Medicare Advantage

[dtotire]

Whose Advantage?
Published: October 10, 2010



Some of the private health plans that participate in Medicare will be dropping out next year, but don’t blame health care reform. Most are unwilling to meet the sensible requirements of a 2008 law that they do more to earn the federal subsidies that have fueled their rapid growth.


Medicare Advantage plans enroll one-quarter of the 46 million Medicare beneficiaries. Medicare subsidizes these plans — paying them more on average than what the same services would cost in traditional Medicare. As a result, beneficiaries pay less or get extra benefits, such as dental coverage or even health club memberships. The extra cost is paid by taxpayers and through higher premiums for enrollees in traditional Medicare.

Health care reform will phase out these unjustified subsidies starting in 2012 and use the savings, $132 billion over the next decade, to help finance coverage of the uninsured. Enrollments are projected to fall as some plans drop out and others raise their charges or reduce benefits. There will still be plenty of private plans available, and any older Americans who can’t find one to their liking will still have access to traditional Medicare.

For the coming year, Medicare Advantage plans covering an estimated 966,000 beneficiaries have decided to get out of the business. For most of these, it is the result of that earlier law requiring them to set up their own networks of doctors and hospitals. Almost all of their beneficiaries will have access to another Medicare Advantage plan serving the same area.

For now, despite all of the shrill warnings from critics, the Medicare Advantage market appears strong. Enrollment will go up next year and premiums will actually decline by about 1 percent. Average out-of-pocket costs will rise about 5 percent per beneficiary, a modest increase these days. Officials attributed that to hard-nosed negotiating with insurers that were planning to charge their enrollees more while increasing their profits.

Over time, the best Medicare Advantage plans will survive and the least efficient will close. That is what should happen. These subsidies are inequitable and far too costly for the American taxpayer.


http://www.nytimes.com/2010/10/11/opinion/11mon3.html?ref=opinion

[Bluenorthwest]

1. Advantage Plans vary greatly across the nation

And the authors of this piece who so casually say if one closes, there is always another fail to mention that one Advantage Plan might be a hundred dollars a month more than another. And traditional Medicare puts people back into a deductible scenario, waiting for money for care.
Over all, the changes are good, but they have to be done with great caring not with a callous 'they have other options anyway' attitude. So I pretty much agree with the factual content, but I do not like the emotional attitude framed around those facts. What 'should happen' is better care, for more people, for less money. The author's main objective is about the faciliities and companies, not about the beneficiaries whom he sort of writes off as having lots of great options. The tone is not welcome.