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NYT: Democrats Critical of New Medicare Guide: Favors private insurance plans

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DeepModem Mom Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 09:01 AM
Original message
NYT: Democrats Critical of New Medicare Guide: Favors private insurance plans
Democrats Critical of New Medicare Guide
By ROBERT PEAR
Published: October 30, 2006

WASHINGTON, Oct. 29 Congressional Democrats say a new government publication being sent to all Medicare beneficiaries inappropriately favors private insurance plans over the traditional government-run program.

The publication, the 2007 Medicare handbook, presents a misleading and biased view of Medicare coverage and options, the Democrats said last week in a letter to Michael O. Leavitt, the secretary of health and human services.

Beneficiaries use the handbook as an authoritative guide. It has become more important in the last few years as Medicare has become more complex, with new insurance options and a prescription drug benefit offered by scores of competing private insurers.

The 2007 handbook strongly favors health maintenance organizations, preferred provider organizations and other private Medicare Advantage plans over the traditional Medicare fee-for-service program, the Democrats said in the letter....

***

Managed care plans often have networks of doctors and hospitals, and beneficiaries may have to pay higher fees, exceeding what they would pay under traditional Medicare, if they go outside the network. In traditional Medicare, patients can choose from a broader range of doctors and hospitals, although a small number of doctors say they do not take Medicare patients because they consider the payments inadequate....

http://www.nytimes.com/2006/10/30/washington/30medicare...
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WePurrsevere Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 09:24 AM
Response to Original message
1. After looking through ours I'd say they're correct. I've been getting these
things since 1992 and it's changed drastically and not for the better either.

What really ticks us off is trying to make sense of it is difficult, that what is covered is less, it's much harder to find doctors willing to accept it and we pay more OOP that many of us can ill afford.
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asjr Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 09:38 AM
Response to Reply #1
3. I think we seniors have been waterboarded!
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area51 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 09:37 AM
Response to Original message
2. k&r (n/t)
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grilled onions Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 09:58 AM
Response to Original message
4. At The Same Time
People are getting purged from insurance left and right because they are sick,aging,have pre exisitng conditions,cannot afford high rates and those who have/had pensions find they are also having to seek medical coverage maybe for the first time. The only ones GUARANTEED to have coverage is the idiots on Capitol Hill--the very ones who don't think this is an issue even worth talking about since they ARE covered. If they had to have the same lack of coverage and the same confusing lack of choices we have to deal with it might have been a different story. Some times they make you feel so small when you show your Medicare card and the receptionist looks at you with beedy eyes and demands "Is that the ONLY insurance you have?" Well gee sorry lady normal insurance seems to frown on takin on those with any kind of medical history and our grand leaders just don't seem to give a damn if it never changes. :mad:
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Brundle_Fly Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 11:33 AM
Response to Original message
5. wow.
they just want to keep screwing Americans any way they can.

Just like a snake oil dealer, they do it with a handshake and a smile.

screw pukes./
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cosmicdot Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 12:14 PM
Response to Original message
6. knr
I'm sure people are, also, confused and/or being hurt by the letters sent out in September to those who had gotten extra help in 2006 for Part D, the prescription drug fiasco, saying extra help won't be automatic for 2007. Extra help, for example, is not having to pay premiums to United Health or other participating insurance companies, plus, having nominal co-pays.

I suspect Mark McClellan's (Scott's brother) mission is surfacing more clearly as time moves forward.

The Medicare Rx 'plan' is a move toward privatization. The Medicare Advantage Plans showing up in the annual handbooks (option to let a private insurance company process one's Medicare coverage by paying them premiums vs. to the Medicare program itself.

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jwirr Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-30-06 09:34 PM
Response to Original message
7. I wonder how many forests they had to cut down to send all the
junk that they put out in all these medical programs? I get something every day for all the different programs I and my disabled daughter are on. The real problem starts when the elderly are expected to read and understand all this shit. Don't our congress people know any 80-90 year old people? Most have a great deal of trouble for one reason or another reading or understanding this crap. My daughter cannot read yet they send the same stuff to her they do to me. I am so sick of the "red tape" that I usually stuff it away and DO NOT READ IT.
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zann725 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-31-06 03:44 AM
Response to Original message
8. Doctors recently told me Medicare pays so quick...quicker than private plans,
they now PREFER billing to Medicare!

Doctors who have their heads in the long-past Private Insurance "gold mine", have an outdated, unrealistic view of who ACTUALLY "pays," and who doesn't pay their Rent and salaries ON TIME. Instead, they live in dreams of the rosey past when Private Plans paid without delay for office visits and procedures. The good old days...

Medicare booklets MAY TRY and encourage Medicare recipients to seek Private Plans, but MOST Aged and Disabled recipients HAVE Pre-existing Conditions), and WOULDN'T qualify for Private Insurance for at least ONE YEAR of NON-treatment of their condition(s)...IF they qualify at all.

Medicare may be TRYING to encourage coverage elsewhere, but most recipients BARELY afford current co-pays on doctor visits and meds. And most have no substantial "nest egg" to pay hundreds MORE per month for "gap" coverage.

That the "System" is even attempting to drive Medicare recipients in droves to Private Plans is a Repug "wet-dream." Besides, Dems will soon have control of the House...and the "big House" soon...so dream on, Pugs...dream on.
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Sgent Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-31-06 04:10 AM
Response to Reply #8
9. Any doctor
who can't wait 30 days for twice the pay has other problems.

There are portions of the country (much of CA and some of FL) where fee for service Medicare pays 90-95% or so of normal insurance companies. But in most of the country, Medicare probably averages about 1/2 of that -- with the added benefit of audits, stark regulations, and criminal charges hanging over your head for "false claims" -- when even the auditors at OMB differ in how they would make various claims.
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