Occasional Brief Observations: Health care re-form IX (Apologies due?)

Sunday, August 30, 2009

Health care re-form IX (Apologies due?)

There has been a lot of snickering about seniors who have expressed sentiments along the lines of "keep the government's hands off my Medicare," the (oft unstated) implication being: 'these duffers don't have a clue to what is going on so they can be ignored and their concerns dismissed out of hand'. Not very long ago, even the President elicited guffaws on this topic. But consider....

Of the approximately 44.8 million (2008) Medicare beneficiaries, around 10.2 million have opted for Medicare Advantage plans i.e. approximately 23% (or just under a quarter). From Wikipedia:

"... With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the Original Medicare plan (Parts A and B)... For people who choose to enroll in a Medicare private health plan, Medicare pays the private health plan a set amount every month for each member. Members may have to pay a monthly premium in addition to the Medicare Part B premium... The private plans are required to offer a benefit “package” that is at least as good as Medicare’s and cover everything Medicare covers, but they do not have to cover every benefit in the same way. Plans that pay less than Medicare for some benefits, like skilled nursing facility care, can balance their benefits package by offering lower co-payments for doctor visits. Private plans use some of the excess payments they receive from the government for each enrollee to offer supplemental benefits. Some plans put a limit on their members’ annual out-of-pocket spending on medical care, providing some insurance against catastrophic costs over $5,000, for example. But many plans use the excess subsidies to offer dental coverage and other services not covered by Medicare and can leave members exposed to high medical bills if they fall seriously ill..."

So, it may be the government that is ultimately paying, but the seniors who are on Medicare Advantage and who are worried about government interfering with "their Medicare", are not necessarily the doddering old fools that they are being made out to be! The more so, because the administration has labeled Medicare Advantage a rip-off, a handout to the insurance companies, and has proposed its elimination! This group of enrollees, at least, contrary to the President's multiple assertions that 'anyone/everyone satisfied with their current private plan can keep it and will not be forced to change', will not have a choice if the administration gets legislation that eliminates these "overpayments."

Bottom line: a senior who has and is happy with his/her current private health insurance (via Medicare Advantage) plan, and who is faced with losing that plan and being moved to original ('government') Medicare might well want to have 'the government keep its hands off their Medicare.'

Note: the above does not address the underlying issues regarding the relative costs or worth of Medicare advantage plans versus traditional Medicare; nor if they should be cut, eliminated, or left alone... The only issue being addressed is the mockery being aimed at some that have expressed the sentiment above...

Sunday, August 30, 2009

Health care re-form IX (Apologies due?)

No comments:

Post a Comment