Sunday, April 29, 2012

Newt Gingrich's Saving Lives & Saving Money 7

For my write-up today on Newt Gingrich's Saving Lives & Saving Money: Transforming Health and Healthcare, I want to highlight what Newt says on pages 145-146:

"The current system dictates a focus on reactive acute care and does not incentivize prevention.  Coverage for prescription medications is a paramount example...Medicare will cover the visit to the doctor to discuss the numbness in the foot, but it will not pay for the insulin to relieve, and stop, the problem.  Medicare will pay for visits to the emergency room when a beneficiary has a heart attack, but it fails to pay for the cholesterol medication that may have prevented the incident all together.  Medicare's end-stage renal-disease program (offers kidney dialysis when the kidneys no longer function) is one of the highest cost programs in Medicare, yet it will not pay for the insulin that could prevent many of those individuals from needing it in the first place."

Newt wrote this before the Medicare prescription drug entitlement was passed into law.  And what Newt said makes sense, for you would expect for prevention to save money by reducing the number of people who end up in emergency rooms.  But did the prescription drug benefit save Medicare money?  As far I as know, Medicare spending has continued to increase since that benefit was passed.  Why?  Is it because the donut hole requires some people to still pay for their prescription drugs, thereby hindering them from a health-plan of prevention?  Is Medicare Advantage part of the problem, as I have read that it entails the government giving money to insurance companies, plus there are questions about the quality of Medicare Advantage plans?  Is the sheer cost of prescription drugs part of the problem?

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