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The New Face Of Healthcare And What It Means For Our Seniors

A cancer care specialist offers a reassuring assessment of healthcare reform.

As the 2010 Health Care Bill passed, numerous patients of mine and the general public alike have asked, “OK, now what?” Countless unanswered questions remain, and there are many parts of the legislation that require clarification. People are still trying to digest the details in order to understand the most important thing of all— how the healthcare bill affects them, their families and our senior community. Many senior citizens are concerned about the effect that the healthcare reform bill will have on them, and rightfully so being that they generally use the health care system more than younger people. Most seniors live on fixed incomes and have little flexibility in their budgets, should health costs rise. As a medical practitioner I share these concerns with my patients. Cancer treatment is a very costly, hands-on practice that requires personal relationships with patients. In addition to what is required of me medically and ethically, I have a responsibility to educate my patients on prevention, treatment, policy and other healthcare matters that affect their lives and wallets. In my practice I consult, treat and work with many seniors that share these same concerns. The face of healthcare has changed multiple times throughout their lives and, with the latest healthcare reform, everyone needs to educate him or herself, most importantly our seniors. The first and most important fact we all need to know is that President Obama’s healthcare legislation requires Americans to pay for insurance or else incur a fine, increase in taxes, taxes on “Cadillac” health care plans and fees/ levies on insurance companies. Conversely the bill will bring insurance to over 32 million Americans who do not currently have coverage and provide more affordable access to health care. For seniors this could mean Medicare cuts or enhancements. The bill doesn’t contain cuts to conventional Medicare benefits; conversely payments for home healthcare will be reduced by $40 billion between now and 2019 and certain payments to hospitals will be cut by $22 billion over that same period. However, the bill will address the Medicare “doughnut hole” problem where after a senior has spend $2,700 on drugs in a year, coverage stops until that same person has spent $6,154 on drugs, when it starts up again. Starting in late 2010, seniors who fall into this hole will receive $250 from the government to help. Thereafter, the US will gradually increase the percentage of drug costs it pays within this gap. For right now, there is no immediate need to worry about whether any changes are on the cuts or enhancement side. Most changes from this bill won’t go into effect until 2014, but there’s no reason why you shouldn’t voice certain concerns to your doctor right now. The savings from Medicare won’t harm patient care. In fact they will improve it. Benefits for seniors will include not having to pay out of pocket for prescription by Medicare Part D in addition to no co-payments for checkups and wellness visits. Much of the money we spend on health care goes to treat chronic diseases, which could be prevented if patients received more preventive care. This, of course, also includes screenings for various cancerous diseases. In addition to these advancements to Medicare, there are two provisions within the bill that are of major importance to seniors and those diagnosed with cancer alike. These provisions will help to expand, train and support the healthcare workforce focused on older adults. They include:
  • The Physicians Payments Sunshine Act, which is a bipartisan policy that requires disclosure of gifts and payments given to doctors from the pharmaceutical, biologic and medical device industries. This provision will help expose the relationships between doctors and industry and expose conflicts of interest that can arise when physicians receive benefits from drug and device makers ultimately resulting in less emphasis on profit and more on treatment.
  • The Medicare Payment Improvement Act will reform the Medicare physician reimbursement so that it rewards health care providers based on the quality of care they provide. Under this provision, states that achieve higher quality-to-cost ratios will receive an increased reimbursement from Medicare.
Again, although we won’t see many of these changes for at least four years, now is a great time to know where you will stand with your health coverage, especially for those who receive some type of specialized medical treatment on a frequent basis. For further information related to the overall healthcare scenario and topics directly rated to those diagnosed with cancer, The Oncology Institute of Hope and Innovation answers questions and will continue to address these issues on our twitter, which can be found at