ObamaCare - Page 3

Blitzen,

I am surprised that you like the Medicare Advantage program.  Isn't it privately managed by pretty much the same insurance companies that also offer the supplemental plans?.  Now may not be the time to switch from original Medicare to Medicare Advantage since it is unknown if it will continue under Obamacare.

The Alzheimer's test is part of the much touted "wellness exam" for Medicare recipients in our area over the age of 75.   Also my husband has to answer a series of questions that may be very helpful for some, I will readily admit, but are totally inappropriate for someone with his medical history and level of activity.  So he goes to the doctor, draws a clock face and positions the hands at 10 minutes to eleven when asked, then goes home and beats the computer at chess.
I am sure that the system works pretty well in more populated areas -- but not in less populated areas, where the economies of scale that make the system work pretty well in large cities just don't exist.   Any system will have its' pros and cons, I am just saying that the new system will impact my family pretty heavily. 
Yeah, Michado, we could go to a CTCA, and probably would if we had to . . mostly we try to avoid that by staying fit, not eating junk food, stuff like that.  Also I hear that having a dog lowers your blood pressure -- not sure if our active boy, Radar has gotten the message!

Micaho - "The theory there was that if a patient "pays" for his care, he will be more discriminating and that would somewhat control unnecessary expenses. And then competition would bring down prices."

Let me first say that I am diametrically opposed to socialized medicine, in any form. My view of the healthcare problem finds me in a place where I struggle to find viable solutions to negative effects of capitalism on healthcare. I suppose I view healthcare similarly to how I view big oil. I can either buy from Exxon Mobile, Chevron, BP etc, where the price fluctuates by a few pennies. Bottom line, competition doesn't keep the prices down, because much like medical treatment, I need the fuel regardless of the price, and they know it. Because I don't look to government to solve all society's problems, I do not support additional government regulation in these scenarios, as government (all government for all time in all societies) has a pitiful economic track record when subverting private industry (why Obamacare won't work). There is a difference between free market, and a form of capitalism which absolutizes captital above anything and everything. Sure entitlements are driving costs, but the face of those depending upon entitlements is rapidly expanding from those who are simply lazy, to those who simply cannot find work, or cannot find work that can cover these types of expenses. Don't believe the unemployment figures reported on tv, as they rarely reflect either U5 or U6 representation, which are indicators of under-employment and also of those who have fallen off of the map altogether. Consider, "“Between 1979 and 2007, average after-tax incomes for the top 1 percent rose by 281 percent after adjusting for inflation — an increase in income of $973,100 per household — compared to increases of 25 percent ($11,200 per household) for the middle fifth of households and 16 percent ($2,400 per household) for the bottom fifth” (Sherman &Stone 2010). So now, our lopsided economy continues to create more who cannot pay, than those who are able to pay. Greed; if we don't reel it in ourselves, it will likely be done for us, in some form or fashion.

Proposed Medicare Advantage Cuts Reversed -- Obamacare's Cuts Remain

By  Patrick Brennan
April 3, 2013 7:00 AM
Comments
11
 
 

Yesterday, the Centers for Medicare and Medicaid Services (CMS) announced that it would be reversing some of the cuts to Medicare Advantage scheduled to be implemented in 2014 — specifically, instead of cutting per-person reimbursement rates by 2 percent next year as they’d proposed in February, CMS will increase them by about 3 percent. This doesn’t, however, have any effect on the health-care reform law’s long-term plans for the private program, which will slowly cut Medicare Advantage’s funding to the levels of traditional Medicare, pushing customers into the latter program. This week’s reversal means that some of the more dire immediate predictions for Medicare Advantage beneficiaries aren’t going to come true, but doesn’t change the program’s long-term fate, which includes about $150 billion in cuts to the expected rate of growth over the next ten years — and more.

Medicare Advantage (technically “Medicare Part C,” I’ll refer to it as MA) works by providing payments to private insurance companies — either HMOs or similar organizations, or private insurers that work on a fee-for-service model, like traditional Medicare — on behalf of seniors to provide at least the same coverage as Medicare. Roughly a quarter of seniors pick the plans, which tend to be more attractive to beneficiaries who don’t mind being limited to a certain network of providers, or who would benefit from having additional services, such dental, vision, or prescription drugs, covered under their single Medicare insurance plan (it replaces Parts A and B).

Why did CMS propose such a significant cut in its payment rates for MA insurers in the first place? President Obama’s acting CMS administrator gave two answers to the Washington Post’s Sarah Kliff when the cut was announced in February: “Part of it is a direct effect of the slowdown in spending, and part of it is open to comment and feedback and for us to take a look at it.” Since the announcement, obviously, the former hasn’t changed, but there has been plenty of “comment and feedback.” Especially of the sort that matters: From lobbyists, to politicians and bureaucrats. Today’s change has been hailed as a colossal victory for health-insurance lobbyists, who worked extremely hard to reverse these potentially devastating cuts (including lots of advertising –in addition to TV buys,  to take one example, for two weeks, March 3 to March 14, the subject line of Politico’s main morning news e-mail read “presented by the Coalition for Medicare Choices”).

So, when the announcement happened at the end of the day yesterday, here’s what happened to the publicly traded insurers that do the most business with Medicare Advantage (according to Avik Roy):

Michado, I don't spend a lot of time worrying about what might happen. If I've learned one thing over my lifetime it's that most things we obsess over never happen. If medicare advantage tanks and if I'm still around, I'll do what 75% of retirees currently do, pay for a supplement that will help cover what Medicare won't. Why should I not like medicare advantage? I pay zero, get a few hundred a year for eye and dental care, can schedule my own mammogram, pap, eye exams, chiropractic adjustments, get my toenails cut, can join a health club free, get some generics free,  and a few other things I've forgotten. No jumping through hoops, no scheduling via a doctor. Humana pays for it all as long as I use one of their hundreds of providers.

The Humana drug plan is better than I had when my husband worked for Harley. When he retired after 30 years Harley we lost the drug plan and HD upped our cost for their supplemental BC/BS from around $200 per month to almost $600 with the promise of another increase on the horizon. We save around $800 every month with medicare advantage, get the same level of care we got from BC/BS, maybe better.  Humana encourages wellness visits, doesn't rain bad news about Obamacare down on us trying to make us think we are going to croak because of it .Other than winning the lottery and not needing any more "entitlements - another misnomer" what could be a better deal for a retiree? Even those who don't need it still take it, don't they?

Carlin, you have said a mouthful about American greed. Just down the road, Tarpon Springs, is a huge home that just sold for 7M. It was once owned by an NBA player, asking price 12M. The new and still unidentified owners are currently adding to the 12,000* square feet of living space. It looks like Motel 6 on steroids. Not a day passes that the local newspaper doesn't have a horrible story about the growing population of homeless in Tampa. It make me sick to think how many of those lost souls could be helped to have a decent life with the money that has been and will be spent on just this one house. Tampa is a great example of the disparity in income that is robbing so many of opportunities. also a great example of American greed. There may have been a time when America was the land of equal opportunity for all, not anymore.

*Edited - Correction: make that  26,000 sq ft, the selling price was 8 M and improvements estimated to cost over $1.5M including a mile long 6 foot high cement block wall.

I agree, Mindhunt, and would add that even those with adequate insurance are also at risk if the insurance providers are allowed to continue status quo.   I don't know either if OC is the answer but doing nothing isn't working.

Its not good enough for the legislators who voted it into law, but its good enough for the rest of us turds, eh? 
Medicaid and MediCal have always been available to people who cannot afford medical care or insurance, welfare available to families with dependent children, food stamps, and not drug companies underwriting prescription medications for those who need it and are willing to apply for it. Under Obamacare the quality of care is doomed to drop to shocking levels. I, for one, cannot afford ObamaCare, let alone private insurance. If my ex brother-in-law wasn't a doctor I would have no health care at all. Guess I'd better stay healthy. 

Why can't you afford Obamacare, Shelley?  If you have no heatlh care now, how is Obamacare going to make it worse for  you?