Impeding changes to our Health Care system

[TheMercenary]

That is your defense!?!?! Holy crap your guys are in trouble.

BTW, I do not now nor have I ever supported the insurance industry in any issue of healthcare reform.

Fail.

Again.

[TheMercenary]

Imagine that.....

CBO says Medicare Advantage seniors WILL suffer from lower benefits, to say nothing of the higher premiums, and the departure of their carriers from the market that will also result from the cut:

"However, the director of the Congressional Budget Office, Douglas Elmendorf, in testimony before Baucus’s own Senate Finance Committee, said, in fact, the cuts in Medicare Advantage would result in a loss of benefits and lower enrollment.

'The effect of the original chairman’s mark on Medicare Advantage enrollment in 2019, would be a reduction of roughly 2.7 million people or 20 percent of the enrollment,' Elmendorf said Tuesday. '[T]he competitive bidding process would reduce the extra benefits that would be made available to beneficiaries through Medicare Advantage plans.'

Elmendorf said that, by 2019, the value of extra benefits provided by private insurers but not by the government, would be cut in half if health reform is passed.

'The additional benefits would be smaller: $42 in additional benefits per month in 2019, and it’s a little less than half of what we would project under current law,' he said."

http://bubbanear.blogspot.com/2009/0...advantage.html


Redux, can you defend the cuts?

[TheMercenary]

Come on Redux. All I am asking you to do is to defend taking away a benefit from the elderly to pay for other's healthcare. This is not difficult. Can you defend it?

Originally Posted by TheMercenary

Come on Redux. All I am asking you to do is to defend taking away a benefit from the elderly to pay for other's healthcare. This is not difficult. Can you defend it?

Merc..in a post earlier today, you discount the CBO because you dont like the numbers.

Now you find a statement from the CBO that you do like...even if it is several weeks old and addressing the original "mark" and does not apply to the final Senate Finance bill that was crafted over the last week (that added protections to Medicare patients in the final version).

You cant have it both ways, Merc.

[TheMercenary]

Originally Posted by Redux

Merc..in a post earlier today, you discount the CBO because you dont like the numbers.

Now you find a statement from the CBO that is several weeks old that does not apply to the final Senate Finance bill that was crafted over the last week (that added protections to Medicare patients in the final version).

You cant have it both ways, Merc.

No, I did not say I did not "like" the numbers. I stated that the calculations were going to be faulty and they did not take in to account many unintended consequences such as employers accepting the penalty over paying for insurance. Among other things.

[TheMercenary]

Originally Posted by Redux

Now you find a statement from the CBO that you do like...even if it is several weeks old and addressing the original "mark" and does not apply to the final Senate Finance bill that was crafted over the last week (that added protections to Medicare patients in the final version).

You cant have it both ways, Merc.

None of that changes the planned cuts in Medicare Advantage.

[TheMercenary]

The Baucus Bill: An October Trick
By Diana Furchtgott-Roth

WASHINGTON--It's October, the month of trick or treat, and Congress is trying to come up with a trick. The Congressional Budget Office's estimate of Senate Finance Chairman Max Baucus's health reform bill makes it looks like a treat-it's projected to reduce the federal deficit by $81 billion over the next 10 years-but in reality it's a Nightmare on Pennsylvania Avenue.

Yesterday CBO came out with its second estimate of the Baucus bill, reflecting the original bill together with amendments that have been hammered out over the past three weeks in committee deliberations. Only in government accounting could an additional 29 million people receive new health coverage with a savings of $81 billion. By this congressional logic, America could insure all 6 billion people in the world at a savings of trillions of dollars.

CBO estimates that the $829 billion bill (over ten years) would be paid for partly with additional taxes-on expensive health insurance plans, on employers who do not provide the right kind of health insurance, and on people who do not sign up for insurance-and partly through savings in Medicare and Medicaid.

The Baucus bill would require everyone to purchase health insurance or face penalties. Americans with incomes up to 300% of the poverty line (currently $66,000 for a family of four) who are not covered by an employer plan would receive tax credits to purchase health insurance plans in an "exchange."

Plans purchased in the exchange would be Cadillac plans, with generous coverage and no lifetime or annual limits on any benefits. Only Americans under 25 would be allowed to purchase "young invincible" plans, catastrophic insurance against major accidents. Most Americans would have to pay a far higher cost for health insurance, since plans would have to accept everyone, regardless of health or pre-existing conditions.

The Baucus bill would be paid for in two major ways-an excise tax on expensive plans and savings from Medicare. CBO underestimates the true cost of both components.

Take the excise tax increase, for instance. The more expensive health care plans would face an excise tax of 40% on premiums above $8,000 for singles and $21,000 for families, bringing in $201 billion from 2013 through 2019. Today health insurance premiums cost on average $4,824 for singles and $13,375 for families.

What CBO doesn't tell Americans is that their health insurance premiums would increase substantially in the decades ahead. The level of health insurance premiums does not have to be incorporated in CBO estimates, because it is not a tax and it is not paid by the federal government. In 2019, in addition to $46 billion in excise taxes, Americans would be paying over $100 billion in higher premiums.

Since CBO forecasts increases in excise tax revenues of 10% to 15% annually after 2019, health insurance premiums must also rise by the same percent annually. This government mandate will amount to a steady drain on Americans' pocketbooks, a tax under another name.

Turning from taxes to savings, nearly 90% of the $404 billion Medicare and Medicaid savings would be from Medicare in the period 2013 to 2019. Thereafter, savings would be expected to continue at the rate of 10% to 15%. Of all demographic groups in America, the elderly would be the biggest losers under the Baucus plan.

CBO estimates that Medicare Advantage plans, popular bundled health maintenance organizations serving 20% of Medicare patients, would be cut by $117 billion.

Under "Ensuring Medicare Sustainability," more than $200 billion would be cut from payments to hospitals, elder care, doctors, and hospices. Payments to Medicare doctors would be cut by 25% in 2011.

Another $55 billion would be saved by "Improving Payment Accuracy," as if one can magically reduce government spending by increasing accuracy. A Medicare Commission would propose further cuts.

The government would persuade doctors to cut Medicare costs by associating more tests with lower reimbursements. Ranked in order of spending per patient, every year the top 10% of physicians would have their reimbursements cut. Since by definition there would always be 10% of physicians in the top 10%, they would have an incentive to avoid the sickest patients or the specialties with the most tests.

America's elderly might soon discover that if they were sick they would be shunned by many doctors, if the bill operated as planned.

But it's more likely that the $360 billion of Medicare savings would not materialize, and that the Baucus bill would add to the deficit rather than reducing it. After all, Congress regularly overrides an existing law requiring Medicare payments to doctors to be cut when the program is in deficit, as it is today. Why should the new law be any different?

As CBO director Douglas Elmendorf so aptly wrote in his letter to Mr. Baucus yesterday, the "mechanism governing Medicare's payments to physicians has frequently been modified (either through legislation or administrative action) to avoid reductions in those payments...The long-term budgetary impact could be quite different if those provisions were ultimately changed and or not fully implemented."

Should some version of the Baucus bill pass, Medicare spending could decline as projected, with catastrophic consequences for seniors' health care. Or, Congress could back away from cuts as it has in the past, with catastrophic consequences for the deficit. Either way, it's no treat for America.

http://www.realclearmarkets.com/arti...ick_97444.html

Oh good...another partisan editorial. Does that make 4 or 5 in the last hour?

Honestly, I dont bother to read them...others may.

Seriously if you want to keep posting editorials, go for it, and maybe you will change some minds here.

I've had my say.

Good luck!

[TheMercenary]

Originally Posted by Redux

Oh good...another partisan editorial. Does that make 4 or 5 in the last hour?

Honestly, I dont bother to read them...others may.

Again, feel free to keep posting them and maybe you will change some minds.

Good luck!

Either way you still cannot defend the facts as presented. I am ok with that. The burden is on you, the defender of the Demoncratic Plan.

All I am asking you to do, as a supporter, is to defend the cuts. Can you?

[TheMercenary]

Youtube:

CBO Director Douglas Elmendorf on Medicare Advantage

http://www.youtube.com/watch?v=ebMSpLaXmls

Please explain and defend Redux.... by 2019 the plan would be reduced to 1/2 of the current plan. Great. So where do they get the care they previously received?

[TheMercenary]

Redux, certainly you can defend this...

From The Atlantic. One of the few magazines I have a subscrip to...

What Will Health Reform Do to Medicare Advantage?
The next reform battle will be fought in a peculiar trench of the health care landscape: Medicare Advantage. The latest controversy began when Humana Inc., an insurance company, sent a note to its enrollees predicting that health care reform would kick millions off Medicare Advantage -- an option for seniors to buy private insurance with public money. Some lawmakers castigated the company and a sterner whipping could be forthcoming. The Wall Street Journal op-ed page is spearheading the conservative indignation and some liberal blogs are playing defense.

But is it true? Will health care reform cut into Medicare Advantage?

It might. Democrats aim to cut as much as $120 billion from private insurers in Medicare Advantage over 10 years. CBO head Doug Elmendorf told lawmakers that those cuts "could lead many plans to limit the benefits they offer, raise their premiums, or withdraw from the program," the WSJ reports.

Back in August Ezra Klein wrote of the Medicare cuts:


From the beginning, Medicare has been named as one of the potential sources of savings that would fund subsidies for the uninsured. That sounds like service cuts, even if the specific changes don't involve anything of the kind (most of the savings would come from reducing overpayments to the private insurers that participate in the Medicare Advantage program).

Today he sounds more circumspect:

Democrats don't want to eliminate the Medicare Advantage program. But they want it to live within the same budget that Medicare uses. Republicans argue that pulling back these payments will force some Medicare Advantage plans to trim their benefits. That may well be true. But it is an argument against ever eliminating government overpayments to any program. It is an argument, in other words, for waste and abuse.

I think he's right -- Medicare Advantage is not going to emerge from $120 billion in cuts to private insurers without any change. The question, then, is whether the changes will be for the better or worse. Will the reforms gut Medicare Advantage and piss off a lot of senior citizens, who force the government to stop cutting the program? That's possible. Will the reforms bring down the taxpayer burden of public health programs while maintaining a very high standard for elderly care? That's possible too! But this country's public health programs are just as popular as private insurance. The important thing to note is that senior citizens love Medicare, with or without the (more expensive) Advantage program.

http://business.theatlantic.com/2009..._advantage.php

Merc....as I noted previously, your youtube of the CBO director is several weeks old, as is the Atlantic article and both are referring to the original mark of the bill....before additional amendments to protect seniors were added.

One such amendment from last week, but after your cites:

The committee also adopted an amendment by Senator Bill Nelson, Democrat of Florida, to protect several million older Americans against the loss of extra benefits they receive from private Medicare Advantage plans.

http://www.nytimes.com/2009/10/03/he.../03health.html

It also has to be consolidated with the Senate Health Committee bill that has additional protections for seniors. And other Democrats have additional amendments related to holding seniors harmless while requiring the insurers to be more competitive in the bidding process.

Posting partisan commentaries about earlier versions of one bill in transition is not a factual representation of the current status of the legislation.

[TheMercenary]

More great facts... Sorry REDux, the facts are beginning to have a common theme. You may consider them to partisan, but the overwhelming majority agree. The Demoncratic plans include cuts to Medicare Advantage, a fact you cannot and have not to this point been able to defend....

HEALTH CARE FACT CHECK: Medicare Advantage not all that advantageous for seniors, government
By Stephen Koff
September 08, 2009, 5:45PM
Q: I am a senior on Medicare Advantage and I like my plan, which covers some services not provided by traditional Medicare. But President Obama has said that he will eliminate Medicare Advantage to pay for his health care overhaul, which means I must go to a new plan. Does that mean I will have to pay the 20 percent co-payment that traditional Medicare now requires, or else have to buy a gap coverage to cover that 20 percent, at a cost of $150 to $250 a month? How is this fair?





A: This is an important question for seniors, containing truths, myths and a bit of political baggage. It also underlies an overlooked point: Senior citizens get a good deal from Medicare, the government's health insurance program for senior citizens. Workers pay taxes into the basic hospitalization program and then, when they retire, they see about $96 a month deducted from their Social Security to pay for doctor's visits and outpatient care.


The average senior gets far more in benefits out of this government program than he or she ever pays in. Someone retiring in 2008 would have paid, on average, $30,650 in Medicare taxes during his or her working years, yet will receive on average $85,360 in hospitalization benefits, if male, or $81,570 if female, according to actuaries at the federal Centers for Medicare and Medicaid Services.


Still, Medicare requires a 20 percent co-payment for outpatient services, and additional co-payments for hospital stays exceeding 60 days. Some seniors simply pay this or work out arrangements with their doctors, while others buy supplemental policies to cover the gap -- and still others turn to Medicare Advantage for all their medical needs.

Medicare Advantage allows seniors to enroll in private health plans, usually through insurers or health maintenance organizations, as an alternative to traditional fee-for-service Medicare. Advantage plans were supposed to operate more efficiently and curtail the explosive growth of Medicare spending because, the thinking went, the private sector could do anything better than federal bureaucrats, and for less money.

For many seniors, this was a great deal, enabling them to avoid the co-payments or gap-coverage policies that many traditional Medicare beneficiaries buy. Some Advantage programs even throw in vision and hearing coverage, though the reader who asked today's question said he does not have those benefits.

About 23 percent of seniors nationwide, and 25 percent in Ohio, are in Advantage plans.

For the government, Advantage plans have not lived up to expectations. Advantage insurers charge the government more money, not less, requiring a taxpayer subsidy that averages 14 percent more per-patient on top of what traditional Medicare pays providers. That's an extra $1,138 per Advantage enrollee nationwide, or $1,166 for those in Ohio, according to a George Washington University analysis.

Medicare Advantage plans also tend to limit the doctors that seniors can see, just as traditional insurers do.

The U.S. Government Accountability Office has noted that many Advantage seniors wind up paying high co-payments when hospitalized, although the reader who asked today's question -- a retired certified public accountant -- said he does not face those kinds of fees under his Advantage plan.

Furthermore, Advantage plans have not spread broadly to rural areas, despite Congress' agreement in 2003 to boost payments to expand rural coverage, according to an analysis published by the Commonwealth Fund, a private, nonprofit organization that studies health care issues. In the six years since then, extra payments to Advantage plans "are estimated to total nearly $44 billion," the study concluded.

Put another way, taxpayers are giving the gentleman who posed today's question an extra $1,166 a year for his health care, providing what he considers excellent coverage. Who could blame him for wanting to keep this deal?

But President Barack Obama wants to eliminate the extra subsidy, just as members of Congress tried to do throughout the 1990s. Obama has not proposed eliminating Advantage, despite rumors to the contrary. His proposals would scale back the subsidies, using a funding formula to put Advantage on parity with traditional Medicare.

Would that force Advantage plans to curtail services or even go out of business?

That's a matter of debate. Critics say the plans could stand to absorb the lower payments since they have profited handsomely from taxpayer subsidies. A recent examination by the Associated Press found that "profits at the insurers offering Medicare Advantage have far outpaced expectations, and their expenses to treat clients have been far lower than projected."

The insurance industry disputes this. Its influence, along with fears by seniors and Advantage-paid hospitals and other providers, was enough to keep the U.S. Health Care Financing Administration from curtailing Advantage funding in the 1990s, when cuts were also proposed, according to Health Affairs, a nonpartisan journal funded by the Robert Wood Johnson Foundation.

Obama proposed the newest trim when campaigning for president last year, and he included it in his proposed 2010 budget, projecting the savings at $177.2 billion over 10 years. The Congressional Budget Office, or CBO, projects the savings at $156 billion. The savings would help pay for a broad expansion of health coverage in the United States, which the CBO says would cost $1 trillion over 10 years.

That means that savings from Advantage would pay for 15.6 percent of Obama's health care overhaul -- not 60 percent, a figure some seniors have heard.

http://www.cleveland.com/medical/ind...k_medicar.html

Originally Posted by TheMercenary

More great facts... Sorry REDux, the facts are beginning to have a common theme. You may consider them to partisan, but the overwhelming majority agree. The Demoncratic plans include cuts to Medicare Advantage, a fact you cannot and have not to this point been able to defend....

http://www.cleveland.com/medical/ind...k_medicar.html

Another editorial that is a month old....well before the current version of the Senate bill. Every recent post of yours refers to earlier versions.

I understand that you would rather focus on those earlier versions of the legislation, but this is getting silly now.

[TheMercenary]

Originally Posted by Redux

Another editorial that is a month old....well before the current version of the Senate bill. Every recent post of yours refers to earlier versions.

I understand that you would rather focus on those earlier versions of the legislation, but this is getting silly now.

Oh ok, So REDUX says that none of the currently proposed programs involve cuts to Medicare. I get it. Really? Where is the money going to come from again to pay for this boondoggle? Not from Medicare or from Medicare Advantage, right?