Posts tagged ‘Fact and Fiction’
This is a scandal. Medicare Advantage plans continue to fail beneficiaries and cost taxpayers. Why don’t more people get it – or act to do something about it?
For more, see:
U.S. Finds Many Failures in Medicare Health Plans
“Federal audits found many coverage denials for medical services and prescription drugs are poorly…” @nytimes http://t.co/59LKyqkJSe
The Medicare trustees reported good news for Medicare today. The Trustees’ annual report finds the life of the Medicare Trust Fund has been extended another four years since their 2013 report, and an additional 13 years from their last projection before the Affordable Care Act passed. The annual report confirms that Medicare continues to provide cost-effective health insurance for more than 50 million older and disabled beneficiaries – and that the Affordable Care Act strengthened Medicare.
Medicare provides health insurance and access to needed care for most Americans age 65 or older and those with significant disabilities. The 2014 Trustees Report confirms that Medicare is working well and will be in fine shape for the foreseeable future. The Trustees conclude benefits are expected to be payable in full until 2030, four more years than they projected in May 2013.
“The Medicare Trustees’ favorable forecast is attributable to slowing health care costs, the recovering economy and the implementation of the Affordable Care Act. The Trustees Report answers skeptics and demonstrates that Medicare is healthy. It continues to be an efficient, cost-effective program that Americans can count on for future generations. It should be protected as one of our great success stories.” said Judith Stein, executive director of the Center for Medicare Advocacy.
The positive outlook for the Medicare Trust Fund is certainly good news. There are opportunities to further improve Medicare’s well-being without reducing benefits or cutting services. Congress could secure the program’s future even more by reducing wasteful overpayments to private Medicare Advantage plans, and by obtaining the best rates possible for prescription drugs.
Too often people with low and moderate incomes fail to get the health coverage they need. Women are frequently harmed the most. In addition to their own health concerns, they are usually the gender responsible for family-planning and family care-taking.
The Supreme Court’s decision in Hobby Lobby reduces women’s rights and erodes women’s access to health care. In Hobby Lobby, the Court found that “closely held” corporations needn’t provide health insurance for their employees if it would violate their religious beliefs Incredibly, the decision advances corporate rights over women’s rights. And it advances the notion that corporations are people too – with religious beliefs!
Corporations don’t bleed; they don’t get pregnant; they don’t take care of children and parents. Women do.
Congress: Take action. Reconsider the Religious Freedom Restoration Act at the heart of the Hobby Lobby decision.
Women, Men, people who bleed, get sick, and take care of others who do: Speak out against this injustice.
From the New York Times, January 8, 2014
“…This past year, I have achieved something big that I’ve not spoken of until now. Countless hours of physical therapy — and the talents of the medical community — have brought me new movement in my right arm. It’s fractional progress, and it took a long time, but my arm moves when I tell it to. Three years ago, I did not imagine my arm would move again. For so many days, it did not. I did exercise after exercise, day after day, until it did. I’m committed to my rehab and I’m committed to my country, and my resolution, standing with the vast majority of Americans who know we can and must be safer, is to cede no ground to those who would convince us the path is too steep, or we too weak. “
How can we not stay the course? We will continue to advocate for those who need a voice – for the long term.
And we quote:
“Private insurers’ Medicare Advantage plans cost Medicare an extra $34.1 billion in 2012
Instead of being more efficient, private insurers have cost Medicare almost $300 billion more over the life of the program
A study published online today finds that the private insurance companies that participate in Medicare under the Medicare Advantage program and its predecessors have cost the publicly funded program for the elderly and disabled an extra $282.6 billion since 1985, most of it over the past eight years. In 2012 alone, private insurers were overpaid $34.1 billion.
That’s wasted money that should have been spent on improving patient care, shoring up Medicare’s trust fund or reducing the federal deficit, the researchers say.
The findings appear in an article published in the International Journal of Health Services by Drs. Ida Hellander, Steffie Woolhandler and David Himmelstein titled “Medicare overpayments to private plans, 1985-2012: Shifting seniors to private plans has already cost Medicare US$282.6 billion.”
Hellander is policy director at Physicians for a National Health Program (PNHP), a nonprofit research and advocacy group. Woolhandler and Himmelstein are professors at the City University of New York School of Public Health, visiting professors at Harvard Medical School and co-founders of PNHP.”
We have to say, Forbes has it right! The co-pay for Medicare home health care proposed in the President’s budget is a big mistake. It will not save money, will harm people with chronic conditions, and will increase avoidable hospitalizations. It isn’t even a good tool for fighting fraud – if that is the goal.
Far from getting too much care, our experience is that thousands of people with multiple sclerosis, Parkinson’s disease, ALS, paralysis, and other long-term conditions, struggle to get the home care they DO need. A little bit of nursing and/or therapy, along with hands-on health aide services, often means the difference between staying home and requiring a hospital stay or nursing home placement. For most Medicare beneficiaries with chronic conditions, home health care is more humane, more effective and less expensive.
If fraud is the concern, fight it. Don’t add co-pays or other barriers for those who really do need home care and qualify for Medicare coverage.
Misconceptions and misinformation about the Affordable Care Act are still too many to innumerate. However, as advocates for Medicare beneficiaries and a strong Medicare program, we can tell you that the Affordable Care Act (ACA) is good for beneficiaries and good for the stability of a full and fair Medicare program. ACA has already added significantly to Medicare-covered preventive services – with no beneficiary cost-sharing, continues to reduce the cost of prescription drugs for people under Medicare Part D, is phasing out wasteful overpayments to private Medicare Advantage plans and added over a decade to Medicare’s long-term solvency.
Happy Anniversary, ACA. As my grandmother would say, “You should live and be well!”