Posts tagged ‘Corporate Greed’

Hold The Applause

We agree it’s important to find a permanent solution to the physician payment formula (“Sustainable Growth Rate” or SGR), but the Bill passed by the House of Representatives today is not the answer. It isn’t balanced. It asks too much from beneficiaries without providing enough in return. It asks nothing from pharmaceutical or insurance companies. It continues the ever-increasing privatization of Medicare by increasing costs for beneficiaries for traditional Medicare and Medigap plans. It adds unnecessary costs for the Medicare program and taxpayers.

Of the portion of the SGR costs that will be off set, roughly half (approximately $35 billion of the total $70 billion over 10 years) would come from Medicare beneficiaries through changes that will increase their out-of-pocket costs for health care, including:
• Adding deductibles to Medigap plans purchased by new Medicare beneficiaries starting in 2020;
• Further means-testing premiums for higher-income beneficiaries; and
• Overall increases in Part B premiums.

While the SGR package would make the low-income, Qualified Individual (QI), program permanent, which we strongly support, and would minimally increase and temporarily extend important funding for beneficiary education and outreach, it does not address other key issues that serve as barriers to care. For example, instead of repealing the annual outpatient therapy caps, the process to seek an exception to the cap is extended for another two years. Instead of addressing hospital Observation Status, the Bill further extends enforcement of the so-called “two-midnight” rule.

In short, Medicare beneficiaries would pay too much, with too little in return. Major drug and insurance industries pay nothing, and stand to gain a great deal. As the SGR debate moves to the Senate, we hope further balance and improvements for beneficiaries will be made.

March 26, 2015 at 9:22 pm Leave a comment

Medicare Public Funds: Increasing Profits for Private Insurance Cos.

”The private Medicare program has been a boon for insurers the past several years, offering sizable volumes and steady profit margins. … “ It will expand in the future as Baby Boomers join Medicare Advantage plans. (Modern Health Care 12/18/2014)

Why is this allowed to continue? How can we justify cutting Medicare coverage for older and disabled people while providing ever-increasing profit margins for private insurance companies?

Wake up people!

December 18, 2014 at 4:38 pm 1 comment

NY Times Reports Unfair Medicare Advantage Coverage Denials

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

October 15, 2014 at 1:42 pm Leave a comment

Corporations Don’t Bleed

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.

July 2, 2014 at 4:47 pm Leave a comment

What a Shame

CMS has decided to raise rates for private Medicare Advantage (MA) plans. This is contrary to its earlier announcement that private Medicare reimbursement rates would be reduced to reflect slower per capita growth in Medicare and health care. Politicians from both parties and insurance companies called for this change and, unfortunately, CMS reversed course.

So, private Medicare will continue to cost more than it would cost to serve similar beneficiaries in traditional Medicare. While this may be good for insurance companies that offer MA plans, it is not good for Medicare, the vast majority of Medicare beneficiaries, or taxpayers.

Why should we spend more of our limited public funds on private Medicare when traditional Medicare costs less? Why should taxpayers ensure private profits to deliver public Medicare coverage? After all, the experiment in privatizing Medicare was originally intended to see if a private model would cost less, while providing the same or better coverage than traditional Medicare. That was not to be.

Private plans left the market when their reimbursements were capped at or below the per capita rate of public Medicare. CMS failed to learn from that experiment, and maintain the cost of traditional Medicare as the maximum taxpayers would pay for private plans. Instead, since the Medicare Act of 2003 we actually pay private plans more than traditional Medicare. This result is not good for the financial security of the Medicare program or for the federal budget deficit. It’s not good for the vast majority of beneficiaries who continue to choose the traditional Medicare program. It’s not even best for many MA enrollees, particularly those with long-term and chronic conditions, who often get less coverage than they would in traditional Medicare. And remember, by design MA plans have limited networks, so private MA enrollees have fewer choices in physicians and other health care providers than they’d have in traditional Medicare.

The Center for Medicare Advocacy continues to call for parity in payments between private Medicare plans and traditional Medicare. It’s the best deal for taxpayers, the Medicare program, and the vast majority of Medicare beneficiaries. Common sense should prevail.

April 8, 2014 at 7:17 pm 2 comments

Stop Bleeding Medicare By Wasting Money on Private Plans

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.”

May 15, 2013 at 6:19 pm Leave a comment

Priorities: People – and Medicare – Before Drug Company Profits

As we said in today’s Politico Op Ed, it’s time to support Senator Rockefeller’s bill – and all serious efforts to reduce what Medicare pays for prescription drugs. High time. There are over 50 million people with Medicare. Why would we not insist on lowering drug prices for all of them? It would save Medicare $141 Billion over ten years. Wal-Mart knows the value of negotiating low prices for vast numbers of people, and is sure to do so. So should Medicare.

April 17, 2013 at 2:35 pm Leave a comment

Not Saying We Told You So …

The cover story of today’s Time Magazine Special Report agrees with our long-standing call for Medicare to negotiate drug prices and lower the age of Medicare eligibility.  Even the CMS Medicare Director agrees that Medicare should negotiate what it pays for drugs. Just seven years ago Medicare  didn’t even have a drug benefit – now it’s the largest buyer of drugs in the world!

Congress:  It’s time to repeal the Bush-era prohibition against Medicare negotiating on behalf of all its customers. That’s how to drive costs down for Medicare, older people, people with disabilities, and taxpayers.

Wal-Mart does it – Medicare should too!

February 21, 2013 at 9:48 pm Leave a comment

Medicare Shoppers: Pay Less for Rx!

Want to lower the costs of Medicare for all beneficiaries and taxpayers? Lower the prices Medicare pays for prescription drugs! Like Medicaid and the Veterans Administration – Medicare should negotiate discounts for all beneficiaries. This would save over $200 Billion over the next 10 years.

It’s time to end the Bush era gift to the pharmaceutical industry, which got 50 million new customers when Medicare began covering drugs in 2006, without being asked to lower prices in return. Walmart and Costco negotiate prices for all their customers, that’s how their customers pay less. Medicare should do no less for its “customers.” Surely older people, people with disabilities and taxpayers deserve the kind of consideration given to Walmart shoppers.

“Check out our website for a full list of solutions that would preserve Medicare coverage while reducing costs to taxpayers.”

February 13, 2013 at 4:28 pm Leave a comment

Cut Through the Rhetoric: Questions to Ask After the Supreme Court ACA Decision

Originally Published at Nieman Watchdog, in ASK THIS, June 14, 2012 (available at http://niemanwatchdog.org/index.cfm?fuseaction=ask_this.view&askthisid=00569), we offer reporters and editors a checklist for stories when the Supreme Court rules on the Affordable Care Act (ACA):

1. Did the Court strike down (or uphold) the entire law?

2. If the entire law is struck down:
  • What will happen to the Medicare Part D Donut Hole coverage, preventive benefit coverage improvements, Part D income-based premiums?
  • Will young adults receiving coverage up to age 26 on their parents’ plans immediately lose their coverage? Will they be able to get coverage elsewhere?
  • Will children with pre-existing conditions lose their coverage? If so, how will they get coverage in the future?
  • What will happen in states that have started to implement the law, for example by setting up “exchanges”? Will some states try to proceed without ACA?
  • What will happen to those who would have been covered by the Medicaid enhancements under the law?
3. Did the Court decide some components are “severable,” (able to proceed although other components of the law are invalid)?
  • If so, what was struck down?
  • What is left?
4. If the individual mandate is struck down (the requirement that people maintain minimum coverage or pay into the system), what does that mean for health care reform?
  • Can the law still work without this requirement?
  • Can the law be amended to make it work, without a minimum coverage mandate?
5. If the law is struck down in whole or part:
  • What demographic groups will be most harmed?
  • What will be the effect on costs to the federal government, states, and individuals?

Unless the entire law is upheld, people in need of health care will lose. Be ready to recognize what will be lost – and by whom.

June 15, 2012 at 2:59 pm Leave a comment

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