Denying Health Care to the Elderly

By Evans, M. Stanton | Consumers' Research Magazine, July 1992 | Go to article overview

Denying Health Care to the Elderly


Evans, M. Stanton, Consumers' Research Magazine


If present trends in U.S. health care continue, you could be denied medical treatment precisely when you need it most--when you are elderly and ailing.

This startling conclusion goes directly contrary to widespread assumptions about our elaborate system of health care delivery, and to official statements concerning the ready availability of medical services under Medicare, Medicaid, and other programs. Yet it is clearly supported by the record on medical regulation in recent years. It also tracks closely with what has happened under government-managed health care systems in other countries.

For the better part of a decade, federal regulators have been working diligently to reduce the level of benefits provided to Medicare recipients, as well as to other beneficiaries of government-assisted medicine.

Principal reason for this effort to cut back on the amount of care delivered is official concern about the spiraling costs of Medicare and other government health programs, and of health care expenses generally. Under prevailing systems of "third party" payment, demand for services, and resulting costs, have skyrocketed. Health care regulators are trying to slow this trend by pressuring for cutbacks, including levels of hospital admissions and days of care provided.

Official documents of the U.S. government promise elderly Americans extensive days of free--or tax-supported--care. The official Medicare Handbook of the Department of Health and Human Services says, for instance, that Medicare patients are entitled to 60 days in the hospital per benefit period, after a deductible, plus an additional 30 days with a co-payment. Moreover, "after you have been in the hospital 90 days, you can use all or some of...60 reserve days if you wish. "

To most people, that sounds as if you are entitled to up to 150 days of tax-supported care, courtesy of the federal government. But if you wind up in the hospital as a Medicare patient, you're apt to discover that this verbiage doesn't mean much--since hospitals and physicians are under constant pressure to move you out as soon as possible.

What the Medicare Handbook manages to obscure is that while you may be entitled to up to 150 days of care according to the law, Uncle Sam won't actually pay for it. The financial burden for this alleged guarantee, instead, is fobbed off on the hospital and attending physician--who therefore have powerful incentives to get you quickly through the system.

Take a look at what Medicare actually pays for, and you discover the average reimbursement to hospitals in 1989 came to 4.7 days of care (exactly half of what was billed). Even for the most complex and costly procedures, involving life-threatening conditions, Medicare will reimburse, on average, for 10 or 12 days of care (again, approximately half of what the hospitals bill).

Looking even less like 150 days of tax-supported care are federal documents advertising a decline in the number of per capita hospital admissions and average length of stay under recent regulations. For the elderly, admission rates fell by 16% from 1983-87, while average length of stay was reduced from 10.37 days to 8.71 in the decade of the '80s. These reductions stem from the Prospective Payment System (PPS), adopted by the federal government in 1983.

The regulators view these declining days of care and rates of admission as signs of progress in the battle against cost. Dr. Gail Wilensky, formerly head of the Federal Health Care Financing Administration (HCFA), reported last year that, under PPS, "the average length of stay for Medicare patients in short-stay hospitals decreased from 10.0 days in fiscal year 1983 to 8.5 days for PPS hospitals in fiscal year 1989...Total Medicare inpatient admissions also fell from 11.7 million in fiscal year 1983 to 10.4 million in fiscal year 1989. "

Prospective payment reverses the incentives that existed under previous billing methods--in which providers were reimbursed according to their costs or customary charges. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Denying Health Care to the Elderly
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.