Medicare: Advantage or Disadvantage?

Medicare is in trouble for many reasons. First, though it is already going broke, on top of this 70 million baby boomers will soon join its ranks. Second, Obamacare is creating new government oversight committees that are sure to cut services in the name of so-called cost-effectiveness. We doctors may not be able to order many of the treatments that we are used to ordering. Third, the new health reform law plans to cut Medicare by $500 billion. Much of that money will no doubt go to beefing up and extending Medicaid, as the new health reform law plans to add 16 million more Medicaid patients. Consider this a Robin Hood effect - robbing one form of public health insurance to bolster another, though many consider it beyond bolstering.

Much of the damage will be done to Medicare Advantage, a program which is often disliked by doctors and hospitals which struggle with its restrictions, but is liked by millions of seniors who would be unable to access essential services without it. One out of four seniors are currently enrolled in Medicare Advantage, which converts Medicare into an HMO and removes the 20 percent gap that Medicare B doesn't cover. Medicare Advantage HMOs also cover prescription drugs and many basic ambulatory services including eye and dental care.

Many seniors who can't afford a secondary insurance such as AARP or Blue Cross or don't have insurance from an employers turn to Medicare Advantage instead. It is illuminating to consider that Medicare Advantage enrollees had 33 percent more doctor visits yet experienced 18 percent fewer hospital days and 10 percent fewer hospital admissions than conventional Medicare patients. This statistic reflects the kind of preventive services that President Obama is always talking about. Yet by 2012 the government following the new health reform law will cut $140 billion from the program, and according to a report published by the Medicare Office of the Actuary, by 2017 over 7 million will lose this coverage altogether.

Many seniors will have to turn to Medicaid for the secondary insurance instead, a further drain on our tax dollar, or end up paying for it out of pocket, if they can afford to, which many can't. Slashing Medicare Advantage is very problematic for millions of seniors.

Millions of seniors also face a 10 percent increase in the top ten drug plans that have signed up 70 percent of seniors under Part D as the doughnut hole is plugged.

Finally, Medicare is also in trouble with doctors, as reimbursements are cut. Medicare already only pays two thirds of private insurance pays, and many doctors are dropping out. And further cuts up to 30 percent are in the works. The so-called doctors' fix never happened, and we are currently faced with an across the board 21 percent Medicare cut that has only been deferred temporarily.

The way we are going, we won't have the doctors to support the Medicare of the near future.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of a new ebook: Swine Flu; the New Pandemic. Dr. Siegel is also the author of "False Alarm: The Truth About the Epidemic of Fear"and "Bird Flu: Everything You Need to Know About the Next Pandemic."Read more at