CNN's Sanjay Gupta continues the CNN lie parade concerning various Medicare Reform proposals, particularly the Wyden-Ryan proposal. He claims (based on a transcript on a non-CNN web site):
"people now younger than 55, when they reach retirmenet would have the option of getting a voucher to purchase private insurance or they could stick with traditional Medicare."
Gupta is incorrect. No one is proposing to give people born after 1952/1955/1956 a voucher when they reach 65 (different dates in different Medicare Reform proposals). The proposals all say
- That seniors then will get help from the Federal government to pay their healthcare insurance premiums (premium support)
- Just like we seniors get help today from the Federal government to pay our healthcare insurance premiums.
- And most likely the way you get premium support from your employer today to pay for you healthcare insurance.
With our premium support from the government today:
All that most of the various Medicare Reform proposals do is rationalize the inconsistencies noted below between capitated Medicare A/B/C integrated care (the wave of the future according to ObamaCare) and Fee for Service (FFS) Medicare A/B/D with its total lack of health-care provider accountability.
Those who want to choose the poor insurance provided by Medicare Parts A and B and then supplement it with insurance from a company such as AARP or from a former employer or union will still be able to do that. Wyden Ryan in particular also proposes to add catastrophic coverage to Parts A and B (that is, remove Original Medicare's lifetime limits) and if that happened more people than today's less than 10% are likely to choose a plan with Original Medicare A/B benefits only because many seniors today buy supplemental insurance for its catastrophic coverage only, paying a considerable amount of money they don't want to spend for benefits like no co-pays or dental coverage they don't want
In most of the reform proposals, competitive bidding will be used to lower the government's and the then (2022) senior's costs just as it has been used successfully for this purpose in Medicare Part D for six years. However -- at least under the 2013 House budget -- if competitive bidding fails to lower costs or keep them from rising, the same cap on government premium support for Medicare as in current law, Obamacare, will apply.
-- Dennis Byron
Detail illustrated Above:
- 1. Today about 30% of us seniors participate in three Parts of Medicare -- Parts A, B and C -- that give us a choice of privately administered capitated plans, mostly HMOs. These plans typically include vision and/or dental coverage, drug coverage, annual physicals, limits on annual out of pocket expenses and other benefits not included in Original Part A/B Medicare alone. However by law, the various plans must also cover all the services included in Original Part A/B Medicare.
- The senior's price varies widely county by county around the U.S. but on average is about $160 per month. Issue is guaranteed if you legally reside in the county of the plan you want to choose.
- The government's price (that is, the premium support provided to the senior) also varies widely but averages around $800 a month based on the most recent data, which is a couple of years old.
- (There are a few fee for service -- FFS -- plans available to us on A/B/C in a few counties in the U.S. but the Part A/B/C FFS program has been cut by Obamacare. Obamacare is trying to eliminate FFS for all Americans, not just seniors on Parts A/B/C but all seniors and all Americans and legal residents of the U.S. Obamacare intends to move everyone in the U.S. on one of its plans to capitation and an HMO, which is what Part A/B/C already is.)
- 2. Today about 30% of seniors participate in three Parts of Medicare -- Parts A, B and D -- that gives us one privately administered FFS one-size-fits-all plan nationwide -- plus prescription drug coverage, which is not included in Original Medicare Parts A and B. Original Part A/B Medicare also does not include annual physicals, vision or hearing coverage, has lifetime limits, geographic restrictions, and very high copays and deductibles.
- The senior's price for this approach varies widely county by county around the U.S. but on average cost about $130 per month.
- The government's price (that is, the premium support provided to the senior) also varies widely but averages around $750 a month based on the most recent data which is a couple of years old.
- The price for the senior and the government is slightly lower than A/B/C (7% less on average) because the insurance is not as good. What many seniors do -- particularly higher income seniors -- is buy the less good A/B/D insurance (instead of the A/B/C insurance described in item 1 above, which is disproportionately used by lower income seniors) and supplement A/B/D with private insurance from companies such as AARP that cost around another $100 a month on average
- (This private insurance is better than both A/B/C and A/B/D because it covers all or part of Part A/B's high copays and deductibles, and removes some or all geographic restrictions, and partially covers Part A/B's lifetime limits and -- unlike HMOs -- allows the seniors to go to any doctor that accepts Medicare without a referrall. However by law these supplements cannot cover healthcare services not included in Part A/B. For that reason, seniors in this group also often buy separate vision and dental insurance. Obamacare will eliminate the choice of buying private supplemental insurance from companies such as AARP that covers all Part A/B's high copays and deductibles beginning in 2014.)
- 3. Today about 30% of seniors participate in two Parts of Medicare -- Parts A and B -- and supplement that insurance with private insurance from a former union or employer. The insurance from the former employer may or may not cover drugs, may or may not be FFS, etc. The choices are typically wider than item 2 above but less than item 1 above.
- The price for the senior begins at $100 a month and then depends on what the union or employer charges the senior versus how much the former union or employer pays.
- The price for the government (that is, the premium support provided to the senior) is the same as in item 2 above.
- 4. Today about 15% of seniors receive Medicaid to help them pay all or part of their monthly Part A/B premium and a slightly larger percentage receive "Extra Help" to pay their Part D premium and their prescription drug deductible and co-pays.
- Items 1-4 add up to more than 100% because some people receiving Medicaid and/or Extra Help assistance use the money they save to buy the private insurance described in items 1 and 2.
- 5. Today less than 10% of seniors participate in two Parts of Medicare only -- A and B -- and some participate only in Part A because they are covered by
- the VA, or
- a spouse still working under a family plan, or
- they are very rich, or
- they have fallen through the cracks and really should be in the groups described in items 1-4 but don't know it.
