A new direction for healthcare...
The first-phase of the new health care law has fully kicked in, and despite ominous predictions from opponents that reform would destroy our health care system, things seem to be going OK.
But that hasn’t stopped the attack on health care.
Last week, the House voted along party lines (239-187) to cut off the funding needed to implement the law. Among the votes – gutting a provision that would make sure insurance companies spend at least 80 percent of your premium on health care, rather than spending it on CEO salaries, marketing and overhead.
Senate leaders have said they will reject the House budget, citing the dramatic cuts in health care, environmental programs, education and enforcement of laws already on the books (one example – the House voted to block a new public database where consumers could check for unsafe products and toys). If an interim budget isn’t hashed out by March 4, there’s the potential the federal government could shut down.
But funding isn’t the only tactic to gut the health care law, which will phase in fully during the next three years. Opponents are trying an outright repeal, stall-and-obstruct tactics, and ultimately legal challenges to stop the benefits promised under the law.
Last month the House passed a straight-up repeal by a vote of 245-189, including three Democrats. Shortly afterward, Senate Republicans tried a similar repeal, but the bill narrowly failed 51-47, with two Democrats, Sens. Warner and Lieberman, abstaining.
Meanwhile, committees in the Republican-controlled House are holding countless hearings on the impact the new law would have on jobs, the budget, and Medicare, as well as the law’s constitutionality. They have brought the Secretary of Health and Human Services, Kathleen Sebelius, and head of the Centers for Medicare and Medicaid, Don Berwick, to the Hill for grilling sessions that illuminated little, but created lots of opportunities for partisan grandstanding.
If you’re not familiar with the new benefits already in place under the health reform law, here’s a short list of some of the biggest changes:
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In addition to wholesale repeal, many in Congress have moved to change specific aspects of the law. Some of these changes have bipartisan support, and even President Obama has said he’s willing to change parts of the law if it can be improved.
One widely supported change would stop the extra paperwork needed from small businesses that get tax breaks for insuring workers. The Senate recently passed a bill to end the requirement that business-owners file tax forms for any purchase made over $600. The House is still considering the issue.
Another measure introduced by Rep. Phil Roe (R-TN) would repeal an advisory board with the authority to reduce wasteful Medicare spending. Experts have supported an independent panel to get costs under control and stop wasteful spending. But Congress is notoriously averse to cutting payments, especially to doctors.
Of course, the final word on the health care law could come from the Supreme Court. Five legal challenges to the law at the district court level have been ruled on to date – with three Democratic-appointed judges upholding the law, and two Republican-appointed judges ruling against it.
Legal experts expect an eventual showdown in 2012 in the Supreme Court, where a swing vote by Justice Kennedy (a Reagan appointee) may be decisive in ultimately deciding the fate of the health law.
In the meantime, Consumers Union will continue working with you to improve implementation of the law so you get affordable access to quality, reliable health care. And we’ll continue to hold insurance companies accountable by working to pass laws in states to require insurance companies publicly justify their rate hikes, and if their rate hikes are excessive, be denied.
Looks to me as if the majority of Government (which we elected) is against “we the people”.
If you’re 75 and against “socialized medicine” (the kind all advanced countries have), you must indeed have rejected your Medicare coverage and be relying on your private insurance. If not, you are committing fraud by accepting and bad-mouthing Medicare. If you had a pre-existing condition, your only hope would be Medicare; private insurers would reject your application or simply drop you after you’d made claims.
In my opinion, it’s unethical–and unAmerican–for health insurance to be a for-profit business, with huge bonuses to executive depending on how many claims they’ve been able to deny.
Don’t forget: the British National Health Service was started by CONSERVATIVE prime minister Winston Churchill!
Michael M.T. Exavtly what I was thinking. That’s why I asked her the questions I did in an earlier post. Do you think she doesn’t know what she has??
I love your response, exactly how my husband and I feel. Medicare is the best run insurance program we ever had. What is the matter with so many seniors to dump on Medicare, yet they all use it!
I’m with you. I think Congress has given itself so many perks that “we the people” had no idea they were doing. Its our own fault, I guess, but who can read though all the bills they propose?
I am a senior, age 75, and I have absolutely no faith in government controlled health care. The less government the better. Our elected officials manage to mess up every program they’ve ever implemented. The most frightening words one can hear as that Congress is “going to get busy”. I don’t want them to get busy. I want them to take a long furlough from busy-ness, especially in matters of health care.
U have no idea what is going on in healthcare to distrust government involvement. Perhaps that is just why government is just now trying to “reform” health care. Just hope that there is A Government that will intervene in the right way.
All I want is the same healthcare that our legislators get. Check it out. It is easy to cut someone elses healthcare if they allready get something themselves. Get real, this is not a budget issue.
look at the fraud with medicare and the IRS already, what makes this any different? And these are government run programs!!!
Jacqueliyn Curry, so I take it you are not on Medicare, even though you’re 75? Do you have your own private insurance?
Larry, when pigs fly! And you’re right, it’s NOT a budget issue.
It makes a good argument though, to keep us from noticing other things they want to slip by us.
What we need is some legislators who live in the real world and have to meet everyday bills.
That’s what we need, but as soon as they are elected they turn against us.
On 2-23-2011 in Arizona ” The Who Cares Less For Her People” Governor and her Rich Merry Bandits ( The Arizona State Republican House Senate) voted and signed a bill abolishing Medicaid for all but 100,000 people. They tired the Politicians to an all day rival until 2:30 in the previous morning when certain Voters caved in to Exaustion. They traded the poor people for tax cuts to Big Corporation. I can only pray at this time. I wonder if The Republican Doctors, Republican Hospital CEOs and Board Members will now worry about their Income and Health Insurance for they will not have any Patients to Over Charge. All Politicians should be on a Volunteer Basis Only, then we would’nt have to worry about them, they simply would be obsolete and we would’nt be covering their Great Benies and Health Care.
Linda, you know Gov Grim Reaper just gave Sheriff Babou 5 million to set up some kind of task force. Surely that is more important than Medicaid in AZ. ou see where her priorities are. No wonder the southern part of AZ wants to get away from her.
It’s so sad that people have been hoodwinked to believe that there is no such thing as good government. Take Medicare as an example of good government. Medicare is insurance. That’s it. Like any insurance organization it has essentially a simple function: Take in money in the form of premiums, and pay money out – to medical service providers in this case.
So the simple measure of efficiency of any insurance organization is what percentage of the premiums paid goes to actually pay for medical services. In the case of private insurers the answer is typically between 70% and at most 85% (of the premiums paid in go to actual healthcare services). But in the case of Medicare the number is a whopping 95%. That means that if you pay a $1000 premium to Medicare, $950 of that $1000 will go to pay for actual medical services and supplies compared to between $750 to $850 for private insurers. Add to that – according to the American Medical Association, Medicare is the fastest payer of all insurers when compared with private insurance. Now the cost of providing medical services is something else – very complicated, but when it comes to insurance the answer is simple. Medicare wins on efficiency hands down. Of course not all government programs are efficient, nor is private industry automatically efficient. It always depends on management and individual circumstances. But for me the best insurance for the country would have been Medicare for all but that isn’t happening. What is happening is that the new Healthcare bill requires private insurers to pay maintain the upper end of their efficiency measure – 85% of premiums must go to pay for medical services. So, while not as good as Medicare, it’s better than what the greedy insurance companies held back before as overhead. The healthcare bill is a compromise between what is best for the country and what is practical – but it puts much needed controls in place and should be supported.
Don’t know if anyone is still reading this but…I was ID’d as disabled after 3 years, a lawyer, etc. Did everyone know that you can not change companies that provide that medigap. Example. If you have Blue Cross Blue Shield (because you didn’t know you’d have it until you were 65) you can’t change to a company with a better plan for less because after 6 months you are no longer guaranteed issue).
It is true that insurance companies can’t deny you insurance because of pre-existing conditions, but..BUT..that does not mean they offer a policy at a reasonable rate. Before disability, my insurance was $900 per month. Then we learned about HSA, which was a better plan. Now, my premium is over $400 per month and not having it is financial Russian roulette. When I’m 65 my premium goes down nearly $200 per month.
I tried to read the new Health Care Law and couldn’t. It was too lawyerly.
Best of luck everyone. AND BE CAREFUL when you first start to get medicare. Research as many medigap offerings as possible before you commit. If you’re 65 orover you may be able to switch companies, I haven’t gotten that far in the spider web of health care yet.
Be careful when you seleclt a medigap provider. This may just apply to individuals on disability, but I found out once I signed on to one insurance company for doctoring assistance, I can not change companies until I’m 65. I’m 58. No one ever advised me of this. I am able to change my prescription plan during December and half of January.
I was really stupid. My only insurer since I was 18 years old was Blue Cross so, I went with them. They are very expensive. I could change but I would be rated. Obviously since I’m disabled it drives my premium up.
Wish someone would write about this. I even got my Senator’s researchers to verify this.
Good luck everyone.
Medicare happens to administer the delivery of health care way more efficiently than any private insurer out there. The administrative overhead is approx. 3%. Adminstrative overhead for private insurers, even “non-profits” like some of the Blues are 10 times that. Then there are the for-profits whose primary responsibility is not to the patients they cover but to their shareholders. (They are basically obligated to deny care in favor of producing profits) “Non-profits” find ways to hide profit as opposed to using it to reduce premiums, usually by way of a for-profit subsidiary, or paying executives obscene salaries. (Highmark Blue shield of PA paid its CEO $5M in ’09, Independence Blue Cross paid theirs closer to $9M) Doctors may not always be happy with what medicare pays them but at least they know that they will be paid and in a timely fashion. So before before anyone badmouths Medicare especially at 75 years old, check into the alternatives; I think you’ll be in for quite a shock.
We are not alone. I think the majority of people blessed with SS insurance/medicare agree with you. I am nearly 83 yrs old, widow and a number of health issues. I have had the good fortune of having taken advantage of the co-insurance ofered by ..I guess Medicaid>> and an RX insurance plan and have been blessed with goos Doctors, timely services and more help than I would ever get under any other plan. Can’t see why it needs a lot of changing since the changes suggested and made into lae to get insurance co to clean up their act.
Hey, Dr. Schoebel, I didn’t mean to bad mouth anyone…except insurance companies who are bleeding me dry financially. I can’t afford it and can’t afford not to have it. I have Ehlers Danlos, live in constant pain and have joints that sublux constantly. I’ve do have disability now…And for everyone out there, I worked and pushed through pain and slipping joints until I was 54 before I just broke down…I always feel the need to explain. I’m not a free loader and NEVER thought I’d have to suck from the public teat.
All I know for sure about Medicaid, for dental work, takes about 6 months for reimbursement and that’s with all the piles of paper work done correctly. It is my son’s experience. He’s a new dentist, five years practicing and bought a practice about 3 or so years ago so he’s in big time debt. Maybe he’s just acutely sensitive to timely reimbursements. I’ve just heard him discuss this problem and how it actually costs him to serve medicaid patients…which he continues to do.
My Medicare seems fine along with the medigap, but I have to pay almost 3 times more for it than a 65 year old person. I think its the same thing as anyone would have to pay for that policy. They don’t understand that my disability income is far from my working income. I don’t know. Duh. Who wants to insure disabled people. They’re disabled for a reason, right.
I’m rambling but I get so dern frustrated with the insurance situation. The government practice that I don’t understand is why I can’t change from Blue Cross Blue Shield to another company where I can get basically the same coverage for less money ONLY if I can go in with guaranteed issue. New term for me. It means they have to take you.
Thank you all for listening.
I agree. the REAL problem is NOT healthcare, its HEALTH INSURANCE.
It is the INSURANCE COMPANIES who determine how much and what type of healthcare you receive, NOT the doctors, and actually not the government CMS is a typical government beaurocracy, too fat, too inefficient, but we are far better off dealing with them than any large private for profit insurance corporation who inserts themselves squarely into the doctor/patient relationship, spending billions annually on influence, advertizing and other activities unrelated to their core business. The HEART of the issue is that health INSURANCE is what needs reform. Much of the overhead associated with medical offices is directly attributable to complying with INSURANCE requirements, NOT government requirements. In the case of rising healthcare costs, insurance companies are the culprits–not the patients, not the government. Just take the outrageous premiums that doctors are forced to pay for malpractice insurance, when in reality a very small percentage of ‘bad’ doctors exist, and rather than penalizing the repeat culprits, the insurance companies penalize all doctors. As far as the British National health system, it has been destroyed beyond all recognition, mostly by the previous socialist prime minister, Tony Blair. Healthcare is now managed more by ‘targets’ (set by the government) and not patient needs. On such a small island, local and regional ‘health boards’ decide what treatments to offer or not offer based on zip codes, age, budget, etc. In fact, you can’t even call it a ‘national’ health care system any more, because it not only varies by country but by city/town in each country (Wales, England, Northern Ireland, Scotland) God forbid that we were to travel that route. Also, If Pres Obama had not buckled in to the big pharmaceuticals, our prescription costs could be cut by 2/3rd overnight. Yes, brand name drugs, not only generics. Although never mentioned, this is his BIGGEST failure of all
Right on, Marilyn, you definitely know what you are talking about!
I agree with Marilyn, too. I’ve had the most anguish with insurance companies. The new law may say that Insurance companies can not “cherry pick” and leave the people with serious health problems in the cold BUT I don’t think the law says the Insurance Company can not rate you because of your problems. I have found out that things change when one turn 65. The policy I now pay about $450 for will go down to $168.00 or something. What I do not understand is how someone on disability-medicare and SS-can pay premiums as high as someone who can work and pay for the premium.
The way this governing in this country is going I can only hope that we are eliminated by natural disasters very soon to prevent un-needed suffering for millions or maybe the government can go in hiding and drop all weapons of mass destruction so we, the poor people in this country and world, who are being bombed with depleted uranium, and other terrible bombs by this government can finally rest in peace.As it is now, we, the poor are homeless due to medical bills, and are being accused of being lazy, deserving our ill fortune. Needless to say that many work for unlivable slave-wages with no rights to any care.and of course many lost their job due to greed from our corporate government. As john trudell stated “I’m not looking to overthrow the US government. The corporate state already has”. America wake up.
I agree with Paul Krugman(NYT)when he recently wrote that the deficit debate is a “sham”. There are only seven words that are at the heart of the deficit. Health care, health care, health care and (then possibly new)revenue. If we realy scrutinized the services and products being provided (or not being provided and paid for), we can eliminate 50% from unnecessary procedures, misdiagnoses, medical errors, preventable infections, over billing, fraud, mismanagement etc. etc. The next step is to hold drug mfgs accountable for bogus meds with only new colored capsules/containers or an irrelevant addition to the formulary to create a “new and improved” product and then charging several times the price of the one being replaced, not doing “apples-to-apples” research with competing drugs as opposed to using just their own with research patients, holding back on negative research until a new product is on the market for over a year and using their “trade off” strategy where this med is know to have problems but is released because the total sales revenues from various applications will be many times what the inevitable FDA fines or legal awards/settlements will be. Test physicians annually and retire those who are incompetent or chemically addicted. Finally, introduce any proven therapy or product from other countries which provides less risk and a better outcome than anything we are currently using. Also, restructure medical schools to focus on nutrition and the whole patient.
Also, restructure medical schools to focus on nutrition and the whole patient.
Yes that had been the strategy decades ago before the government gave the corporations (insurance industry, a license to practice medicine). Now they own medical education. The kids coming out of these institutions don’t know crap. “Physicians” are replaced by “techies” who have had only 2years of training, nurse practitioners, who have had NO MEDICAL training or PA’s. But who cares anyway? (sarcasm). As long as you and your relatives get out of the hospital alive, who care about anyone else.
I know Linda, I live in AZ. It is shameful what they do in Phoenix.
I’m done with all you children. You have gone so far off the subject matter that it’s difficult to follow your logic. Go back to school and take a couple of courses in debating and logic. Yes, I’m on Medicare. When my husband retired in October 1996, we were notified that we had until March 31, 1997 to enroll in Medicare or we would be fined a certain percentage of our income I believe it was. I don’t remember that we were dropped from his former employer’s health coverage, but it did become more and more expensive because of the number of retirees was ever increasing. However, we kept it as supplementary insurance.
You might need to discuss your source availabilities with your local Social Security Office. They are always helpfull if needed.
Just to be clear, there is no “fine” for not signing up for Medicare. You are likely referring to the penalty for not signing up for Medicare Part B (doctor visits, etc) by 3 months after your 65th birthday. You pay 10% more of the Part B premium (currently about $115) for every year you wait. This is to keep people from signing up for Part B once they get sick but it is never mandatory and there is no fine. More info: http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=316
Don’t get so upset. You said you had no faith in Government controlled healthcare, but you have Medicare. Medicare is government controlled and better than any private health insurance. So are Veterance Insurance and Social Security.
I am on Medicare, and I never ever had any problems with it.
Check with your local SS office. They may be able to offer you some alternatives.
You might need to talk to your local SS office. They may be ableto give you some alternate choices.
You May need to check with your local SS Office. They may have some less expensive alternate choices.
I don’t undersatnd why people in the Congress are so angry at the new health care. The members of Congress have one of the best, if not the best health care programs in our country. Why are they so afraid the let the rest of the population have the same coverage as they do? We have been taken care of by military and Medicare most of our adult lives, and have been very happy with it. Maybe people should stop letting their emotions get in the way of commom sense.
It’s easy to say that the pay out from insurance is only 70% to 85% of premiums but for the vast majority of insurers, this is not true. For my non-profit it is above 90%. The real problem with government running anything is : What is their incentive to do better or be more efficient? No increase in pay, and no threat of losing their job. Just plod along.
And yes, people are satisfied with Medicare. They should be; the general tax fund pays 50% of the cost!
Well that’s great that your non-profit has a higher efficiency than the for-profit companies. Congratulations for that – and I mean it seriously. But let me comment on your generalization about incentive – It occurred to me recently that incentive is only for the owners. People who work for a company don’t experience incentive in the way. I’m not saying that the incentive system doesn’t improve productivity or efficiency, but I used the example of Medicare specifically to point out that it is efficient by any measure – Consequently it is unfair to say the ALL government programs are inefficient. I work in private industry and have to say I see a lot of inefficiency there as well. It depends on how the organization is managed and management does not always directly benefit from the profit incentive in corporate structures.
People that work for a company DO have incentive to do a better job: keeping their job and, indeed, getting a raise. Working for the government doesn’t have these same incentives.
As Charles Krauthammer wrote on 2/26/11: “In the private sector, the capitalist knows that when he negotiates with the union, if he gives away the store, he loses his shirt. In the public sector, the politicians who approve any deal have none of their own money at stake. On the contrary, the more favorably they dispose of union demands, the more likely they are to be the beneficiary of union largess in the next election. It’s the perfect cozy setup.” The same applies to government run enterprises. The bosses don’t have any skin in the game. If their subordinates do a good fob, they aren’t going to get a raise and if they do a poor job, they aren’t going to be fired.
While motivating people through fear of losing their jobs works, it functions the same way that draconian laws keep the peace under a dictatorship; it is not the best way to get people to work efficiently. If people tie their work to some greater cause, are happy with their overall work conditions, or simply enjoy their work they tend to perform better and are happier overall.
Mr. Krauthammer implies that unions should not exist. Personally I like the fact that there is a roughly 8-hour work day (usually more) and that on Friday people can leave work knowing they have a weekend to recover from the week – both rights won in hard fought negotiations with unions (coincidentally in Wisconsin a century ago). Unions are not always right or reasonable, but balance is needed against corporate insistence that workers be the ones to always sacrifice.
The wealthiest can sacrifice without threat to their basic human needs. The same is not true for the middle-lower classes. In times of scarcity the wealthiest should do so but I don’t see it happening. Instead they get the lowest tax rates in a century and cry every time someone suggests they slow their vast accumulation.
Unions are the only entities with that can actually negotiate with corporations in an effort to strike a balance in the workplace. Otherwise companies can dictate working conditions which too often works out bad for the workers. I for one do not trust the benevolence of large corporations. There are exceptions, but after watching the way Wall Street greed took the countries economy into the hole and the way BP handled the oil disaster in the Gulf the answer is self evident.
Going back to healthcare – I don’t really care if government workers are hard to fire if they manage their work as well efficiently as Medicare is managed overall, the quality of service is worth it. Finally if the country had universal health care it would relieve a huge pressure from the countries corporations and small businesses at the same time as removing perhaps the most fearful thing in American culture – the idea that as you grow old you will not have the resources or ability to get the medical care you need.
One area where Medicare falls short is the length of time it takes for them to reimburse doctors. The doctors I know as friends say it takes up to 6 months to be reimbursed and that there is a whole lot of paper work which requires another employee to manage. That being said, I don’t think that all government run agencies are inefficient.
I have also talked to doctors getting reimbursed by Medicare. What they told me is that they are incredibly fast, but notoriously precise. If the paperwork is not precisely the way they want it the payment doesn’t come. Could that be what happened to the doctors your are referring to? Because I have actually asked a few doctors and from what I heard they really are fast. I believe that the AMA also did a study that found Medicare pays faster than any of the private US insurers.
Well, to be specific, its reimbursement for dental care for Medicaid patients, not Medicare.Sorry. This information comes from a family member a friend from college who had a small internal medicine practice.
In response to Mary Rumley: I don’t think that’s quite true, If the doctor files the papers correctly, the claim will be paid just as fast as the private insurance companies pay. I get my statements from Medicare and I check them, and never was anything paid “late”. They are really doing a good job. The six month turnaround is just not true.
Heidi
Hi, Heidi, I just wrote about this a second ago. All I know is that “my son the dentist” who, admittedly is new (5 years) says it takes up to 6 months for reimbursement for Medicaid patients. He says it costs him to treat them but he does. (I throttle him if he did not) That is where I get the 6 month thing. He has tons of debt from school and buying a practice so maybe he’s just hyper sensitive to it. Also, I wonder if it is different in different states
It’s just not Medicare. The doctor has to hire people to manage other insurance company policies also. This is just as much as a cost added to the doctor’s visit as any other insurance that needs to be processed for a patient. Insurance will find any reason to not reimburse, requiring extra time to appeal, etc., and payment is delayed.
What an irony that so many of our citizens distrust and ridicule “Our Government” To start with,
I suggest that those people take their index finger and point it towards a mirror. The reflection is
our Government. Secondly, it seems the same people who complain that our Government can’t do
anything right will use vocabulary such as : Socialism, Obama Care, etc etc. If the people are so dissatisfied, just imagine what the ideal could be if all that energy and passion would be directed towards making “GOVERNMENT” better, efficient and working FOR THE PEOPLE rather than for the big corporations. Thirdly, Since the majority seems to be so unhappy it is worthwhile to think that they deserve what they got. We have lost our democracy long ago. We are now run by private money only; and they know how to sugarcoat through very clever advertising and unpatriotic, uncultured and down right evil people such as the Koch Brothers, the Becks on Fox and a few elected officials. I guess the bottom line is the country has been dumbed down sufficiently and they won.
What an irony that so many of our citizens distrust and ridicule “Our Government” To start with,
I suggest that those people take their index finger and point it towards a mirror. The reflection is
our Government.
Secondly, it seems the same people who complain that our Government can’t do
anything right will use vocabulary such as : Socialism, Obama Care, etc etc. If the people are so dissatisfied, just imagine what the ideal could be if all that energy and passion would be directed towards making “GOVERNMENT” BETTER, efficient and working FOR THE PEOPLE rather than for the big corporations.
Thirdly, Since the majority seems to be so unhappy it is worthwhile to think that they deserve what they got. We have lost our democracy long ago. We are now run by private money only; and they know how to manipulatet the public at large by very clever and expensive advertising and unpatriotic, uncultured and down right uneducated fear mongering.
I guess the bottom line is the country has been dumbed down sufficiently and they won.
Why are people in congress so angry at the new health care ? That’s easy, it is upsetting their corperate sponsers. Medicare has it’s problems, but when compared with with the no amount of profit is enough system of private insurance it is one heck of a deal.
WHY do the Republicans hate average people? I can identify with the feelings of the people in the middle east countries who are so angry. Even though the Libyans have education, health care, cheap housing, “pretend” jobs and other things we don’t, they feel intensely unrespected by M. Quadaffi, their ruler for 40+ years. He does not listen to them.
The Republicans listen to lobbyists, very rich supporters, Wall Street, Banks, The Chamber of Commerce. They dismiss the wants and ideas of average people, unionized workers, teachers, nurses, people in need at any level and that includes me. Money trumps human beings in their book.
The only way I can see that they get elected is that the average-income person does not have easy access to information that would help them weigh the political talk we hear from politicians and media. The NY Times is expensive and takes time to read. One can listen to Fox or CNN or networks with half and ear while you’re fixing dinner! Of course, we get what we pay for.
I now call people who belong to the Tea Party TEA POTS and I say they are all empty. That makes me feel better.
Only recently I learned that “rhetoric” is actually a Department at our local university; I’m not sure what they teach, but I guess lawyers and politicians have been required to learn it. They sure fool us with it
I plan to look for more info on rhetoric on Google.
They should have opened Medicare up for everyone. It’s a simple, easy to understand insurance that has worked for many, many years for disabled and retired Americans. Why couldn’t it work for everyone? It’s already established, accepted, and working!! Why complicate issues with all this new healthcare mumbo jumbo that the average person doesn’t understand? And if you don’t want Medicare, you can keep the insurance that you currently have. Plus, with Medicare available for everybody, the insurance companies would be forced to lower the prices on their heavily inflated policies, making insurance for everyone affordable. This just seems like a sensible solution to a long, ongoing problem. I am very happy with Medicare and have never had a problem with payments or finding a doctor that accepts it.
I think that Obama tried, and was vehemently turned down, even by the Democrats. Also his Public Option was turned down, and that would have made all the diffrence.
However, in the end we get what we voted for, and we got it.
I think opening up Medicare as an medigap option is a terrific idea. If I paid my monthly preium to Medicare to help incase of catastrophic illness, I don’t think I’d feel as mad as I do when I see how much CEO’s and board members of Insurance Companies make. Treating Medicare like another insurance company that is truly non-profit (as opposed to “not for profit”) it could supply some much needed competition to Insurers and help lower the price of premiums.
As far as doctor’s not accepting Medicare, well, it IS being talked about amongst the doctors. Several of mine have told me they are not sure what they will do if Medicare cuts back even more on reimbursement. The answer to this is going to be higher priced Medigap insurance.
We who vote retain some control over govt health care. We have none over health insurance companies. They care only for their salaries and perks and not getting caught. (ie Enron, those “Too Big To Fail, et al.) Look at the numbers (if you can find them).
How folks get so fooled into voting and speaking against their own best interests boggles the mind. (advertising? complacency? too much TV? no books? way too much money in way too few hands?) The demise of this “empire” is imminent. We might get willing to learn from the lesser countries as we join them.
I pay $110.50 per month for my Medicare. If you are low income, the premium is paid for you by Medicaid and you get extra help with prescriptions. Part D is around $39., which you don’t pay if low income and your co-pay is like anywhere from $3. to $6. and you have no doughnut hole. Medicare pays 80/20, so you do really need a supplement as your 20% could really add up. However, I am unable to afford an extra supplement, but so far, I have been alright and able to pay. I’m a 61 yr. old disabled widow so I don’t know what will happen, if anything, when I turn 65. Medicare would work for all and it is affordable for everyone. Congressmen, Senators, and the like have absolutely FREE medical, so what do they care if we have healthcare insurance or not? They have the best available and pay nothing, and then fight us being able to obtain decent insurance for our families.
I live in California, and am disabled. I was so relieved when I turned 62, and got a ‘fixed income’ with social security disability. I am now 70.
I was in physically poor shape, and financially as well. I got by, but that ss disability helped me tremendously. My Medi Cal(Medicaid in other states) pays all my dr. fees, all my prescriptions (except for $l or $3 copay for meds.
Straight medi Cal allows me to go to any dr. who accepts it, and the ones I have, all do, even the specialists.
However, I have been informed that some time this year, all Medi Cal recipients will be forced to use an HMO, of which there are only 3, and I am told that Evercare, a Secure Horizons segment, is by far, the only one worth signing up with. I am thankful that because of my ability to see my doctors, and am provided with my needed medication. Life is good today.
I also was told by one of my dr’s that some people who went ahead and signed up already, are very disappointed because they are now stuck with having to make a $35 copay per visit to this specialist.
If they are going to eliminate any co pay help, we (I) for sure, am going to be in deep doodoo. They have already made tremendous cuts including no more dental help. I used to go to an American Indian Center that allowed non Indians to half price fees (which still was quit a bit)if income was below ll00. per mo. They have now reduced that requirement to less than $900 per month. I don’t personally know anyone who is living off the street, and has income of less than $900 mo. The only service Denta Cal segment of Medi Cal will provide is free extraction of a tooth. No wonder I see so many people with no teeth, or only a few. I know it is worse for families with children.
I would like to know when we are going to stand up together united and say we are not going to take living here, in such an unbalanced world. We know what is going on. We know government doesn’t care
about our health. Why should they? They are in their jobs basically because of the money and benefits they get. It must be easy to get used to.
But this is insanity people. We all know what’s what. What is the solution??????? I sign every petition I am sent by health organizations. We can make a difference, I truly believe, if we are all willing to stand together….
However, I have been informed that some time this year, all Medi Cal recipients will be forced to use an HMO, of which there are only 3, and I am told that Evercare, a Secure Horizons segment, is by far, the only one worth signing up with. I am thankful that because of my ability to see my doctors, and am provided with my needed medication. Life is good today.
This is the only part about the Health care reform bill I don’t like. Why should I be forced under another Ponzi scheme, this time mandated by the government the corporations bought off on the bill for health reform with their lobbying, just to make another company rich and get no health care. I am stuck to receive treatment by their sold-out doctors who don’t think but just go along with an insurance company protocol who will just stick with billable diagnosis options for the treatment of your complaints. Why is the government endorsing another Ponzi scheme and economic crisis?
Sure Medicare is a bargain for you: Others (taxpayers) are paying the rest of your true costs. Why wouldn’t you like it. If you got Medicare Advantage (run by private companies but paid by the government), you wouldn’t have to pay the extra 20% and some of these policies don’t cost anything.
As far as Congressmen not paying anything for healthcare, they do pay the same as every other federal employee. It’s not free.
Donald, you must be one of those rich ignorant people.
This I absolutely do know is true. None of the specialists I need to see will take Advantage plans. I went misdiagnosed for over 30 years. I live in a rural area and my Internist did the best he could. I have a rare genetic screw up. I don’t know if a medigap advantage plan is the same as Medicare Advantage, but I would not be able to get help from a Rheumatologist closer than an hour and a half away from my home if I choose an Advantage plan.
I would assume that you are not interested in obtaining Medicare then, Donald, since you don’t want to burdent the taxpayers. I paid taxes all my life; worked since I was 15. I think I am only getting back what I have paid in, which is why it was setup to begin with. Don’t try to guilt me or others because we take advantage of the program. I have read that Congressmen get free healthcare. If I am incorrect, I apologize and I certainly will research that further.
I think the deal with the Federal insurance policy is that they get more benefits for the buck than the rest of us. It used to be “free” if you were only inusring yourself,then you’d have to pay extra for dependents.
Also, my father (who died in ’93) used to get furious that Congress kept raiding monies collected for social programs like Social Security, Medicare and Medicaid. Plus, besides having hands in that till, there was either low or no interest on this “borrowed money”. Daddy used to say THAT was the reason these programs were going to run out of money: Congress raided that cookie jar and didn’t replace the pilfered funds.
Now, after raiding our social security and public health care, Congressmen stand before us and impress on us that “someone” will have to make the “tough” decisions.
I’m also like Catherine. I started working at 15 and did a pretty good job until I turned about 55. I’m on disability and I feel like I gave blood, sweat and tears for those “entitlements”.
I totally agree with you, Mary, with the raiding of the cookie jar! My mom was just complaining about that tonight. They “borrow” from social security/Medicare and don’t pay it back and then expect us to take less benefits and the doctors to receive less pay for the same quality of care. Government employees get up to 75% of their premiums paid for? Add it up!! That’s hundreds of dollars per month per thousands of employees. And Medicare is driving the country bankrupt? I think not! What’s good for some of us should be good for all of us. Just because you have a government job or your in politics, doesn’t mean you get better benefits.
OK, who pays back the money borrowed from Social Security? The taxpayers (us) do. It’s just taking out of one pocket (the taxpayers) to put in the other (those receiving benefits). How does that save the country anything? It’s not like loaning money to a private company and then getting paid back; we’re loaning it to ourselves!
Donald, I’m not sure I understand about taking out of taxpayers pockets to put in Medicare recipients pockets?? The way my father told me the story back in 1980 something (he has been dead for about 20 years) Congress “borrowed” money from SS payments that my dad and company and even myself by then and other boomers while we were young and working and contributing. The cookie jar was depleted for projects OTHER than paying for benefits at that time. Therefore, the money wasn’t safe. Congress debated for a long time about making SS a “lock box” that could not be used but they did anyway funding whatever. Now that I’m an aging boomer, there’s not enough money.
The “tough decisions” that should have been made were that Congress keep their paws off SS. No telling what projects were funded in the past from SS money. It may be that now it is taking money from the tax payer to pay for my Medicare, but I contributed to the system from 1968-2007. That’s a long time. I feel like I’ve earned my Social Security and Medicare.
Did I misinterpret you?
Reply to Mary Rumley below (for some reason this website didn’t give option of replying directly below): You partially misinterpreted me. You are correct that the government borrowed from Social Security in the past and spent it on other things but what else were they to do with it–put it under a mattress (in a “lock box”)? That wouldn’t do any good. Social Security, unlike real insurance, was designed to be a pay-as-you go plan: money collected from workers and their employers would go in the same year to retirees collecting benefits. Retirement insurance takes money from workers and their employers and invests it until the worker retires. The investments grow so that the benefits will be more than the worker and the employer put in.
In past years Social Security collected more money than they paid out but they couldn’t invest it in private companies so they loaned it to the government (i.e. actually to themselves, the government, us). So in future years when the amount collected is less than is paid out (actually beginning this year), who is going to pay back Social Security? The taxpayers, government, us, that’s who! That is what I meant by taking out of one pocket and putting in the other: taking from taxpayers and giving to Social Security beneficiaries.
Medicare is similar except that Medicare was designed to only charge the workers and their employers 50% of the actual cost and the other 50% would be paid out of general tax revenues.
Neglect the statement about website not allowing the reply to be below. Somehow it did get below.
Congressmen do not have free healthcare. See factcheck a reasonably reliable source: http://www.factcheck.org/2009/08/health-care-for-members-of-congress/
Federal workers do not have free healthcare, according to the link above, but they sure have low premiums for the benefits they get. of the cost? Now THOSE are benefits we should all be so lucky to receive.
Sorry. My apologies if I have offended anyone. I think bottom line is I’m scared. I worked hard. I’ve saved money. I’ve lived modestly and put two children through undergraduate programs. Played by all the rules and I’m afraid I’ll loose what little I have because of health care costs. It is frightening.
Catherine, I am on Medicare right now. Sure I’m taking advantage of it. Why not; it’s cheap but that doesn’t mean that it’s good for the country. It’s costing taxpayers so much that it will drive the country to bankruptcy.
What is wrong with Medicare? There are few restraints on benefits. People expect to receive every possible test and procedure. Everyone must agree that if a procedure costs $1 million and has a 1% chance of success ($100 million/success), it cannot be done but Medicare is expected to pay for everything.
I don’t think people expect every test and procedure. I think doctors can get away with ordering them, and making money off them. And as long as doctors fear legal expenses, and insurance companies control how medicine can be practiced, it will continue to be a bankrupting business.
The main reason they order so many is: THEY CAN! Medicare is going to pay for it anyway and it might possibly have some small benefit. It’s no skin off their back. THAT is the problem with Medicare or any other government sponsored plan.
Hi Donald. Sorry I misunderstood you to be putting me down for being on Medicare. I do understand the few restraints. I myself, will not do any unnecessary testing for anything as I can see that they are just “milking” the system. My father was almost 85 and in the hospital w/congestive heart failure, diabetes, and dying, and they insisted on taking him down for a bone density test. What the heck? Of course his bones were brittle! He was over 84 yrs old and what did it matter? He was dying and so uncomfortable. It was not in his best interest to drag him down for testing. We argued and fought w/the staff but lost. What a waste of money for Medicare that was and it is done all the time. There should be limitations on testing but who is to set these? I don’t claim to have any answers; just questions. It would just seem that a healthcare system setup as simply as Medicare would work or perhaps that is just my hopes.
Catherine, do you really believe the government can set limitations on tests and procedures? The public will come down hard on any limitations for non-medical reasons and the government will succumb as they already have in the case of maternity hospital stays, mammograms, prostate tests, etc. The limitations must be written into insurance contracts and people can pay for them or not as they choose.
This is totally true. If Medicare is not billed EXACTLY the precise way that they want it, you will have the paperwork bouncing around forever. I just got a bill last week for an office visit from two years ago; billed incorrectly. And yesterday, I got a bill for a CT scan from Oct. Again, billed incorrectly. The hospital that did the Oct. scan has not even sent me a bill for my co-pay which tells me that they too, have billed Medicare incorrectly. Whenever I go to see my lung doctor or my primary, they are paid that month and I am billed for my portion. So the rule here is to bill correctly the first time around and Medicare will pay the bill promptly if you do it right the first time around.
When we have what our elected officials have, that is, affordable health care, then the two-tiered system, and all the screaming, can stop. Until it is fair across the board, the current elected “officials,” so many of them in the pockets of insurance companies and special interest sponsors, are showing us they could care less about governing, and more about obstruction. I abhor the current stance of the Republicans, and am sorry so many voters acted against something in the last election, and not for progress. We are in dire times.
The only reason it is “affordable” is that someone else is paying for it! In the case of Federal employees or Medicare (or Obamacare in many cases), it’s the taxpayers that are paying. Wouldn’t it be fair if those people receiving subsidized care receive a basic level (perhaps through government clinics) and those who want to pay more either through insurance or their own funds could receive better plans.
There is alot of controversy on what Medicare should or should not pay. In the case of testing such as mammograms, pelvic exams, prostate, or colon cancer, is it right to not pay for these tests KNOWING that the poor and the elderly won’t have them done as they don’t have the money for these extras? These are life saving tests that are necessary and when I was working and paying into the system, I certainly didn’t begrudge anybody on Medicare having them done and still don’t. I don’t take advantage of Medicare or anything else that the government has to offer; nobody should.
Hi again Mary, Medicaid is not the same as Medicare. Medicaid is usually run by the individual States, and in that case, your son might very werll be right.
I can imagine about the cost of getting his degree. It’s tough. I have a grandson who also wants to be a dentist. He is starting college this year. God help us. I hope he gets lots of scholarships.
Have a great day.
Heidi
Thanks for the information, Heidi. Good luck to your grandson. If he can get into a dental school, they will provide the financial aid, at least that was the policy with my child. UNC, NYU, U of Michigan, U of Louisville, ?? that’s all I can think of but each offered a mix of a various scholarships, various sorts of loans, etc. If you can get accepted to a school, they’ll help with loans. Many of the loans could be paid back if the student went to practice in an underserved area for X years. It can be done if your grandson wants it badly enough…And if he truly does want to be a dentist or doctor, don’t give up if a particular school doesn’t accept him. Go to another school OR go to the desired school and get a job in the dental school. He’ll wind up with great experience, good references, and probably published research. Just some ideas.
Like you said, God bless us. I am afraid we will commit the ultimate sin: need our children to help us when we hit our 80′s.. depending on our very modest investments. It is all very frightening. And like I always used to say “Peace”
I think doctors order so many tests to cover their rears in case of malpractice suit.
Mary, that is part of the problem but perhaps a bigger reason is that THEY CAN. Insurance is going to pay for it anyway and there might be some small chance that additional tests might be of benefit. Why not order them? It may not be cost effective but so what. Everyone must agree that if a test or procedure costs $1 million and has a 1% chance of success ($100 million/success), it can not be done but where is the limit? Present plans (including Obamacare) do not address this.
That’s right, federal workers pay less than most people for insurance because WE (the taxpayers) are paying the rest of the cost. As the present system (and Obamacare) works, the only way healthcare insurance is affordable for everyone is if someone else (taxpayers again) pay some of the cost. The only way to really lower costs is to reduce the number and cost of tests and procedures. I don’t think the government has the stomach for that.
If Medicare Advantage is so great , why does it cost Medicare from 14 to 19% more than traditional medicare? If anything will bankrupt Medicare it is the advantage plans. If these insurance companies can provide coverage for people at a premium equal to the Medicare premium ,why don’t they just offer Advantage plans for everyone? They are getting more taxpayer money that we don’t know about.They aren’t telling Americans everything about Medicare Advantage. Why do insurance companies charge 3 to 4 times as much as Medicare costs us for Medigap plans that only pay the 20% Medicare doesn’t pay?
Medicare has worked very well for my wife and I. I still pay income tax and even on a portion of my Social Security . I have no qualms if a small portion of my tax goes to support Medicare.
I think the only problem with Medicare and other programs is that they always try to do them on the cheap. They are almost always set up to go in the hole very quickly so they can be done away with. As an example if Medicare could be provided by a $10.00 contribution from a workers weekly paycheck , they set the cost at $8.00, where if they set it at $11.00 per week it would grow a surplus over time instead of going in the hole. Its just like the Medicare drug plan , they underfunded it from the beginning and they knew it.
Another thing , it was not the taxpayers money they took from Social Security. It was the workers who contributed to Social Securitys money. They did not borrow taxpayers money. They should have increased taxpayers rates to cover their spending instead of using Social Security money. They just don’t want to make the hard choices to put the Social Security money back. They want the people who contribute to Social Security to pay again. That is wrong.
Medicare Advantage plans cost Medicare more because they offer more: lower copays, no deductibles, and other benefits like vision care, health clubs, etc. They could offer more than Medicare at the same cost because there is competition between insurance companies whereas there is no competition in Medicare.
Medicare premiums don’t pay for most of Medicare. Most is paid by a combination of the portion of FICA going to Medicare plus the general taxes. That is why Medigap costs more than Medicare: Medicare is mostly paid by someone else (taxpayers) while Medigap is only paid by the purchaser.
What is to be done with any surplus paid into Medicare? Put it under a mattress (lockbox)?
You are right, the money borrowed from Social Security came for workers who contributed to Social Security but, of course, they are also taxpayers. So the left pocket is Social Security and the right is taxes. Money is borrowed from the left pocket and paid back by the right pocket. Does anyone gain from this?
Yes Social Security contributers are taxpayers, but all taxpayers are not contributers to Social Security. You ask who gains from borowing from the left pocket and paying back by the right pocket . The question really is , who loses. The answer is very simple . The people who have paid into and are still paying into social Security. It is their money , not the taxpayers . If the government (taxpayers) don’t put the money back , it is stealing.Where else can you borrow money, without permission , and then refuse to pay it back. I , or anyone I know , has never had a deal like that.
As for Medicare paying more into Medicare Advantage plans . they should not pay one penny more for a person enrolled in an Advantage plan than they do for a person on traditional Medicare.
You will never convince me that Medicare Advantage plans cost less because of competition. They are getting much more money from the government than anyone is telling. There is no way Medicare advantage can provide the level of service as traditional Medicare.
They are no different than other insurance plans . Theycut services or coverage and limit which Dr’s you can use . They , just like you , consider money , the most important thing , and they will do anything to make a profit, and they are using funds from Medicare to do it.
The only ones who should make a profit from healthcare , is Dr’s Nurses , other healthcare workers and technicians , clinics , hospitals etc. The money people pay for healthcare should go for healthcare , not insurance co’s and stockholders.
Donald A; I don’t know if you will make it back to this blog or not, but I feel a great need to interject here and in several of your previous posts pertaining to federal workers (and Obamacare). The reason ALL federal employees — which includes Congress & the Presidents — pay less than most people NOT because taxpayers pay the rest but mainly because they are the largest pool of insureds in the country. This large volume of insureds qualifies for deep, deep discounts from the insurance agencies. And let’s not forget that federal employees are taxpayers too.
As I see it, Medicare For All, or a plan similar to the Feds plan, is the best alternative there is, but only IF everyone pays a premium. This will create an even LARGER pool of insureds the likes of which no insurance company could deny the best possible discounts or coverage.
Earlier, you stated that Obamacare does NOT address Medicare waste or abuse. Please note the excerpt below, taken from page 5 of
prescriptionforchange.org_affordable_care_act.pdf. Note last Paragraph:
Medicare Changes
Medicare is our nation’s health-care program for seniors and people with disabilities, funded with taxpayer dollars. Some 36 million Americans are covered by traditional Medicare, and 11 million more are enrolled in private Medicare Advantage plans, which receive federal funding. About 4 million Medicare enrollees will fall into the “doughnut hole” in 2011 because they had drug expenses over $2,530.
How it works:
• No-cost preventive services: Traditional Medicare beneficiaries no longer have to pay any out-of-pocket costs for preventive services such as mammograms, colonoscopies, immunizations, and annual physical exams.
• Drug discounts: If you fall into the “doughnut hole” and have to pay full price for your drugs, you will get a 50% discount on brand-name drugs and a 7% discount on generic drugs in 2011. These discounts will increase each year until the doughnut hole is completely eliminated by 2020.
• Better pay improves access to primary care providers: Doctors, nurse practitioners, and physician assistants will receive a 10% bonus for providing primary care. General surgeons in underserved areas will also get a 10% bonus.
• More resources to fight fraud: New rules go into effect to keep bad medical providers and suppliers from participating in the Medicare system, and new resources will beef up enforcement against those who abuse Medicare waste and abuse.
Deborah J, I believe there are several logic errors in your analysis. You say that the reason federal employees pay less than other people is that the pool is larger rather than the employees pay a lower percentage of the insurance. What percentage do the employees pay? I believe it is less than employees of private companies pay. That is the main reason the federal employees pay less. As far as economy of scale reducing costs, this can only go so far. Administrative costs can not be reduced to zero. My non-profit has less than 10% administrative cost so that is the limit there. The major costs are for the providers, doctors and hospitals. They can only be reduced to the point where they can stay in business. My non-profit bargains them down by 30%-50%. (For Medicare and Medicaid, the providers make up the difference by charging more for private insurers but that can’t be done with a single-payer plan because there are no private insurers.)
You are in favor of Medicare for all (a single payer plan) or the federal plan for all but these are two different concepts. Medicare for all would not have any competition between companies to result in discounted costs and would not result in transferring costs to private insurers because there wouldn’t be any. A federal plan for all would not result in any significant discount because those are already being achieved by some private insurers today.
Under your “Medicare Changes”, most of those listed will increase costs to the program, either to the government or to the people. It is all well to talk about fraud and abuse but that could be undertaken with the present system. The main cost reductions can come about by limiting the number and costs of tests and procedures that are performed and Obamacare does not address these.
Hey guys, I’ve been ignoring ya’ll because I try to keep myself from getting depressed.
Food for thought that shocked me. Even the employees at Blue Cross Blue Shield of NC have to pick a plan and pay for some of it. It isn’t free and that is for an individual, not even a family. Our state used to pay for state employees only but it got pricey when you added family.
Point is, I think Federal Employees need to cough up some of the premium.
Also, I think all fed grants should be ended and that money given back to “the people” so they can decide what causes they wish to support – or not. I wonder how many dollars go to grants. All of those causes could be created and funded on the local level, grass routes causes. I feel sure there would be people supporting public radio and TV, I would. Besides that, they could market all those Sesame Street items from dolls to books.
Anyway, its just an idea. Oh yea, no tax dollars for pork. No trading votes for local benefits that translate into votes.
OK, pick me apart if you wish. Mary
To Donald, Mary, Deborah and all those taking part in this amazingly long dialog I have been following on and off through emails from CU, I send my greeting and offer my own comment.
I think it is very important to separate out the function of insurance from actual providers of medical services and supplies. The latter forms a very complex topic involving service by service analysis, competitive drug pricing and so forth.
It is obvious that economies of scale can be applied to commodity drugs in the hopes of decreasing costs – harder with highly specialized and less popular medications. It’s more complex with services; highly specialized procedures, complex operations, advanced testing and so forth are commanding unbelievably high prices where day to day services such as well-care, family physicians and so forth are being cut back a lot.
I am not one to say that someone who spends 8 years getting highly specialized training using some advanced technology (robotics etc) should not get his fair share for sacrificing so much time in achieving a high level of expertise. But as a country we are truly in a time where shared sacrifice is needed, and those at highest earning levels in the medical earning spectrum need to sacrifice as well – or be scrutinized in order to reach a level of fair and reasonable compensation, so that the less compensated areas in the medical profession can have their incomes increased. (I am thinking about family physicians, pediatricians and many other doctors who are overworked and underpaid for what they do.)
But insurance is another story. Sure it is complex. But at the end of the day all they do is take money in, in the form of premiums, and pay money out for services and supplies.
I know they have actuaries, people evaluating the markets, all kinds of money management, but that’s part of the insurance function – their overhead. They also have a lot of power to effect the markets -what doctors get paid; and even control over what medicines we can receive.
Short anecdote: recently changed insurance companies – I am a few years from retirement age. I have been taking lipitor for years. I went to refill and the insurance company said no – must go to a generic statin.. OK I’m willing to do that, but it feels weird that my doc’s recommendation is being overruled by a company that doesn’t know me at all.. Maybe it’s fine, but as I said it feels strange that someone who is not my medical provider has a say over my medical care. But that will exist whether the insurer is private or it is Medicare simply because the available pool of money is limited and it is the insurers job to keep the costs down in order to stretch the available revenues as far as they can. There is an interested on their side in keeping costs down while pharmaceuticals and specialists seem to be trying to charge a premium.
But from an insured’s point of view the most important thing is the pool of money the insurer has available to pay out and that’s where Medicare stands out. The money available from the Medicare pool is much larger as a percentage of revenue, than the money available from a private insurers pool simply because Medicare has a lower overhead. All the other insurance stuff is the same: The insurers fight the medical providers to lower their prices while the medical providers try to keep them up. Essentially from a functional point of view, private insurers do the same thing as Medicare.
So the question is as a recipient of insurance which would you rather have – an insurer that pays out 75% – 85% of the money it takes in, to be paid out to Medical providers, doctors, drugs etc, or an insurer that pays out 95% of the money it takes in as a premium for the same purpose. From this point of view the answer is rather obvious: Unless you have some special interest in private insurance, Medicare is the far better deal.
The idea being proposed by congressman Paul Ryan that the Medicare premiums should be converted into vouchers for private insurers would have the effect of directly decreasing the net value of your premiums by somewhere between 10% to 20%. Practically speaking such an action would have a extremely deleterious effect on medical coverage for seniors.
So I apologize for my long post but the discussion was interesting enough that I wanted to add in my 2 cents. Be well.