Impeding changes to our Health Care system

[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.

I really dont know why I am bothering anymore.

Carry on.

[TheMercenary]

So help me out here REDux. Are you trying to tell us that because the Bill has not been finalized that you are saying and defending that cuts to Medicare Advantage have not been actually approved and therefore they really are not going to cut the program? or they are not going to cut Medicare reimbursement at all and the program, as currently proposed, will not have cuts to Medicare?

Please defend if you believe any of this. thanks.

[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?

Merc...I just dont have the patience anymore.

Say what you want, post what you want, declare yourself the winner, criticize me as a lobbyist and Democratic mouthpiece, pretend that you are posting factual and timely editorials,.....

Its all good!

[TheMercenary]

Come on Redux. All I want you to do is defend the proposed cuts by your Demoncratic guys and gals in Congress. Tell my 89 year old mother how that is going to make her life better and save her money without cutting or decreasing her benefit. Thanks. I am waiting.

[TheMercenary]

Originally Posted by Redux

Merc...I just dont have the patience anymore.

Say what you want, post what you want, declare yourself the winner, criticize me as a lobbyist and Democratic mouthpiece.

Its all good!

Care to defend that you are not?

You know the least you could do is admit it...

Merc...I stand by my posts, just as you stand by yours.

As I again stated previously, I am comfortable with others reading through this entire discussion and deciding for themselves.

[TheMercenary]

Originally Posted by Redux

Merc...I stand by my posts, just as you stand by yours.

As I again stated previously, I am comfortable with others reading through this entire discussion and deciding for themselves.

Come on Mate, I am only asking you to defend the cuts to seniors. That is all. It is your party that is making the cuts, or if you want to sugar coat it, proposing the cuts. Just defend the position of cutting off my 89 year old mother and the rest of the seniors that depend on Medicare Advantage. Pretty simple.

Originally Posted by TheMercenary

Come on Mate, I am only asking you to defend the cuts to seniors. That is all. It is your party that is making the cuts, or if you want to sugar coat it, proposing the cuts. Just defend the position of cutting off my 89 year old mother and the rest of the seniors that depend on Medicare Advantage. Pretty simple.

Proposing cuts that have been lining the pockets of Medicare Advantage providers at excess levels is not the same as proposing cuts to patients...particularly with amendments that protect the patients.

We see it differently...it is as simple as that and others will form their own opinions.

There is nothing more for us to debate.

And, lets not forget that today, it was a Republican Senator who blocked a simple bill that would freeze your grandmother's Medicare B costs for another year.

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

[TheMercenary]

Originally Posted by Redux

Proposing cuts that have lining the pockets of Medicare Advantage providers is not the same as proposing cuts to patients...particularly with amendments that protect the patients.

We see it differently...it is as simple as that and other will form their own opinions.

There is nothing more for us to debate.

And, lets not forget that today, it was a Republican Senatir who blocked a simple bill that would freeze your grandmother's Medicare B costs for another year.

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

The cuts are to the patients. The cuts are to the providers. The cuts are across the board. Can you defend it?

It ain't my grandmother, it is my mother.

And, lets not forget that today, it was a Republican Senatir who blocked a simple bill that would freeze your grandmother's Medicare B costs for another year.

Strawman and deflection of the argument that you CANNOT defend. Just admit it. Your party is going to royally fuck seniors on Medicare.