Apparently sensing some momentum moving against them, the far-left-wing's hate for public Part C Medicare Advantage plan is spewing forth all over the place in the form of the typical lies and the less obvious deceptively misleading statements.
The proximate issue is the Obama administration's February 2014 proposal to cut another estimated 10% in Part C capitation fees in 2015 after an alleged 6% cut this year. The reason for the cuts is supposedly the Patient Protection and Affordable Care Act (PPACA) but if you believe the American Health Insurance Plan lobby (I don't always!), these cuts to public Part C plans will take the capitation fees down to a level much lower than called for by PPACA.
1. A typical lie by the hate-filled academics is that these capitation fees go to insurance companies (usually worded as "blood-sucking for-profit insurance companies") rather than seniors. Forgetting the fact that most public Part C plans are run by non-profits, the fact is that the extra benefits1 go/went to us seniors, not the insurers. The math differs for every senior in every county in the country but just using me as an example:
- My comparative choice, living in Barstable County, Massachusetts, is between paying approximately $4000 a year for Part B Medicare/Medigap/Part D Medicare vs. paying approximately $2000 a year for Part B and C Medicare (Medicare Part A is "free," not counting almost 50 years of Medicare payroll taxes and Medicare taxes paid for me by my employer -- which was usually me)
- For $2000 less, I get the following "extra benefits:"
- an annual out of pocket spending limit, which I cannot otherwise buy in Massachusetts (To me this is the reason I buy insurance. It is effectively catastrophic coverage that you cannot otherwise get. I would choose a public Part C Medicare Advantage plan for this extra benefit if for no other reason; and yet it costs me less than the other approach and the senior haters in academic want to remove this true insurance from my options)
- built-in drug coverage (this is actually somewhat limiting for some seniors but does not present an issue to me because I am able to use all generics)
- a vision stipend of $150 for a new pair of glasses each year (I am visually disabled)
- a "free" annual physical (not included in Part B Medicare or Medigap although some doctors do them and charge Medicare for an annual wellness visit)
- a "free" prostate exam (20% co-pay required under Original Medicare but that co-pay would likely be covered depending on which private Medigap plan I chose)
- other benefits that I do not personally use but that others might like such as a large discount at the largest pharmacy in the area (for over the counter medications not covered by Medicare)
- the simplicty of dealing with one insurance company rather than four or five
- The downside -- in addition to the possible problem with drug coverage -- is that almost all public Part C Medicare Advantage plans are networked; they will not do the job if not accepted by favored providers nor are they good for seniors that spend extended periods of the year in two different parts of the country (e.g., snowbirds)
2. The typical misleading statement by the haters in colleges and think tanks is that these payments amounted to 14% more than the government was paying for people on Original fee for service (FFS) Medicare in my county. That was true in 2009 and 2010. It's old news. The far left is beating a dead horse. According to MedPAC, the difference was 1% in 2013 (in a range between 1.5% and 0.5%), not counting the allegedly illegal Obama-administration bonus program that had nothing to do with the 2003 law. Most likely, given the cuts made a year ago to Part C funding by the Obama administration, parity has been reached in the plan year we are currently in
1As an aside and as I have stated elsewhere on this blog, I agree with that part of PPACA that says that the extra incentives formerly paid to Original Medicare beneficiaries on a public Part C Medicare Advantage supplement like me because of the 2003 Medicare Modernization Act (MMA) were not fair to people on Original Medicare with a Part D standalone drug plan and some private supplement, be it Medigap or from an former employer. Also since the extra MMA payments went disproportionately to the poor and minorities, I am not sure they were wrong even though I disagreed with them on a fairness basis.