There is good news and bad news about Medicare premiums for 2007. As premiums rise, physician reimbursement declines and it's all related.
The good news is that Medicare hikes in premiums for 2007 will be the lowest since 2001. The bad news is that the reason for the low hikes is based on a mathematical formula which takes into consideration the 5% reduction in physician reimbursement also planned for 2007.
Physicians May Refuse to Treat Medicare Patients
The reduction in reimbursement to physicians may have long lasting effects on healthcare for seniors as the American Medical Association's survey of physicians indicates that over 45% of MDs intend to refuse new Medicare patients and some will discontinue services to Medicare patients over the next few years. Planned reduction in Medicare reimbursement is expected to increase each year and to reach 37% over the next nine years. As it is, there are not enough physicians are entering the field of geriatrics let alone see the number of physicians accepting Medicare patients decline.
As the Baby Boom generation heads into the Medicare ranks, this can present serious health care issues. The first of the Baby Boom generation turned 60 in 2006. Medicare eligibility begins at 65 for the majority of seniors.
How Much Wil I Pay?
The increase for Part B Medicare which covers physician care and outpatient services, will be 5.6% or roughly $5 per month to $93.50 for 96% of the Medicare beneficiaries.
Sliding Scale Begins for Affluent Seniors
The remaining, more affluent 4% of Medicare beneficiaries, will be subject to the new law (Medicare Modernization Act of 2003) which becomes effective in 2007 and requires those seniors earning over $80,000 per year ($160,000 for married couples) will bay slightly higher premiums based on their income levels. Their premiums will range from $106 to $162.10 per month. Their premiums will continue rise approximately 10% over the next 3 years.
If Congress Blocks Reimbursement Reductions...
In the event that Congress decides not to reduce physician reimbursement by 5% in 2007, Medicare beneficiaries would see no increase in premiums for 2007. Contingency funds would make up the difference at this point. At some point down the line the contingency funds would have to be replenished, but there is no plan at the present to do this.
The copyright of the article 2007 Medicare Premiums in Health Field is owned by Kathy Quan . Permission to republish 2007 Medicare Premiums in print or online must be granted by the author in writing.
We're hopelessly caught up in a healthcare downward spiral which will
continue until a critical mass of people take better care of themselves.
I know that sounds insensitive, and I realize that many people
acquire health problems despite taking the best care of themselves they
know how. These things have happened to me, too, and my family.
These are not the people crushing our health care infrastructure. The
crush is coming from the millions of people ignoring all the information
about smoking, heavy alcohol consumption, drugs, obesity, lack of exercise,
and all the other self-induced harmful behaviors.
Medicare,
Medicaid, HMO's, and health-care insurance are all basically sound programs
designed for people who take good care of themselves but need medical
assistance from time to time. These programs can't keep up with us if we
continue to self destruct.
Sep 18, 2006 1:48 PM
Kathy Quan :
I agree with you whole heartedly. We for far too many years blamed the
practitioners for our health problems and malpractice premiums put many
fine physicians out of business.
The trend today is to hold the
patient accountable for their health status. HMOs, for all the complaints
we've heard over the years, helped to bring this about. They put the cabosh
on many patients with hypochondriacal tendencies. No you can't stay in the
hospital for 2 weeks, no you can't have hundreds of tests that aren't
medically indicated... It went too far in some ways and now the pendulum is
swinging back.
Obesity is a condition we are all battling
whether or not we are personally aflicted. It is killing us, our systems
and putting our children at very high risk.
We do indeed have to
take more responsibility for our health and forget the sense of entitlement
because we pay premiums!
Sep 19, 2006 3:11 PM
Robert Dailey :
I'm sorry, Jerry, but I do disagree with you. I came from the banking
industry and worked for a very large, multi-national bank which also owned
insurance companies.
Health insurance, per se, is a good thing.
Health insurance, as it has evolved,particularly in the U.S., is not. I'm
not disagreeing with profit. Companies have to be profitable to exist. But
when half the middle class of this country, and almost all of the poor,
cannot afford health insurance, while insurance companies make obscene
profits, andthen there is a very serious problem.
When doctors
choose not to take Medicare patients (or manipulate Medicare reports to
steal from it), when HMOs are so restrictive that profits and astronomical
bottom lines are more important than the services offered, then there is a
basic and fundamental problem with our entire health care system.
People who take care of themselves still contact diseases and illnesses.
Many people who take care of themselves are actually poor. When they cannot
afford the insurance, the medication, the physicians, and still handle the
necessities of life, then we need to look at the system.
To
blame the consumer for the shortcomings of our Medicare, Medicaid, HMOs and
health care insurance programs is like blaming a farmer for the failure of
his crop.
I know, and have known many people who contracted
cancer, had heart disease, diabetes, who didn't smoke or drink, who weren't
obese, and who took good care of themselves.
I don't mean to be
vituperative, Jerry, but as you can see, I feel strongly about this.
I feel the entire health care system (or industry as it is called
in the corporate world) is in critical shape, and needs to be rethought and
redesigned from the bottom up.
I do agree with you that nothing
will happen until things reach critical mass, but that will happen soon
enough. Then we will see how many health-care insurance companies, HMOs,
and yes, even those quasi-government groups like Medicare and Medicaid,
step up to the plate, and how many seek Chapter 11 to escape their
obligations.
I have been extraordinarily lucky in my life. I
have retired, I have relatively good (but also relatively expensive) health
care insurance. Our six children are almost all raised. There have been no
serious illnesses in our immediate family. But for every one of me, there
are thousands who have no health care insurance (and cannot afford it),
little or no adequate health care, and little hope of ever getting
Sep 15, 2006
