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Back in the 80's I sold Medicare Supplemental Insurance (Med Supp). I was out the business when the Medicare Catastrophic Coverage Act (MCCA) was passed, but I was paying attention because I had been in the industry and my father was on Medicare Disability. Looking back at what I thought was a great piece of legislation and how it was undone by the insurance lobby after it passed and signed into law, nothing they do or say surprises me.
They so frightened the seniors in 1988-89 that they (seniors) actually caused Congress to repeal MCCA. Then as now they created an atmosphere that caused seniors to be upset that their Medicare premium was going to increase even though that premium was less than they were paying to the insurance companies.

I had clients paying as much as $200 dollars a month for a Med Supp. That was pretty much top of the line then. That's $2400 a year, these people were upset that their Medicare premium would go up an additional $800 dollars a year when it would have eliminated the $2400 they were paying to the Med Supp companies. That's a $1600 a year savings. IIRC, the primary reason was, there were going to be subsidies for Social Security recipients who's checks put them well below the poverty line. In other words Tom didn't want to pay for Harry's Medicare, even though Tom was currently paying an Insurance company $2400 a year now. (Remember, these are 1990 dollars we're talking about.)
A few highlights;

  1. - Doctors' bills-effective January 1, 1990. Medicare patients under Part B would have had their out-of-pocket expenses for doctors' bills limited to $1370. However, if the doctor charged more than Medicare approved, the patient would be liable for the difference. The patient would have paid the first $75 as a Deductible for the approved charges, and Medicare would have paid 80% of the remaining approved charges up to $1370, and 100% of the approved charges above $1370. Any payments made by the patient's private insurance would be applied to the $1370.
  1. Hospital bills-effective January 1, 1990, Medicare patients would have paid a deductible of $564 per year for the first stay in the hospital. After this deductible was paid, Medicare would have paid 100% of all hospital bills regardless of the length of stay.
  1. - Drugs-effective January 1, 1990, Medicare would have begun paying for Outpatient prescription drugs. After the patient paid a $550 deductible, Medicare would have paid 80% of the cost of intravenous drugs, to include antibiotics, and 50% of the cost of immunosuppressive drugs. Effective January 1, 1991, after the patient paid a $600 deductible and a 50% Copayment Medicare would have paid for most other prescription drugs and insulin. Effective January 1, 1992, after the patient paid a $652 deductible and a 40% copayment, most prescription drugs would have been covered by Medicare. Effective January 1, 1993, and beyond, after the patient paid a deductible yet to be determined and a 20% copayment, most prescription drugs would have been covered by Medicare.

That's some pretty scary coverage isn't it? How about those drug benefits? There's things yet to be filled in, but as it was written, better than what we have today.

Here's one that's really frightening;


  1. - Hospice care-effective January 1, 1989, terminal patients would have been entitled under Medicare to unlimited hospice care.

Part of my point here is, even after  Health Care Reform (HCR) is passed, the battle is far from over. The Insurance Lobby will still be in full kill mode. Just as they were 20 years ago.

Originally posted to TexDem on Thu Sep 10, 2009 at 08:15 AM PDT.

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