The Obama Medicare Plan: Rob It and Let it Die

[ScreamingEagle]

The Obama Medicare Plan: Rob It and Let it Die - Reince Priebus - Page 1

Because of President Obama’s failed record on nearly every issue from the economy to the deficit to Medicare, the Obama campaign has become increasingly dirty, despicable, and desperate. Their latest lies on Medicare are no exception.

That’s why it’s important to remember the truth. President Obama is the only president who has cut Medicare by $700 billion. And he is the only candidate in this race willing to let Medicare die.

 

[Leweman]

It's his America plan.

 

[Greenbeard]

The Obama Medicare plan is to address the cost drivers that make the program (and, ultimately, every private sector health plan, as well) unsustainable: the inflationary payment mechanisms and flawed delivery systems that have plagued the health system for decades.

Remove the perverse incentives that make it more lucrative to provide worse care inefficiently, and instead reward doctors and hospitals for providing better care more efficiently. Reorganize the system so that it not only can but is encouraged to deliver better care less expensively. One of the few private sector pilots to taking this approach--replacing fee-for-service reimbursement with new payment mechanisms and incentivizing higher quality care--saw costs drop 10% in a single year last year for providers making that transition, at the same time quality improved.

This is the only way to save Medicare--and the rest of us. And Obama is the only one in this race who's shown any interest in making Medicare, and health care more generally, more sustainable.

 

[ScreamingEagle]

The Obama Medicare plan is to address the cost drivers that make the program (and, ultimately, every private sector health plan, as well) unsustainable: the inflationary payment mechanisms and flawed delivery systems that have plagued the health system for decades.

Remove the perverse incentives that make it more lucrative to provide worse care inefficiently, and instead reward doctors and hospitals for providing better care more efficiently. Reorganize the system so that it not only can but is encouraged to deliver better care less expensively. One of the few private sector pilots to taking this approach--replacing fee-for-service reimbursement with new payment mechanisms and incentivizing higher quality care--saw costs drop 10% in a single year last year for providers making that transition, at the same time quality improved.

This is the only way to save Medicare--and the rest of us. And Obama is the only one in this race who's shown any interest in making Medicare, and health care more generally, more sustainable.

the BIG difference is that under the Ryan plan your health care is patient-centered.....not government-centered.....

 

[Greenbeard]

the BIG difference is that under the Ryan plan your health care is patient-centered.....not government-centered.....

Entirely wrong. "Patient-centered" is a term of art that actually means something, not just a buzzword for making Ryancare sound like it doesn't shit all over seniors.

And what it means goes directly to what I was just talking about: payment and delivery system reforms, aimed at overcoming the fragmented system that leaves patients (and providers) in the dark right now. It's not about how you pick your insurance, it's about how the health care delivery system treats you when you're a patient in it. It's about the relationships your doctors have with you and the relationships your doctors have with each other, as well as the infrastructure that supports those relationships. And that's a delivery system design issue.

Which isn't something Ryan takes an interest in. Obama's reforms, on the other hand, are quite interested in finding ways to make the system more conducive to those kinds of positive re-arrangements. Coupons for insurance don't quite get to the level of making care itself better, more effective, and less expensive. Yet another reason Obama's Medicare reforms are far superior to Ryan's.

 

[Amazed]

The Obama Medicare plan is to address the cost drivers that make the program (and, ultimately, every private sector health plan, as well) unsustainable: the inflationary payment mechanisms and flawed delivery systems that have plagued the health system for decades.

Remove the perverse incentives that make it more lucrative to provide worse care inefficiently, and instead reward doctors and hospitals for providing better care more efficiently. Reorganize the system so that it not only can but is encouraged to deliver better care less expensively. One of the few private sector pilots to taking this approach--replacing fee-for-service reimbursement with new payment mechanisms and incentivizing higher quality care--saw costs drop 10% in a single year last year for providers making that transition, at the same time quality improved.

This is the only way to save Medicare--and the rest of us. And Obama is the only one in this race who's shown any interest in making Medicare, and health care more generally, more sustainable.

Actually the op...while a tad dramatic is true.....that is his plan....MC won't be needed when the Gov has to step in because there will be no Private Insurers.

 

[Mac1958]

It's not about how you pick your insurance, it's about how the health care delivery system treats you when you're a patient in it.

This is an important point. While I can understand people not wanting government sticking its nose into the health care delivery process, what they don't know is how much insurance companies stick their nose into the process.

That's why I'm for a public/private partnership, a Medicare-for-all foundation and a robust, free-market supplemental system. The foundation would provide the preventive and diagnostic coverage that we so desperately need to keep mid-term and long-term costs down. Sadly, those who knee-jerk against that idea have no idea how much they're paying for our system's inefficiencies. The radio tells 'em what to say, they say it.

.

 

[Mustang]

The Obama Medicare Plan: Rob It and Let it Die - Reince Priebus - Page 1

Because of President Obama’s failed record on nearly every issue from the economy to the deficit to Medicare, the Obama campaign has become increasingly dirty, despicable, and desperate. Their latest lies on Medicare are no exception.

That’s why it’s important to remember the truth. President Obama is the only president who has cut Medicare by $700 billion. And he is the only candidate in this race willing to let Medicare die.

Republicans must be even more scared than I thought of the consequences of Romney's selection of Ryan for VP if they're trying to make this claim.

 

[ScreamingEagle]

the BIG difference is that under the Ryan plan your health care is patient-centered.....not government-centered.....

Entirely wrong. "Patient-centered" is a term of art that actually means something, not just a buzzword for making Ryancare sound like it doesn't shit all over seniors.

And what it means goes directly to what I was just talking about: payment and delivery system reforms, aimed at overcoming the fragmented system that leaves patients (and providers) in the dark right now. It's not about how you pick your insurance, it's about how the health care delivery system treats you when you're a patient in it. It's about the relationships your doctors have with you and the relationships your doctors have with each other, as well as the infrastructure that supports those relationships. And that's a delivery system design issue.

Which isn't something Ryan takes an interest in. Obama's reforms, on the other hand, are quite interested in finding ways to make the system more conducive to those kinds of positive re-arrangements. Coupons for insurance don't quite get to the level of making care itself better, more effective, and less expensive. Yet another reason Obama's Medicare reforms are far superior to Ryan's.

No....you still don't get it....

"Patient-centered" means the patient is the buyer of his own health insurance....in a free competitive market....

this is the only way we are going to bring costs down and get decent service as well...

Obama may have all kinds of cute little ways to "deliver" healthcare (or ration it) but it is always government-centric.....meaning it's run by the government where the patient has no real control or choice....

 

[ScreamingEagle]

The Obama Medicare Plan: Rob It and Let it Die - Reince Priebus - Page 1

Because of President Obama’s failed record on nearly every issue from the economy to the deficit to Medicare, the Obama campaign has become increasingly dirty, despicable, and desperate. Their latest lies on Medicare are no exception.

That’s why it’s important to remember the truth. President Obama is the only president who has cut Medicare by $700 billion. And he is the only candidate in this race willing to let Medicare die.

Republicans must be even more scared than I thought of the consequences of Romney's selection of Ryan for VP if they're trying to make this claim.

Obama stole nearly a TRILLION from Medicare.....how is that going to help seniors.....?

The choice of Ryan is a direct confrontation of Obama's destructive policies....

 

[Greenbeard]

"Patient-centered" means the patient is the buyer of his own health insurance....in a free competitive market....

No, that's not what it means. And this is an important point. "Patient-centered care" is about the experience of being a patient. It's not about the experience of being in the market for an insurance product.

It's entirely about the way the health care delivery system is organized to treat you and attend to your many (including not strictly medical) needs when you get sick.

The reason this is important here is that this is exactly the area where the Ryan and Obama Medicare plans diverge. Obama's reforms are aimed at changing the way Medicare and health care providers do business to build that patient-centered system around patients. Ryan's proposal doesn't think a step beyond offering its insurance voucher.

Here's a brief description of what patient-centeredness really means from the Institute of Medicine. It's what you (apparently) want, yet it's not something the Ryan proposal is offering.

Gerteis et al. (1993) have identified several dimensions of patient-centered care: (1) respect for patients’ values, preferences, and expressed needs; (2) coordination and integration of care; (3) information, communication, and education; (4) physical comfort; (5) emotional support—relieving fear and anxiety; and (6) involvement of family and friends. Each dimension is briefly discussed below.

• Respect for patients’ values, preferences, and expressed needs. Patient-centered care responds precisely to each patient’s wants, needs, and preferences. It gives patients abundant opportunities to be informed and involved in medical decision making, and guides and supports those providing care in attending to their patients’ physical and emotional needs, and maintaining or improving their quality of life to the extent possible. Patient-centered care is highly customized and incorporates cultural competence. Some patients wish to avoid risk; others may choose a risky intervention despite a relatively low likelihood of benefit. Patients’ preferences are likely to change over time and to depend on the clinical
problems in question; therefore, the enterprise of shared decision making is a dynamic one, changing as patients and circumstances change.

• Coordination and integration of care. Because of the special vulnerability that accompanies illness or injury, coordination of care takes on special importance. Many patients depend on those who provide care to coordinate services—whether tests, consultations, or procedures—to ensure that accurate and timely information reaches those who need it at the appropriate time. Patient-centered care addresses the need to manage smooth transitions from one setting to another or from a health care to a self-care setting.

• Information, communication, and education. With respect to their health, people tend to want to know (1) what is wrong (diagnosis) or how to stay well, (2) what is likely to happen and how it will affect them (prognosis), and (3) what can be done to change or manage their prognosis. They need answers that are accurate and in a language they understand. Patients are diverse in the way they prefer to interact with caregivers: some seek ongoing personal face-to-face relationships; others prefer to interact with the health care system only when unavoidable and with no substantial interpersonal relationship, being comfortable with e-mail and other Web-based communication technologies. Common to all such interactions is the desire for trustworthy information (often from an individual clinician) that is attentive, responsive, and tailored to an individual’s needs.

• Physical comfort. Among the committee’s more disturbing findings is the frequency with which patients experience pain, shortness of breath, or some other discomfort. Especially at the end of life, they need not undergo such suffering. Sadly, many patients fail to receive state-of-the-art pain relief or respiratory management (Ingham and Foley, 1998; SUPPORT Principal Investigators, 1995). Attention to physical comfort implies timely, tailored, and expert management of such symptoms.

• Emotional support—relieving fear and anxiety. Suffering is more than just physical pain and other distressing symptoms; it also encompasses significant emotional and spiritual dimensions (Byock, 1998; Cassell, 1991). Patient-centered care attends to the anxiety that accompanies all injury and illness, whether due to uncertainty, fear of pain, disability or disfigurement, loneliness, financial impact, or the effect of illness on one’s family.

• Involvement of family and friends. This dimension of patient-centered care focuses on accommodating family and friends on whom patients may rely, involving them as appropriate in decision making, supporting them as caregivers, making them welcome and comfortable in the care delivery setting, and recognizing their needs and contributions.

One of the foremost advocates of building a patient-centered health system that meets the needs of patients used to be in charge of Medicare. But he couldn't muster the support in the Senate to keep his post. Imagine that.

 

[Sherry]

 

[uscitizen]

The Obama Medicare Plan: Rob It and Let it Die - Reince Priebus - Page 1

Because of President Obama’s failed record on nearly every issue from the economy to the deficit to Medicare, the Obama campaign has become increasingly dirty, despicable, and desperate. Their latest lies on Medicare are no exception.

That’s why it’s important to remember the truth. President Obama is the only president who has cut Medicare by $700 billion. And he is the only candidate in this race willing to let Medicare die.

And Ryans plan is any different?

 

[ScreamingEagle]

"Patient-centered" means the patient is the buyer of his own health insurance....in a free competitive market....

No, that's not what it means. And this is an important. "Patient-centered care" is about the experience of being a patient. It's not about the experience of being in the market for an insurance product.

It's entirely about the way the health care delivery system is organized to treat you and attend to your many (including not strictly medical) needs when you get sick.

The reason this is important here is that this is exactly the area where the Ryan and Obama Medicare plans diverge. Obama's reforms are aimed at changing the way Medicare and health care providers do business to build that patient-centered system around patients. Ryan's proposal doesn't think a step beyond offering its insurance voucher.

Here's a brief description of what patient-centeredness really means from the Institute of Medicine. It's what you (apparently) want, yet it's not something the Ryan proposal is offering.

Gerteis et al. (1993) have identified several dimensions of patient-centered care: (1) respect for patients’ values, preferences, and expressed needs; (2) coordination and integration of care; (3) information, communication, and education; (4) physical comfort; (5) emotional support—relieving fear and anxiety; and (6) involvement of family and friends. Each dimension is briefly discussed below.

• Respect for patients’ values, preferences, and expressed needs. Patient-centered care responds precisely to each patient’s wants, needs, and preferences. It gives patients abundant opportunities to be informed and involved in medical decision making, and guides and supports those providing care in attending to their patients’ physical and emotional needs, and maintaining or improving their quality of life to the extent possible. Patient-centered care is highly customized and incorporates cultural competence. Some patients wish to avoid risk; others may choose a risky intervention despite a relatively low likelihood of benefit. Patients’ preferences are likely to change over time and to depend on the clinical
problems in question; therefore, the enterprise of shared decision making is a dynamic one, changing as patients and circumstances change.

• Coordination and integration of care. Because of the special vulnerability that accompanies illness or injury, coordination of care takes on special importance. Many patients depend on those who provide care to coordinate services—whether tests, consultations, or procedures—to ensure that accurate and timely information reaches those who need it at the appropriate time. Patient-centered care addresses the need to manage smooth transitions from one setting to another or from a health care to a self-care setting.

• Information, communication, and education. With respect to their health, people tend to want to know (1) what is wrong (diagnosis) or how to stay well, (2) what is likely to happen and how it will affect them (prognosis), and (3) what can be done to change or manage their prognosis. They need answers that are accurate and in a language they understand. Patients are diverse in the way they prefer to interact with caregivers: some seek ongoing personal face-to-face relationships; others prefer to interact with the health care system only when unavoidable and with no substantial interpersonal relationship, being comfortable with e-mail and other Web-based communication technologies. Common to all such interactions is the desire for trustworthy information (often from an individual clinician) that is attentive, responsive, and tailored to an individual’s needs.

• Physical comfort. Among the committee’s more disturbing findings is the frequency with which patients experience pain, shortness of breath, or some other discomfort. Especially at the end of life, they need not undergo such suffering. Sadly, many patients fail to receive state-of-the-art pain relief or respiratory management (Ingham and Foley, 1998; SUPPORT Principal Investigators, 1995). Attention to physical comfort implies timely, tailored, and expert management of such symptoms.

• Emotional support—relieving fear and anxiety. Suffering is more than just physical pain and other distressing symptoms; it also encompasses significant emotional and spiritual dimensions (Byock, 1998; Cassell, 1991). Patient-centered care attends to the anxiety that accompanies all injury and illness, whether due to uncertainty, fear of pain, disability or disfigurement, loneliness, financial impact, or the effect of illness on one’s family.

• Involvement of family and friends. This dimension of patient-centered care focuses on accommodating family and friends on whom patients may rely, involving them as appropriate in decision making, supporting them as caregivers, making them welcome and comfortable in the care delivery setting, and recognizing their needs and contributions.

One of the foremost advocates of building a patient-centered health system that meets the needs of patients used to be in charge of Medicare. But he couldn't muster the support in the Senate to keep his post. Imagine that.

WHO is going to determine or make the final decision to accept or reject your parameters listed below....?
....the patient or the government....?

1) respect for patients’ values, preferences, and expressed needs;
(2) coordination and integration of care;
(3) information, communication, and education;
(4) physical comfort;
(5) emotional support—relieving fear and anxiety; and
(6) involvement of family and friends.

...with Obamacare it will be the government who decides what is best for the patient....government-centered...
...with the Ryan plan the idea is to give the patient as much freedom of choice as possible...patient-centered....

PS: right now with Obama robbing Medicare it is going to go bankrupt very quickly and seniors will have to move into "Obamacare" or what is really known as Medicaid......and we all know how 'great' Medicaid is.....

 

[Lakhota]

Mint Romney and Ayn Ryan's plan is the same ole Nazi-Con plan to "starve the beast"...

Starve the beast - Wikipedia, the free encyclopedia

 

[ScreamingEagle]

Mint Romney and Ayn Ryan's plan is the same ole Nazi-Con plan to "starve the beast"...

Starve the beast - Wikipedia, the free encyclopedia

correct....we need to starve the beast.....do you want the Beast deciding your health care......i sure don't.....

speaking of Nazis....who are nothing more than socialists......check out my by-line re Marxism and healthcare.....

 

[Greenbeard]

WHO is going to determine or make the final decision to accept or reject your parameters listed below....?

Are you trying to construct some kind of logical paradox or infinite regression? Who decides if the patient gets to decide?

...the patient.

...with the Ryan plan the idea is to give the patient as much freedom of choice as possible...patient-centered....

The Ryan plan is completely silent on all of these issues. It has nothing to say about patient experience or the quality of care or the design of the delivery system. Its only interest is insurance, and even that interest doesn't stretch very far.

 

[ScreamingEagle]

WHO is going to determine or make the final decision to accept or reject your parameters listed below....?

Are you trying to construct some kind of logical paradox or infinite regression? Who decides if the patient gets to decide?

...the patient.

...with the Ryan plan the idea is to give the patient as much freedom of choice as possible...patient-centered....

The Ryan plan is completely silent on all of these issues. It has nothing to say about patient experience or the quality of care or the design of the delivery system. Its only interest is insurance, and even that interest doesn't stretch very far.

people will buy the insurance that 'delivers' what they expect to get....if they don't like it they will change to a different program...that is the beauty of a free market....and competition will lower costs....

once we are locked into a government system people will no longer have any choice to move to a different program....and Obama's IPAB (Independent Payment Advisory Board) will be there to decide what type of treatments and procedures should be paid for and how much to pay for them....this is the notorious but real "death panel" that will most likely result in some patients dying because of lack of treatment...

the IPAB panel will also reduce Medicare payments to doctors which will result in less doctors and more rationing....how the hell is the lack of care going to "respect patient's needs" or "provide physical comfort" or "emotional support"......?

 

[Mac1958]

.

Both the patient and the doctor take a back seat to either the government or the insurance company. Both bureaucracies have the power to influence the ultimate course of care, and that's where many critical decisions usually are made.

Don't people know that?

The doctor and the patient? No. Not unless the patient is paying cash.

.

 

[JoeB131]

The Obama Medicare Plan: Rob It and Let it Die - Reince Priebus - Page 1

Because of President Obama’s failed record on nearly every issue from the economy to the deficit to Medicare, the Obama campaign has become increasingly dirty, despicable, and desperate. Their latest lies on Medicare are no exception.

That’s why it’s important to remember the truth. President Obama is the only president who has cut Medicare by $700 billion. And he is the only candidate in this race willing to let Medicare die.

Hysterical- after 40 years of trying to kill Medicare, the GOP is now out to save it? Really?

It's kind of like listening to Jeff Dahmner extol the virtues of vegetarianism.