Many women would like home health care support when they are having their baby…

Lesson # 4: From a practicing physician’s perspective, the idea of DRG and RBRVS cannot be defined as a positive development. Quite to the contrary of the author’s assertions, these methods of calculating payments to physicians has skewed payments toward procedure-based specialties and incentivised higher volume of procedure-based services, thus resulting in health care inflation, which was exactly what it should have prevented. Further, use of a flawed SGR method to calculate physician payments further worsened the situation. This artificial price-fixing will result in further alienation of physicians, who will drop participation in Medicare if these rules don’t change soon. thus any advantage of expanding Medicare-type coverage to the under-65 population, will be meaningless if access to participating physicians worsens. Furthermore, Medicare has been the last to demonstrate any innovation such as providing incentives for use of HIT or use of unconventional care processes that produce superior clinical outcomes or providing incentives to beneficiaries for improved lifestyles or incentives to providers who help beneficiaries improve their lifestyles or even providing online provider enrollment, etc.

Lesson # 5: The prime reason for lower administrative costs for Medicare are brutal price-fixing with no opportunity to negotiate real-life payment rates for services. All other reasons mentioned are minor in nature. If Medicare had to compete in the open market on a level playing field, its costs would be much higher (given the well-known inefficiency of government bureaucracy). Medicare does not need to advertise since it has been around for 44 years. Newer plans that compete in the open marketplace need to market themselves in order to succeed. (I am not supporting the private payers here, just stating the obvious).

So before we all jump on this bandwagon, let’s reexamine the options more objectively.