Thread: Seniors wait on care, grow sicker as copays rise

Seniors wait on care, grow sicker as copays rise

Higher Medicare copays result in more elderly hospitalized, study says

updated 2:25 p.m. PT, Wed., Jan. 27, 2010

LOS ANGELES - Higher Medicare copays, sometimes just a few dollars more, led to fewer doctors visits and to more and longer hospital stays, a large new study reveals.

With health care costs skyrocketing, many public and private insurers have required patients to pay more out-of-pocket when they seek care. The new study confirms what many policymakers had feared: cost-shifting moves can backfire.

"Patients may defer needed care and may wind up with a serious health event that might put them in the hospital. That's not good for the patients, not good for society, not good for anybody," said Dr. Tim Carey, who heads the University of North Carolina's Sheps Center for Health Services Research.

Carey had no role in the research, published in Thursday's New England Journal of Medicine.

The study included nearly 900,000 seniors in 36 Medicare managed-care plans from 2001 to 2006. During that period, half of the plans raised copays for visits to doctors and specialists. Researchers compared medical use patterns in those plans with use in similar Medicare managed-care plans that kept copays the same. Copays for prescription drugs remained unchanged in all plans. INTERACTIVE

Fact or fiction? No freeze on health spending
President Obama's budget freeze won't have a big impact on federal health care spending. Msnbc.com fact-checks this claim — and more.


Among plans that increased patient cost-sharing, the average copay for a doctor visit roughly doubled, from $7.38 to $14.38. The copay to see a specialist jumped from $12.66 to $22.05. By contrast, the average copay for unchanged plans was $8.33 to see a doctor and $11.38 to see a specialist.

For every 100 people enrolled in plans that raised copays, there were 20 fewer doctor visits, 2 additional hospital admissions and 13 more days spent in the hospital in the year after the increase compared to those in plans whose copays did not change, researchers found.

The trend was most pronounced among blacks, people living in lower-income neighborhoods and those with chronic illnesses such as diabetes, high blood pressure or heart disease.

The results suggest that raising copays to contain costs is counterproductive, said Dr. Amal Trivedi, assistant professor of community health at Brown University, who led the study. Not only may it lead to higher health care spending, but patients also suffer, he said.

http://www.msnbc.msn.com/id/35107033/ns ... alth_care/

Wait until they take a half trillion dollars out of Medicare. Then see how high co-pays go. This is one of the fundamental flaws in any form of government sponsored health care. The government cannot afford it. If it increases taxes enough to off set the increased costs, the economy is suppressed, with fewer jobs, more unemployment payouts and less taxes overall the result. If payment to providers is cut, providers opt out. Either by getting out the medical business altogether, or by refusing to take Medicare patients. There is no winning combination for Medicare or Medicaid, let alone Obamacare. But neither the Democrats or Republicans will admit it. Medicare should never have been established; it is another Ponzi scheme just as Social Security is. Both of these programs are now technically bankrupt, i.e., expenses in the last two fiscal years have exceeded taxes collected for both programs so the difference comes out of other tax money (or more likely, it is covered in the debt ceiling increases that seem to be passed every month).

If this nation has trillions of dollars worth of unfunded obligations in the next 20 years (and if that figure is not exact, I do think it is in the right neighborhood) with just the current debt, plus Social Security, Medicare, and Federal retirement programs (including Congress and Dept of Defense), how can we possibly take on additional obligations? We can't, and Obama, Reid, and Pelosi know it. Everyone in Washington knows it. But how many are saying it, and how loud? And who has come forward with a workable approach for dealing with it?