By Elizabeth Lee Vliet, M.D. -
Chaos, cost increases, and turmoil reign since Obamacare took effect. Hidden changes drastically transform Medicare, affecting your ability to get needed medical care—even if you pay out of pocket.
Here is my list of the Top 9 government attacks on American seniors:
1. CMS proposed a 678-page rule (1-6-2014) requiring enrollment in Medicare for all prescribers of drugs covered under Part D Medicare. Currently, medication prescribers only need to have an active state license permitting prescribing. CMS is restricting Medicare beneficiaries’ ability to use their benefits if they see an independent physician outside “the system.” Independent physicians can see patients but cannot order anything for them. It’s like telling an auto mechanic that he can fix cars but he can’t use any tools.
Even Doctors enrolled in Medicare risk having their enrollment revoked if, in the eyes of the government bureaucrats, they “fail to meet Medicare requirements.” The requirements change almost daily, and Medicare rules are often subjectively interpreted, so this means doctors may avoid prescribing something YOU need rather than risk a Medicare sanction and losing income.
2. Hospitals increasingly are classifying hospitalized Medicare patients as being “under observation,” rather than admitting them as “in patients,” not telling them this means thousands of dollars in out-of-pocket costs. Only “inpatient” status is covered under Medicare Part A. “Observation” status comes under Part B. After discharge, patients learn about exorbitant hospital bills and increased co-payments for medications, procedures, and tests. Worse, without an inpatient stay, rehabilitation services and skilled nursing care will not be covered by Medicare, hitting unsuspecting patients with huge added medical bills.
3. Obamacare’s new Medicare rules deny payment if a hospital patient is readmitted within 30 days of discharge. This is particularly damaging to patients with chronic lung disease, congestive heart failure, diabetic coma, and other such medical problems needing brief readmission to stabilize life-threatening situations. If not re-admitted when medically needed, patients may die. Catch-22 happens if they are readmitted to hospital “under observation,” then get hit with unexpected exorbitant hospital bills.
4. In 2012, Obamacare rules forced hospitals contracted with Medicare to do FEWER surgeries for Medicare patients to be paid MORE. If employed by the hospital, doctors may not tell you this reason behind failing to suggest a surgery that could benefit you.
5. Other than government-determined copayments, Medicare patients are not legally allowed to pay cash out of pocket for needed “covered” services if they see a Medicare-contracted physician. Patients must find a physician who has legally opted out of Medicare to be able to pay cash for a service, say one that is not available at the Medicare-allowed price—or to keep their medical records from being sent to the federal government medical database.
6. Medicare patients are likely the ones hit harder by the new Obamacare 2.3% medical device tax that inflates the cost of pacemakers, stents, knee/hip/shoulder replacement devices, prosthetic limbs, etc.
7. Obamacare’s new direct Medicare taxes also hit retirees harder: a 3.8% tax on unearned income (dividends, rental income, capital gains), and a 0.9% surtax (for those with incomes above $200,000 individual or $250,000 family), added to existing 1.45% Medicare payroll tax.
8. Reduced payments to cancer, heart/lung, and surgical specialists typically caring for older patients. Medicare fee cuts to these specialists can result in payments below the cost of staying in business, so seniors lose access to more doctors.
9. Draconian $716 billion direct cuts from Medicare attack seniors in serious ways from 2013 – 2022: (Source: CBO)
- $260 billion from hospital services budget
- $156 billion from Medicare Advantage
- $66 billion from home health
- $39 billion from skilled nursing
- $17 billion from hospice care
- $145 billion from DHS (Disproportionate Share Hospital) payments to hospitals that serve a large number of low-income patients
- $33 billion from all other services
Increases in out-of-pocket costs and higher taxes are a huge burden on seniors on fixed income. Changes in the rules and regulations can be even more significant, even life-threatening, when they lead to covert denial of medical care.
Who would have thought after a lifetime of service to our country in homes, jobs, and communities, seniors would be attacked by their own government with many threats to their savings and lives in retirement?
Elizabeth Lee Vliet, M.D. is a 2014 Ellis Island Medal of Honor recipient, and the 2007 recipient of the Voice of Women award from the Arizona Foundation for Women for her pioneering advocacy for the overlooked hormone connections in women’s health.