Domino Effect 2011

This is not – most emphatically – a political forum, nor should it be.   That said, several of us here are worried, quite seriously worried, about the recent failure of the Joint Select Committee on Deficit Reduction to prevent some of the upcoming federal budget cuts, cuts that will doubtless hurt America’s elderly.


The Select Committee, or ‘super committee’, made up of twelve Congressmen (six Democrats and six Republicans), threw in the towel the other day.  They simply could not satisfy their primary directive: to come up with recommendations on ways to reduce the national deficit by $1.5 trillion.  This failure, in turn, triggers a series of federal budget reductions and cuts set to start in 2013.  Should these budget cuts take place, they will affect spending on all sorts of programs, everything from military projects to support for education.  Social Security and Medicaid will not be affected, but Medicare certainly will be.

Is is alarmist to worry about 2013?  Doesn’t that leave plenty of time to revise or amend the cuts?  Ordinarily, it would be enough time to establish some sort a decent dialogue.  But remember – 2012 is an election year.  We are already overwhelmed with politicking and campaigning.  Both sides refuse to compromise on most issues, or even entertain a civil debate.  It isn’t likely that the challenges facing elderly Americans and their caregivers will get much attention in 2012.

The biggest change involving Medicare, in the current plan, is a 2 percent annual reduction in payments to doctors who take Medicare beneficiaries.  This is in addition to the one-time 27.4% reduction in Medicare reimbursements to doctors that is to go into effect on January 1, 2012,  the date that the temporary freezes on previously scheduled reductions ends.  Medicare beneficiaries will not have to pay more going forward, but that’s only part of the story.  There may not be much to buy with those dollars.

Doctors choose whether or not to take Medicare patients.  As their reimbursements go down (while all expenses, private and professional,  go up), it is inevitable that fewer and fewer physicians will be able to stay in the program.  The American College of Physicians (ACP) says that the cuts will ‘within weeks endanger Medicare beneficiaries’ and military families’ access to care’.

Further, according to Anne-Marie Botek of AgingCare, LLC, the ACP envisions physicians and health care providers being forced by economics to make difficult decisions that will affect not only senior’s access to care, but the value and quality of the care they eventually receive.  Doctors will have to make staffing cuts, forego new equipment and technology investments, perhaps even give up private practice altogether.  If any of you have tried to help an elderly relative or ill friend navigate the already bewildering world of clinics, visits, consults, refills, check-ups, therapy sessions – it never ends –  you know first hand that seeking and receiving treatment, and coordinating the whole process, is tough, really tough.  Having fewer doctors who take Medicare patients will not help.

It’s easy to blame greedy doctors and smarmy politicians for this mess, but it’s just not that simple. Most doctors are not greedy; many political representatives are sincerely dedicated to the public good.   We are all in this together.  Impending budget cuts, the stalled economy, the housing, retirement and student loan disasters, they affect us all.  If we are committed to reducing the federal deficit, there is a real price to pay.  In fact, many are already paying it, especially those of us caring for elderly parents or relatives.

Changes in Medicare directly touch our lives, even if we ourselves are ten or twenty years from retiring.  Think how different it would be if mom and dad no longer had access to skilled and professional medical care, effective treatments, the best medications.  Their health, their independence, their peace of mind, their quality of life, it could all vanish – and, very likely, so could ours.  Oh, we can  ignore the elderly – some of us already do just that.  This is a selfish time in our nation’s development, after all.  But what does that tell the young?

We’ve got some thinking to do.


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