicare projects as well as a key goal of the healthcare reform law."
"New Hampshire has a high percentage of Medicare Advantage enrollees. Last month, 7,600 of them received notices that their coverage was being cancelled. Obamacare and another federal law passed in 2008, the Medicare Improvement for Patients and Providers Act, are killing Medicare Advantage to steer senior citizens back into regular Medicare, which offers fewer choices and is more heavily controlled from Washington. As a result, thousands of Granite State seniors are being forced to switch doctors because they have to switch coverage."
"Wanda Jones, president of San Francisco's New Century Healthcare Institute, said Anthem Blue Cross also may be reacting to changes in federal regulation of Advantage plans that are being implemented as part of health care reform... Anthem's decision will affect 113,000 Medicare beneficiaries statewide, and decisions by other health plans to drop their Advantage plans will force another 37,000 beneficiaries in California to switch plans,"
"These cuts are substantial, real, and already enacted into law. If you are a Medicare beneficiary who has chosen a Medicare Advantage plan, you will probably not be able to keep it, no matter how much you like your plan. Even if you can keep your plan in name, the plan you like now will be a shell of its former self."
"During the health care debate, the Mayo Clinic, the Cleveland Clinic, Geisinger Health System and Intermountain Healthcare were repeatedly touted as models for a new health care delivery system. Now, they have something else in common: All four have declined to apply for the 'Pioneer' program tailor-made by the Obama administration to reward such organizations."
"Expensive technologies like proton beam therapy and hot chemo baths are among the reasons America’s health care spending is rising at an unsustainable clip and making the federal deficit so hard to tame. But two of the nation’s top health care economists are expressing doubts that accountable care organizations — one of Obama administration’s most-hyped mechanisms to save money — will be able to overcome the medical system’s lust for the new new thing."
"'Accountable care organizations' is the health wonk phrase du jour. Obamacare’s advocates point to its support for ACOs as one of the important cost-control initiatives in the law. Except that, like nearly everything about Obamacare, the truth isn’t so simple. It turns out that the government’s idea of an accountable care organization is completely unworkable, to the point where nearly all leading health providers have declared it dead on arrival."
"CMS’s effort, launched by Obamacare, to use the leverage of Medicare reimbursement to impose and control a favored model of health care delivery is bound to fail, but only after increasing the angst of providers and patients and dissipating large amounts of resources—money, time, and brainpower. It blocks the development of other ideas for reforming health care delivery. However, changes in the proposed regulations to fix the anomalies and problems discussed above, and numerous other provisions like them not discussed here, would not be sufficient to rescue the scheme. The Shared Savings Program and its ACOs are fatally flawed by the overweening assumptions embedded in the PPACA itself."
"President Obama used to claim Medicare would save money by implementing the principle that if the 'red pill' works just as well as the 'blue pill,' but costs half as much, patients should get the red pill. That dangerously simplistic notion now boasts an enforcer created by last year’s Obamacare legislation."
