Uncategorized

Obama’s Medicare Half-Truth

Picture 12

Obama was called a liar during his recent address to a joint session of Congress. Actually, he was not fully truthful
about the implications of cuts to Medicare. Obama repeated that his
health reform plan includes payment cuts for private Medicare Advantage
(MA) health plans:

The only thing this plan would eliminate is the
hundreds of billions of dollars in waste and fraud, as well as
unwarranted subsidies in Medicare that go to insurance companies —
subsidies that do everything to pad their profits and nothing to
improve your care. … So don’t pay attention to those scary stories
about how your benefits will be cut… That will never happen on my
watch. I will protect Medicare.

Obama’s claim that the cuts will trim insurer profits but not Medicare benefits was meant to calm nervous seniors. As I and others
have pointed out the proposed cuts will in fact reduce benefits to some
degree, contrary to the President’s assertion. But seniors, in
general, should not be concerned. First, only about 23% of Medicare beneficiaries are enrolled in an MA plan.

Second, there will be very little loss in consumer surplus due to MA payment cuts. Estimates from my 2008 International Journal of Healthcare Finance and Economics paper (co-authored by Steve Pizer and Roger Feldman)
suggest that the consumer surplus loss associated with cuts in payments
to MA plans will be only 14 cents per dollar saved. The study on which our paper
was based was funded by the Changes in Health Care Financing and
Organization (HCFO) Initiative of the Robert Wood Johnson Foundation
and is summarized in a HCFO Findings Brief.

In this case, consumer surplus is the dollar value that Medicare
beneficiaries receive from the benefits provided by their chosen health
plan. This is estimated by examining the detailed choices seniors
actually make and then calculating what they would be willing to pay,
on average, for particular bundles of benefits. It turns out that the
additional benefits and flexibility created by recent increases in MA
payment rates simply weren’t worth very much to seniors. By comparison,
the consumer surplus loss per dollar saved associated with eliminating
prescription drug plans, something no one has proposed, would be nine
times larger.

Despite Obama’s rhetoric, the truth is that under his plan a small fraction of Medicare beneficiaries will
lose their MA benefits and/or face higher costs. However, the potential
savings are enormous and research shows that the benefit cuts needed to
achieve them will not be terribly missed. While Obama’s statements
about Medicare cuts are not strictly true, in practice they will turn
out to be mostly true.

Austin Frakt is a health economist and principal investigator
with the Department of Veterans Affairs’ Health Services Research and
Development Service and assistant professor with the Boston University
School of Public Health, Department of Health Policy and Management.
The views expressed in this post are his alone and do not necessarily
reflect the positions of Boston University or the Department of Veterans
Affairs.  Frakt
blogs at The Incidental Economist where this post first appeared.

Also by this Author:

THE HEALTH CARE COST SHIFTING MYTH

EHRs AND MULTI-PROVIDER USE: LESSONS FROM THE VA

Spread the love

34 replies »

  1. Nate, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, prohibits undocumented immigrants from being eligible for most public benefits and codified procedures for verifying eligibility.
    In the case of Medicaid, according to the GAO, six states spent $16.6 million of federal and state taxpayer dollars to implement extra verification procedures but only caught eight undocumented immigrants, while at the same time blocked thousands of U.S. citizens.
    This doesn’t make any moral, economic or practical sense.

  2. Margalit have you not read the White House website on this? If Obama’s changes pass an illegal alien can come into the country and purchase a non exchange policy with no pre-ex and no limits. Nothing in his proposal stops them from doing exactly what I said. You don’t need a drivers license, bank account, or IRS number to apply for insurance. As long as you don’t try to get an exchange plan. This is a blatant attempt to kill off private insurance.
    Greg you might want to look up the initials GAO, CMS, and CBO all have done studies on the number and dollar amount of benefits illegals receive under medicaid and other government programs. Audits of state mediciad eligibility usually shows citizenship can’t be determined for 5-10% of enrollees becuase of failure to verify the documents you claims prevent this from happening.

  3. Nate, I didn’t say anything about race (that’s in our other discussion).
    Why are you always going to the fringes? If “illegal aliens” can have IRS numbers, pay taxes, have bank accounts and driver licenses, then they must have proof of residence and they didn’t just “sneak in” half dead with some dreadful illness.
    MD as HELL, non profit hospitals are exempt from paying taxes in return for some charity care (another hornets nest) and there are lots of them out there.

  4. There is nothing in the health care bills that changes the already stringent verification mechanisms prohibiting undocumented immigrants from being eligible for public benefits. Tax policy experts have further pointed out that it would be difficult for undocumented immigrants to even apply for subsidies because tax returns are required to determine a person’s eligibility. And conservatives obsessed with health care reform’s price tag should take note that enforcement mechanisms are expensive. So demonizing immigrants will have a high political cost on their part.

  5. Great,
    The brave president will not cover illegals with health insurance. You can bet they will still be in the ED and will get care. That is the same as it is now. They ae not covered for payment, but the are covered by EMTALA.
    Margalit, the ED is not supported by tax dollars. It is supported by the hospitals and the docs eating it when people do not pay.
    My group presently collects about 30 cents on the dollar. Our biggest deadbeat is Medicare fleecing us with low payment. Next is Medicaid. Next is TriCare. At least I can take the uninsured to court. But a bum is judgement proof.
    Do you want fries with that?

  6. your smarter then that Margalit and not nearly that dishonest. Obama wants to make it law that insurance companies must sell them a policy outside the exchange. At the same time he will make it law that they can’t have pre-existing and lifetime or annual maximums. He also advocates community rating.
    THe problem isn’t the illegal that buys health insurance when they are healthy and don’t need it. Obama wants to open a huge freaking door for sick citizens of other countries to sneak into America just to buy insurance to treat conditions they already have. You can’t make up a worse case of adverse selection. Private Insurance would be bankrupt in a couple years. Instead of having an honest discusion about facts you try to make it a race issue and accuse people of being racist.
    Lets have an honest discussion about this. How can private insurance stay in business when it is forced to sell policies to illegal aliens that sneak in to get treatment? Is it fair for American citizens to subsidize illegal aliens that sneak in to get treatment?

  7. Can we please stop this “illegal aliens” charade? If all “illegal aliens” were to disappear tomorrow, we would be drowning in garbage, unwashed dishes and rotting crops, to name a few.
    These folks are here to stay. The IRS is perfectly willing to collect taxes from them, some banks will happily open accounts for them and some states are issuing driver licenses or certificates.
    So why shouldn’t they be able to purchase health insurance? Is it better to treat them in the ED at tax payers’ expense?
    Not to mention the hypocrisy of collecting taxes from people that have no representation in government.
    Let the healthcare reform bill take care of health care. The immigration situation deserves its own separate reform.

  8. from Dr. Weinstein:
    “The “You’re a liar” remark was in response to the president’s assertion that the public option would not be available to those who are here illegally. So let’s look at the veracity of this statement. While technically correct (3 of the 4 proposed bills do explicitly exclude illegals), the fact is there is no verification procedure proposed. The federal government would undoubtedly adopt a don’t ask, don’t tell policy vis a vis citizen verification, just as it does for most social programs. The result would be plenty of illegal aliens signed up for the govt option.”
    Of course there would be. Anyone in Washington — and anyone who is a “healthcare journalist” — would know that what counts is not what is written in the text of a bill, but what subsequent rulemakers will do with it. Congress knows this, which is why they don’t read the bills. For people to say “Look, it is right there in the bill, stop being mean to our handsome, suave President, who is reading it to you in his adult voice!” — while his Democratic Party is resisting efforts to get enforcement language — it’s just silly.
    Obama knows how the game works. He was being deceptive.
    For 8 years the Left called Bush Hitler, a chimp, and invited assassins to take a shot at him. “Liar” would have been a mild day. Harry Reid called Bush a liar on national television.
    Now, we’re racist for disagreeing. Nice way to heal racial divisions, “progressives”.

  9. let me amend that;
    there is substnatial savings garnered by moving seniors from FFS to MA in high cost and urban areas

  10. Maybe we need a trigger for Medicare?
    6/28/07 from Orszag
    “Previous work by CBO has shown that plans’ bids for operating Medicare Advantage plans vary less from county to county than per capita FFS spending does (see
    Table 1). As a result, in areas with high FFS costs per capita, Medicare Advantage plans’ bids are relatively low in comparison with FFS spending, and vice versa. In
    particular, in areas with the highest per capita FFS spending, health plans’ bids are about 9 percent below FFS spending. By contrast, in the lowest-cost FFS areas,
    health plans’ bids are about 16 percent above FFS spending.”
    “Because private plans try to restrain medical costs by managing the level and intensity of service utilization, they have greater potential to achieve savings relative to the FFS program in geographic areas where FFS practice involves relatively high utilization
    of costly services—which also tend to be areas with high per capita FFS expenditures.”
    Maybe we need to be pushing MA in parts of TX and other high cost areas? Unless my napkin math is off even after accounting for the inflated benchmarks there is substnatial savings garnered by moving seniors from FFS to MA.

  11. I promise to come back later (few days?) to sum up some reaction to comments. Just a quick one now in response to Maggie Mahar. She wonders about the headline and seems to ask who is responsible for it (I’m reading in to her “Matthew ?????” line).
    While the headline is mine in the sense that it appears on my own blog, I actually didn’t ask or intend for it or this post to appear here at all. It was posted on *my* blog first and The Health Care Blog picked it up based, I guess, on a courtesy e-mail announcement I sent the editors.
    So Maggie, you are correct to ask Matthew about the post (headline and all).
    Having said that, I don’t mind that the post is here and now that it is, I will defend it, to a point. But that is for another day.
    Meanwhile, I would not mind in the least if the editors also defended or commented on it since they chose to re-post it without my request or pre-authorization. So, yes Maggie, I agree: Matthew ?????

  12. Rick how about the CBO?
    “In contrast, payments to HMOs averaged 10 percent above FFS costs,MedPAC estimates. On average, HMOs offered extra benefits and rebates equal to 13 percent of FFS costs; those additional benefits reflected the difference between the benchmarks (which averaged 10 percent above FFS costs) and plans’ bids (which averaged 3 percent below FFS costs).”
    If the boss or clients need more I’m for hire. I charge to much and am an ass but the ROI is incredible. Clients that listen to me have trend about equal to inflation.
    There was a much better and in depth study I read but I can’t find it as I sit here.
    aaahhh another crazy comment from maggie. Maggie you have no clue what you are talking about, have you ever even read a policy? Care to link to any examples of this happeneing let alone many times? MA plans are filed and approved you do not see bait and switch benefit changes, if they did that would only get them one year of enrollment growth. You don’t see many benefit changes at all becuase of the cost of rolling out plan changes.
    If carriers really were doing bait and switch how do you account for the year over year growth? If what you said had any truth to it, that would be a first, then there would be one year with a spike in enrollment then declining enrollment as members left after being tricked. None of which has happened. Then again you never had a problem making things up and if anyone dare calls you out on it you just delete the comment.
    Medicare stable; by what measure is that? Medicare didn’t even cover Rx until 06. 3 years of coverage makes it stable? How does minor policy tweaks of MA make them unstable? 20 years of MC/MA is unstable becuase they have more changes then 3 years of Part D, that is one of your wackier claims.

  13. Austin:
    I’m sorry to see yet another headline suggesting that President Obama lies. (Or tells half-truths.)
    I realize that ultimately you say:
    ” the truth is that under his plan a small fraction of Medicare beneficiaries will lose their MA benefits and/or face higher costs. However, the potential savings are enormous and research shows that the benefit cuts needed to achieve them will not be terribly missed.”
    This is entirely true.
    So why the Fleet Street headline?
    (Matthew ?????)
    We’re in a situation where people are carryig Signs that say “Bury Obama with Kennedy.” We don’t need more headlines to help fuel their hatred.
    On Medicare Advantage, just three points:
    1) Some Medicare Advantage patients get “extras” through MA, but many of those “extras” disappeared after the first year. Bait-and-switch
    2) Unlike Medicare, which is pretty stable,the e provisions of Medicare Advantage plans are always changing. Some of our sickest seniors are now asked to pay prohibitively expensive co-pays for drugs under Advantage plans.
    3) Bottom line– On balance, Medicare Advantage has done seniors more harm than good. (The Medicare Payment Advisory Comission (MedPac) describes Medicare Advantage’s results as “depressing.”

  14. Oh, and since I applaud the trend toward commenters asking for authoritative sources for other commenters’ assertions, here is a link to the CDC website regarding both seasonal and H1N1 (swine) influenza. You can navigate around the site to have other questions about flu answered.
    http://www.cdc.gov/h1n1flu/recommendations.htm

  15. Karen;
    Your example of John and Sara points out the complexities of patient expectations and reasonable costs. Once their child was diagnosed with influenza A, the swine flu test was irrelevant from a treatment standpoint, since the treatment for seasonal influenza A and swine flu ( a novel type of influenza A) are the same: Tamiflu, IF INDICATED. (see below). The only usefulness of the swine flu test at that point is epidemiological, and the CDC has well-established surveillance protocols for determining spread of epidemic/pandemic diseases.
    The “if indicated” caveat is that some experts say that not every case of swine flu needs Tamiflu and perhaps Tamiflu should be reserved for those patients with influenza A who have underlying health conditions. There are influenza viruses which are resistant to Tamiflu, so its overuse is not without risk.
    Therefore, it was quite reasonable for their insurance company not to pay for a specific swine flu test, and Karen’s reasoning is that of a lay person whose expectations have been influenced by the lay media.
    If we try to meet everyone’s expectations all the time instead of using some sort of medical necessity criteria, then health care truly will become unaffordable, for everyone.

  16. I am concerned about keeping our promise to seniors, but let’s see if someone can find a way to fund healthcare for lots of the folks below, many with insurance, many without which are going to use our resources one way or another. Just because you have insurance doesn’t mean that you get coverage – John and Sara couldn’t get insurance to cover their child’s swine flu test. (see link below)
    Check out MyamericanHealthcarestory.org for a some stories of average American’s dealing with the healthcare situation as it is now.
    Nellie’s American Healthcare Story
    http://myamericanhealthcarestory.org/nellies-american-healthcare-story/
    John and Sara’s American Healthcare Story
    http://myamericanhealthcarestory.org/john-saras-american-healthcare-story/
    Ben’s American Healthcare Story
    http://myamericanhealthcarestory.org/bens-american-healthcare-story/

  17. Austin–I believe you should spend some time in a health plan administering the Advantage product to see what the impact would be. We can argue whether or not an Advantage senior should have enhanced benefits over a traditional Medicare senior because that is the case. Advantage plans receive 9-17% above traditional Medicare risk adjusted and to attract members have enhanced the traditional benefits considerably for the trade off of less flexibility/portability for the Senior. Advantage usually cover Part B, have limited or Zero deductibles, transportation and travel benefits and most importantly for this additional cost get drugs covered (an embedded Part D if you will). Obama wishes not to decrease payments to commercial payers by 9-17%, he wishes to end the program. Either way, all of these coveted benefits (I do not believe your senior value proposition since I live in this world with Seniors) will disappear to the 23% who now have them. Drugs and loss of no deductibles particularly will be catestrophic for many. Advantage is growing rapidly now and thus highly valued compared to its beginnings. It was only 9% of Medicare Seniors in 2005. So, Nate I delare your criticisms are correct.
    Additionally, I am always nonplussed when someone knowledgable says Medicare administration rate is a lean machine compared to commercial payers. The word “RATE” a non meaningful/comparable term when the cost/age demographics are widely different. Rate is the administrative cost/premium (cost). The Medicare cost(premium) per capita is much higher and thus the rate drops–but the per capita rate is near identical for commercial plans and Medicare. The cost of adjudicating claims is about the same everywhere. Where commercial plans do more for the patient, e.g. disease management, telephonic office appts., member outreach, etc., there costs are more. Medicare almost does nothing except adjudicate the claim. It has no medical management for the most part and is the most robust freewheeling uncontrolled plan imaginable. So when you compare rates for administration you are telling a half lie as Obama. You must consider the per capita adminstrative cost and cost of the premium to understand the rate metric (which is nonsense).

  18. @Nate:
    “Um no they are not, MA is paid 14% more then the cost of FFS to deliver benefits worth 15-16% more then FFS. MA delivers FFS benefits for 98-99% of the cost for FFS to deliver said benefits.”
    Please cite your source and post links to authoritative verification because this is the very first I heard of this, and I research health benefits for a living. My boss — not to mention our clients — would be very upset if what you posit here is true and we didn’t know about it.

  19. Half truths are for a public that cannot handle the truth. Fully cover any medical intervention that I want and that the docs in McAllen Tx need to fund their investments/boats/homes, keep paying the highest costs on the planet for drugs and devices and specialists, give me a $$ million in end of life care that will give me a few more weeks on this planet, and cut my costs and don’t increase the budget or my taxes. Oh, those tax sucking illegals, how dare they want a free ride. Welcome to healthcare in America.

  20. Not only is this an unfortunate title for this post, the first paragraph is also unfortunate. As Dr. Weinstein remarked, Obama was called a liar in response to the president’s assertion that the public option would not be available to those who are here illegally, not because of the implications of cuts to Medicare. This, despite that fact that both the House and Senate bills explicitly exclude undocumented immigrants from receiving health benefits. Obama has blamed the right for the difficulty getting agreement on the bill, saying they have failed to take him up on his offer to cooperate.
    The outburst signaled the resurgence of the right-wing’s preferred tactic du jour, the immigration wedge strategy, as they are trying to do with tort reform. Obama expressed his skepticism over the idea of capping medical malpractice awards (“So far, the evidence I’ve seen is that caps will not do that”) but would consider any and all ideas for reducing healthcare costs. He questioned whether it was fair to tell patients who have been the victim of negligence that you can only get a certain amount of money, no matter the severity of the malpractice.

  21. If I had a nickel for every politician of either party who spoke a half-truth I would be rich today. So why all the manufactured outrage about truths, lies, or inaccuracies?
    And sure, he promised it wouldn’t be politics as usual, but when the rules of the game are already established, it’s hard to play the game outside the rules. The other players tend not to play with you.
    I am more concerned about the order-of-magnitude increase in disrespect given to the office of the President since Obama has taken office. Even George Bush did not absorb this level of abuse. Could this be (dare I say it) a racial issue, or is it because Obama is younger than usual, or what? (I can’t remember how old Clinton was when he started; I don’t follow politics so closely as you guys.) Perhaps we should not pat ourselves on the back for being post-racial yet.

  22. Not only is this an unfortunate title for this post, the first paragraph is also unfortunate. As Dr. Weinstein remarked, Obama was called a liar in response to the president’s assertion that the public option would not be available to those who are here illegally, not because of the implications of cuts to Medicare. This, despite that fact that both the House and Senate bills explicitly exclude undocumented immigrants from receiving health benefits. Obama has blamed the right for the difficulty getting agreement on the bill, saying they have failed to take him up on his offer to cooperate.
    The outburst signaled the resurgence of the right-wing’s preferred tactic du jour, the immigration wedge strategy, as they are trying to do with tort reform. Obama expressed his skepticism over the idea of capping medical malpractice awards (“So far, the evidence I’ve seen is that caps will not do that”) but would consider any and all ideas for reducing healthcare costs. He questioned whether it was fair to tell patients who have been the victim of negligence that you can only get a certain amount of money, no matter the severity of the malpractice.

  23. Interesting title for a post that has nothing to do with the assertions of Joe Wilson. Handy.

  24. “MA plans are overpaid by ~14% relative to FFS.”
    Um no they are not, MA is paid 14% more then the cost of FFS to deliver benefits worth 15-16% more then FFS. MA delivers FFS benefits for 98-99% of the cost for FFS to deliver said benefits.
    If you cut the 14% premium carriers will cut the 15-16 benefit increase. Remove the increased benefits there is little reason to be in MA. MA is sold as a comprehensive benefit package that includes your medciare benefits, medi-gap benefits, and usually some dental and vision.
    While MA could deliver FFS level benefits cheaper then Medicare I don’t see a vibrant market for the 1-2% marginal return.
    “beneficiaries in general do not value the *extra* benefits they receive through MA today”
    I hope you didn’t spend much on the research, no one values their benefits. Rather your talking MA, private insurance, or public plans people don’t value what they have or even know the true cost. I don’t see how you can use that to apply a true economic value to benefits delivered. Knowing the true value of the benefits delivered I don’t know why you would even try to measure their perceived value excpet to say we don’t appreaciate what we have.
    I think we should cut Medicare back to the catostrophic plan democrats sold the public in 1965. I don’t see a plan part way between the public financing mechanism we have now and a catostrophic plan we should have had as an improvement. That sounds like the worse of both worlds. Either pay everything under a socialized system with co-pays, or go to a free market catostrophic system with personal responsibility. 44 years in the middle has been a complete failure.
    At a certain age the needs of the consumer change so that they are not capable of making decent HC decisions. I think when people start losing their faculities they need to be in a comprehensive capitated plan. The room for financial abuse and neglect is to great. I think to many FFS now have no idea what is going on and are just doing what they are told. Having processed Medicare Supp claims for 10 years+ and takeing calls form these seniors they need help. MA plans or hopefully something with independent management, I would suggest TPAs, need to be mandatory for Seniors at a certain age.
    What half of Obama’s platform do you think is honest? I love the part about AARP endorsement, like you can’t buy that with a couple percent marketing kick back. His rehetoric is either completly dishonest or he doesn’t have a working comprehension of Medicare. I think they know what they are proposing and know the effect it will have but are ok as long as their bill passes.
    When Medicare was passed in 65 with promises of Grandma no longer having to worry about a long hospitalization taking all her assets they had to know the limited days covered by Medicare did nothing to prevent that. They sold what they had to sell to get the votes. Obama is making the same promises today, he has to know he can’t keep any of them.

  25. @Dr. Pandey – I’m afraid I don’t understand your point. My piece was not about waste. It was about cutting payments to MA plans.
    @Nate – 23% will not lose their MA plan. 23% are currently enrolled in a plan type that will face funding cuts. MA plans are overpaid by ~14% relative to FFS. Cutting funding back to the level of several years ago will probably lead to enrollment at the level we had then (10-15%) and a level of benefits available then.
    Was that level of enrollment too low? Were those benefits too stingy? Is it sensible for taxpayers and the remaining ~80% of beneficiaries to pay for extra benefits in MA? And finally, as my paper shows, beneficiaries in general do not value the *extra* benefits they receive through MA today (*relative* to those received in 2003) very highly. Sounds like a sensible place to cut to me.
    You, I, and others have already written a great deal about cost shifting at https://thehealthcareblog.com/the_health_care_blog/2009/08/the-health-care-cost-shifting-myth.html
    @Hal Horvath – I agree with you about headlines. I stand by my contention that Obama is speaking in half-truths on Medicare. Politifact.com agrees with me (or I with them): http://www.politifact.com/truth-o-meter/statements/2009/aug/14/barack-obama/obama-claims-medicare-benefits-will-not-be-cut-und/

  26. @Dr. Pandey – I’m afraid I don’t understand your point. My piece was not about waste. It was about cutting payments to MA plans.
    @Nate – 23% will not lose their MA plan. 23% are currently enrolled in a plan type that will face funding cuts. MA plans are overpaid by ~14% relative to FFS. Cutting funding back to the level of several years ago will probably lead to enrollment at the level we had then (10-15%) and a level of benefits available then.
    Was that level of enrollment too low? Were those benefits too stingy? Is it sensible for taxpayers and the remaining ~80% of beneficiaries to pay for extra benefits in MA? And finally, as my paper shows, beneficiaries in general do not value the *extra* benefits they receive through MA today (*relative* to those received in 2003) very highly. Sounds like a sensible place to cut to me.
    You, I, and others have already written a great deal about cost shifting at https://thehealthcareblog.com/the_health_care_blog/2009/08/the-health-care-cost-shifting-myth.html
    @Hal Horvath – I agree with you about headlines. I stand by my contention that Obama is speaking in half-truths on Medicare. Politifact.com agrees with me (or I with them): http://www.politifact.com/truth-o-meter/statements/2009/aug/14/barack-obama/obama-claims-medicare-benefits-will-not-be-cut-und/

  27. The overweight is harmful to health because it can affect our body, such as the heart, blood pressure increases due to diabetes, gout, arthritis, hypertension, etc, and findrxonline say that the best way to lose weight is to eat a healthy diet and exercise. When performing exercises burn more calories.

  28. This is an unfortunate title for this post.
    The author or editors fail to consider that much of the population does not read articles, they read headlines, in effect.
    Your headline *is* your conclusion, to many Americans.
    So some will take this post to say: proof — even the experts say the administration is dealing in “half-truths” (therefore we can take it as proven the administration is lying about everything, all the time).

  29. Using his own metric for efficiency, reducing total Medicare expenditures, while increasing the administrative costs of that would be needed to root out fraud and abuse, would naturally make Medicare appear less efficient.
    This is partly why administrative costs in the private sector appear to be higher, they are just doing what Medicare should have been doing in the first place.

  30. The “You’re a liar” remark was in response to the president’s assertion that the public option would not be available to those who are here illegally. So let’s look at the veracity of this statement. While technically correct (3 of the 4 proposed bills do explicitly exclude illegals), the fact is there is no verification procedure proposed. The federal government would undoubtedly adopt a don’t ask, don’t tell policy vis a vis citizen verification, just as it does for most social programs. The result would be plenty of illegal aliens signed up for the govt option. Personally, I think this is better than the illegals having no insurance at all. But the sentiment that the president was dishonest, however boorishly and disrespectfully expressed by Mr. Wilson, is accurate
    (Subsequent to Wilson’s outburst, verification apparently will be added to the legislation…we shall see).

  31. Austin,
    I would love to hear your gauge of relevance.
    “First, only about 23% of Medicare beneficiaries are enrolled in an MA plan.”
    It’s not a problem because it only affects 23% of the population involved. Why are we even discussing universal coverage when only 2.6% of the population can’t get insurance? There are more seniors who will lose their MA plan then there are Americans who can’t get insurance.
    “However, the potential savings are enormous”
    You’re missing a few key words here. The potential savings to the federal government are enormous. What was once paid by the MA plan funded by the government will now be paid by the senior. Nothing is saved, it only shifts cost. MA profits are a small percentage of the total cost. Those profits are almost completely negated by the increase in cost of basic benefits that will now be incurred by traditional Medicare. Or are you going to try and claim that once forcibly removed from their MA plan, I guess keeping you plan only applied to those with employer insurance, seniors are going to reduce utilization?
    This is a common trick by those on the left that don’t understand healthcare. Like Obama claiming cutting hospital reimbursements will result in that much of savings, ignoring the fact the cuts will just be shifted to someone else. Making seniors pay more out of pocket isn’t saving money, it’s shifting cost. Not necessarily a bad thing but call it what it is.

  32. Asking to cut cost is not cutting the funding…someone has to step up and say enough to this waste…..
    Do you in your right mind believe that there is no waste? If every dollar is spent well….then let us stop the debate….because then there is nothing to improve.
    rgds
    ravi
    blogs.biproinc.com/healthcare
    http://www.biproinc.com

Leave a Reply

Your email address will not be published. Required fields are marked *