Proposals


Medicare Proposals

 

 

There are many proposals to deal with the Medicare insolvency. Here are some below.

 

1. Simpson Bowles Plan

2. Domenici Rivlin Plan

3. The Heritage Foundation

4. The Cato Institute

5. AARP Plan

6. Ryan-Wyden Plan

7. American Medical Association Plan

8. United We Stand Proposal (see below).

 

United We Stand Proposal

 

In order to insure the long term solvency of the Medicare Program, there are many steps that might be taken to accomplish this important national priority. However, the options to reach this important goal come down to increasing the Medicare taxes to support the program, increasing payments from beneficiaries, lowering the benefits provided to beneficiaries, or lowering expenditures to providers. Where the information is available, we will note the effect on the overall annual Federal deficit as well as the current estimate of the effect on closing the solvency gap within just the Medicare program.

 

For beneficiary payment increases, we propose the following provisions.

 

1. Increase the Medicare Part B premium to beneficiaries from 25% to 35% of overall costs of the program.  This will raise the current Part B premium from $104.90 to $146.86 per month.  This will decrease the deficit by $31 billion per year.

 

2. Raise premiums for higher income beneficiaries for Part B and Part D services to cover more of the costs of their insurance. Do this in two ways. Lower the modified adjusted gross income (Magi) threshold when beneficiaries must begin paying additional premiums for Part B and Part D services (for instance, from the current $170,000 of Magi for Married, filing jointly taxpayers to $120,000 of Magi). Secondly, increase the payment rates now paid by current higher income beneficiaries. This will reduce the deficit by $3 billion per year.

 

 

For benefit decreases, we propose the following provisions.

 

1. Force Medicare/Medicaid Dual eligibles into Managed Care.

 

 

For decreasing Medicare expenditures to providers, we propose the following provisions.

 

1. Reduce Hospital and Pharmaceutical fees by 5% each year for 3 years. Insure that the Hospital cost cutting involves supplies, services, overtime, but not staffing numbers. For the Hospitals, if FTE’s are reduced, then retroactively reduce the payments to the hospital by another 5%. This will reduce the deficit by $18 billion in year 1, $40 billion in year 2, and $70 billion in year 3.

 

2. Require drug companies to give price concessions to Medicare based upon the Medicaid formulas. This will reduce the deficit by $11 billion annually.

 

3. Freeze non primary care physician rates for 3 years. This will reduce the deficit by $5 billion in the first year, $7 billion in the second year, and $10 billion in the third year.

 

4. If overall costs increase more than expected by the cuts in fees and the addition of new Medicare patients, cut fees by that amount the next year. Develop and implement a system to cut the individual providers that have the unjustified volume increases.

 

5. Introduce another procedure code for physicians and their staff for monthly monitoring and management of chronically ill patients especially in the areas of diabetes and heart conditions. These 2 areas alone constitute major expenditure categories for Medicare yet no provider has the funding to monitor and manage the care of these patients.

 

6. Develop and implement a standard program for the monitoring and management of diabetic and heart problematic patients. Compare the results of that program as to patient condition and cost to the unmanaged patient.

 

7. Review the Medicare database for other chronic conditions that are high cost drivers and put together similar standards for monitoring and management.

 

8. Reform medical malpractice.  This will save $2 million per year.