I read that. Twice. I don't see him admitting any such thing. What he said was that providers that continue to be inefficient will not be profitable. The presumption is that they will either become efficient or go out of business to be replaced by providers that are efficient, not that there would be a loss of access to treatment. Unless the author has in mind the potential for loss of access during lag time for the replacement or the potential that no one would consider it worth the bother to become a replacement, I don't see any admission in there.
It isn't an admission -- you're never going to get that from Obama or his people.
But it IS a fact. The really important part of the article was:
"And let's put up some of what the Medicare actuary says. They say that 15 percent of Medicare providers will be unprofitable by 2019. 25 percent of Medicare providers will be unprofitable by 2030. And the Medicare actuary concludes - this is his quote - in practice Medicare providers could not sustain continued negative margins and, absent legislative changes, would have to withdraw - withdraw - from providing services to Medicare beneficiaries, merge with other provider groups or shift substantial portions of the Medicare costs it to their non-Medicare non-Medicaid providers. In other words, according to the actuary, Medicare patients, millions of them will lose access to Medicare benefits."
This is a predictable outcome because providers have been losing money on government health care for a long time and it is only going to get worse. At some point it reaches a tipping point where providers are not willing to continue taking the hit.
These problems are not susceptible to being solved by mere efficiency increases. The reason this is true is that providers already operate reasonably efficiently, and the real efficiency problems are in the mountain of data that providers have to track. This is going to get worse under Obamacare, not better.
If MC/MCD would just allow (and provide incentive for) their admin contractors to run operations the way the contractors run their own insurance operations you'd have tremendous savings. But that isn't going to happen.
In the end, people are not going to get the care they've gotten in the past, they are not going to be able to "keep their insurance" and they aren't going to "keep their providers". Call it a committee or a Death Panel, but there are going to be government bureaucrats making rationing decisions and they will do so with the ice-cold efficiency government is known for. |
