Impeding changes to our Health Care system

Originally Posted by TheMercenary

I will thank you with a car bomb. So what, you are a narcissist? You think any of us should thank you for anything the Demoncrats do? ROTFLMAO!

Well, hell, you blamed me in another post after your meltdown, I want credit!

[TheMercenary]

Originally Posted by Redux

You can thank me when your health care choices are expanded and your premiums stop increasing at rates more than 4-5 times faster than your salary.

Tell you what there Reflux. I will let all those middle class families that now have to come up with extra money or get fined by the feds for health insurance call and thank you, care to publish your home address and phone number so all those appreciative people can call you and bless you?

Originally Posted by TheMercenary

Tell you what there Reflux. I will let all those middle class families that now have to come up with extra money or get fined by the feds for health insurance call and thank you, care to publish your home address and phone number so all those appreciative people can call you and bless you?

I see another meltdown coming on!

take a deep breath and relax, Merc.

[TheMercenary]

Originally Posted by Redux

I see another meltdown coming on!

take a deep breath and relax, Merc.

No meltdown, you have just stepped up to the plate and accepted the responsibility of the success of the program. You will also accept the failure. Good on you. I will be here to pat you on the back or stab a knife in it. Most likely you will do as most and just fade to black as it goes down the shitter. Typical Lobbyist.

Originally Posted by TheMercenary

No meltdown, you have just stepped up to the plate and accepted the responsibility of the success of the program. You will also accept the failure. Good on you. I will be here to pat you on the back or stab a knife in it. Most likely you will do as most and just fade to black as it goes down the shitter. Typical Lobbyist.

Yesterday, you blamed me for the failure....and now you want to car bomb me...or stab me in the back.

Man, how am I supposed to sleep tonight?

[TheMercenary]

Wow, looks like Medicare is headed for some problems... Where is the money going to come from?

I dont disagree with you on the need for entitlement (Medicare and Social Security) reform, but that is a separate discussion.

[TheMercenary]

Originally Posted by Redux

I dont disagree with you on the need for entitlement (Medicare and Social Security) reform, but that is a separate discussion.

I never once said we did not need reform.

[TheMercenary]

A nice little summary of how Medicare is saving us soooo much money and is soooo efficent.

CHAPTER 7 - MEDICARE

Content Last Updated: 6/17/2009 9:28:21 AM
Graphics Last Updated: 6/15/2009 9:01:51 AM
Charts and graphs for this chapter are listed in the right column of the page.


Originally written by Gail Wilensky, Ph.D.,
Project HOPE, former chairman of the Medicare Payment Advisory Commission and former administrator of the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services)
This chapter was made possible by the Robert Wood Johnson Foundation.


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FAST FACTS

Medicare is a federal program that covered 44.1 million people in calendar year 2007 -- 36.9 million aged 65 and over and 7.2 million who met Medicare’s definition of disability. 1
The first of the baby boomers will reach age 65 – the Medicare eligibility age for non-disabled people – in 2011. By 2030, when the youngest boomer turns 65, there are expected to be 78 million people on Medicare.2
Annual expenditures for Medicare were $436 billion in 2007 and are expected to rise to $887 billion in 2018.3
Financial assets of the Hospital Insurance Trust Fund that pays for Part A of Medicare are projected to be exhausted by 2019.4
To finance Part A’s expected needs through 2083, the Medicare payroll tax would need to be increased immediately by 122 percent, program outlays would need to be reduced by 51 percent immediately, or some combination of the two, according to the program’s trustees.5
The American Recovery and Reinvestment Act of 2009 includes Medicare incentive payments to encourage physicians and hospitals to “meaningfully use” electronic health records. The incentives phase out over six years, followed by penalties for non-adopters.6


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BACKGROUND

Medicare is a federal program that helps pay medical bills for people age 65 and older, and a relatively small group of people who are judged to be severely and permanently disabled.

The program was signed into law in 1965 but has since been expanded in terms of services and populations covered. The most important of these expansions were the decision to cover people with end-stage renal disease (ESRD) in 1972 and the coverage of outpatient prescription drugs enacted in 2003.

At age 65, a person automatically becomes eligible for Medicare if he or she is a U.S. citizen or a legal resident (green card holder), and has lived in the U.S. for at least five years in a row.7 The eligibility rules for people with disabilities are more complicated but generally, if a person qualifies for cash benefits under Social Security Disability Insurance (SSDI), they can qualify for Medicare after a two-year waiting period.8 Special rules apply for those with ESRD or ALS, also known as Lou Gehrig’s disease.

As with Social Security, eligibility for Medicare does not depend on income. Also like Social Security, much of Medicare is funded on a “pay-as-you-go basis,” which means it depends primarily on today’s working population to fund the expenses of today’s beneficiaries.





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Medicare covers benefits that fall into four parts. (Click here to see text box with details on what's covered by each part and how much beneficiaries have to pay for premiums and services under each.)

Part A - Hospital Insurance
Part A, known as the Hospital Insurance (or HI) program, covers inpatient hospital care, skilled nursing care up to 100 days after a hospitalization, home health and hospice care. It is funded by a portion of the wage tax – 2.9 percent, with employers and employees each paying 1.45 percent. Beneficiaries pay a deductible ($1,068 for each “spell of illness” in 2009), and substantial copayments for extended inpatient hospital or skilled nursing facility stays. If they have worked in the U.S. for 10 years or more (40 quarters of Medicare-covered employment), beneficiaries pay no Part A premium. (See text box, “What Medicare Covers,” for Part A premiums charged to those who have worked fewer than 40 quarters of Medicare-covered employment.)

Part B - Supplementary Medical Insurance
Part B, known as Supplementary Medical Insurance (or SMI), covers physician services, outpatient care and home health care after 100 visits. It is funded partly by premiums, which accounted for 24.8 percent of the Part B income in 2007.9 The rest comes from general revenue. The monthly premium for most beneficiaries is $96.40 in 2009. Some with higher incomes pay higher, income-related premiums; some with low incomes and assets pay no premiums. Most face a Part B deductible of $135 in 2009. In 2009, premiums for the wealthiest beneficiaries will cover 80 percent of their Part B costs.10

Part C - Medicare Advantage
Part C replaces the benefits from parts A, B and D by enrollment in a private plan called a Medicare Advantage (or MA) plan, which includes at least the benefits associated with traditional Medicare. In 2008, around 10 million beneficiaries were enrolled in MA plans.11 (See the Glossary for more.)

Part D - Prescription Drug Benefit
Part D is the outpatient prescription drug benefit which took effect in 2006. The benefit is provided by free-standing private drug plans (except for those beneficiaries who are enrolled in Medicare Advantage plans with a prescription benefit). It is funded by general revenue, contributions from the states and premium payments from beneficiaries (an amount that made up 7.9 percent of Part D income in 2007).12 Each plan sets its own premium; the national average in 2009 is $30.36 per month. The deductible cannot be more than $295.

There are also some important benefits that Medicare does not cover. These include custodial long-term care, dental services and most vision and hearing services.

For a detailed description of what Medicare covers and how it is financed, go to the websites for the Medicare Rights Center (www.medicarerights.org) and the official U.S. government website for people with Medicare (www.medicare.gov).

Assuring adequate funding for both Social Security and Medicare faces the problem that, with the aging of the population, there will be fewer workers supporting each retiree. (See chart, “Historical and Projected Number of Medicare Beneficiaries and Number of Workers Per Beneficiary.”)

More:

http://www.allhealth.org/sourcebookcontent.asp?CHID=70

[TheMercenary]

Hey REDUX. Where's the Bill?

[Radar]

2/3 of America want health care reform to pass, and want a public option. It will happen no matter how much money the insurance companies throw at it.

[classicman]

That there will be some healthcare reform legislation isn't the issue. I think we all recognize that. The issue is whether it will be a productive and beneficial change, and at what cost.

[classicman]

Finance Committee Democrat Won’t Read Text of Health Bill

Sen. Thomas Carper (D.-Del.), a member of the Senate Finance Committee, told CNSNews.com that he does not “expect” to read the actual legislative language of the committee’s health care bill because it is “confusing” and that anyone who claims they are going to read it and understand it is fooling people.

“I don’t expect to actually read the legislative language because reading the legislative language is among the more confusing things I’ve ever read in my life,” Carper told CNSNews.com.
Carper described the type of language the actual text of the bill would finally be drafted in as "arcane," "confusing," "hard stuff to understand," and "incomprehensible." He likened it to the "gibberish" used in credit card disclosure forms.

Last week, the Finance Committee considered an amendment offered by Sen. Jim Bunning (R-Ky.) that would have required the committee to post the full actual language of the proposed legislation online for at least 72 hours before holding a final committee vote on it. The committee defeated the amendment 13-10.

Sometime in the wee hours of this morning, according to the Associated Press, the Finance Committee finished work on its health-care bill. "It was past 2 a.m. in the East--and Obama's top health care adviser, Nancy-Ann DeParle in attendance--when Sen. Max Baucus, D-Mont., the committee chairman, announced that work had been completed on all sections of the legislation," said the AP.

Thus far, however, the committee has not produced the actual legislative text of the bill. Instead the senators have been working with “conceptual language”—or what some committee members call a “plain English” summary or description of the bill.

Senator Jeff Bingaman (D-N.M.), who sits on the committee, told CNSNews.com on Thursday that the panel was just following its standard practice in working with a “plain language description” of the bill rather than an actual legislative text.

“It’s not just conceptual, it’s a plain language description of the various provisions of the bill is what the Senate Finance Committee has always done when it passes legislation and that is turned into legislative language which is what is presented to the full Senate for consideration,” said Bingaman.

But Sen. John Cornyn (R-Tx.), who also serves on the committee, said the descriptive language the committee is working with is not good enough because things can get slipped into the legislation unseen.

“The conceptual language is not good enough,” said Cornyn. “We’ve seen that there are side deals that have been cut, for example, with some special interest groups like the hospital association to hold them harmless from certain cuts that would impact how the CBO scores the bill or determines cost. So we need to know not only the conceptual language, we need to know the detailed legislative language, and we need to know what kind of secret deals have been cut on the side which would have an impact on how much this bill is going to cost and how it will affect health care in America.”

Carper said he would "probably" read the "plain English version" of the bill as opposed to the actual text.

Probably??? FFS isn't it his job to read the bill?

Originally Posted by classicman

Finance Committee Democrat Won’t Read Text of Health Bill


Probably??? FFS isn't it his job to read the bill?

I agree with Carper. Members of Congress dont read the actual full text of bills, particularly comprehensive bills like this one. Anyone who says otherwise is probably lying.

Try reading most bills yourself...much of any bill simply points back to amending existing laws and cites sections of the US Code....with language like:

"subsection A(1)x of this new bill replaces USC Title 1, sec 23.xyx"

"insert...."this word or phrase" of the new bill to replace "this word or phrase" of USC V.3 (a)2(b)

Huh?

One would need the entire 20+ volume of the US Code at your side to read many bills.

That is the job of the Committee staff and they prepare a detailed, comprehensive section-by-section summary in "plain English" that is available to every member.

Credit Carper for outing the truth.

[glatt]

Originally Posted by Redux

Try reading most bills yourself...much of any bill simply points back to amending existing laws and cites sections of the US Code....with language like: "subsection A(1)x of this new bill replaces USC Title 1, sec 23.xyx"

I work at a law firm. It's been a while because I'm in a managerial position now, but I've had to read the US Code and read laws as passed and go back to the Code to try to piece together what they mean. It's painfully fucking slow and tedious and you are never really sure that you got it right.

In my experience, Redux is correct on this point.

There are a lot of lawyers in congress, and unless you expect every one of them to be a lawyer, you shouldn't expect them to be reading the bills they are voting on.