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Obamacare impact on seniors

At several campaign events, Democrat candidates have disapprovingly noted that the U.S. lags behind European and other nations in not having full government health care.

A closer examination reveals that may be a good thing. It has become a fairly common pattern for foreign leaders seeking the most advanced care to travel—sometimes secretly—to America for treatment. Forbes reports that “An estimated 40% of all medical travelers are looking for the world’s most advanced technologies…Commonly seeking cutting-edge cardiovascular, neurological or oncology treatments, the bulk of medical travelers head to U.S. medical facilities … there’s the United States’ reputation when it comes to health care…”

A study from the Batelle Technology Partnership Practice  notes that the U.S. is the world’s leader in medical innovation, although increasing taxes and regulations may affect that going forward. There are viable and very relevant questions as to whether the adoption of European style medical care would change that.

One group of Americans has a particular vulnerability to the flaws in government-administered health care: senior citizens. The United Kingdom’s National Health Service (NHS), often set up as an example for those advocating government-administered health care in the U.S., has been frequently criticized for its failure to meet the needs of older patients.

The BBC has disclosed that English and Welsh health experts are concerned that older people in need of urgent help are being failed by the NHS, and the NHS’s own studies concur.  “Too many over-65s end up in accident and emergency unnecessarily” according to the NHS Confederation’s Commission on Improving Urgent Care for Older People. The group said this was because of a “lack of help when they fell ill…The commission’s report said older people were “poorly served.”

America’s most significant step towards greater federal involvement in health care has presented significant challenges to quality health care for seniors.

In 2014, John Goodman, writing for Forbes, stressed that “One of the best kept secrets of the Affordable Care Act (ACA) is that it imposes a global budget on Medicare spending – for the first time in the program’s history. Heretofore, Medicare was a pure entitlement program. The government had to pay for whatever care the elderly and the disabled obtained. But going forward, the health reform law imposes a cap on spending.

“For most of its history, per capita Medicare spending in real terms grew at about twice the rate of growth of real per capita GDP – just like the rest of the health care system. But going forward, the law requires Medicare to grow at a rate that is not much more than the growth of GDP – regardless of what happens to other health care spending. If the historical trend continues, that means spending on health care for the elderly and the disabled will grow about half as fast as spending on everyone else’s care.”

A New York Post review of Obamacare’s effect on healthcare for seniors: “It’s skimping on it, socking seniors with unexpected bills for “observation care” and likely shortening their lives…”

Senior Living.com   notes: “The cuts to Medicare—about $700 billion between 2013 and 2022—are actually decreases in the spending rate for this program. According to the Congressional Budget Office, the cuts will be felt in hospital services, Medicare Advantage plans, skilled nursing services, home health services and others. “

Dan Weber, writing for the Washington Times, describes another attack on senior care under Obamacare:

Medicare’s home health care services, formerly serving 3.5 million elderly beneficiaries across the country, were cut under Obamacare. The cut deleted exactly 14 percent, or an estimated $22 billion, from these lowest-income Americans over four years. …This cut does irreparable damage to recipients of Medicare’s home health care services, those who are aged, homebound and sicker than the average Medicare population. Indeed, nearly two-thirds of Medicare home health care users live at or below the federal poverty level, meaning they are the most economically compromised of America’s precious senior citizens.”

The Galen Organization summarizes the impact on Medicare:

“ObamaCare doesn’t modernize the program or improve it for seniors. ObamaCare’s solutions are detrimental to today’s seniors:

  • The law takes $716 billion out of Medicare over 10 years to help fund a huge expansion of taxpayer subsidies for health coverage.
  • It creates an unelected, unaccountable board — the Independent Payment Advisory Board — with powers to limit payment and access to health care for seniors and which will become Medicare’s rationing board. ObamaCare drives your doctors and hospitals out of Medicare
  • The law makes deep cuts in payments to physicians treating Medicare patients.
  • Cuts to Medicare providers mean it will be harder for seniors to find doctors and hospitals to treat them.
  • Doctors are already threatening to drop out of the program in large numbers if the payment cuts go into effect.
  • Medicare actuaries predict that more than 40% of Medicare providers eventually will either go out of business or stop seeing Medicare patients altogether if the law’s cuts take effect.”

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Quick Analysis

Obamacare found to be detrimental to seniors

In the public discussions leading up to the passage of the Affordable Care Act (Obamacare,) a point repeatedly brought up by the opposition was that it would lead to discrimination against the elderly. It now appears that the critics were correct.

“Senior citizens”, notes  Sciencecodex, “were concerned about the Affordable Care Act because they knew adding more people to Medicare would lead to even fewer doctors available. And they were right, they are now discriminated against by the healthcare system and it is not just stressful, it is literally bad for their health. A national survey shows that one in every three older Americans who are on the receiving end of age-related discrimination in the healthcare setting will likely develop new or worsened functional ailments in due course. This follows a study led by Stephanie Rogers, a fellow in geriatrics at UC San Francisco in the United States.”

HOW THIS HAPPENED

The question, of course, is how this occurred. A Forbes study provides an answer.

“One of the best kept secrets of the Affordable Care Act (ACA) is that it imposes a global budget on Medicare spending – for the first time in the program’s history. Heretofore, Medicare was a pure entitlement program. The government had to pay for whatever care the elderly and the disabled obtained. But going forward, the health reform law imposes a cap on spending.

“For most of its history, per capita Medicare spending in real terms grew at about twice the rate of growth of real per capita GDP – just like the rest of the health care system. But going forward, the law requires Medicare to grow at a rate that is not much more than the growth of GDP – regardless of what happens to other health care spending. If the historical trend continues, that means spending on health care for the elderly and the disabled will grow about half as fast as spending on everyone else’s care…

“One bad result is that that Medicare beneficiaries are likely to be pushed into a second tier health care system – where access to care will become increasingly difficult, as seniors less financially attractive to providers become Medicaid patients. The impact will become worse through time. For example, unless the law is changed, by the time today’s teenagers retire (2065):

  • Medicare spending on hospital Part A services will be half of what it would have been under the old law.
  • Medicare spending on doctors (Part B services) will be 61 percent of what it would have been under the old law.

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“As Thomas Saving (a former Medicare Trustee) and [John Goodman]  noted in a blog post at Health Affairs, for 65-year-olds, the forecasted reduction in spending is roughly equal to three years of average Medicare spending. For 55-year-olds, the loss expected is the rough equivalent of five years of benefits; and for 45-year-olds, it’s almost nine years.

“How does Obamacare accomplish the spending reductions? The new law gives an Independent Payment Advisory Board the power to recommend cuts in reimbursement rates for providers of health care. Congress must either accept these cuts or propose its own plan to cut costs as much or more. If Congress fails to substitute its own plan, the board’s cuts will become effective. Moreover, the advisory board is barred from considering just about any cost control idea other than cutting fees to doctors, hospitals and other suppliers.”

THE POLITICAL ANGLE

Some reviewers believe there is a political angle to these decisions. An American Thinker  article describes this:

“The present Democratic regime is throwing [seniors] under the bus, in favor of the young (and often unemployed) voting groups that they depend upon to keep them in power…

“…ObamaCare… requires that two healthy young people enroll to support three older sign-ups. The young are not cooperating; in fact, many of them will have to be subsidized. The Democrats won’t dare antagonize them, since they are one of their most important supporting groups. So guess who’s going to get thrown under the bus. [seniors] are living too long and spending too much healthcare money to do so. You must be persuaded to gracefully depart

“One way is healthcare rationing. You probably laughed when Sarah Palin began talking about ObamaCare death panels…But that may not be enough to balance the budget. Old people who should die and won’t die may have to be persuaded to die.”

INTERNATIONAL EXAMPLES

Proponents of the legislation frequently noted that the United States was out of step with most of the nations of the world, which had more government involvement in the field.

Those advocates should have reviewed those other nations more carefully, particularly in their treatment of senior citizens. Interestingly enough, those programs envied by American proponents of Obamacare do discriminate against seniors.  In a significant expose in England’s Daily Mail , it is revealed that “According to shocking new research by Macmillan Cancer Support, every year many thousands of older people are routinely denied life-saving NHS treatments because their doctors write them off as too old to treat.

“It is often left to close family members to fight for their rights. But although it is now British law that patients must never be discriminated against on the basis of age, such battles often prove futile…experts at Macmillan Cancer Support… warned last week that every day up to 40 elderly cancer sufferers are dying needlessly because they are being denied the best treatments. This is particularly true, it says, for patients over the age of 70…

“Discrimination against the elderly affects not only cancer treatment but goes right across the board, according to another new report…

“Last week, the respected health research charity, the King’s Fund, warned that prejudice about older people means they often go without treatment for conditions such as depression, and are not even tested for illnesses such as heart disease.

“The Patients Association and Care Quality Commission have both recently published studies detailing ‘shocking’ standards.”

Former House Speaker Nancy Pelosi (D-Ca.) famously stated that “we would have to pass [Obamacare] to find out what’s in it.” The legislation has passed, and what has been found is inappropriate, especially for  seniors.