"Curtail Medicare"

A friend sent the following news excerpt, "President Obama today unveiled a multi-trillion-dollar budget. It would boost taxes on the wealthy, curtail Medicare and lay the groundwork for universal health care..."

I have been asked, "What does he mean, "curtail Medicare?"

The wording suggests that Obama would cut Medicare benefits and turn the old folks loose to fend for themselves. This is a misrepresentation and I offer the following clarification:

The plan, according to the Post, would (1) force private insurers who sell Medicare managed-care plans to undergo a competitive bidding process, which would save an estimated $175 billion over the next decade. (2) Drug makers would have to increase their medication rebates to Medicaid patients from 15 percent to 21 percent. (3) And hospitals that have high readmission rates would be paid less by Medicare, using a system of flat fees for the first hospitalization and 30-day follow-up.

1. "...force private insurers who sell Medicare managed-care plans to undergo a competitive bidding process"

The Bush administration privatized medicare behind closed doors. Insurers were gifted with no bid contracts.

It was the winter of 2003 when Congress, in the dead of night, overhauled Medicare. But buried inside the bill was another deal — one that CBS News investigation has discovered was not necessarily a benefit for seniors. A large portion of one of the most successful public programs in history was quietly placed in the hands of private insurance companies. Three independent reports found private insurance companies are paid, on average, 12 percent more than what it would cost the federal government — in some cases, 50 percent more.

An independent report found when it comes to the fastest-growing plans, known as private fee-for-service, half of that extra money goes back to the insurance companies. All these private Medicare plans are expected to cost taxpayers an additional $54 billion over the next five years.

"Taxpayers are losing; people in Medicare are losing," Hayes said. "And the structure of Medicare as a national treasure that we need to rely on moving forward, is being undermined."

2. Drug makers would have to increase their medication rebates to Medicaid patients from 15 percent to 21 percent.

When the Medicare Part D prescription drug legislation was being developed, Congress and the Bush Administration decided to specifically prohibit the Medicare program from bargaining with pharmaceutical companies to secure lower drug prices. This controversial decision took the responsibility for moderating drug prices away from the Medicare program and, instead, placed it in the hands of private drug plans.

Keep in mind that "big insurance companies to lobbyists for consumers, doctors, hospitals and pharmaceutical companies" are all taking part in crafting health care reform.

3. Hospitals that have high readmission rates would be paid less by Medicare, using a system of flat fees for the first hospitalization and 30-day follow-up.

Denying medicare coverage for hospital errors was started during the Bush administration. The goal is to force hospitals to improve their performance. Not only will it save money but will help stop hospitals from killing people. Hospitals should not be rewarded for mistakes.

The key to healthcare reform will be to improve hospital efficiency.

One last thing - the original statement says that the budget lays the groundwork for universal health care. The goal is health insurance coverage for every American, not universal healthcare. Universal healthcare implies a single payer system.