Matthew Holt

Expect to hear a whole lot about this…

Seniors care about death panels (apparently) but they usually really care about drug prices and costs. Part of the political rationale for the Republicans passing Medicare drug coverage in 2003 was to deny the Democrats the ability to bundle seniors’ desire for drug coverage with a universal coverage bill. So far the Republicans have to say the least muddied the waters as to whether universal coverage is a good thing for Medicare recipients—or at least the ones that don’t care about their kids or grand-kids.

But there’s one minor trick. The deal with big Pharma that’s part of HR 3200 cuts the donut hole in half. That’s real money for seniors.

And when the cuts to Medicare Advantage become apparent, that donut hole is going to affect many more seniors who now are getting good benefits from Medicare Advantage and are pretty unaware about what’s about to happen to those benefits, according to this recent Silverlink/Suffolk University poll. (Hint, many Advantage plans will get much less generous).

In that case, knowing that there is something in the bill that helps them might change some seniors’ minds. Right now the Silverlink/Suffolk poll does not make happy reading for the Administration:

The survey also polled Medicare recipients on healthcare reform. Despite high levels of satisfaction and relatively strong amounts of optimism, nearly half of Medicare recipients polled (48%) say they do not believe the Obama administration is looking out for their best interests when it comes to healthcare reform. The remaining are split, with 28% believing the administration is looking out for them and 24% unsure.

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Matthew HoltJim BertschJohn BallardMargalit Gur-ArieMark Recent comment authors
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Mark
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Mark

Margalit,
I am agreeable to your suggestion that those who opt-out of offering to donate their organs would fairly be denied an organ themselves despite their time of need. At some point, we have to recognize that men are not Gods, the world is not perfect, and hard problems will require uncomfortable solutions at times. Good idea, in my opinion.

Mark
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Mark

John B, No calculation was necessary to evoke your response. Such discussion is a clear tiptoe on the slippery slope toward a eugenics view of society. Show Emmanuel’s view to most Germans (of which I do have heritage) and they will be apalled. It takes no imagination to draw the line. Once we decide that we, as humans, should systematically choose on a societal scale who is more worthy to be treated than another, we have lost our humility and dignity. I am a physician who would be satisfied to draw straws for my organ…I don’t want a bureaucratic or… Read more »

Mark
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Mark

Margalit,
Regarding organ transplantation, I actually agree completely with your proposal that anyone should be able to opt-out of the organ donor system, with the consequence that they not be eligible to receive an organ in that case. I’m on board. A good solution.

eric Novack
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eric Novack

Not naughty, my friend… “on average” is the key line — the millions of seniors who do not spend much on prescriptions will see a net increase… add to the that the millions of non-Medicare customers in the system with subsidized care from an individual mandate…. the final result being more money in the pockets of PhRMA companies… thus their $150 million in advertising support. So, you are correct, if Mrs, Jones was spending $10,000 per year, she will see (eventually) a decrease (assuming that the plan is not altered by Congress before full implementation that decreases the financial benefit).… Read more »

Matthew Holt
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naughty naughty Eric. Selective quoting means that you missed the most important sentence in the CBO draft IMMEDIATELY after the one you quoted, and when you quoted it you didn’t indicate that you’d made such a cut. You wouldn’t be scared that other readers wouldn’t come to your conclusion. I’ll let THCB readers come to their own conclusions about what they CBO meant by this sentence: “However, beneficiaries’ spending on prescription drugs apart from those premiums would fall, on average, as would their overall prescription drug spending (including both premiums and cost sharing).” But somehow I can see the Democrats… Read more »

Jim Bertsch
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Jim Bertsch

Payment reform, payment reform payment reform. Everything begins and ends with payment reform. Without payment reform their is no health care reform. Fee-for-service and pay-per-pill are the root cause for all of our health care problems. A public option will not correct the problems. Supposed competition will not correct the problems. Fee-for-access corrects the problem. Pay upfront (like we do now) and access the health care system for free. No copays for anything including: doctor visits, hospital stays, medications, etc. Doctors, Pharma and hospitals get paid when you pay. They get paid upfront (unlike now) before you access the system.… Read more »

John Ballard
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“…since when are humans fit to make the judgment that one man at age 35 is more valuable than one at 65? How does one judge disabled people against those who are not. What about people who are high functioning with multiple medical problems? Should they have less access to necessary treatments?” Fascinating string of fear-inducing questions, not calculated, I’m sure, to evoke the worst outcomes of eugenics and campaigns for racial purity, but just enough to nourish those long-exploited generic fears. By what metric does Mark propose we answer them? Age? Political affiliation? Net worth? Luck? Citizenship? Wait! I… Read more »

Margalit Gur-Arie
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Mark, Dr. Emanuel’s Lancet article is NOT talking about “expensive” treatments. It is talking about allocation of VERY scarce medical interventions, such as organ transplants. No matter how much you are willing to pay, there are not enough organs to go around. Organ transplants are allocated today based on different factors. Dr. Emanuel is merely proposing a more equitable allocation system. Are you disagreeing with the particulars of his proposal? Do you prefer the current organ rationing system? Do you have any suggestions to make organ transplants a non-scarce intervention? I do, but I don’t think you’ll like it. Let’s… Read more »

Mark
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Mark

Wake Up America! The stimulus hid ominous healthcare provisions!!! Information technology providers from ambitious startups to the behemoth GE have been waiting for the opportunity to grab a big piece of the health care dollar in America. They found their perfect partner in the federal government this year. In the innocent guise of cost savings, the Obama Administration has plans to use computerized health information to gain federal control over all of health care. This is no hyperbole. This very significant health legislation was hidden, placed quietly within the stimulus bill (rather than including it in other health care reforms… Read more »

Eric Novack
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Eric Novack

Matthew — sorry you missed the CBO publication on Friday on this issue… http://www.cbo.gov/ftpdocs/105xx/doc10543/08-28-MedicarePartD.pdf “Overall, CBO estimates that enacting the proposed changes would lead to an average increase in premiums for Part D beneficiaries, above those under current law, of about 5 percent in 2011. That effect would rise over time and reach about 20 percent in 2019. Beyond the 10-year budget window, the premiums would increase slightly more until the doughnut hole was eliminated in 2022; beyond that point, enrollees’ premiums would grow along with the cost for covered drugs. As already noted, the proposed changes would also reduce… Read more »