Are the Democrats planning the public option "beyond" Medicare and Medicaid? I am so confused.

I read part of the following article with surprise, guess I was thinking it would just be expanding Medicare and making some changes...or at least along those lines. Maybe I am reading it wrong, maybe it doesn't matter...but just surprised. I think there has to be competition, or no progress will be lasting.

Many people on Medicare now would be uninsurable because of their age and illnesses. I guess, though, if they have another "public option" set up....it would have the policy of allowing anyone to be part of it. I would hope so.

Seems easier to use an existing program and expand and improve on it than forming another one, unless it is NOT going to be a government run option. I find myself thinking about what happens to people left behind in programs that are abandoned for new ones. They will not get the best care or service. They will be "phased out" apparently.

Here is where I read the part about going "beyond" the existing programs.

In televised special, Obama calls for compromise' on health care

"There's no perfect unanimity across the table in terms of every single aspect of reform," the president said in remarks after their meeting. "I think everybody here wants to make sure that governors have flexibility, that they have input into how legislation is being shaped on the Hill."

The scope of what Obama, many Democrats and some Republicans want to do is massive, and lawmakers have various ideas about how to get it done.

The most controversial proposal in the emerging debate is to create a so-called public option,beyond Medicaid and Medicare, as an alternative to private insurance. Obama supports that. He has said that would keep private insurers honest and efficient because they'd have to compete.

Of course, after the Sunday shows when Kathleen Sebelius and David Axelrod made sure to let us know that they were compromising on this issue, that there would be NO line in the sand...I wonder if any form will be included.

The thought that the public option would be something "beyond" Medicare might be right, as Obama had announced that he would be advocating 313 billion in cuts to Medicare and Medicaid spending.

Now that sounds scary. Doctors are worried, and many of us fear they would refuse to take Medicare patients just as many refuse to take Medicaid patients right now.

Obama's thoughts:

Reporting from Washington -- Under pressure to pay for his ambitious reshaping of the nation's healthcare system, President Obama today will outline $313 billion in Medicare and Medicaid spending cuts over the next decade to help cover the cost of expanding coverage to tens of millions of America's uninsured.

Among the proposed policy changes outlined by the president are:

* Reductions in payments to providers to reflect increased efficiencies in the system, which the White House estimates could save $110 billion over the next decade.

* Cuts in federal subsidies to hospitals that treat large populations of uninsured patients, estimated to save $106 billion over the next decade.

If the cuts to payments and subsidies would come naturally with a new health care program helping those without care....that might be feasible. But that is a lot of money that doctors and hospitals will be losing short term. They are concerned. Emergency room treatment is about the only care millions of people with no insurance can get. Cutting those subsidies is making many nervous.

Here is more about the severe cuts to these programs, so it does sound like some in the administration are not thinking of preserving Medicare and Medicaid. It sounds like they will form a new insurance program and get the savings from Medicare and Medicaid.

Obama also proposed cutting payments to hospitals to treat uninsured patients by $106 billion on the assumption those ranks would decline as healthcare reforms phase in.

An additional $75 billion would come from "better pricing of Medicare drugs," Orszag said, adding the White House was in talks with stakeholders over the best way to do that.
The remaining $22 billion in proposed cuts would come from smaller reforms, such as adjusting payment rates for physician imaging services and cutting waste, fraud and abuse.

The new cuts are in addition to a $635 billion "down payment" on healthcare reform that Obama outlined in his budget to Congress earlier this year. About half of that came from cuts in Medicare and Medicaid and the rest from revenue proposals such as cutting tax deductions for families that make over $250,000 a year.

Altogether, the Obama administration is now asking Congress to trim spending on Medicare and Medicaid by more than $600 billion over the next decade, which is more than some Democrats are willing to swallow.

Obama eyes more in cuts for health care reform

This sounds like perhaps without talking much about it, that Zeke Emanuel's idea of phasing out Medicare and Medicaid is being considered. Here is more about his ideas. He is very much in close contact with the Chief of Staff and with the president and his financial advisors.

Zeke Emanuel, health care advisor to Obama, wants to phase out Medicare and Medicaid.

The Guaranteed Healthcare Access Plan proposes to repair the health care system by giving all Americans a voucher to select a standard benefits package offered by insurance company. In most areas, American will be able to choose between 5 and 8 insurance companies. And the insurance companies will be required to enroll anyone who wants and cannot exclude coverage for pre-existing conditions. The standard benefit package is based on what Congressman and Senators receive, and is more generous than what most Americans currently have through their employers or government program. Americans will also decide if they wanted to buy additional services, say wider selection of doctors and hospitals, more mental health benefits, or coverage for alternative medicines.

The Guaranteed Healthcare Access Plan will be administered by a National Health Board and regional boards modeled on the Federal Reserve System with fiscal, administrative, and political independence to make tough decisions based on the merits, not special interest lobbying. There will also be an Institute for Technology and Outcomes Assessment to assess the effectiveness of new drugs, devices, procedures, and other interventions. It will also assess and make publicly available data on the clinical outcomes of patients in different insurance companies. This will permit comparative shopping based on real quality results.

He says no one will be forced out of Medicare....but no one else will be enrolled.

...but there will be no new enrollees. People who turn 65 will simply stay in the Guaranteed Healthcare Access Plan. The special tax benefits related to employer based coverage will be eliminated and most employers will stop offering health insurance.

Again, my concern is what happens to those left in the Medicare system.

When we talk about a public option being offered alongside private plans, it is misleading not to make clear that they are taking big money from Medicare's present members and cutting payments to doctors and hospitals.

On Meet the Press, David Axelrod made a comment that I am not sure I understood. Yet it too sounds like there is a plan to go outside Medicare and phase it out. He refused to commit to a public option. Here are his comments.

MR. GREGORY: But you're confident about getting that bill with a public plan this year.

MR. AXELROD: I'm confident that we're going to get a healthcare reform bill. I think a public choice will be part of it. I think the public wants to have that option and wants to see that kind of competition, and I think we will, we will have that.

..."R. AXELROD: Well, first of all, I think that if we don't pass healthcare reform it's going to be a catastrophic problem for the country, not just the Democratic Party; for families, businesses and the country itself. Look, we believe strongly in, in a public choice; not one that's subsidized by the government, but one that will embrace the best practices, that will reduce healthcare costs and give people the best quality care. What the president said was illogical were the same people who say that the government is incompetent, the government can't run anything, the government shouldn't be involved in, in anything say, but we can't let that be one of the choices because it'll be an unfair advantage against the, against the insurance companies.

If it's not a government run plan, then it would be a privately run plan...right?

I wonder if they are going to set up a whole new insurance plan, or if they will recontruct or rebuild Medicare. But how will they do that if they keep taking money away from doctors and hospitals?

Will they give them an incentive to keep patients?

I thought it was the Republicans who did not want a public plan run by the government, but now it appears the Democrats don't either.

If you have not read this great post by Daily Kos front pager, David Waldman, it is short clear, and to the point about who has the power to bring forth a bill with real reform in it.

From Congress Matters website:

Who's the gatekeeper on the public option in the Senate?

If the HELP committee reports out the bill they've been promising, with a public option included, and the Finance committee doesn't, who reconciles the two and decides which package gets to the floor?

Harry Reid does.

In the FISA Senate battle at the end of 2007, the Intelligence committee and the Judiciary committee reported out different versions of the bill. That case, though, involved a sequential referral of a House bill, and Reid said he was relying on the custom of bringing up the bill that came out of the committee to get the first referral as the base bill, though the option was open to him as Majority Leader to change direction. But it at least made some sense, even if it was obvious that there was a conscious choice to refer the bill to the more receptive of the two committees first.

Health care isn't a referral, though. These are two original Senate bills competing for consideration. The Majority Leader has considerably more flexibility on this. He'll be guided by the chairmen of the committees in this, of course. But you'll learn an awful lot about who stands where if HELP includes a public option, Finance doesn't, and neither does whatever comes to the floor.

It appears that the bill could be stripped of real reform by just a handful of people. I know that is how things have worked for ages, but I was naive enough to think our majority this time mattered.

The rest is salvageable, and needs tweaks.

Medicare D was a sell-out to big pharma, and both parties knew it. It was yet another battle we progressives lost to the corporations.

but repaired and made part of Basic Medicare...

Close the doughnut hole and grant negotiating power to Medicare and we'd have something we can use --

And extend to the rest of the people as the PUBLIC OPTION...

Looks like it will drop....I have a lot of questions that are not being answered.

:hi:

http://www.maximumedge.com/cgi/news/article.cgi/2009070...

WASHINGTON - "Democrats on a key Senate Committee outlined a revised and far less costly health care plan Wednesday night that includes a government-run insurance option and an annual fee on employers who do not offer coverage to their workers.

The plan carries a 10-year price tag of slightly over $600 billion, and would lead toward an estimated 97 percent of all Americans having coverage, according to the Congressional Budget Office, Sens. Edward M. Kennedy and Chris Dodd said in a letter to other members of the Senate Health, Education, Labor and Pensions Committee.

Separately, Democrats and Republicans on the Senate Finance Committee are at work trying to reach agreement on an alternative that calls for creation of nonprofit cooperatives to sell insurance in competition with private industry. Agreement has been elusive on that and other issues, and it is not clear whether a deal is possible before Democrats opt for a more partisan approach.

In their letter, Kennedy and Dodd said the Congressional Budget Office "has carefully reviewed our complete bill, and we are pleased to report that CBO has scored it at $611.4 billion over 10 years, with the new coverage provisions scored at $597 billion. ...The completed bill virtually eliminates the dropping of currently covered employees from employer-sponsored health plans."

Harry Reid gets to decide which to present.

"In addition, our bill, combined with the work being done by our colleagues in the Finance Committee, will dramatically reduce the number of uninsured - fully 97 percent of Americans will have coverage, a major achievement."

to everyone there will be competition not only for health care dollars among groups, but access to doctors...based on their plans.

Also a few years later and look who gets left out...

Massachusetts Makes Cuts to Universal Health Plan

http://blogs.wsj.com/health/2009/06/24/massachusetts-ma... /

"Massachusetts’s universal health plan, long discussed as a possible model for the nation, is getting a $115 million haircut. Faced with lower revenues and a growing number of citizens who lost their jobs and their health insurance, the state didn’t have enough money to pay for insurance subsidies for needy residents under the current plan, the Boston Globe reports...

“It’s a warning for the federal government as it looks to do something similar,” he said. “I’m not saying we can’t afford any of it, but it certainly doesn’t appear that we can afford all of it.”

http://www.boston.com/news/local/massachusetts/articles...

"Overseers of Massachusetts’ trailblazing healthcare program made their first cuts yesterday, trimming $115 million, or 12 percent, from Commonwealth Care, which subsidizes premiums for needy residents and is the centerpiece of the 2006 law.

The board of the Connector Authority made the cuts as officials confronted two side effects of the recession: the state budget crisis and a surge in enrollment by the recently unemployed.

The largest share of the savings will come from slowing enrollment. An estimated 18,000 poor residents who qualify for full subsidies, but who forget to designate a health plan, will no longer be automatically assigned a plan and enrolled and thus could face delays in getting care...

Also hanging in the balance is the health insurance status of 28,000 legal immigrants whose Commonwealth Care coverage was dropped in the budget lawmakers approved for the fiscal year that begins July 1. Patrick has until Monday to decide whether to veto any of that budget, which set aside $116 million less for Commonwealth Care than he proposed..."

I do not see how we will pay for this public option, Medicare enrollment is expected to increase dramatically within the next decade or two, any savings from the Medicare program he speaks of will be needed to fund all the new enrollees. Maybe we'll just get a voucher at 65 instead.

http://www.kff.org/medicare/upload/7305-04-2.pdf

"...Over the long term, an aging population, a decline in the
number of workers per beneficiary, and increasing life
expectancy will present fiscal challenges for Medicare. From
2010 to 2030, the number of people on Medicare is projected
to rise from 46 million to 79 million, while the ratio of workers
per beneficiary is expected to decline from 3.7 to 2.4..."

"increasing life expectancy" won't be an issue if things go on as they are.

You may remember that before the election, I said that poor folk would take the brunt of this.... now it's happening.

And more and more "progressives" like Ed Schultz are calling for more regressive taxes that only hurt poor folk.

But when I mention this, and that poor folk see no percentage in voting when NEITHER PARTY cares about us, DUers tell me our votes "aren't wanted or needed".

Does any of it matter?

He's calling for Single-Payer -- the ONLY plan that would actually control costs, provide universal care for less than what we're paying now for Health Care/Insurance.

The latest Dem plan would COST $60 Billion per year... $600 billion over 10 years

HR676 would SAVE $300 BILLION per year... SAVE $3 TRILLION over 10 years...

to support said Single-Payer.

Now, would you like to be a little nicer?

Or are you just itchin' for a fight because you can't find any RWers to fight anymore?

Come to think about it.. Ed is continually now calling for the Dems to counter the SHIT from the RW with more shit. So, since you wanted to dump on me, I'll counter with a dump of my own that is typical DU---

TRY READING WHAT I ACTUALLY WROTE!

THEN TRY LISTENING TO WHAT SCHULTZ IS SAYING!

HR676 - Single-Payer Health Care or Medicare for ALL does NOT require any regressive taxes.

You are confusing single-payer with the deficient Dem plans being floated in the House and the 2 Senate Committees.

I will grant you that I haven't watched Schultz lately and he may now be pumping for one of the defective Dem plans now that DO require stupid, asynchronous taxing schema because, by retaining the for-profit insurance mafia and their mindless needs for costs to go up to make sure profits go up, they would need MUCH more revenue than single-payer in order to cover (nearly) everybody.

HR676 - Single Payer -- WOULD save over $400 Billion per year, drive down overall health care costs and cover EVERYONE.

dump on me, like I'm your goddamned enemy.

Listen now.... pay attention, if you can:

ED SHULTZ KEEPS TELLING PEOPLE THAT IT CAN BE PAID FOR WITH REGRESSIVE TAXES (but of course, he doesn't label them as REGRESSIVE)

He talks about added fuel taxes to pay for health care, added sales taxes to pay for health care, and GET THIS, an "Internet User TAX".

Now, instead of attacking me and talking down to me like you consider me an imbecile, which certainly isn't "progressive" of YOU, why don't you back up, check out what Schultz is actually saying, then apologize for your aggressive and bullying behavior.

THEN you can educate HIM, instead of trying to bully ME.

I know all about HR676, which is a part of why what he's talking about infuriates me!

NOW, treat me kindly, or just back off.

be outside Medicare and Medicaid. They talked about possible payments of 10% over Medicare rates and also funding the public option through cost cuts to Medicare and Medicaid so this is what I was expecting.

Could they go further and phase out new enrollees to Medicare???

medicare advantage which involves insurance companies. those doctors get paid more.

why would they phase out new enrollees? i don't think you have to worry about that.

Obama talked about Medicare Advantage, where you can opt out of Parts A and B in favor of a private plan. Instead of giving your subsidies to traditional Medicare, the government provides them to the private company you select. It seems things are not always done best in the private sector, since GWB and his Bush league lapdog GOP Congress decided they had to give more money to these Medicare Advantage private companies than the subsidies to traditional Parts A and B. Obama has said that has to end; the government will pay no more than the subsidy to the government run plan. That's a good thing.

But the issue being discussed here is different. I've seen this before, a suggestion that money should be taken out of Medicare to pay for whatever they come up with in the name of health care reform. This is incredibly bad.

These companies have been given free rein for several years to contact and confuse seniors who think they are traditional Medicare. Our doctors office said recently they much prefer traditional Medicare.

"Part C: Medicare Advantage plans

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). These programs were known as "Medicare+Choice" or "Part C" plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, "Medicare+Choice" plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as "Medicare Advantage" (MA) plans.

Traditional or 'fee-for-service' Medicare has a standard benefit package that covers medically necessary care members can receive from nearly any hospital or doctor in the country. For people who choose to enroll in a Medicare Advantage health plan, Medicare pays the private health plan a capitated rate, or a set amount, every month for each member. Members typically also pay a monthly premium in addition to the Medicare Part B premium to cover items not covered by traditional Medicare (Parts A & B), such as prescription drugs, dental care, vision care and gym or health club memberships.<9> In exchange for these extra benefits, enrollees may be limited on the providers they can receive services from without paying extra. Typically, the plans have a 'network' of providers that you can use. Going outside that network may require permission or extra fees.

Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower copayments for doctor visits. Medicare Advantage plans use a portion of the payments they receive from the government for each enrollee to offer supplemental benefits. Some plans limit their members’ annual out-of-pocket spending on medical care, providing insurance against catastrophic costs over $5,000, for example. Many plans offer dental coverage, vision coverage and other services not covered by Medicare Parts A or B, which makes them a good value for the health care dollar, if you want to use the provider included in the plan's network or 'panel' of providers.

Because the 2003 payment formulas overpay plans by 12 percent or more compared to traditional Medicare<10> in 2006 enrollees in Medicare Advantage Private Fee-for-Service plans were offered a net extra benefit value (the value of the additional benefits minus any additional premium) of $55.92 a month more than the traditional Medicare benefit package; enrollees in other Medicare Advantage plans were offered a net extra benefit value of $71.22 a month more.<11> However, Medicare Advantage members receive additional coverage and medical benefits not enjoyed by traditional Medicare members, and savings generated by Medicare Advantage plans may be passed on to beneficiaries to lower their overall health care costs.<9> Other important distinctions between Medicare Advantage and traditional Medicare are that Medicare Advantage health plans encourage preventive care and wellness and closely coordinate patient care.<12>

Medicare Advantage Plans that also include Part D prescription drug benefits are known as a Medicare Advantage Prescription Drug plan or a MA-PD."

http://en.wikipedia.org/wiki/Medicare_ (United_States)

They are a step in privatizing Medicare without saying so.

The proposed cuts have gotten much play.

Are you going to protest on our behalf?

Are you going to speak up to Ed Schultz and others protesting their proposed REGRESSIVE taxes?

Of COURSE we worry... we are ALONE

by Ezekiel Emanuel - 2008

"...Americans will also decide if they wanted to buy additional services, say wider selection of doctors and hospitals, more mental health benefits, or coverage for alternative medicines.

The Guaranteed Healthcare Access Plan will be administered by a National Health Board and regional boards modeled on the Federal Reserve System with fiscal, administrative, and political independence to make tough decisions based on the merits, not special interest lobbying. There will also be an Institute for Technology and Outcomes Assessment to assess the effectiveness of new drugs, devices, procedures, and other interventions. It will also assess and make publicly available data on the clinical outcomes of patients in different insurance companies. This will permit comparative shopping based on real quality results.

No one receiving Medicare, Medicaid, or any other government program will not be forced out, but there will be no new enrollees. People who turn 65 will simply stay in the Guaranteed Healthcare Access Plan. The special tax benefits related to employer based coverage will be eliminated and most employers will stop offering health insurance.

Maybe the Guaranteed Healthcare Access Plan sounds too good to be true. How much more will it cost? It will not cost any more than we are paying today. By using a standard benefits package open to all Americans, there will be huge savings from reduced administrative costs to insurance companies. The end of Medicaid, SCHIP, and coverage of state employees, will produce huge savings -- decreasing state budgets by about a third. Similarly, phasing out of Medicare reduces federal taxes. When employers stop providing health insurance, workers' wages will increase commensurately. Instead Americans would pay a dedicated Value Added Tax..."

I thought there were more saving than just Medicare Advantage being discussed to finance the public option, how do you do that when the number of people eligible for Medicare will begin to increase dramatically in the next couple of decades.

:shrug:

Paying for Health Care Reform
http://www.whitehouse.gov/MedicareFactSheetFinal /

Really "progressive", eh?

And where is the outrage?

Who gives a flying fuck what happens to poor folk?

was that pun on purpose?

with basic coverage for all, as so many other industrialized have done.

Just last week...

http://www.boston.com/news/local/massachusetts/articles...

"Overseers of Massachusetts’ trailblazing healthcare program made their first cuts yesterday, trimming $115 million, or 12 percent, from Commonwealth Care, which subsidizes premiums for needy residents and is the centerpiece of the 2006 law..."

WE're shoved into a corner, unless our votes are wanted.

that would be a step in the right direction.

I cannot for the life of me comprehend why poverty is so misunderstood, and so ignored by "progressives"

system could be put to better use.

Thank you soooo very much for discounting and ignoring us.

Then you wonder why so many poor people are giving up voting in YOUR best interests.

profit system for everyone, it not only provides health care to all, it is the most cost efficient means of doing so.

Any money saved could be used to address other problems.

Doing what the RW does... I call you on not listening, so rather than actually HEAR what I'm saying, you tell me I'm not listening.

That's worthy of Faux.

This card shuffling obfuscation is, for lack of a more polite term, bullshit. The information is depressing but necessary. The bottom line is that our reps are too well bribed to give a damn, so they come up with this useless fancy dance that looks to make things worse rather than better. What to do?

I am too tired and disgusted to come up with anything more than: thank you, madfloridian.

K&R from one of the uninsured, likely to be uninsured for the rest of my life... expectancy subject to terms and obligations.

I should know better than to read and post when tired. It leads to defeatist thinking, and that's just a waste of time. Onward. :hi:

I had a reply finished to this post of yours, but just before I could send it, the power went out, and I lost it all. sigh.....

I just want you to know that we're all feeling like this, and you have every reason to honestly express it. My saying "Fight like hell" wasn't a criticism... just a recognition that we're feeling battered, but hope we can punch 'em out!

I really do know where you're coming from..... that's how i feel about the issue of homelessness. I've done everything I know to put this issue in front of "progressives", but it just doesn't matter. It's not sexy enough to be popular. And without it being popular, people aren't going to pay attention, because it's not something that gets a big draw, and that feeling of belonging.

I can't even begin to tell you the feeling of isolation I have, and what that does to me. And, yes, I'm at the point of giving up, so I understand completely what you posted.

i'm 48 and on medicare due to permanent disability...when i tried to get medicare supplement insurance, i was told that i wouldn't be able to get it until i turn 65, due to the fact that i'm disabled- since no private company would offer it to me.

who would accept Medicare.

That's why every civilized country has gone to Single-Payer...

When it's Single-Payer the docs CAN'T refuse to accept patients.

A minority of the medical professionals in this country make too damn much money. The drug companies make too damn much money. The insurance companies shouldn't be in the business of "health care" AT ALL!

HR676 - Health Care for All

... are planning to screw the proles yet again. That would be the usual collection of gullible rubes and bliss ninnies who still believe democrats represent them when, in fact, they're only interested in obtaining preferential treatment for their corporate sugar daddies -- whom they DO in fact represent.

Is there an image more disgusting than that of a bunch of overfed, overstuffed fat boars and sows as seen from the rear, snorting and chomping and farting as they huddle around the corporate slops troughs of america v2.0, shoulder to shoulder with their "bi-partisan" soulmates who serve the exact same masters, just for higher fees.

Then every two, four or six years, they put on this huge shock and awe production for the locals, use all that corporate money to insert their insipid grinning faces into every single TV show in a) their districts, b) their states or, c) the country.

Having bought name identification and brand equity, they're now electable as only a sanitized product in a hyper-consumption society can ever be.

Or does this sound too cynical, despite their behavior ever since Saint Raygun rolled into town and started privatizing everything that wasn't welded to the earth's iron mantle?

sf

Several different people from the administration are saying different things, which is leading to too much confusion on the issue.

The bottom line is that what gets passed by Congress and signed by the President will be the plan. We need to monitor what the plan is coming out of the House to get an idea of where this is going...

On Edit:

CNN asked a stupid question and got a stupid result:

From everything you have heard or read so far, do you favor or oppose Barack Obama's plan to reform health care?

51% Favor, 45% Oppose

OK, so in fact there's nothing stupid about the question at all. The public's response, likewise, is perfectly reasonable given the information they were provided.

But a better question might be: what exactly is Barack Obama's health care plan? Does he have one?

http://www.fivethirtyeight.com/2009/07/obama-has-health...

So far, obviously not!

putting out different stories about events is a standard technique of intelligence operations.

my question would be is the multiple storyline a symptom of pr failure, or?

It's too risky a decision.

My parents included - we don't have hundreds of thousands of extra cash lying around to take care of them, and even though they exercise and live and eat sensibly, people do tend to accumulate serious, but treatable health problems as they age.

Maybe Obama meant payments to private Medicare Advantage Plans which totaled $11.4 billion in 2009.

Now that I would find acceptable. These programs are not traditional Medicare, and they are costing us plenty.

$43 Billion In Extra Payments Have Been Made To Private Medicare Advantage Plans Since 2004

These are the private plans that bombard seniors all the time, making them think they must change from traditional Medicare...the back door way to privatization.

New York, NY, May 4, 2009—Private Medicare Advantage (MA) plans will be paid $11.4 billion more in 2009 than what the same beneficiaries would have cost in the traditional Medicare fee-for-service program, according to a new report released today by The Commonwealth Fund. This new analysis, The Continuing Costs of Privatization: Extra Payments to Medicare Advantage Plans Jump to $11.4 Billion in 2009, estimates that since MA was enacted in 2004, $43 billion in extra payments have been made.

In the report, Brian Biles, professor of health policy at George Washington University and colleagues find that extra payments to MA plans will amount to an average of $1,138, or 13 percent over fee-for-service costs, for each of about 10 million Medicare beneficiaries enrolled in Medicare Advantage plans. The $11.4 billion in extra payments in 2009 represents a 34 percent increase over 2008 payments, which totaled $8.5 billion. According to authors, the steep one-year increase was due to the increase in payment rates and enrollment in the private MA plans.

The bulk of these extra payments were mandated by the Medicare Modernization Act of 2003, which was intended to expand the role of private plans in Medicare in an effort to reduce growth in Medicare spending. Since 2004, MA plan enrollment has increased from 4.8 million to the current 10 million.

“It is clear that private plans are continuing to substantially raise the cost of serving Medicare beneficiaries,” said Commonwealth Fund president Karen Davis. “Modifying these payments in 2010 is an excellent first step, but policymakers should examine whether or not these plans are the best use of Medicare dollars for the beneficiaries they were designed to serve.”

Fix Medicare, stop paying the private plans out of the public coffers....pay doctors a good rate.

If our Democrats stand up for this...if this is what Obama meant about taking funds from Medicare...I could see where that would save. Our party spokespersons need to communicate better what they mean.

Because what we need is to give up more control.... we need to let greedy parasites - scuse me, "entrepreneurs" provide every service with no oversight so they can continue to battle each other to provide the worst service possible while we have no alternative....

http://www.azcentral.com/news/articles/2009/07/02/20090...

"Americans who refuse to buy affordable medical coverage could be hit with fines of more than $1,000 under a health care overhaul bill unveiled Thursday by key Senate Democrats looking to fulfill President Barack Obama's top domestic priority."

older people don't need to go to the dentist. Jeez! I hope Obama's plan will be universal and include GOOD dental coverage for everyone.

Medicare D needs to be scrapped.	madfloridian	Jul-01-09 07:01 PM	#1
Not Scrapped	ProudDad	Jul-02-09 03:26 PM	#25
K&R	New Dawn	Jul-01-09 07:18 PM	#2
Thanks	madfloridian	Jul-01-09 08:24 PM	#3
#5 nt	bananas	Jul-02-09 06:29 AM	#9
You're not the only one, apparently	varelse	Jul-02-09 08:42 AM	#12
Thanks for that link. I had missed that.	madfloridian	Jul-02-09 11:43 AM	#19
HELP plan appears to have public option. Senate finance works on co-op plan	madfloridian	Jul-01-09 10:26 PM	#4
Unless we have a system that extends basic coverage	slipslidingaway	Jul-02-09 01:09 AM	#5
regarding that last quote:	barbtries	Jul-02-09 03:09 PM	#23
Could very well turn out to be true :( n/t	slipslidingaway	Jul-02-09 11:47 PM	#38
From what I read, Medicaid and Medicare will be CUT HUGE by the federal government.	bobbolink	Jul-02-09 03:24 PM	#24
You might want to check your "facts" about Schultz	ProudDad	Jul-02-09 03:29 PM	#26
Geeeez. thanks for the SNARK, dearie. I was talking about him calling for REGRESSIVE taxes	bobbolink	Jul-02-09 03:30 PM	#27
Check your facts, I say...	ProudDad	Jul-03-09 02:10 AM	#40
YOU'RE the one who is confused! I told you to listen to Schultz, but you'd rather argue and	bobbolink	Jul-03-09 11:12 PM	#51
That is why I am for a single-payer not for profit system. n/t	slipslidingaway	Jul-02-09 11:49 PM	#39
To answer your initial question, I thought the public plan would	slipslidingaway	Jul-02-09 01:15 AM	#6
i think obama talked about	DesertFlower	Jul-02-09 02:30 AM	#7
That's different.	Lasher	Jul-02-09 06:51 AM	#10
The Medicare Advantage plans are not like traditional Medicare. Link to info.	madfloridian	Jul-02-09 10:49 AM	#17
Why don't you think we poor folk have to worry? WHO IS THERE TO PROTECT US?	bobbolink	Jul-02-09 03:36 PM	#31
Phasing out new enrollees was from a link in the OP...	slipslidingaway	Jul-02-09 11:40 PM	#36
Exactly right. Cutting poor people's health care to fund MUDDLE CLASS health care.	bobbolink	Jul-02-09 03:33 PM	#30
Muddle class	DonCoquixote	Jul-02-09 09:59 PM	#35
One group against another will continue to happen until we start	slipslidingaway	Jul-02-09 11:46 PM	#37
funny thing is, the systems of those "other nations" are under attack too.	Hannah Bell	Jul-03-09 03:07 PM	#43
That's my understanding. "We are the world" takes on a whole new meaning.	bobbolink	Jul-03-09 08:15 PM	#47
one globe, under capitalism, with poverty & feudalism for all non-elites.	Hannah Bell	Jul-03-09 09:04 PM	#48
Yes they are :( n/t	slipslidingaway	Jul-03-09 11:21 PM	#52
It will continue anyway, because muddleclass "progressives" don't align themselves with us poor folk	bobbolink	Jul-03-09 08:14 PM	#46
Probably true, but at least if everyoone had the right to health care	slipslidingaway	Jul-03-09 11:29 PM	#53
Please think this through...IT'S IMPOSSIBLE TO STAY HEALTHY WHEN YOU'RE HOMELESS.!	bobbolink	Jul-04-09 07:00 PM	#54
And the money saved by instituting a single-payer not for profit	slipslidingaway	Jul-05-09 12:01 AM	#55
So, the healthh of homeless people doesn't concern you...?	bobbolink	Jul-05-09 02:11 PM	#56
What are you talking about, I'm for a single-payer not for	slipslidingaway	Jul-05-09 02:26 PM	#57
Try LISTENING for once,	bobbolink	Jul-06-09 11:51 AM	#58
You are obviously not listening, any further discussion is not worth	slipslidingaway	Jul-06-09 01:05 PM	#59
You've been carrying on a monologue, not a "discussion"	bobbolink	Jul-06-09 08:07 PM	#60
Access to medical care is a basic human right on moral grounds. Period.	crickets	Jul-02-09 03:40 AM	#8
"What to do? " Fight like hell.	bobbolink	Jul-02-09 06:48 PM	#33
You're right!	crickets	Jul-03-09 02:32 PM	#42
You weren't "defeatist"--You were being honest, and I respect that.	bobbolink	Jul-03-09 08:11 PM	#45
K & R n/t	chill_wind	Jul-02-09 08:39 AM	#11
K&R	SammyWinstonJack	Jul-02-09 08:43 AM	#13
K&R	pleah	Jul-02-09 09:05 AM	#14
if they cut medicare payments to dr.s and hospitals- won't that mean that patients have to pay MORE?	dysfunctional press	Jul-02-09 09:11 AM	#15
No, it just means it would be harder to find a doctor	ProudDad	Jul-02-09 03:32 PM	#28
Democrats, as has usually been the case since the scotus ruled money=speech...	warren pease	Jul-02-09 09:46 AM	#16
The biggest problem here is a communications issue. It's a nightmare even.	berni_mccoy	Jul-02-09 11:10 AM	#18
I blame Obama the Chameleon	ProudDad	Jul-02-09 03:33 PM	#29
"different people from the administration are saying different things, leading to to confusion"	Hannah Bell	Jul-03-09 03:11 PM	#44
Thanks for posting this, Madflo. Your concerns are shared by many. I'll read the details later.	bertman	Jul-02-09 11:55 AM	#20
I don't want them phasing out Medicare.	madfloridian	Jul-02-09 12:52 PM	#21
It would be deadly to some :(	varelse	Jul-02-09 02:45 PM	#22
Maybe Obama meant payments to private Medicare Advantage Plans	madfloridian	Jul-02-09 04:53 PM	#32
Oh my fucking god not vouchers	DireStrike	Jul-02-09 06:59 PM	#34
What is this about fining people?	HotHussy	Jul-03-09 02:25 AM	#41
Kick!	Luminous Animal	Jul-03-09 09:12 PM	#49
Medicare is an embarrassment. It doesn't even include dental! As if	Liquorice	Jul-03-09 09:19 PM	#50