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Monday, July 17, 2006

The Bush Plan for killing Medicare and Social Security
Posted by Jill | 7:05 AM
Make sure that old people die sooner.

Now we see how the pro-life president, who cares deeply about the lives of stem cells but cares not a whit about people who are already here, plans to deal with health care for the elderly.

First, starve the hospitals of reimbursements for new treatments and new technologies. If amputation without anesthesia was good enough for great-grandpa, they're good enough for us, right?

The Bush administration says it plans sweeping changes in Medicare payments to hospitals that could cut payments by 20 percent to 30 percent for many complex treatments and new technologies.

The changes, the biggest since the current payment system was adopted in 1983, are meant to improve the accuracy of payment rates. But doctors, hospitals and patient groups say the effects could be devastating.

Michael O. Leavitt, the secretary of health and human services, said the new system would be more accurate because payments would be based on hospital costs, rather than on charges, and would be adjusted to reflect the severity of a patient’s illness. A hospital now receives the same amount for a patient with a particular condition, like pneumonia, regardless of whether the illness is mild or severe.

Medicare pays more than $125 billion a year to nearly 5,000 hospitals. The new plan is not expected to save money, but will shift around billions of dollars, creating clear winners and losers. The effects will ripple through the health care system because many private insurers and state Medicaid programs follow Medicare’s example.

Dr. Alan D. Guerci, president of St. Francis Hospital in Roslyn, N.Y., said the new formula would cut Medicare payments to his hospital by $21 million, or 12 percent. “It will significantly reduce payments for cardiac care and will force many hospitals to reduce the number of cardiac procedures they perform,” Dr. Guerci said.

A coalition of patient organizations, including the Parkinson’s Action Network and the Society for Women’s Health Research, told the government in a letter that the new system “could have a devastating impact on payment for critical treatments for seriously ill patients, with reimbursement for some essential procedures cut as much as 30 percent.”

The basic payment for surgery to open clogged arteries, by inserting a drug-coated wire mesh stent, would be cut by 33 percent, to $7,590. The payment for implanting a defibrillator, like the one used by Vice President Dick Cheney, would be cut 23 percent, to $22,000, while the payment for hip and knee replacements would be reduced 10 percent, to $14,500.

“This is a bit of a catastrophe,” said Dr. Herbert Pardes, president of NewYork-Presbyterian Hospital. In its zeal to cut the profits of doctor-owned specialty hospitals, including cardiac hospitals, Dr. Pardes said, the government has inadvertently hit many nonprofit academic medical centers.


Then, make sure that research into diseases like Alzheimer's can't advance because of NIH budget freezes that amount to cuts at a time if rapidly-increasing costs:

While President Bush's proposed $28.6 billion budget for the National Institutes of Health for fiscal 2007 is unchanged from last year, proposed funding for Alzheimer's research is $645 million, down from $652 million in fiscal 2006 and $658 million in 2003.

Such reductions are nothing less than devastating, says Sam Gandy, M.D., director of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia and chairman of the Alzheimer's Association's medical and scientific advisory council.

"The greatest progress we've enjoyed in the last 15 years is threatened," he says. During the past 20 years, researchers have been able to discover Alzheimer's genes and develop animal models that they believe will cure humans. Now, the treatments are being tested on humans, and the lowered funding means fewer treatments will be tested at the same time. "Instead of testing a number of drugs simultaneously," Gandy says, "we have to test some drugs this year, then other drugs the next."

Such delays could hamper Alzheimer's research just as new studies raise the prospect that its impact may not be limited to the elderly. The disease affects 4.5 million Americans, including 5 percent of Americans 65 to 74 and half of those over 85, according to the National Institute of Aging. A University of Michigan study also found that half a million Americans between 55 and 64 reported cognitive impairment. Another concern: Alzheimer's progresses so slowly that it often takes years to determine the efficacy of a drug, as opposed to some diseases where a drug's effectiveness is apparent within months.

After more than doubling from 1998 to 2005, NIH's overall budget for 2007 is flat for the second straight year. Funds are reduced for research into pre-emptive strikes against or treatments for some of the nation's most debilitating diseases, among them breast, prostate and lung cancer, hypertension, diabetes, arthritis, osteoporosis, stroke, macular degeneration and mental illness.

[snip]

NIH supports research into 6,600 rare and common diseases, employing more than 200,000 scientists at 3,000 research facilities around the world and on its campus in Bethesda, Md.


The Bush Administration gives a great deal of lip service to the support of science, but the reality is far different. In his State of the Union address this year, Bush pledged to double the federal commitment to the most critical basic research programs in the physical sciences over the next 10 years. Obviously medical research is not part of his agenda and is going to get short-changed so he can fund scientists to deny that what we do has anything to do with global warming, and write papers about how since they don't understand the process by which the evolution of species took place, it must be magic done by some Big Alpha Male in the Sky.

Disclosure: My job is dependent on grant money, with much of that grant money coming from NIH-funded projects. But the point remains.
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