If it is deemed unconstitutional to force citizens

[Deleted]

So insurance companies now get a piece of medicare market too?... lol... they get to profit from the elderly as well... or at least, theoretically...

Do you really see insurance companies fighting with each other to provide better services at a lower cost than medicare dictates? ... How could they?... This could not be cheaper... and it would go up for everyone in the pool... because the old/sick are the ones that actually need care and would never be able to purchase insurance on an open market...

The only way supplemental medi insurance works is because the government SUBSIDIZES it too ... the only way for this to work is if the government not only gives the indivdiual $ to purchase, but ALSO back door subsidized the insurance companies... so more and more of our tax dollars can go to corporate profits..

why oh why am i not a republican any more....

[marjar]

Jan 27, 2011 11:51:51 GMT -5 ugonow said:

Will the providers agree to provide, or will they reject applicants?

Hmmm this has not been addressed.Seeing as how they will be seniors it could be a thorny issue.

I've had to deal with this in trying to obtain my own health insurance, two years ago. I was rejected because of a couple of years on anti depressants and a bout of carpal tunnel, several years before I applied. It's a nightmare.

My brother was rejected, when applying for Medicaid supplemental, because of a bum knee. Former BIL had the same, and his wife was turned down because of hypertension.

Options are NOT going to help if providers don't have to accept applicants.

[fairlycrazy23]

Jan 27, 2011 11:54:48 GMT -5 oped said:

So insurance companies now get a piece of medicare market too?... lol... they get to profit from the elderly as well... or at least, theoretically...

Do you really see insurance companies fighting with each other to provide better services at a lower cost than medicare dictates? ... How could they?... This could not be cheaper... and it would go up for everyone in the pool... because the old/sick are the ones that actually need care and would never be able to purchase insurance on an open market...

The only way supplemental medi insurance works is because the government SUBSIDIZES it too ... the only way for this to work is if the government not only gives the indivdiual $ to purchase, but ALSO back door subsidized the insurance companies... so more and more of our tax dollars can go to corporate profits..

why oh why am i not a republican any more....

The private insurance companies ARE the ones subsidizing medicare now.The voucher would have to be large enough for the poorest people to buy adequate insurance, no other backdoor would be required.

[marjar]

This message has been deleted.

[marjar]

Jan 27, 2011 12:13:43 GMT -5 fairlycrazy23 said:

Jan 27, 2011 11:54:48 GMT -5 oped said:

So insurance companies now get a piece of medicare market too?... lol... they get to profit from the elderly as well... or at least, theoretically...

Do you really see insurance companies fighting with each other to provide better services at a lower cost than medicare dictates? ... How could they?... This could not be cheaper... and it would go up for everyone in the pool... because the old/sick are the ones that actually need care and would never be able to purchase insurance on an open market...

The only way supplemental medi insurance works is because the government SUBSIDIZES it too ... the only way for this to work is if the government not only gives the indivdiual $ to purchase, but ALSO back door subsidized the insurance companies... so more and more of our tax dollars can go to corporate profits..

why oh why am i not a republican any more....

The private insurance companies ARE the ones subsidizing medicare now.The voucher would have to be large enough for the poorest people to buy adequate insurance, no other backdoor would be required.

Doesn't mean companies will accept them.

[Deleted]

It is NOT PROFITABLE to insure the elderly. Why do you people not understand that?... To make it profitable to insure the elderly... we would have to pay MORE... not less...

[marjar]

Jan 27, 2011 12:19:03 GMT -5 oped said:

It is NOT PROFITABLE to insure the elderly. Why do you people not understand that?... To make it profitable to insure the elderly... we would have to pay MORE... not less...

Exactly!

[ugonow]

Medicare Advantage did not make sense to me.Why is a private insurance company adding to a government run programs costs?Either it is government paid or it is insurance paid,not both with a service charge to taxpayers tacked on...This voucher program will make that a moot point.

[marjar]

It will only work if insurance companies are forced to accept applicants, regardless of medical history and pre existing conditions.

[fairlycrazy23]

Jan 27, 2011 12:43:19 GMT -5 @marjar said:

It will only work if insurance companies are forced to accept applicants, regardless of medical history and pre existing conditions.

This is already the way it was to a large extent for group plans, at least after HIPAA,so i would expect it to be the same or similiar. If you went straight from medicare to a new plan, you would not be subject to limitation on pre-existing conditions because there would be no significant break in credible coverage.

[Deleted]

Still... how can an insurance company... with higher overhead and profits... provide health care to an elderly population for LESS than we currently are... we already know that Medicare Advantage costs like 30% more than plain medicare... so how is it possible that involving the insurance companies suddenly makes this LESS expensive?... it will cost MORE...

This is at best the SAME system that the republicans objected to for everyone else outside of medicare... they didn't want a federal exchange from which the uninsured could go to and choose a policy that adhered to group plan regulations...

[fairlycrazy23]

Jan 27, 2011 12:57:17 GMT -5 oped said:

Still... how can an insurance company... with higher overhead and profits... provide health care to an elderly population for LESS than we currently are... we already know that Medicare Advantage costs like 30% more than plain medicare... so how is it possible that involving the insurance companies suddenly makes this LESS expensive?... it will cost MORE...

This is at best the SAME system that the republicans objected to for everyone else outside of medicare... they didn't want a federal exchange from which the uninsured could go to and choose a policy that adhered to group plan regulations...

The medicare actuary is the one who says it will reduce costs.

But the main point is medicare is unsustainable in its current form, more and more providers are opting out of accepting it.

The lower overhead costs of medicare is somewhat misleading for several reasons number one is that medicare recipients on average use more care and because the way efficiency is measured this makes there overhead look better than private insurers, there are several other factors too.

Medicare can keep costs lower also by simply not paying the real cost and instead pass this along to private insurance, this why providers are opting out of medicare and what the "doc-fix" is all about. You may start to find it hard to find someone who accepts medicare..actually I think some people already have an issue with this.

[Deleted]

Please point me to the actuary report that says this will reduce cost while still insuring the same population...

[Deleted]

Explain to me how Medicare Advantage costs MORE, but this will somehow cost LESS...

Explain to me how we will now make elder health care a PROFITABLE enterprise... and pay LESS

[fairlycrazy23]

The actuary said this:



Also notice on the road map he said cost, but obamacare he said maybe price.

Medicare can control its costs, with price control, but the actual costs still have to be covered by somebody and at some point providers will simply decide not to accept medicare.

If all there is is medicare, then some people may simply decide not to go into the health care field, reducing the amount of resources left available and if costs can't rise because of price controls then you will have to wait longer for health care

[jkapp]

Jan 27, 2011 11:54:48 GMT -5 oped said:

So insurance companies now get a piece of medicare market too?... lol... they get to profit from the elderly as well... or at least, theoretically...

Do you really see insurance companies fighting with each other to provide better services at a lower cost than medicare dictates? ... How could they?... This could not be cheaper... and it would go up for everyone in the pool... because the old/sick are the ones that actually need care and would never be able to purchase insurance on an open market...

The only way supplemental medi insurance works is because the government SUBSIDIZES it too ... the only way for this to work is if the government not only gives the indivdiual $ to purchase, but ALSO back door subsidized the insurance companies... so more and more of our tax dollars can go to corporate profits..

why oh why am i not a republican any more....

So you prefer to have the government pay for the coverage with our tax dollars, subsidize the supplemental insurance with our tax dollars, and waste $60 billion dollars a year in waste and fraud with our tax dollars?

Why oh why am I not a Democrat?

[jkapp]

Jan 27, 2011 12:19:03 GMT -5 oped said:

It is NOT PROFITABLE to insure the elderly. Why do you people not understand that?... To make it profitable to insure the elderly... we would have to pay MORE... not less...

And if everyone was on a single-payer Medicare type of plan we would also have to pay more not less...because then medicare wouldn't have any private insurance to pass off its underpayment of services to. If they paid the same as now our medical industry would be bankrupt in a matter of months.

[Deleted]

Ok... that only said if we used more R&D, we could have technology to reduce health care costs... and that even he didn't know how other proposed cuts were going to actually work... It didn't say anything specific about how private insurers were going to insure elderly populations for LESS than medi now... just R&D pipe dreams (which would reduce the cost to ANY program)...

[Deleted]

And if everyone was on a single-payer Medicare type of plan we would also have to pay more not less...because then medicare wouldn't have any private insurance to pass off its underpayment of services to. If they paid the same as now our medical industry would be bankrupt in a matter of months.

No they wouldn't... because instead of paying extra overhead, extra profits and extra redundancy costs... the premiums from the healthy people would go into the pool that actually pays out for CARE...


"So you prefer to have the government pay for the coverage with our tax dollars, subsidize the supplemental insurance with our tax dollars, and waste $60 billion dollars a year in waste and fraud with our tax dollars?"

I don't think you read that right... i was saying that is NOT what i want... I do not want them to supplement insurance... I want them to pay for care with minimal overhead, so tax dollars are going directly to care.... and i do believe that fraud prevention should be a stronger component, and prosecution for fraud should not just be about fines, but criminal charges... i've said that lots of times... the qui tam process should be strengthened and shortened, and higher level administrators held accountable for what they allow to go on, as well as those directly involved...

[Deleted]

By the way... fraud efforts actually HAVE been strengthened under Obama...

[marjar]

This is slightly off topic, but............ my kid has a medical condition that causes her to develop nasty moles. The first one was very atypical and required a second surgery. Since then, every couple of years she develops and nasty one that has to be removed. This comes along with a higher than normal risk for melanoma. Over the last 17 years, she's had these done in a plastic surgeon's office, with the surgeon and one assistant performing the task. A highly respected and board certified surgeon, I might add.

She is currently a student and employee of a major university with a huge teaching hospital. Her medical coverage is through the institution. For the most recent mole, she had to drive almost 40 miles away from the hospital, to the out patient plastic surgery center. She had to disrobe change into a hospital gown, and surgery was performed in a surgical suite. A total of 7 people, from surgeon, PA, anesthetist - he gave her the local anesthetic, to nurses were involved and hands-on with this procedure. The bill was more than triple what her past surgeries have cost. When she asked why this was deemed necessary, they responded with it was procedure.

All of her past surgeries were successful, she had no complications, and they were far less stressful to her. Not to mention less costly. Think this is why medical costs are in the stratosphere?

[ugonow]

So you prefer to have the government pay for the coverage with our tax dollars, subsidize the supplemental insurance with our tax dollars, and waste $60 billion dollars a year in waste and fraud with our tax dollars?

You are describing medicare and medicare Advantage to a T. I have no idea why republicans defended Advantage other than because Obama wanted to cut it.It does not belong in a government program. Paul Ryan's plan will not only end the medicatre problem,it will make Advantage a moot point.

[Deleted]

Won't it basically make everything Advantage?...

[jkapp]

>>No they wouldn't... because instead of paying extra overhead, extra profits and extra redundancy costs... the premiums from the healthy people would go into the pool that actually pays out for CARE... <<

No, not really...because Medicare has HUGE overhead - every government agency does. The difference is Medicare gets to cover its overhead with a bucket of different funds (called TAXES) instead of having to fund it from premiums like private industry. This is why Medicare and politicians can bs the public into thinking it has low overhead.

And you could add up all insurance industry profits and still not equal what Medicare loses in waste and fraud. And Obama may be cracking down on it, but it's something like 1%...not very spectacular.

And does anyone actually think government has LESS redundancy than private industry? Government is the DEFINITION of redundancy...if you find something to be completely time intensive, inefficient, and/or wasteful than 99 times out of 100 you are looking at something government has its hands in.

[ugonow]

Won't it basically make everything Advantage?...

Advantage makes more sense to me outside the framework of government run healthcare.

[Deleted]

No, not really...because Medicare has HUGE overhead - every government agency does. The difference is Medicare gets to cover its overhead with a bucket of different funds (called TAXES) instead of having to fund it from premiums like private industry. This is why Medicare and politicians can bs the public into thinking it has low overhead.


Yeah... this is the point about no redundany... we would STILL have a tax collection body even without medicare... so why not use the SAME body, and while we're at it, a uniform coding system... to reduce overhead?

ugonow... i do not know what you mean?

[ugonow]

A government subsidizy to buy your own insurance sounds more logical to me on it's own,rather than within the framework of government run healthcare. Aren't you defeating the whole premise of both sides of the argument if you use both within the same program?