OT: Medicare

I don't know if the Supremes will declare Obama Care unconstitutional are not or just parts of it. Either way I have a feeling healthcare for seniors will cost a lot more and be less effective in the near future just by the large number of people coming into the system.

We can argue about what political fix would be best and I'm sure my belief would be just the opposite from many here but the fact is we will just have to live with whats handed to us. So, I hope we can keep all of our hose head friends informed on what will be the best supplement insurance for the buck.

idamtnboy....... The Insurance Company that administers the Advantage Plan gets the $97 per month that the participant now pays to Medicare Part B. That, plus the 'subsidy' that the government pays. The Insurance Company does ok.

Medicare Advantage Plans are for healthy seniors who rarely go to the doctor or ever have to be hospitalized.... otherwise for people like me who have many health problems and need the best of the best when it comes to medical care....Advantage just does not work.

LSAT wrote:idamtnboy....... The Insurance Company that administers the Advantage Plan gets the $97 per month that the participant now pays to Medicare Part B. That, plus the 'subsidy' that the government pays. The Insurance Company does ok.

The amount of the 'subsidy' is the number that would be interesting to know. What would be more interesting yet though, would be to learn how that amount, which I prefer to think of as the contract amount, compares to what it cost Medicare to directly pay for the same level of service for the same number of people. I believe the Advantage plans came into being supposedly because it would be less. But, contractors, or insurers in this case, always manage to figure out how to milk Uncle for every last dime they can so the Advantage plans may, or may not, now be less costly than original Medicare. It would also be interesting to see how the Medicare payments to insurers compare to health insurance premiums in general. The total premium for my BCBS insurance, family plan to cover both me and my wife, is over $1300 per month. My share is $430. This is the same for current employees and retirees.

Not intending to create a pro/anti government argument, but an interesting case of real Government efficiency is the Thrift Savings Plan for Federal employees. It's basically the same as regular 401k retirement plans, and runs by the same rules and regulations. The TSP has the lowest management cost of any retirement program in the US, private or public. Its performance is on par with the best managed private index funds. The management cost is borne entirely by the employee investors, not taxpayers.

The Strategic Petroleum Reserve has an operating cost lower than any other oil reserve in the world.

Just because a program is run by the Government does not automatically mean it costs more than what it would for private industry to run it. Many times, yes. Always, no.

There is an article in today's Idaho Statesman about the cost of appendectomies. The charge for similar conditions and similar operations ranges from $2000 to $150,000. The expectation is that with Obamacare these kinds of disparities would be greatly reduced.

Just because a program is run by the Government does not automatically mean it costs more than what it would for private industry to run it. Many times, yes. Always, no.

Even a blind pig finds an acorn from time to time.

jwerley wrote:Medicare Advantage Plans are for healthy seniors who rarely go to the doctor or ever have to be hospitalized.... otherwise for people like me who have many health problems and need the best of the best when it comes to medical care....Advantage just does not work.

I'm going to politely disagree with this blanket statement.

I am NOT a healthy senior. I am a victim of Muscular Dystrophy and went on disability when I was 43. Investigating all my options told me that an Advantage plan was the most economical way for me to go. 2008 was a horrendous year with emergency gallbladder removal, pneumonia and a non-emergency surgery at the end of the year, not to mention all the typical stuff that I have on a regular basis.

I had no trouble whatsoever. But, I am also very organized and never ASSUME a provider or procedure is covered without checking beforehand (sans the surgery, but I knew my hospital was in-network as I had investigated that BEFORE I signed up).

I am sure that in some areas, the Advantage plans do not work as well as what I have experienced. However, in some areas and for some people, they work well.

idamtnboy wrote:There is an article in today's Idaho Statesman about the cost of appendectomies. The charge for similar conditions and similar operations ranges from $2000 to $150,000. The expectation is that with Obamacare these kinds of disparities would be greatly reduced.

Yes... one can equate having an appendectomy to buying a used car. Same car - lot 1, is $10,000. Lot 2, same car, similar condition, $1,800.

Obama care isn't perfect ... but, if things like this can be stopped, imagine how much better it would be if Apnea Mask A would be the same price wherever you purchase it.

ems wrote: ... imagine how much better it would be if Apnea Mask A would be the same price wherever you purchase it.

I have experienced such a situation. Short parts of my career were spent in eastern European countries with centrally planned economies. These are very unpleasant conditions under which to live both as a consumer and as a worker or producer. Of course very unhealthy also.

God Bless America and may her eyes be reopened,

idamtnboy wrote:There is an article in today's Idaho Statesman about the cost of appendectomies. The charge for similar conditions and similar operations ranges from $2000 to $150,000. The expectation is that with Obamacare these kinds of disparities would be greatly reduced.

$150,000 for an appendectomy is not a statement that I will believe without delving into it myself.

VVV wrote:$150,000 for an appendectomy is not a statement that I will believe without delving into it myself.

Actually the highest charge was $182,995 for a woman who also had cancer, but the bill had no charges listed that related to the cancer. I was going from memory when I wrote the comment so the $150,000 number should have been "well over $100,000."

Here's a quote from the AP story, which is at http://www.google.com/hostednews/ap/art ... 417991578d.

The lowest and highest bills were not freak occurrences; many cases involved charges well over $100,000 and under $2,000, Hsia said. Also, within geographic regions, the lowest and highest charges differed by tens of thousands of dollars.

Even your beloved Faux News quoted the story. http://www.foxnews.com/health/2012/04/2 ... ry-widely/.

Here's the link to the Statesman, which is the same article. http://www.idahostatesman.com/2012/04/2 ... k=misearch

VVV wrote:

ems wrote: ... imagine how much better it would be if Apnea Mask A would be the same price wherever you purchase it.

I have experienced such a situation. Short parts of my career were spent in eastern European countries with centrally planned economies. These are very unpleasant conditions under which to live both as a consumer and as a worker or producer. Of course very unhealthy also.

God Bless America and may her eyes be reopened,

I think that what ems meant was that it would be better if everyone knew in advance what the range of prices were among reputable and experienced providers of services and supplies, and that this would lead to less price disparity. In fact, I thought that this was supposed to be a fundamental principle of capitalism and the free enterprise system not, as you imply, something than can only occur under communism. Knowledge is power. Aren't consumers entitled to power under capitalism? I think they are.

Regards, Nate

That is precisely what I meant, Nate!

Price transparency should be part of any healthcare law.
Price secrecy should be illegal.
If providers were required to disclose prices freely, there would be COMPETITION.
Then, the law only needs to assure that any corner-cutting is not detrimental to anyone's health.
Cheaper appendectomies at the Motel 6--don't have to support the Taj Mahal--just pay the maids good.
(not really the Motel 6, but a no-frills hospital)

Another thought - If the law, through either state or federal regulation of health insurance companies, required that all policies gave the policyholder, not the company, the option to purchase their own own FDA-approved medical equipment, online if they so chose from sources like cpap.com, and then be reimbursed by their insurance company in accordance with their policy terms, then the prices for cpap equipment for example would come down, and both the insurance companies and Medicare would save money. The insurance company or Medicare would still have the right to determine the medical necessity of the equipment in accordance with existing guidelines, tests, prescriptions, etc. but once they did so, they would have to give the policyholder the option of making the reimbursable purchase themselves if they so chose.

This would/should reduce the cost of private health insurance, and the cost to the taxpayers for Medicare.

And this would be in accordance with the best of the free enterprise, competitive market system, for which we could all Bless America as VVV encourages us to do!

Any opinions out there on this idea?

Regards, Nate

This is not going to happen because it makes too much sense... at least not in my lifetime.