Impeding changes to our Health Care system

[Spexxvet]

Originally Posted by Shawnee123

Yeah, and so what if they do? They haven't lived long enough to form any real ties and haven't had time to contribute much to society.

But who will work in fast food chains?

[TheMercenary]

Originally Posted by Spexxvet

How can you complain about the cost being too high, and tax increases, then complain about cutting programs. Make up your mind. [/total tailpost]

Cutting which programs specifically? I can complain about anything I want, including high costs, tax increases, and the cutting of programs. It depends on high costs on which things, who is gettting a tax increase, and which programs are going to be cut. Care to tell me what you think about any specific part of your broad generalizations you believe what I believe?

[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]

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.

[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.

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.

[TheMercenary]

More great news for your guys plan from the NYTimes....

September 23, 2009, 4:10 pm Medicare Advantage: Suddenly a Battle With Three Fronts
By David M. Herszenhorn
Three related issues consumed lawmakers on the Senate Finance Committee as they debated major health care legislation on Wednesday afternoon, but connecting the dots from one controversy to the next isn’t easy.

Here’s the back story:

The health care bill proposed by Senator Max Baucus, Democrat of Montana and the committee chairman, seeks to cut $123 billion in payments to private insurance plans that administer health benefits for roughly 10 million Medicare beneficiaries.

The private insurance plans, known as Medicare Advantage, were originally intended to save money, and the government initially paid them 95 percent of the projected cost of enrollees in traditional Medicare.

But in recent years, spending on Medicare Advantage has soared, in part because the federal government offered incentives to the private insurers to offer coverage in underserved regions, including many rural areas.

Studies show that the private plans now cost about 14 percent more than traditional Medicare, and many Democrats say insurance companies are profiting excessively from them.

To attract customers, Medicare Advantage plans typically offer enhanced benefits compared to traditional Medicare, including vision and dental benefits and, in some cases, gym memberships. The added perks make Medicare Advantage popular among beneficiaries, and the proposal by Mr. Baucus to reduce payments to them has stirred opposition, particularly in Florida, where about 1 million people are covered by the plans.

As a result, Senator Bill Nelson, Democrat of Florida, has proposed an amendment to the health care legislation that would protect Medicare Advantage plans in areas where they are more cost-efficient than traditional Medicare, like Florida. (Big surprise.)

Now that proposal has set off at least three related controversies on the Finance Committee.
First, lawmakers in rural states are furious at the idea of protecting Medicare Advantage plans only where they are cheaper than traditional Medicare, because that’s typically true only in higher-cost regions like Mr. Nelson’s home state.

Second, to cover the cost of protecting some existing Medicare Advantage plans, Mr. Nelson has proposed extracting at least $86 billion more in savings over 10 years from drug manufacturers, potentially upending a deal between the pharmaceutical industry and the Obama administration.

And third, Republicans are furious that the federal Centers for Medicare and Medicaid Services, a division of the Department of Health and Human Services, has warned private insurers not to lobby customers over the health care legislation.

That last fight stems from a letter sent by Humana, one of the largest providers of Medicare Advantage coverage, to Medicare beneficiaries warning of potential cuts in benefits.

The Senate Republican leader, Mitch McConnell of Kentucky, has accused Democrats and the Obama administration of trying to muzzle critics of the legislation.

So as the Finance Committee debate shifted into high gear, Senator Orrin G. Hatch, Republican of Utah, proposed an amendment seeking to shield all Medicare Advantage plans from reduced payments. Mr. Hatch’s amendment was rejected by a vote of 14 to 9, with Senator Olympia J. Snowe, Republican of Maine, joining all of the Democrats on the committee to defeat it.

Senator Jon Kyl, Republican of Arizona, has offered an amendment seeking to protect the First Amendment rights of private insurers who might want to criticize the proposed health care legislation.

Mr. Baucus fired back at Mr. Kyl, saying Humana had overstepped its bounds and had frightened American seniors by warning them that their benefits would be cut. “There is no First Amendment right to lie,” Mr. Baucus said. “There is no First Amendment right to mislead.”

Some Republicans said Mr. Kyl’s amendment was valid even if Humana had made misstatements. “You have a right to be wrong,” said Senator Pat Roberts, Republican of Kansas. Mr. Kyl’s amendment was defeated 13 to 10, with all Democrats opposed and all Republicans in favor.

In an appearance in Maryland on Wednesday, Vice President Joseph R. Biden Jr. sought to refute the Republican assertions about cuts to Medicare Advantage. “Here’s the truth — you’ll continue to be able to get Medicare Advantage if that’s what you choose,” Mr. Biden said.

Mr. Biden said that less than a quarter of those eligible choose Medicare Advantage, “but those of you who have it, you’ll be able to get it.”

“All we’re doing,” the vice president said, “is just cutting the padding out of the subsidies that insurance companies are already getting.”

But some health insurance industry experts say that the proposed cuts in payments to Medicare Advantage plans will mean that insurers either have to reduce benefits or cancel their plans altogether.

Senators on the Finance Committee will be debating that point in the hours ahead.

http://prescriptions.blogs.nytimes.c...-three-fronts/

[TheMercenary]

Go ahead Redux, defend it....

You can't....

Are we done yet?

[TheMercenary]

Sure, you can't defend the cuts. I am done if you can't defend the cut to the elderly who in the end are going to be royally fucked by the Demoncratic plan.

Originally Posted by TheMercenary

Sure, you can't defend the cuts. I am done if you can't defend the cut to the elderly who in the end are going to be royally fucked by the Demoncratic plan.

Merc...I am very comfortable with the clear and concise response I provided in my own words:

....the plan will take money out of the pockets of the insurance providers (add: who have been overcharging for years) 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.

If you want to post more partisan editorials, that is your choice.

The folks following this discussion (sic) can decide for themselves, as will the voters.

[TheMercenary]

Well it has been 10 minutes. I guess you can't defend the cuts to the elderly. No biggie. I will wait for Pelosi and Reid to feed us their bullshit on why it is ok. Make it a great day Redux...