Obamacare Already Starts Collapsing Into Medical-Industry Feeding Frenzy

[eridani]

http://www.opednews.com/articles/Obamacare-Already-Starts-C-by-Eric-Zuesse-130406-33.html

Part of the Obama Administration's promise to the American people regarding Obamacare was that the enormous waste in America's medical expenses would be reduced. The reversal of that promise has already begun, with the Administration's announcement, on April 1st, that it will increase, instead of (as had been promised) decrease, taxpayer subsidies to private health insurance companies.

<snip>

On 14 March 2012, the Journal of the American Medical Association, headlined "Eliminating Waste in US Health Care," and estimated that the waste amounted to somewhere between 21% and 47% of the total U.S. medical expenses, mixed public and private.

One of the most wasteful parts of the entire system now is Medicare Part D "Advantage" private supplemental insurance plans, which are heavily subsidized by U.S. taxpayers, and yet, on average, still are costlier to Medicare recipients than is the government-run Part B program. On 25 July 2008, the Los Angeles Times bannered "Medicare Part D a Boon for Drug Companies, House Report Says: Taxpayers pay up to 30% more for prescriptions under the privately administered program" than under the publicly administered one, and Nicole Gaouette reported that, "U.S. drug manufacturers are reaping a windfall from taxpayers because Medicare's privately administered prescription drug benefit program pays more than other government programs for the same medicines. ... In the two years Medicare Part D has been in effect, drug manufacturers have taken in $3.7 billion more than they would have through prices under the Medicaid program." For example, "Bristol-Myers made an additional $400 million from higher prices for a single drug, the stroke medication Plavix."

[hobbit709]

1. I never expected anything less from the Health INSURANCE plan instead of a health COVERAGE plan.

[valerief]

12. MEDICAL insurance plan. Has nothing to do with Health. nt

[Carolina]

67. exactly, it was a sellout plan from the get go

with a few bones (e.g. the donut hole fix) thrown in for some people.

And don't you just love the name: The Affordable Care Act...

[eridani]

3. You'll find out whether the plan is any good when you or a family member gets expensively sick

Your odds for that are 15 out of 100. Four years after Romneycare was enacted, medical bankruptcies are STILL 50% of all bankruptcies. Elimination of lifetime caps is great, but insurance companies can still impose yearly caps.

And will people ferchrissakes STOP confusing insurance with care!

If you are between 55 and 64, you have a pre-existing condition that will triple your premium--your age.

[bvar22]

22. Gosh, graham4anything,

with the numbers you are posting,
you must be pretty well off.
You are "saving" more per month than some of us are making.

You would be better served having some compassion for those of us struggling to make ends meet, than gloating about how much you are "saving".

One of the problems I had/have with the ACA and the Mandate is that, like Cash for Clunkers it appears to have most helped the Upper Middle Class, while forcing the struggling Near Poor even further in the hole.

I guess I should be happy that You got YOURS,
and I'll put it on my list of things to do today.

[graham4anything]

23. that is so untrue. The old healthcare was bankrupting us

but it's russian roulette if you have none, so we stuck with it the last decade or so when it kept going higher and higher.

Anyway you cut it, its a 57% in my pocket savings

as it is for SELF-EMPLOYED FAMILIES regardless of whether or not one can afford it

[bvar22]

27. Medical Bankruptcy will STILL be Big Business in the USA,

even after all the provisions of the ACA are enacted,
probably even BIGGER business as the Mandated "Bronze" plans are used in attempts to access actual Health CARE.

Do you mind citing the specific provision of the Affordable care Act that changed existing law to enable you to secure such profound savings.

I have read the whole act, and remember nothing that would provide for the savings you are claiming.

[graham4anything]

29. Jeb Bush will surely get you what you are looking for. Or Ron Paul/Dennis Kucinich

I hear the two are teaming up according to a post someone else wrote.

It goes to show this Paul/Kucinich meet-up.

Someone the other day was posting about something like it, with someone like Kucinich on the left teaming with the Right. Like going around the block and bumping into each other.

And now it turns out, it is going to happen if that article another poster posted is real.

[bvar22]

30. Did you overlook my request?

Would you please cite the specific provision of the Affordable Care Act that changed existing law and allowed you to access those incredible savings?

There is a possibility that you were blindly overpaying your previous Insurance Company and achieved your savings by merely shopping around.

So, help us all out here and tell us what the ACA changed in your particular case.
Most, if not all, of the cost saving elements of the ACA won't be enacted until 2014.

[graham4anything]

31. we COULD NOT change plans any year prior to this year. Preexisting stopped it.

This year, NO ban for preexisting so we could change. Last year we couldn't
It really is quite simple.

and btw

you just now said most states it hasn't started yet
So your other is hyperbole as it is not due to his plan that it has gone up

Insurance rises 15% each year for decades, so you cannot blame the past before this year and next

[bvar22]

38. Please go back and re-read my post.

I said:
[font color=blue]"Most, if not all, of the cost saving elements of the ACA won't be enacted until 2014."[/font]
That IS an absolutely TRUE statement.

But there is something troubling about your claims and counter claims.

You stated that the "Pre-Existing Clause" is the reason you were able to save so much money from your previous insurance company.
But this statement could not possibly be true.

Under the old rules allowing Insurance Companies to exclude coverage for those with pre-existing conditions, you would not have been able to purchase ANY Health Insurance at all.

So under the already enacted clauses of the Affordable Care Act, you CAN now purchase Health Insurance for the FIRST time.
So, how is it you are bragging about all the "Savings" form your previous Health Insurance Company all due to ObamaCare?

There is absolutely NOTHING in Pre-Existing Conditions Clause that legislates Lower Prices for anyone.

Can you explain this contradiction?
Inquiring Minds want to know.

[graham4anything]

40. no contradiction

I was with Aetna
I couldn't leave before this year because of preexisting, which the same company last year refused to cover last year so we were forced to stay with Aetna

This year the new company took us without question, and that includes the preexisting, so we are covered.

12 months ago, this was not possible

So now all preexisting are covered. Last year they werent.

One company and another company
Two companies(different)

two different years

new law now allows us to change no matter the preexisting.

What point would it make to change to a company where anything preexisting was not covered? That would be pointless as it would entail any/all

Now long as we pay monthly premium(like any) we are covered forever.

(we were covered forever on Aetna, but only at the price of "A" with nothing cheaper.
If we wanted D on Aetna this year it would be like $9000 a month on Aetna.

On HorizonNJ, we are C. C on Aetna would have been probably double of A(which was $3100 a month).

[bvar22]

41. You're one of the very fortunate ones.

Most of the people with Pre-Existing Conditions that I know
can't afford the Buy In for these rather pricey plans.

They can't be excluded because of their Pre-Existing Conditions,
but ARE excluded because they
aren't wealthy enough to come up with the front money.

Good for you!

[graham4anything]

42. You gotta do what you gotta do

But we wouldn't have been able to keep the other one any longer, so it was luck that it happened at all.

To be honest, I almost didn't even bother looking thinking it was hopeless, my wife did the homework. I had taken it for granted that it would be next year
Of course it should be alot cheaper for everyone, no one says it shouldn't.
BUT, it also has to include doctors, they are not innocent either.

And there still has to be some way of paying for everyone, and someone somewhere is not going to like it or be able to afford it.
After all, it just isn't really free unless we truly go to a REAL socialist system or really raise taxes on everyone, because one can only tax the rich so much til there is nothing left, but 300 million people more to insure.

BTW, one must also then think what about all the employees of all these companies
Where will they find work? Those are 9 to 5ers.
Other countries have had their system for years. To start a brand new one at this time, how do you even go about it quickly(assuming it could get passed,which still will take many cycles til it happen?)
It cannot happen from one day to the next.

[bvar22]

48. We're cool.

I don't begrudge anyone for taking advantage of the cracks they can slide through.
I will be doing the same myself, intentionally holding down my "taxable" income to qualify for the Medicaid expansion in 2014.

I do find it crass to brag on DU about taking advantage of a provision
that is a HUGE gift to the Very RICH and Upper Middle Class Americans with enough wealth to take advantage of this narrow loophole.

This is NOT available to the millions of struggling Americans who can't afford the Buy In for this exceptional privilege,
but reading your posts on DU would seem to promote the idea that this was a gift to everyone.

It wasn't.

[JimDandy]

54. Thanks for being persistent and clawing that out.

I kept reading each of his posts and wondering how the heck he was able to do that.

[Dragonfli]

55. That took two bags of virtual popcorn but it was well worth it

you were on your game (graham cracker is below your weight class, but he chose to enter the ring)

Graham's performance was a bit disappointing, not because I expected a good argument, but his word salads have become a favorite of mine and the ones in this subthread, just don't live up to the quality of performance art I've come to expect. This installation, although interactive as usual, will not be remembered as his best work, or memorable art.

[eridani]

61. The act of not taking advantage of a privilege you have does nothing to gain it for others

That would be like straight people getting divorced to support marriage equality. Much more useful to phonebank for Referendum 74 (which won in WA State last year). What you are justiflably asking here is that he take all the straight phonebankers for Ref 74 as role models.

[riderinthestorm]

49. Actually that aspect of the insurance about PEC's doesn't start until January 2014 (for adults)

The insurance companies until then can certainly still deny (and DO still deny) those with pre-existing conditions AND can charge anything they like with the premium.

That you were able to switch AND get a cheaper rate is weird because I've tried a few times already (my husband has a serious PEC) and been denied 4x in the past 24 months).

While I'm glad for you (sad for us) that you were able to do so has nothing to do with the ACA.

Yet.

[magical thyme]

4. Actually, Reeve used up his lifetime cap in 1+ years, not 1 week.

Last edited Sun Apr 14, 2013, 06:17 AM - Edit history (1)

And yes, due to his position in life he was able to continue living at a retrofitted home with round the clock care, as opposed to ending up in a state nursing home as would happen with most of us, insured or not.

The amount you are *saving* on insurance happens to be more than many of us earn in a year. We will be forced to buy insurance that, even with subsidies, we very simply cannot afford. So we, the very poor, will be in effect subsidizing the 1% health insurance industry.

In the meantime, my experience when I did have insurance with the the best HMO at the time, Harvard Health, was to be refused a single diagnostic test, told my 20% weight loss and other symptoms were "all in my head" and left to die when I was clearly very ill. It turned out I was septic and my dentist saved my life, and not with dental insurance, either.

I'm really glad that Obamacare is saving you $19,000/year. That is more than I earned last year working at 2 part time jobs. In a couple years I will be forced to shell out over $1,000 of my meager earnings for either fines or insurance in return for which I get nothing.

Sorry, but your love of Obamacare is coming at my expense and I frankly do not fucking appreciate it.

[RedRocco]

7. wish we could rec individual posts

[Dragonfli]

56. Agreed

[idwiyo]

8. K&R (((hugs)))

[zeemike]

10. Yep...that savings is more than I live on.

And I have medicare...but can't afford the co pay for most things...and can't afford the expensive drugs I am supposed to be taking.
But I guess we should be happy that some people are making out and are able to afford insurance that saves them money...but it sure as hell not poor people.
But let's face the facts....poor people need to die, so they won't be such a drag on the rich.

[Bluenorthwest]

11. "I never imagined politics would get in the way of hope." - Christopher Reeve

Rather than preach at the crass display of bogus misinformation offered up thread, let me simply post a link to the Christopher and Dana Reeve Foundation and in specific their page for activists.
"I think a hero is an ordinary individual who finds
the strength to persevere and endure in spite of overwhelming obstacles. They are the real heroes, and so are the families and friends who stood by them."
-Christopher Reeve

http://www.christopherreeve.org/site/c.ddJFKRNoFiG/b.4426041/k.4255/Reeve_Foundation_Action_Network.htm

[graham4anything]

24. Cool post.

[HiPointDem]

39. +1

[woo me with science]

57. Thank you. nt

[Cal Carpenter]

17. "So soundbytes aside, this is a great thing. "

So, people who still can't afford health care are soundbytes to you? Millions of people who will slip through the gaping holes in this legislation are merely soundbytes? Since you got yours, no one else matters?

Billions of dollars being funneled into insurance company *profits* at taxpayer expense is a soundbyte?

When everything is reduced to rhetoric, it is no wonder the political debate is so absurd in this country.

How easy it is for you to dismiss and degrade people who actually struggle under our system and will see no relief under Obamacare.

How easy it is for you to discount the real conditions and real results of policy because you already got yours.

What lack of compassion.

[Rex]

60. Ya that one had to be self deleted.

[FreakinDJ]

5. 5-10% annual increases, 25-30% profit margins for stockholders and overpaid CEOs

whats not to like about it

[graham4anything]

26. Is the price of milk that the milkman delivers still 3cents a glass bottle?

[progressoid]

51. That allegory is

well, nonsensical.

[eridani]

62. The price per capita that the civilized world pays for health care is half what we pay

And they are dealing with the same increase in expensive high tech treatments that we are dealing with, and often their populations are even older on average than ours.

[graham4anything]

64. And? So it is in Cuba.

[eridani]

65. WTF does Cuba have to do with anything? Their system costs 5% of what ours does.

I was referring to developed countries in Europe and Asia, which pay half of what we pay.

[graham4anything]

66. Which country in Europe? Greece? France? Italy? Austria? Germany?

BTW, Asians actually have the actuary number raw demographical statistical longest life span
of 80.
Why?
Because of wellness.

I don't hear many in the Asian community in the USA complaing and whining.
Yet, they are the ones directly affected most by SS, as they live the longest after 67.

Most minorities only live to 70 according to the records.

Did you know that?

It is an interesting concept the study of statistics. Long before Nate Silver was born, I was into stats. Raw number stats.

BTW, you do know that in Europe, gas is about 10 bucks a gallon, and that in France, the sign on the gas pump is for 1/2 a whatever they call a gallon over there. Because it is so expensive.

So, not everything is cheaper there.

BTW-in many Asian countries, school is all year long.
No 8 weeks off to enjoy summer then forget what one studied prior to summer and spend 3 months catching up.

Of course, they have higher up front taxes too.

I see nothing wrong with any of that.

Gas here should be double, or even triple.
And their cars are cheaper, because so many use smart cars(the really really small ones).
They also practice wellness and don't drink 48 ounce sodas. They walk and take bicycles and mass transit(like NYers do).

There is a price for anything and everything.

We have 325 million people. And a split 50/50 of how one wants the 320 million to live.
Perhaps we should do what USSR did, and actually split into half.
And then people can decide which half they would like to reside, and leave the other half alone.

Remember too, baseball used to have doubleheaders on a beautiful spring day.
Two for the price of one.
Now its one for the price of two.

[eridani]

68. But health care is cheaper

Good for Asians--they didn't even complain much about internment camps at the time. I suppose you think that's a good thing.

Health care per capita is about half what we spend in
Japan--government-dictated private insurance regulations
South Korea--single payer
Taiwan--single payer
Britain--socialized medicine
Norway--socialized medicine
France--70% government, 30% government-dictated private insurance regulations
Sweden--socialized medicine
Denmark--socialized medicine
Switzerland--recently forced its private insurers to become non-profit
Germany--government-dictated "sickness funds"
Spain--socialized medicine, currently under attack

Other eastern and southern European systems are as cheap, though unlike the above, the quality is not as high.

[KG]

6. ACA - the quaint notion that insurance companies give a shit about providing health care.

[green for victory]

9. you summed up 900 pages in 13 words

[Autumn]

13. I still recall Obama calling it insurance finance reform.

He was right.

[City Lights]

14. Our premium is increasing to $1846/month in May.

It started at $750/month in May of 2010 when we signed up with them. And it covers next to nothing. It reduces the amount the doctors/lab, etc. can charge without paying anything. Our "savings" comes through reduced payments to providers. We're left footing the bill for the rest of it. It absolutely sucks.

The system is still broken, IMHO. It's been patched, but it's not fixed.

[Hoyt]

15. Millions of Medicare beneficiaries like Medicare Advantage because the plans offer coverage

for things traditional Medicare does not. There is even an annual cap on on out-of-pocket expenses. The plans also provide coordination of care that traditional Medicare does not.

I've got another year to research it, but will likely go with a Kaiser Plan.

If they do a good job, and make a few bucks to plow back into the organization, I'm OK with that. Traditional Medicare just doesn't have the coordination among providers.

[randome]

16. Let's get the fucking obsructionist Republicans out of the House and maybe we can get single payer.

[green for victory]

18. Max Baucus is a Senator and a Democrat who had Single Payer Doctors and Nurses Arrested at a Hearing

watch (starts @2:40):

History has been made. Max Baucus will be famous for hundreds of years.

The Democrat who prevented Single Payer advocates from speaking at a hearing.

Those of us that were called racists for not cheering on a heritage foundation plan won't forget that anytime soon either.

[Babel_17]

21. Do you happen to remember if we were promised that single payer was to be part of the discussion?

I remember the narrative changing on several things but I'm not positive about that.

It's this "evolving narrative" on many issues that promotes hyper-vigilance. That isn't going to change overnight. Those that caused it can't complain about having to deal with it.

[riderinthestorm]

50. You may be getting confused because Obama DID support single payer for many years

before he hit national office.

Here's a great timeline from Politifact:

http://www.politifact.com/truth-o-meter/statements/2009/jul/16/barack-obama/obama-statements-single-payer-have-changed-bit/

"To find out more about the video, we tracked down some of the people who worked on health care reform with Obama when he was a state senator in Illinois. Dr. Quentin Young said he has followed Obama's career since Obama first decided to run for state senator in 1995; he lives in Obama's Hyde Park neighborhood in Chicago. A longtime activist in health care matters, Young left his medical practice a few years ago to volunteer full time for Physicians for a National Health Program, a Chicago-based advocacy group for single-payer. The group features Obama as part of its Web site.

snip

"As I recall, this was his categorical response, that he thinks single-payer is the way to go," Young said. "Over the years, there's been ever more edging on his part, to the point where what he has now is a multitiered program, but it ain't single-payer." "

[Babel_17]

53. Thanks! (nt)

[bvar22]

25. We worked really hard to Get Rid of DINO healthcare Obstructionist Blanche Lincoln...

.. in the Arkansas Democratic Primary 2010.

We did EVERYTHING right to "give President Obama Democrats who will help him implement his agenda."


Guess who turned out to be our BIGGEST enemy?
..No, not the Republicans.
No,..not the Conservatives.

Our biggest enemy to replacing the "obstructionists" was the Obama White House and Bill Clinton.

Its really bizarre.
It seems like the Last Thing the Party Leadership wants is for The People to remove the obstructions.
Go Figure!



White House support for Health Care Obstructionist Blanche Lincoln in the 2010 Democratic Primary

"So what did the Democratic Party establishment do when a Senator who allegedly impedes their agenda faced a primary challenger who would be more supportive of that agenda? They engaged in full-scale efforts to support Blanche Lincoln. Bill Clinton traveled to Arkansas to urge loyal Democrats to vote for her, bashing liberal groups for good measure. Obama recorded an ad for Lincoln which, among other things, were used to tell African-American primary voters that they should vote for her because she works for their interests. The entire Party infrastructure lent its support and resources to Lincoln — a Senator who supposedly prevents Democrats from doing all sorts of Wonderful, Progressive Things which they so wish they could do but just don’t have the votes for.

Ordinarily, when Party leaders support horrible incumbents in primaries, they use the “electability” excuse: this is a conservative state, the incumbent has the best chance to win, and the progressive challenger is out-of-step with voters. That excuse is clearly unavailable here. As Public Policy Polling explained yesterday, Lincoln has virtually no chance of winning in November against GOP challenger John Boozman. And while it would have also been difficult for Halter to beat Boozman, polls consistently showed that he had a better chance than Lincoln did. That’s unsurprising, given how much better non-Washington candidates are doing in this incumbent-hating climate than long-term Washington insiders. And it’s rather difficult to claim that Halter is out-of-step with Arkansas given that they elected him their Lt. Governor. Whatever the reasons Washington Democrats had for supporting the deeply unpopular Lincoln, it had nothing whatsoever to do with electability.

What happened in this race also gives the lie to the insufferable excuse we’ve been hearing for the last 18 months from countless Obama defenders: namely, if the Senate doesn’t have 60 votes to pass good legislation, it’s not Obama’s fault because he has no leverage over these conservative Senators. It was always obvious what an absurd joke that claim was; the very idea of The Impotent, Helpless President, presiding over a vast government and party apparatus, was laughable. But now, in light of Arkansas, nobody should ever be willing to utter that again with a straight face. Back when Lincoln was threatening to filibuster health care if it included a public option, the White House could obviously have said to her: if you don’t support a public option, not only will we not support your re-election bid, but we’ll support a primary challenger against you. Obama’s support for Lincoln did not merely help; it was arguably decisive, as The Washington Post documented today:"

<much more>

http://www.salon.com/2010/06/10/lincoln_6/

I was there, and the reality On-the-Ground in Arkansas was WORSE than that in the above clip.
After the White House decided to rescue Lincoln't failing campaign,
we had to watch the Obama Oval Office Endorsement of Lincoln 24/7 in which he claimed that Lincoln was a great supporter and needed in the Senate.
Bill Clinton was even WORSE in his honor and acclaims for Lincoln.

But the White couldn't let it lie there.
After Lincoln squeaked a WIN in the Democratic Primary,
the White House had to add insult to injury by gloating about their Beat Down of Organized LABOR and the Grass Roots.

Ed Schultz on Obama support for Lincoln, and the Beat Doen of Organized LABOR in the Arkansas Primary 2010
http://videocafe.crooksandliars.com/heather/ed-schultz-if-it-wasnt-labor-barack-obama-


I will tell you something about Union thugs.
We may occasionally take an ass whooping, especially if someone Sucker Punches us unexpectedly, but we NEVER forget,
and won't turn our backs next time.

Naturally, Lincoln was STOMPED in the General,
and you can and the loss of THAT seat squarely around the neck of the White House,
protecting the Anti-LABOR Health Care Obstructionists.

[KoKo]

33. Remember some of that...thanks for the Schultz clip.

We got little to no help here in NC in 2010 or even for 2012 when the Dem Convention was held here. It didn't help that our Dem Party leadership had scandals...but, there wasn't any organizing here from the OFA for anything except Obama. And NC voted for him in 2008. Then the activists were gone and without support (money) we floundered and now after 2012 we have an Historic all Repug take over of our State House and Senate ramming through ALEC Bills. I have always felt that Obama didn't really want NC to stay blue after 2008. The convention was held in Bank of America Stadium. What kind of signal was that? And our Dino Dem in Senate is up for re-election. I'm sure she will be supported for another term since she votes with Repugs. The Tim Kaine disorganization after the great years of Howard Dean and Dennis Kucinich activist turning NC Blue collapsed when the Obama activists swarmed and then left. Again...we had Dem Scandals at the top, but still it was depressing to see all our gains slip away.

[Babel_17]

45. Strong unions don't forget

If you do, you become a doormat.

[Marr]

47. I remember that-- it was sickening.

And it was the last nail in the coffin for me. No doubt whatsoever what the game was after that.

[ProSense]

19. First of all

The reversal of that promise has already begun, with the Administration's announcement, on April 1st, that it will increase, instead of (as had been promised) decrease, taxpayer subsidies to private health insurance companies.

...this is a postponement of cuts to Medicare Advantage. The insurance companies got Senators to lobby on their behalf to postpone the cuts until the law is fully implemented.

The reports are framing both the cuts and the postponement as detrimental to retirees and, at the same time, claiming that the postponement is profitable for insurance companies.

<...>

The Centers for Medicare and Medicaid Services in February proposed cutting reimbursement rates (what the government pays insurers to treat patients) for Medicare Advantage, the private health insurance program for seniors, by 2.2%. Not only was the proposed cut unexpected because the government usually raises the rates every year, says Robert Zirkelbach, spokesman for trade association America’s Health Insurance Plans, but it was also the largest cut ever proposed. The reduction would have affected the 28% of Medicare beneficiaries who are enrolled in Medicare Advantage by raising their medical copays and plan deductibles. But instead, CMS reversed its original plan this week and announced that it would raise rates by 3.3%.

<...>

Retirees aren’t out of the woods yet, though, Zirkelbach says, because the health-care reform law stipulates $200 billion in cuts to Medicare Advantage over 10 years, only 4% of which had been implemented at the end of 2012. This week’s rate increase just softens the blow slightly: “The cut was going to be so detrimental because it’s happening on top of all these other things,” Zirkelbach says.

http://www.marketwatch.com/story/what-new-medicare-rates-mean-for-patients-2013-04-08?link=MW_latest_news

It's all bullshit to delay the inevitable. In fact, AHIP posted the letter signed by 22 Senators, including Chuck Schumer, Kristen Gillibrand and Jeff Merkley.

http://www.ahipcoverage.com/wp-content/uploads/2013/03/CMS-MA-3-13.pdf

They will have no more excuses when the law is fully implemented. Congress needs to stop worrying about insurance companies and get on with strengthening the health care law and Medicare.

Obama budget is a disaster for drugmakers
http://www.democraticunderground.com/10022660318

On a side note, when it comes to the RW's ability to demonize the law, nothing changes: http://www.democraticunderground.com/?com=view_post&forum=1002&pid=2662578

[madrchsod]

28. oh well..... i guess we old folks are really screwed.

actually i`m pleased my part d is a hell of a lot cheaper than my for profit drug coverage was.

[Hoyt]

32. Some 25% of Medicare beneficiaries freely choose to enroll in Medicare Advantage plans.

Generally, they receive some additional benefits, and there is a cap on annual out-of-pocket costs that the traditional Medicare program does not.

Medicare Advantage plans control drug costs much better than traditional Medicare. I think the lady is wrong about Advantage plans paying more for drugs that traditional Medicare, because traditional plans have been prohibited by Congress to negotiate drug prices (that should be changed).

The ACA has numerous incentives for Advantage type plans, called Accountable Care Organizations.

The biggest "advantage" to me is that these plans are more coordinated than traditional Medicare, and offer some coverage that Medicare does not. Some of these plans are non-profit, like Kaiser. Next year, I will probably enroll in a Kaiser plan for all the reasons above.

[Cleita]

34. What a load of crap. Medicare Advantage programs sell you a

big lie. I know. My husband fell for one. We were given a list of providers we could go to. It turns out none of them wanted to accept said MA's patients because they paid too low when they did and mostly they fought paying anything. So we couldn't find a doctor to take him as a patient. He was promised that he could get care in any state he traveled in. It turned out to be a lie because in order to get ER care paid for, you had to get permission first. He had a stroke in a different state when we were traveling. Because we were out in the woods, when I came to the first available pay phone, about a mile down the road, I called the ambulance, not the HMO for permission. We ended up paying more than $10,000 in medical bills because the MA refused to pay on that technicality.

We went back to traditional Medicare with a supplement the following enrollment period. You can see any doctor you want in any state of the union. Most doctors and hospitals accept the terms to treat Medicare patients unlike the MAs which they don't like. You can call an ambulance directly with no middle man in between and they pay. Now that we have Medicare prescription benefits and gym access, there is nothing the MA can offer that is better.

[Hoyt]

35. Sorry that happened. I suspect you did not have a plan like Kaiser.

You probably chose one of the cheap for-profit plans, that did not have an established provider network or arrangements when you are out of the local area.

In any event, 25% choose Advantage Plans, and reup every year. The number is growing. I think if they were all dissatisfied, they'd opt back into traditional Medicare. But maybe they are just stupid.

Personally, I have found that doctors in traditional Medicare don't communicate well with each other, don't easily share information, send you for tests that turn out to be non-covered, aren't really evaluated in any effective manner for quality, gripe about payment levels, etc.

[Cleita]

36. It was no cheaper than Kaiser, which incidentally only operates in certain places.

It was run by a so-called very reputable medical insurer. Also, Kaiser runs very differently than most HMOs. I used to have Kaiser a long time ago myself so I know what you are referring to and as a non-profit, they are better than the others, but like I said they are limited in the areas they cover. They will not cover you if you are out of the state you are covered in, period.

[Hoyt]

37. Yes, Kaiser does cover you when you are traveling.

All I'm saying is that a lot of people like the Medicare Advantage programs. I want to say, they can't all be wrong -- but I suppose they could be.

[Cleita]

43. The other problem with MAs is that they siphon funds off of traditional Medicare

weakening the fund. Besides Medicare Part D which was a big wet kiss to Big Pharma, it's one of the reasons Medicare is in trouble. We have to get back to the single payer way of doing Medicare. We need to cover 100% too, to keep the insurance companies out of it. I know that Medicare can function efficiently if the money diverted to the MA HMOs were used to give Medicare 100% coverage with prescription coverage. You could still go to Kaiser if you like it. They would just get their money directly for your care from Medicare instead just like the other doctors and hospitals do.

[Hoyt]

44. Don't disagree with most of that. I do think drug coverage is the most important addition to Medicar

in recent years. Although, drug prices should be negotiated. We will never see 100% coverage for anyone but poorest. When, you factor in services Advantage plans cover, that traditional Medicare does not, cap on out-of-pocket costs, etc., I don't think most folks will give it up.

[GeorgeGist]

46. As I recall Medicare Part D is from Bush not 'ACA'

Ignorance is bliss.

[indepat]

52. By its design, the principal purpose of Part D was to sprinkle a multi-billion-dollar largess

on big pharma, courtesy of the American taxpayers: one would have though this egregious travesty would have been eliminated in 2009 with election of a progressive president.

[woo me with science]

58. Huge K&R

[grahamhgreen]

59. Another terrible republican idea implemented by the White House.

[sendero]

63. Who is surprised?

This is why I'm inherently skeptical of complex multi-faceted regulations/laws. The devil is in the details and the details are a crazy-quilt of often contradictory items.

I've said since day one that it would take years to even determine if Obamacare is actually a good deal for more Americans because it is 2,500 pages too freaking long.

And this is why I likewise put no faith in his latest SS proposals, that take away here but give back there and just micro-tweak after micro-tweak that might or might not actually be made into law in one piece.

Micro-managing crazy-quilt lawmaking is just a way to play a shell game where no one can tell what is really happening.