Posts tagged ‘Fact and Fiction’
In 1995 Newt Gingrich predicted that privatization efforts would lead Medicare to wither on the vine. He said it was unwise to get rid of Medicare right away, but envisioned a time when it would no longer exist because beneficiaries would move to private insurance plans.
Well … that’s what’s happening. Not just by happenstance, but rather according to a determined, strategic plan. The plan has included the following:
- Government subsidies to private plans, renamed “Medicare Advantage,” ranging from 14% – 2% above traditional Medicare per-beneficiary costs;
- Additional benefits added to private Medicare Advantage, benefits that weren’t added, and aren’t allowed, in traditional Medicare;
- Part D prescription drug coverage wrapped into Medicare Advantage, but not into traditional Medicare;
- Increases in traditional Medicare Part B premiums, especially for the middle class;
- Limits on access to Medigap insurance to supplement traditional Medicare and on benefits for those who can obtain a Medigap policy.
It didn’t take a crystal ball. It took a vision, planning and persistence.
The Center for Medicare Advocacy also has vision, planning and persistence. We do all we can to keep Medicare focused on the needs of older and disabled people, not the insurance industry. We speak out with expertise and with the stories of real people.
With your support, we’ll keep insisting that Medicare is fully present for the families that rely on it – now and in the future. We’re ready to keep Medicare from withering on the vine.
The title of Paul Krugman’s piece in today’s NY Times says it all. The Medicare Killers tells the truth about the Trump/Ryan plan to turn back the clock on Medicare and give it away to the private insurance industry. A good deal for insurance companies, but a very bad deal for the 60 million older and disabled people who access health care through Medicare. Importantly, as Krugman writes, this is not necessary. It’s just the latest ploy to privatize Medicare. Call it what it is.
Help the Center for Medicare Advocacy speak out against false claims and misinformation that could rob older people and people with disabilities of necessary health care – and diminish Medicare for generations to come. Spread the word. Tell the truth about Medicare.
Speaker Paul Ryan is already in the news saying that because of “Obamacare” Medicare is going broke (Fox News, 11/13/2016). As a consequence, he says, he intends to bring back his plan to privatize Medicare and change it into a voucher system. Under his plan, individuals would be given a set amount to help pay premiums for insurance on the open market. This tired idea is not necessary and not best for Medicare beneficiaries or taxpayers – all of whom would pay more and get less under the Ryan plan. It would “save” Medicare in name only.
The truth is Obamacare is good for Medicare and Medicare beneficiaries. It added about 10 years to the solvency of the Medicare trust fund, preventive benefits with no co-pays, and reduced prescription drug prices for beneficiaries. Surely Mr. Ryan knows this.
The truth matters. Pass it on.
For more information see the Washington Post article that gives Ryan’s statement “4 Pinnochios,” their fact-checker’s worst rating for accuracy.
As the New York Times reports today, people don’t have to improve to qualify for Medicare-covered care in most settings. Unfortunately, older and disabled people are constantly told otherwise – and refused care as a result. The Centers for Medicare & Medicaid Services could fix this pretty easily. Just issue a CMS Ruling stating definitively and clearly that skilled nursing and therapy can be covered to maintain a patient’s condition or slow deterioration. It’s the law. Disseminate the Ruling to all Medicare providers and adjudicators. Post it on the CMS website.
If there’s the will, there’s the way.
Finally, the Center’s long-time concerns about costly misuse of public Medicare funds may be gaining attention. For years we’ve been pointing to Medicare overpayments for prescription drugs and to private Medicare Advantage plans. These huge expenditures help pharmaceutical and insurance industries, not older and disabled people. If these costs were reigned in, billions of dollars would be freed to cover necessary health care and sustain the Medicare program. This week these matters received some much needed publicity:
Prescription Drug Pricing
An excellent and well-timed (given #Epi-gate) article appeared in this week’s Journal of the American Medical Association discussing the reason drug costs are so high in the U.S. According to the article, the major cause is the “granting of government-protected monopolies to drug manufacturers, combined with restriction of price negotiation at a level not observed in other industrialized nations.” Thus, state the authors, “providing greater opportunities for meaningful price negotiation by governmental payers” is one of the conclusions. A “possible solution” is described as “Price negotiation: Enable Medicare to negotiate drug prices for individual Part D plans and to exclude coverage for expensive products that add limited clinical benefit; experiment with value-based drug pricing and rational prescribing reimbursement models for Medicare.” For more information, see http://jama.jamanetwork.com/article.aspx?articleid=2545691#.V8OQC8OH7Hg.twitter
Medicare Advantage Overpayments
NPR recently published an article from the Center for Public Integrity entitled “Medicare Advantage Audits Reveal Pervasive Overcharges” (August 29, 2016) by Fred Schulte. The article reports on recently-released federal audits of 37 Medicare Advantage (MA) plans relating to overpayments made in 2007. According to the author, these “audits reveal how some private Medicare plans overcharged the government for the majority of elderly patients they treated, often by overstating the severity of certain medical conditions, such as diabetes and depression.”
As discussed in previous Alerts, including one in May 2016 entitled “Government Auditor Finds Billions in Improper Payments to Medicare Advantage Plans Coupled with Inadequate Oversight by Federal Regulator,” MA “upcoding” – when an MA plan reports an enrollee as being more sick than they actually are in order to obtain a higher risk-adjusted payment from the Medicare program – remains a problem that policymakers must address, particularly as they weigh policy proposals that would shift additional costs on to Medicare beneficiaries.
Since 1965, Medicare has opened doors to health care and increased economic security for hundreds of millions of older people, people with disabilities, and their families.
2015 will also usher in a new Congress. Many of its leaders and members will likely champion plans to further privatize Medicare. These proposals will likely surface despite increasing reports that Medicare costs and the federal deficit are declining, and that traditional Medicare costs less than private Medicare. Once again we will likely hear about plans to transform Medicare to “Premium Support” (a voucher towards the purchase of private insurance). We will probably read about proposals to increase the age of Medicare eligibility, decrease the value of Supplemental Medicare Insurance (Medigap), redesign Medicare to make it “simpler” (but less useful for most beneficiaries). We urge you to listen carefully for these and other such plans. And respond!
Since 1986, the Center for Medicare Advocacy has been on the front lines, advocating for people who depend on Medicare and for a comprehensive Medicare program for future generations. As we mark Medicare’s 50th anniversary, help us ensure its promise to advance access to healthcare. Help us explain what’s true and what’s not, where real savings exist, and when the true interests of beneficiaries are at stake. Help us ensure a real Medicare program lasts for another 50 years.
Be part of our Medicare Truth Squad. Ask us if you have questions. Spread the word – on Twitter, Facebook – in conversations! The future of a comprehensive Medicare program may depend on it.
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