Impeding changes to our Health Care system

You can spread the fear all you want, Merc.

IMO, it puts you in the same company as those other fear mongers on the right.

And, I dont doubt that some will buy into it.

As for me, I'm not impressed with the Doctor Doom impression.

[TheMercenary]

Originally Posted by Redux

You can spread the fear all you want, Merc.

IMO, it puts you in the same company as those other fear mongers on the right.

And, I dont doubt that some will buy into it.

As for me, I'm not impressed with the Doctor Doom impression.

Fear? You can't be that much of a manipulator of the facts on the table. Facts are facts. You are ignoring them or you are trying to deflect the issues at hand in an effort to gain support for the Demoncratic talking points. I am here in the trenches and can only report my experiences in 5 different healthcare settings. Ignore my points all you want. In the end you may be the person who disappears from this forum because you can't face the failures of your party. I will be here to remind you of your failings.

[TheMercenary]

Redux, now please defend the fact that Medicare Advantage is not about to be cut by 21%. Thanks.

Originally Posted by TheMercenary

Fear? You can't be that much of a manipulator of the facts on the table. Facts are facts. You are ignoring them or you are trying to deflect the issues at hand in an effort to gain support for the Demoncratic talking points. I am here in the trenches and can only report my experiences in 5 different healthcare settings. Ignore my points all you want. In the end you may be the person who disappears from this forum because you can't face the failures of your party. I will be here to remind you of your failings.

Hmmmm..who is the one who has flooded this discussion with false and/or misleading partisan talking points (from Megan McArdle et al)?

That would be you.

I'll be here and I still wont flood the discussion with partisan editorials. I never have.

Originally Posted by TheMercenary

Redux, now please defend the fact that Medicare Advantage is not about to be cut by 21%. Thanks.

The proposal is to utilize the Medicare Advantage average cost; not the cost of the most expensive provider.....and not on a national basis, but for each market.

I have not seen any independent, objective analysis that this would result in a significant increase in patient costs, rather than a lower payment by the government to the insurance providers.

But if you rely on your partisan editorials and analysis, its all about fear and scaring seniors.

[TheMercenary]

Originally Posted by Redux

Hmmmm..who is the one who has flooded this discussion with false and/or misleading partisan talking points (from Megan McArdle et al)?

That would be you.

I'll be here and I still wont flood the discussion with partisan editorials. I never have.

You do love to focus on one report which I admitted was misleading and out of line. But whatever, if it makes your panties wet go for it.

[TheMercenary]

Originally Posted by Redux

The proposal is to utilize the Medicare Advantage average cost; not the cost of the most expensive provider.....and not on a national basis, but for each market.

I have not seen any independent, objective analysis that this would result in a significant increase in patient costs, rather than a lower payment by the government to the insurance providers.

But if you rely on your partisan editorials and analysis, its all about fear and scaring seniors.

Maybe you missed the memo. A %21 cut in the program.

[TheMercenary]

Originally Posted by Redux

I'll be here and I still wont flood the discussion with partisan editorials. I never have.

Hmmmmm.... an admitted lobbyist and shrill for the Demoncrats? Nice try. Fail.

[TheMercenary]

Redux, Please dispute this fact.

APRIL 7, 2009.U.S. Reduces Subsidies for Private Medicare

By VANESSA FUHRMANS and JANE ZHANG

The federal government made good on its plan to cut 2010 payments for private Medicare plans, whittling the subsidies to health insurers sooner than the industry originally expected.

The cuts, announced late Monday by the Centers for Medicare and Medicaid Services, are slightly less severe than the 5% reduction the federal agency signaled in February, but still raise concerns about what has been a critical source of profit growth for many health insurers. Reimbursements to private insurers that administer so-called Medicare Advantage plans would fall by as much as 4% to 4.5% next year.

The agency said it would raise the baseline rate for the private plans by 0.81%, slightly more than the 0.5% it proposed in February, though significantly less than the roughly 4% insurers have seen in recent years. But the payment rates also include a 3.41% reduction as a result of a change in how the government uses a reimbursement scale pegged to enrollees' health.

The move makes clear the Obama administration's intent to swiftly rein in the private plans. More than 10 million Medicare beneficiaries get their medical and drug benefits through Medicare Advantage plans. Republicans during the Bush administration pushed the plans' extra benefits for seniors and subsidies to insurers to promote more private-sector involvement in Medicare. But President Barack Obama has argued that insurers are overpaid to administer the plans, and he wants to finance part of his health-care overhaul by paring their subsidies.

Health insurers, though, hadn't expected cuts to begin until 2011 and were caught off guard by the February regulatory announcement. Last month, the administration also set stricter terms for companies bidding to offer such plans in 2010, including a requirement that they can't charge sick, low-income patients more than what they would pay under traditional Medicare.

Humana Inc., Coventry Health Care Inc. and other insurers that have made big bets on Medicare Advantage are expected to feel the rate cuts the most. With more than 1.4 million Medicare Advantage members, Humana is the second-biggest provider of private Medicare plans, and the business comprises roughly half of its overall revenue. UnitedHealth Group Inc. is the biggest provider of such plans with about 1.5 million members.

Medicare Advantage plans wrap physician and hospital services in one, often with vision and drug coverage. Unlike traditional Medicare, the government doesn't pay physicians and hospitals directly but instead pays insurers to manage care. Currently, though, a patient in these plans costs the government an average of 14% more than if he or she stayed in traditional Medicare.

The cuts mean beneficiaries enrolled in the private plans could see higher premiums or cost-sharing amounts next year, depending on the extent to which insurers try to preserve the 3% to 5% profit margins they usually make on the plans. The Blue Cross Blue Shield Association, for instance, said it had calculated average monthly premium increases of $50 to $80 if the 2010 cuts were to go through. That won't be clear until plans submit bids and benefit designs later this year.

Insurers and Republican lawmakers say the administration's cuts go too far, particularly because they assume a prospective 21% cut in Medicare reimbursements to doctors that Congress is all but certain to override later this year. Medicare officials said that if the physician fee cut is reversed, they would work with Congress to incorporate the change into Medicare Advantage payments then.

Humana declined to comment. UnitedHealth said it was still reviewing the Medicare announcement, but that it would continue to offer affordable plans. "We have long-standing experience with addressing the changing rate environment within Medicare Advantage and we will use all our business levers to make the adjustments necessary to manage these changes for 2010."

http://online.wsj.com/article/SB1239...html#printMode

In fact, this is from action earlier this year and I do like the fact that it "also set stricter terms for companies bidding to offer such plans in 2010, including a requirement that they can't charge sick, low-income patients more than what they would pay under traditional Medicare."

The partisan editorial suggests that patients "could see higher premiums" bu quoting one provider that is not even certain how or if it will absorb part or all of the increase.

And maybe, in the future bidding process, the insurers will be required to absorb more of the cost, with even stricter regulations and other offsets to protect seniors in the current reform bills.

But, I'm really not interested in responding to every partisan editorial you can find.

[TheMercenary]

Originally Posted by Redux

In fact, this is from action earlier this year and I do like the fact that it "also set stricter terms for companies bidding to offer such plans in 2010, including a requirement that they can't charge sick, low-income patients more than what they would pay under traditional Medicare."

The partisan editorial suggests that patients "could see higher premiums"...and maybe they wont, with even stricter regulations and other offsets in the current reform bills.

So you can't dispute it. Thanks.

You're welcome.

And, I am still not interested in responding to every partisan editorial you can find.

[TheMercenary]

Obamacare: Cut the Elderly and Give to AARP
Among the $500 billion in Medicare cuts that will provide the bulk of the financing for Obama's health care plan is a $160 billion to $180 billion cut in the Medicare Advantage program, which offers a range of benefits not available to beneficiaries under basic Medicare.

Medicare Advantage should be Obama's favorite program. It combines all the elements he likes — premiums are subsidized for low-income elderly, and the companies negotiate low-priced, managed care that emphasizes prevention, treatment of chronic conditions and coordination among doctors. As a result, its costs on the one hand and its premiums on the other are both much lower than with conventional insurance.

Ten million primarily low-income elderly have voluntarily enrolled in Medicare Advantage and realize savings of about $1,000 annually in enhanced benefits over and above what Medicare itself provides. These extra benefits include reductions in out-of-pocket costs and comprehensive drug coverage, vision, dental and hearing benefits, wellness programs (like gym memberships), and disease management and care coordination programs.

Medicare Advantage, which gained momentum during the Bush-43 years, essentially implements all the economies and efficiencies that Obama preaches nonstop. Doctors speak to one another, duplication is avoided, care is managed, and there is an emphasis on prevention.

The alternative to Medicare Advantage is Medicare supplement plans, popularly called Medigap coverage. But these conventional health insurance policies offer fewer benefits at higher premiums. They offer no care coordination, no chronic care management, no pay-for-performance incentives. They have no way to control costs. They just write out checks.

Because Medicare Advantage negotiates payment levels and saves money through bulk purchasing, inpatient costs run 20 percent to 25 percent lower than under Medigap insurance.


More patients are handled through outpatient care. X-rays and other radiation cost 10 percent to 20 percent less, and durable medical equipment like wheelchairs, walkers and oxygen bottles run one-fifth less than with conventional insurance policies.

So why is Obama so keen to cut Medicare Advantage?

Here's a clue: AARP (the American Association of Retired Persons) does not sell Medicare Advantage. But it makes a vast amount of money selling Medigap coverage. AARP has had no higher political priority than to curb the Medicare Advantage program and replace it with Medigap insurance. The profit margins on Medigap are greater, and AARP has every intention of exploiting them with Obama's help. His price? AARP backing for his program.

The American Seniors Association (ASA), an alternative to AARP that represents hundreds of thousands of elderly, says, "It is outrageous that Medicare Advantage, a private program with premium assistance for seniors ... has come under attack." Stuart Barton, ASA president, notes that under Medicare Advantage, private healthcare companies "compete to provide care based on a negotiated price."

Obama's deal with AARP represents special interest politics at its worst. He has already negotiated a deal with the big drug companies to get their support for his bill (and their advertising bucks to promote it) in return for guaranteeing that the cuts in their prices and profits will be small. And, by cutting Medicare Advantage, he signed up the AARP too.

Obama plans to slash the premium subsidies to low income elderly for Medicare Advantage coverage. This would drive up the premiums and drive many poor seniors into Medigap coverage. And then, most cynically, he would take the money he saves on shortchanging poor old people and use it to subsidize the policies of people in their 20s, 30s, 40s and 50s who are, by definition, not poor (and thus not eligible for Medicaid).

And all this from a liberal? A Democrat?

http://www.creators.com/conservative...e-to-aarp.html

Hate him or love him he knows the "Clitons" like no other previous confident.

[TheMercenary]

Originally Posted by Redux

You're welcome.

And, I am still not interested in responding to every partisan editorial you can find.

Facts are facts. Read it and weap...

I didn't think you could defend it anyway.

This is your party's plan, least you could do it support and defend why it is a good idea to take benefits away from the elderly to take care of the rest of the nation.

In fact, it was a Republican in the Senate today who blocked a simple "unanimous consent" request (separate from the reform bills) to hold next year's Medicare (Part B) cost to the current level.

It's not reform related, but still very interesting. Republican Sen. Tom Coburn blocked a unanimous consent request Wednesday to approve a House bill that would prevent seniors from paying more for Medicare.
Because no lawmaker likes to jack with seniors' Medicare rates, the House bill passed 406-18.

CongressDaily's Peter Cohn has more:

Seniors are facing uncertainty over Medicare costs next year after Sen. Tom Coburn, R-Okla., blocked a unanimous consent request Wednesday to approve a House-passed bill keeping Part B premiums constant at 2009 levels. The House bill, which passed 406-18 on Sept. 24, is needed to freeze monthly Part B insurance premiums, which pay for seniors' physician visits, at $96.40 next year. Those premiums are usually deducted from Social Security checks.

http://www.politico.com/livepulse/10...care_bill.html

This is not an editorial like the WSJ piece, it is a fact that one Republican Senator blocked this bill.

Originally Posted by TheMercenary

Facts are facts. Read it and weap...

I didn't think you could defend it anyway.

This is your party's plan, least you could do it support and defend why it is a good idea to take benefits away from the elderly to take care of the rest of the nation.

IMO, and I have not seen any facts to the contrary, the plan will take money out of the pockets of the insurance providers with tighter requirements in the bidding process (including holding patients harmless as much as possible), not the patients...and that is why the Republicans and the insurance industry have opposed it and vilify it and are scaring seniors.