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View Diary: New Medicare Advantage Rates Preserve Insurance Industry Subsidies...Again (28 comments)

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  •  And I'll repost my reply. (3+ / 0-)

    Medicare Advantage DISadvantages

    You left out some essential information.

    Medicare Advantage plans, pushed by Bush, Ryan, Romney et al, are the grand Republican plan to privatize Medicare and kill original Medicare. While promising the lower costs and efficiency of private business, Medicare Advantage plans cost the federal government MORE per recipient.

    While Medicare Advantage plans may work out well for healthy people, the seriously or chronically ill often pay higher costs and leave Medicare Advantage plans. Unlike original Medicare where you can see any doctor, most Medicare Advantage plans are HMOs with VERY LIMITED lists of LOCAL providers that can change on short notice. While you may only change or leave a Medicare Advantage plan during one window per year, the plan can kick your doctor off the provider list with thirty day notice. Here in Florida, United Health Care Medicare Advantage plan completely dropped the leading cancer treatment facility (Moffett). So sad, too bad, for the patients were were currently undergoing treatment there. The United Health Care Medical Advantage plan in my area had a grand total of FOUR oncology providers that no one ever heard of. Advantage plans also have the nasty habit of denying care (sorry, not medically necessary), denying long-term nursing care, denying emergency care at an off the list hospital, patients paying more out of pocket for chemotherapy, denying patients newer chemotherapy drugs and insisting outdated older treatments are tried first.

    What Republicans Don't Want You to Know About Medicare
    http://sandiegofreepress.org/....

       But Medicare Advantage has a dark side. With traditional Medicare you can go to any doctor you want, even specialists, without a referral. You can get a second opinion, even a third if you choose. With Medicare Advantage you have to stick to a certain network of doctors, and you can even be refused treatment under some circumstances. Ah, there’s the rub. Medicare Advantage will offer you lures — cheap lures but, when it comes down to those expensive operations, you might be refused the permission to undergo the operation by the insurance corporations. After all, that’s how they make their money – denying service for the expensive stuff while luring you in with the cheap stuff.
    Medicare Advantage or DISadvantage?
    http://wendellpotter.com/....
       The real bottom line you need to understand is that the insurer might want to keep you enrolled only as long as you’re relatively healthy. When that changes, you just might find that you’re no longer considered a valued member and that the traditional Medicare program is a much better deal for you.

        The study, published recently in the Medicare and Medicaid Research Review, confirmed what some who are familiar with the Medicare Advantage program, including me, have suspected: when people enrolled in MA plans become critically ill, many realize that the only way they will get coverage for the care they need – and at a facility of their choice – is to return to the traditional Medicare program.

    What about the climate cliff?

    by wayoutinthestix on Tue Apr 08, 2014 at 12:33:39 PM PDT

    [ Parent ]

    •  Actually, Medicare Advantage (4+ / 0-)

      originally was created under the 1997 Budget deal between Clinton and the GOP Congress and was originally known as "Medicare + Choice", but in fact Medicare had been doing it via a series of demonstration projects going back to the 1980s.

      The reason was to fill a real need - Medicare part A and B didn't cover dental, vision, etc., people had to come out of pocket for a whole lot of costs due to high deductibles and lack of annual out of pocket maximums, and (until 2003) had no coverage for prescription drugs.

      As I mentioned, there is an argument for creating a single, streamlined, more comprehensive Medicare with things like lower deductibles and copays, and annual out of pocket maxmimums, and coverage for dental, vision, holistic medicine, and a drug benefit, all outside the private insurance system.

      But would you make it optional, namely, could people still pick A, B, or D a la carte or choose this new super Medicare plan, or make it apply to everyone?  And how would Medicare having out of pocket maximums - thus paying 100% beyond a certain limit, unlike now where under traditional Medicare there is no such limit - affect its costs?  Would you have to raise premiums and/or payroll taxes?  I think going this route would be worth it - but you'd still have to consider all those questions and make arguments accordingly.

      What seems untenable, however, is simply returning to traditional Medicare with its high out of pocket costs and limited coverage.  

      "Those who have wrought great changes in the world never succeeded by gaining over chiefs; but always by exciting the multitude." - Martin Van Buren

      by puakev on Tue Apr 08, 2014 at 01:06:10 PM PDT

      [ Parent ]

      •  Medicare does have problems (2+ / 0-)
        Recommended by:
        whenwego, yoduuuh do or do not

        but Medicare Advantage plans will take us farther from, not closer to, a solution. Medicare Advantage plans satisfy the objective of the corporate mantra -- privatize the profits, socialize the losses-- by heavily marketing cheap perks to a healthy population and treating the expensively sick so poorly they have no option but to return to tradition Medicare.

        I have to wonder why you repeatedly paint such a rosy, one-sided and misleading picture of Medicare Advantage plans.

        What about the climate cliff?

        by wayoutinthestix on Tue Apr 08, 2014 at 01:50:55 PM PDT

        [ Parent ]

        •  Politically Not Doable. (2+ / 0-)
          Recommended by:
          puakev, whenwego

          Do you know any elderly people? Have you talked with them about Medicare?

          Every year my brother and I help my mom (now 82) sort through her Medicare options. Advising her to take Medicare Advantage is just a no-brainer. Cut it and you'll be pissing off not just insurance companies, but millions of seniors (a high-turnout vote demographic) and their middle-aged kids who help them figure out their Medicare choices.

          Instead of trying to cut Medicare Advantage, we should be raising the traditional Medicare benefit schedule to equalize the level of per-patient expenditure. I wrote a longer comment on how to finance this.

          "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

          by HeyMikey on Tue Apr 08, 2014 at 02:14:31 PM PDT

          [ Parent ]

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