Onerous Details That Damage Patients
A new levy on Medicare Advantage programs would damage lower-income seniors the most.

While hastening to save a patient, a doctor's primary duty is to "do no harm." That involves remembering that occasionally a treatment can make matters worse. And so it should be with the healthcare reform proceeding through Congress. Clearly this subject is excessively big and too crucial to dismiss. For America's interest, reform needs to occur. But it is also too intricate an issue to hurry a treatment with items that could induce harm.

Most of us concur that America's healthcare arrangement needs to be mended. Families and businesses are fighting to keep pace with surging prices. Too many Americans are without decent insurance coverage. And all of this is damaging our economic system. But it will do no good to reform the scheme if it winds up cheapening the caliber of care most of us presently receive or burdening coming generations of Americans with outrageous debt.

As always, the devil is in the details, and we had better be paying very close attention to their rich potential for inadvertent results. For instance, one proviso in the Senate's adaptation of healthcare reform would levy a new taxation on a number of federally-funded healthcare benefits.

Effectively, the federal authorities would be taxing the money it furnishes for Medicare and a host of other crucial programs. By so doing, it would unintentionally endanger the caliber of care that a lot of our most elderly, sickest and most susceptible citizens depend upon.

The US Senate legislation inflicts this annual premium tax on for-profit and not-for-profit health programs, yielding an approximated $60 billion in revenues over its initial nine years. Government-run programs would be immune from the tax. Even so, the tax would be imposed on Medicare, the Children's Health Insurance Program, Medicaid, and Tri-Care for the families of armed forces dependents when rendered by a private-sector plan.

Large private-sector health plans providing a diverse product line would probably recuperate the cost of the tax by increasing premiums on their other products.

But for those health programs specializing in Medicare, Medicaid and other government programs, there would be no such alternative. These suppliers are rigorously bound by federal contracts and often function at or near cost, servicing America's elderly, higher-risk and higher-cost patient populations. Since they've no monies with which to assimilate the taxation or any power to pass it on, they will have just one alternative—to trim back the healthcare services they furnish. Surely this Is not what the US Senate means.

All the same, about 10.2 million Americans who now decide to buy Medicare Advantage through private suppliers because it affords them more suitable benefits at lower cost could be hurt. These are oftentimes lower-income aged folks with a large number of difficult health troubles. The services they undergo permit a lot of of them to stay in their homes close to friends and family during their terminal years, instead of be moved into nursing homes where their care would be far less affordable and their days a good deal hollower. They'd be among the victims of this new federal taxation.

What sort of Americans are we discussing? Here are a few actual cases: An 89-year-old woman who lives alone recuperating from a mastectomy, who has degenerative arthritis, glaucoma and osteoarthritis. An 81-year-old man living in his daughter's home who has bone, liver and bladder cancer. An older couple where the wife has difficulty walking because of arthritis, while the husband suffers from Alzheimer's demanding 24-hour attention. These are the sort of folks healthcare reform should be assisting, not hurting. Offering benefits to a few Americans by cutting back care for others Is not reform—it is unjust.

Repairing our nation's healthcare arrangement is an important project. As Congress works toward a resolution, I encourage my former colleagues to pay very close attention to the particulars and be aware of the inadvertent consequences of what they do now, as the impact of their decisions will be with us for generations. A treatment that leaves the system in more insecure shape Is not a remedy.




“Under the care of Leo J. Borrell, M.D. since December 2001, I have seen a remarkable improvement in my mother’s condition. She is responding dramatically to the new regiment Dr. Borrell has prescribed”

- Beth Rose


Feb 3, 2008

The Interdisciplinary Team; The Role of the Psychiatrist

by Dr. Leo J. Borrell, featured in Assisted Living Consult for November/December 2006. A HealthCom Media Publication