Will the Quality of Care from Public Health Programs Such as Medicare and Medicaid Improve?



PRO (yes)

David Bazelon, former Circuit Court of Appeals judge, stated in its July 27, 2010 posting “Medicaid Reforms in the Patient Protection & Affordable Care Act and the Health Care & Education Reconciliation Act,” available at www.bazelon.org:

"The new laws…

- Improve Medicaid home and community-based services through improvements to state plan options and waivers;

- Improve prescription drug coverage;

- Encourage collaborative care through health homes;

- Improve services for individuals who are dually eligible for Medicaid and Medicare; and

- Include a number of provisions designed to improve the quality of Medicaid services…

The law confirms and clarifies that the original intent of Congress in providing ‘medical assistance' through establishment of the Medicaid program was to ensure that beneficiaries do, in fact, have access to and receive promised services. This provision is effective immediately, and responds to a handful of federal court decisions contending that states are not required to ensure that services are indeed available, only to provide payment for services should they be acquired. The clarification requires states to operate their programs so as to ensure that beneficiaries receive covered services with reasonable promptness, and not simply be reimbursed if they are able to obtain services on their own...

… the Affordable Care Act establishes an Office of Coordination for Dual Eligible Beneficiaries to align Medicare and Medicaid policies for dual eligibles, integrate the two programs' benefits, improve continuity of care and enhance coordination between the federal and state governments.”





The US Department of Health & Human Services on wrote in a Mar. 31, 2011 press release “Affordable Care Act to Improve Quality of Care for People with Medicare,” available online at www.hhs.gov:

"By focusing on the needs of patients and linking payment rewards to outcomes, this delivery system reform [Accountable Care Organizations], as part of the Affordable Care Act, will help improve the health of individuals and communities while saving as much as $960 million over three years for the Medicare program.

Under the proposal, ACOs – teams of doctors, hospitals, and other health care providers and suppliers working together – would coordinate and improve care for patients with Original Medicare (that is, who are not in Medicare Advantage private health plans).”





The Centers for Medicare & Medicaid Services stated in a paper “Affordable Care Act Update: Implementing Medicare Cost Savings,” available online at www.cms.gov (accessed on Sep. 21, 2012):

"The Affordable Care Act includes a series of Medicare reforms that will generate billions of dollars in savings for Medicare and strengthen the care Medicare beneficiaries receive. The new law protects guaranteed benefits for all Medicare beneficiaries, and provides new benefits and services to seniors on Medicare that will help keep seniors healthy. The law also includes provisions that will improve the quality of care, develop and promote new models of care delivery, appropriately price services, modernize our health system, and fight waste, fraud, and abuse.'"




Ron Pollack, JD, Families USA Executive Director, wrote in his Sep. 6, 2012 article “Why Obamacare Is Good for Seniors and America: Families USA,” available at www.smmirror.com:

"Reform also means that there are no longer any deductibles or copayments for annual wellness visits and such basic screenings as bone mass measurements; cervical cancer screenings, including Pap smear tests and pelvic exams; mammograms; diabetes screenings; prostate cancer screenings; cholesterol and other cardiovascular screenings; and more. It's just common sense reform. Removing any disincentive for seniors to get important preventive care helps make Medicare a more comprehensive health care plan—and keeps seniors healthier longer.”





President Barack Obama, JD, 44th President of the United States, stated in his Sep. 21, 2012 remarks to the AARP Convention via satellite, available at www.whitehouse.gov:

"…I have strengthened Medicare as President. We've added years to the life of the program by getting rid of taxpayer subsidies to insurance companies that weren't making people healthier. And we used those savings to lower prescription drug costs, and to offer seniors on Medicare new preventive services like cancer screenings and wellness services.”




CON (no)

Betsy McCaughey, PhD, former Lt. Governor of New York, wrote in her Sep. 12, 2012 article “ObamaCare's Cuts to Hospitals Will Cost Seniors Their Lives,” available at www.FoxNews.com:

"President Obama is wooing seniors with promises to protect Medicare as they've known it. On the defensive because of the $716 billion his health care law takes from Medicare, Obama assures seniors he's cutting payments to hospitals and other providers, not their benefits.

Don't be bamboozled. It's illogical to think that reducing what a hospital is paid to treat seniors won't harm their care. A mountain of scientific evidence proves the cuts will worsen the chance that an elderly patient survives a hospital stay and goes home. It's reasonable to conclude that tens of thousands of seniors will die needlessly each year.

Under ObamaCare, hospitals, hospice care, dialysis centers, and nursing homes will be paid less to care for the same number of seniors than if the health law had not been enacted. Payments to doctors will also be cut...”





Economic Policies for the 21st Century stated on its page "Medicare," available at www.ObamacareWatch.org (accessed Sep 20, 2012):

"ObamaCare cuts a half-trillion dollars from Medicare over the next decade. These cuts are unsustainable and will lead to a reduction in the quality of care for seniors who rely on the program to secure access to needed medical services. The cuts in Medicare Advantage will impose steep costs on millions of Medicare beneficiaries, and will fall disproportionately on low income and minority seniors.”





Robert Moffit, PhD, Director of the Center for Health Policy Studies at the Heritage Foundation, wrote in his May 20, 2010 article "Obamacare: Impact on Seniors" available at www.heritage.org:

"...much of the financing over the initial 10 years is siphoned off from an estimated $575 billion in projected savings to the Medicare program. Unless Medicare savings are captured and plowed right back into the Medicare program, however, the solvency of the Medicare program will continue to weaken. The law does not provide for that. Medicare is already burdened by an unfunded liability of $38 trillion.

Medicare Advantage plans, which currently attract almost one in four seniors, will see enrollment cut roughly in half over the next 10 years. Senior citizens will thus be more dependent on traditional Medicare than they are today and will have fewer health care choices...

In 2011, the new law provides a 10 percent Medicare bonus payment for primary care physicians and general surgeons in ‘shortage' areas. This is a tepid response to a growing problem.

With the retirement of 77 million baby boomers beginning in 2011, the Medicare program will have to absorb an unprecedented demand for medical services. For the next generation of senior citizens, finding a doctor will be more difficult and waiting times for doctor appointments are likely to be...

Seniors deserve better than what Obamacare gives them.”





Scott Gottlieb, MD, American Enterprise Institute Resident Fellow, wrote in his Apr. 26, 2012 article “Toss Gran in an HMO a Fresh Obamacare Outrage,” available at www.nypost.com:

"The latest installment of ObamaCare is a scheme that's uprooting the elderly poor and disabled who get care under Medicare and herding many into state-run Medicaid plans.

All of these folks are dually eligible for both Medicare and Medicaid; they are low-income people who are elderly or have disabilities. But it's hard to see how they'll be better off in bare-bones, and sometimes poorly-run state Medicaid plans than by getting access to Medicare options they were entitled to before ObamaCare…

Some states have already said they plan to automatically place these folks in existing Medicaid plans — which often aren't equipped to serve an older, sicker group of patients. That will mean big savings for the state and worse care for the vulnerable.”