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Even though these plans are marketed as nationwide and have no networks – this is false. They limit access to care and choice because significant numbers of doctors and hospitals have refused to accept the card, especially out-of-state. For example, many West Virginia retirees who moved out of state could get no doctor to accept the private MA plan.


MA private fee-for-service plans may offer additional benefits, such as gym memberships (the only major additional benefit in West Virginia), or hearing aids and eyeglass coverage, but they modify their benefits to cut corners in more important areas, such as limiting hospital days or charging higher co-pays for nursing homes than Medicare. Indeed, officials in West Virginia actually told a state legislative committee in November that “we know that … retirees who use more medical care will be worse off under this plan”.


PFFS plans more frequently deny claims in order to hold down costs.


The appeals processes are more difficult under the private plans. Retirees are no longer enrolled in traditional Medicare and must go through the company rather than Medicare’s transparent appeals process. Further, beneficiaries are often bounced between CMS and the insurance company seeking redress.


The subsidy to the private plans causes government employers, many of whom have secure, self-insured medical plans, to switch control of their medical decisions to these private companies, break up their efficient risk pools, and allow private companies to profit off our retirees.


The plans are not stable. They can and do pull out of markets, disrupting health care services and causing much anxiety among beneficiaries.
“There is a lack of quality and accountability. These private replacements for Medicare are exempt from basic quality reporting requirements.

NateS wrote:Advantage Plans are really great as long as you don't get sick.

LSAT wrote:The medical advantage plans are different in different states. I have the AARP plan in WI. It's great! Before I chose this plan I was paying $250 month for my wife and for me...plus, we had to buy a Part D plan for $50 month. That's $600 per month besides each if us paying $97 month for part B. With the AARP plan our premium for both of us is 0...that's ZERO. We do pay $20 co-pay to see our doctor, a 20% co-pay for some procedures and a co-pay for drugs. Last year our out of pocket medical expenses were under $2000 compared to the previous years premiums of $7200. Obama wants to eliminate these plans so he can divert $$$ to his health plan.

chunkyfrog wrote:My MIL had medicare with the cheapest medigap possible--not too bad, except for the donut hole.

NateS wrote:No matter what your political beliefs, you will be astounded and sickened to read this article from today's New York Times:

http://www.nytimes.com/2012/04/25/busin ... tml?src=se

Nate

NateS wrote:No matter what your political beliefs, you will be astounded and sickened to read this article from today's New York Times:

http://www.nytimes.com/2012/04/25/busin ... tml?src=se

Nate

They are seeking free health care despite some indications they could easily afford a doctor or even health insurance. Many of them are using smartphones in the ER and smartphones are expensive initially and every month thereafter. Smartphones are also not necessary for a good life. The cars they arrive and leave in are late model cars with all the option packages and are well maintained.

kempo wrote:So why is obama trying to extended a another year?

Monday, April 23, 2012

To: Friends & Supporters

From: Gary L. Bauer


COUNTDOWN TO VICTORY: 197 DAYS TO THE 2012 ELECTIONS


Manipulating Medicare

Barack Obama just got busted trying to manipulate Medicare for political purposes. Here is what's going on.

Beginning in 2013, ObamaCare eliminates Medicare Advantage -- a popular program that 12 million seniors rely on. But in order for Medicare Advantage to be eliminated next year, seniors would have to register for a new program this year -- about a month before the election.

Desperate to avoid having millions of seniors ticked off weeks before the election, the political hacks in the Obama Administration found a way to postpone the phase out of Medicare Advantage. Federal law allows the Department of Health and Human Services to spend money on "demonstration projects" without congressional approval so long as it is conducting a legitimate study intended to improve the effectiveness and quality of various health care programs.

It turns out that HHS has set aside $8 billion in "bonuses" for Medicare Advantage. Republicans have long complained that this spending has only one purpose -- to delay the demise of Medicare Advantage until 2014, but the media and the White House have ignored their complaints.

A report from the non-partisan Government Accountability Office strongly suggests the GOP complaints are valid. The Associated Press reports that government auditors say the bonus program should be cancelled. Consider this excerpt:


"GAO, the investigative agency of Congress, did not address GOP allegations that the bonuses are politically motivated. But, its report found the program highly unusual. It 'dwarfs' all other Medicare pilots undertaken in nearly 20 years, the GAO said. Most of the bonus money is going to plans that receive three to three-and-half stars on Medicare's five-star rating scale, the report said. …

"But GAO questioned whether the bonus program will achieve its goal of finding better incentives to promote quality. 'The design of the demonstration precludes a credible evaluation of its effectiveness in achieving (the administration's) stated research goal.'"

Of course it precludes a credible evaluation of effectiveness! HHS isn't studying anything. Remember -- the Medicare Advantage program is scheduled to be eliminated. So why are taxpayers providing billions of dollars in "bonuses" for average performance? As the AP notes: "Available through 2014, the bonuses will soften much of the initial impact of the Medicare Advantage cuts, acting like a temporary reprieve. This year, for example, the bonus program offset more than two-thirds of the cuts in the health care law."

Republicans should conduct a thorough investigation of this program and do everything they can -- even though the media will ignore much of it -- to expose this abuse of power. This is just one more example of the corruption of this administration. Obama's willingness to bend the rules and waste your hard-earned money for political purposes knows no limits. And it is another example of why conservatives are right to resist Obama's siren song of higher taxes, even on "millionaires and billionaires." The problem in Washington is not a lack of revenue. It is too much spending!

VVV wrote: What NYT will not tell you is what my sister-in-law's sister told us at Christmas. She sometimes works the desk in the ER and I paraphrase what she said about many, not all, of the people coming to the ER:

They are seeking free health care despite some indications they could easily afford a doctor or even health insurance. Many of them are using smartphones in the ER and smartphones are expensive initially and every month thereafter. Smartphones are also not necessary for a good life. The cars they arrive and leave in are late model cars with all the option packages and are well maintained.

I have heard anecdotes like this from several other people.

Our generosity is definitely being abused by many people. It will soon get to the point that we cannot help the truly needy because of all the leeches who take advantage of the system.

What is a hospital to do? Let their resources be stolen in broad daylight right underneath their noses? Or hire a tough collections agency in an attempt to collect from the immoral leeches?

kempo wrote:So I am just trying to see what others have done after reaching 65 yoa. I will be in your shoes within 4 years.

Thanks for the replies.