Ben Keeton: Something to ponder – will cuts to Medicare limit access, drive up costs?

When Congress gets back to work after the election, their focus will likely turn to Medicare and what to do about its increasing costs. Congress has engaged in much discussion about ways to reduce our country’s growing deficit and Medicare is getting some close scrutiny.
 

Medicare provides health care benefits to some of our most vulnerable sectors of the population including our seniors. While some feel cutting Medicare funding could help reduce the deficit, others are concerned that drastic changes may have the unintended consequence of jeopardizing patient access to providers, treatments and medications which could result in increased long-term health care costs.
 

In an effort to curb spending, some in Washington have proposed to change the way the Medicare Part D prescription drug benefit operates to set prices for prescription medications. However, studies have indicated that Part D has actually saved money while increasing access to medications for Medicare beneficiaries.
 

The Part D prescription drug benefit currently helps 40 million Medicare beneficiaries – 90 percent of total beneficiaries – afford expensive prescription medications. A recent study in the Journal of the American Medical Association indicated that improved access and adherence to medicines through the Part D program, has saved close to $1,200 per senior who previously lacked comprehensive prescription drug coverage, per year in hospital and nursing visits. This equals about $12 billion per year in savings across Medicare and further savings by providing better access to prescriptions that can prevent long-term health care costs.
 

Part D spending is 41 percent lower than initial 10-year projections, according to the Congressional Budget Office and The Centers for Medicare and Medicaid Services estimates the average monthly Part D premium for 2012 is slightly lower than the average premium amount in 2011 at about $30. Those who support the program say that the success of Part D comes from its use of free market principles, allowing competitive forces in the market dictate medication prices.
 

Along with cost saving, the Part D program has ranked significantly high in satisfaction ratings. Recent polls have consistently indicated that Part D enrollees are overwhelmingly satisfied with their medication coverage. A recent survey in Medicare Today found that 84 percent of seniors covered under the Part D prescription drug benefit were satisfied.
 

Many argue that as access to health care decreases, treatable and preventable illnesses will go unchecked. People will no longer be able to afford regular doctor’s visits and providers will be squeezed out of the market as the result of extreme cuts. They fear that when patients have less access to preventive services or early detection testing, what would be a quick trip to the doctor’s office today becomes an expensive emergency room visit or hospital stay tomorrow.
 

Others have cited the Medicare Part D program is an example of a government mechanism that functions effectively and efficiently, saving money in the long run because people have access to preventative services, early detection testing and medications that can help prevent expensive catastrophic illnesses.
 

As Congress discusses ways to reduce the deficit, many government programs may face the chopping block. Congress has a tough road ahead in weighing decisions about how to reduce the debt without damaging quality programs, like Part D, which seem to be working well for those who depend upon them. Needless to say, millions of Americans will be watching and waiting to see what happens.
 

Ben Keeton is the publisher of Medical News, a monthly publication based in Louisville that focuses on the business of healthcare in Kentucky and Southern Indiana. Through his publications, Keeton helps health care leaders find ways to improve health care while improving the efficiency of each health care dollar. For more information on Medical News, click here.