More Medicare stuff

Ezra Klein, who else, had some more comments on Medicare that I think are worth noting.

First, in a chat, he relays that according to MedPac--the agency that advises Congress on Medicare-related issues--96.8 percent of physicians say they will take new Medicare patients. So the argument that Medicare's lower reimbursements are driving doctors to stop taking Medicare patients seems, well, questionable.

Second, this very insightful post
argues that it's a mistake to simply paint insurers as the villians and physicians as the victims. Insurers seem like villians because they're doling out health--they're distributing life and death-- on a free-market basis. Of COURSE the people trying to make such a system profitable are going to seem evil. But it's the entire system that needs reform, and that includes providers.

Here's how Klein puts it:

"Most importantly, they [physicians] should be forced to work in a way that doesn't hurt society. That, after all, is the guiding principle behind the insurance reforms: Insurers will have to live with a market that society can live with. Similarly, providers will have to live within a market that society can afford. That will mean a strict budget, at least within the federal programs (and over time, as the private programs become unaffordable, they will probably come on budget as well).

"Providers won't like this, of course. It means adjusting to a lot less revenue than they currently expect to have, and no one quite knows how to do that. People run businesses atop the assumption of growth, not contraction. And the complaints are understandable: They haven't been doing anything wrong, and don't feel like they should be punished.

"But this isn't punishment. This is, well, medicine. It's that or national bankruptcy. And the problem, if left untreated, will only get worse, and the eventual correction, when it comes, will only be more severe. That, however, is exactly what they're asking Snowe, and the rest of Congress, to permit. The fear with Medicare buy-in is that Medicare pays somewhat lower rates than private insurers because it tries to live within a budget, even if it fails. But like it or not, that's the future, or one variant of it. And as most providers know, putting a scary diagnosis off is generally not a good idea"