From NEWSMAX.COM, a video on, “Obamacare’s 5 Biggest Changes” (watch below). Also, NEWSMAX.COM published, “New England Journal of Medicine Blasts Obamacare” (snippet shown below video).
Among the other KEY points of the [New England Journal of Medicine] editorial:
FEE-FOR-SERVICE: Despite widespread recognition that fee-for-service reimbursement rewards doctors and providers for the quantity of healthcare services delivered and not high quality, Obamacare does little to change reimbursement strategies now used in Medicare. “Much of the coverage expansion is financed through Medicare budget savings, which are produced by reducing the fees paid by Medicare to institutional providers such as hospitals, home care agencies, and nursing homes,” Wilensky noted, “but using the same perverse reimbursement system currently in place.”
PHYSICIAN PAYMENTS: Obamacare contains no reform of the way physicians are paid for some 800 specific services, which is “the most dysfunctional part of the Medicare program,” she argued. “This system rewards the provision of highly reimbursed services without consideration of whether clinicians are providing low-cost, high-value care for patients.”
MEDICARE CUTS: Obamacare provides Medicare “productivity adjustments,” but unless these institutions find ways to reduce costs, lower Medicare reimbursements will force providers to bargain for higher payments from private insurers. “Eventually, seniors’ access to services will be threatened,” she said. “The Medicare actuary expects that 15 percent of institutional providers will lose money on their Medicare business by 2019, and the proportion will increase to 25 percent by 2030.”
FEW QUALITY PROVISIONS: Although some reforms are included in the law, such as value-based purchasing and accountable care organizations (ACOs), that could drive up quality while holding down costs, she said the amount providers will be paid are small and not likely to lead to many changes.
NO MARKET-BASED REFORMS: Like Medicare, Obamacare relies on regulatory methods, instead of harnessing market forces, to promote spending reductions and improve quality of care. If that approach fails, the law authorizes an Independent Payment Advisory Board to reduce payments to clinicians and institutions. Although Congress can override the IPAB’s recommendations, it can do so only by a three-fifth’s “super majority,” and only if it acts within a limited time and comes up with comparable savings.