ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, July 7, 1996 TAG: 9607080134
SECTION: EDITORIAL PAGE: 2 EDITION: METRO
MEDICARE patients who use hospital outpatient services are paying a disproportionate share of their bills. This is a legislative oversight that the government concedes is a burden for many, yet is making no move to correct.
Why? For the same reason it has made no serious effort to reform the entire Medicare program: Any change will create new winners and losers, a politically risky endeavor that can be avoided in the short term by ignoring the problem.
After meeting their deductible, Medicare beneficiaries who use hospital outpatient services can be billed for 20 percent of whatever the hospital decides to charge, rather than 20 percent of a Medicare-approved charge. The result: While Medicare keeps its costs in check by paying 80 percent of a Medicare-approved amount, the patient pays 20 percent of the actual, often higher, charge.
At the same time hospitals are reasonably providing more services on an outpatient basis to reduce costs, Medicare beneficiaries are picking up a larger portion of the tab. They now pay on average 37 percent of hospital outpatient charges, according to a federal advisory panel, and the percentage will keep growing unless the law changes.
Meanwhile, those least able to afford the higher charges feel the pain disproportionately.
To bring the patients' share of bills to 20 percent, the government either will have to make hospitals adopt Medicare-approved charges for various services (thereby increasing regulation of the health-care industry, which it doesn't want) or boost the government's share of the payment (thereby increasing spending by taxpayers, who hardly seem in the mood). Or do some of both, if neither option is politically palatable.
But why worry about fixing inequities in one part of Medicare when the entire program is sailing toward insolvency? Long-term, the lack of government resolve to reform sickly Medicare may just rid the patient of all symptoms, by killing it.
LENGTH: Short : 43 linesby CNB