theabcsofmedicare

Medicare Advantage Is Public Medicare

No looney lefty lie is more recurring than the one that public Part C Medicare Advantage health plans are "private" and that Original Democratic-Party/LBJ Medicare is "public." Part C Medicare Advantage plans are no more private or public than Original Medicare.

 

That is, all four Parts of Medicare --- A and B, better known as Original Medicare, and C and the Part D drug program -- are

• all administered by private insurance companies today (and always have been)
• all paid for publicly¹ 

So you can either say all Parts of Medicare are all private or all are public but you cannot say some are private and some are public.

 

Whichever, neither term means much.

 

¹The government sends the private insurance company a check covering the services paid fee for service under Original Medicare or for the capitation fee under public Part C Medicare or for the defined contribution under Part D Medicare with the money from two Medicare trust funds containing money the beneficiaries gave the government over the years in payroll and income taxes... plus interest on one of those trust fund's balances -- which was in surplus from the mid 1980s until recently -- and from those who sadly never made it to Medicare age. In addition the programs are paid for via ongoing monthly premiums paid for -- in most cases -- by the beneficiary once on Medicare.

"Let's Fix Medicare, Instead of Destroying It," Write Famous Advocates for Healthcare

That's the way I feel too so I was drawn in by the headline and jumped right to the story, which began:

"Writing in the National Post, Marni Soupcoff called Brian Sinclair, an aboriginal man who died needlessly in a Winnipeg ER waiting room, a “martyr to medicare” ..."

I was mislead multiple ways.

1. The authors were Canadian, not American.
2. Why does Canadian Medicare (Canada's version of Obamacare) need fixing; the left keeps telling me it is the greatest thing since sliced bread?

Oh well, back to our own problems. Give us seniors a defined contribution (some call it premium support; others call it voucher) healthcare plan just like the one we've had for the 50 years before we went on U.S. Medicare. 

For Democratic senior citizens that want the uncoordinated health care of Original Democratic-Party/LBJ Medicare with its $1200 hospitalization deductibles, 20% co-pays, no annual physical, no drug coverage, limits on skilled nursing, no annual out of pocket limits, lifetime limits on acute-care hospital benefits, and state-run private gap insurance that does not guarantee coverage in case of a pre-existing condition, let them buy it¹. Let the rest of us buy real coordinated one-stop-shopping insurance -- from high deductible to Cadillac if we want it, just as we can today through public Part C Medicare health plans and (for a decreasing few of us) employer-retirement policies.

1Four Harvard professors just proved that almost no one will take Original Democratic-Party/LBJ Medicare even when it is almost given away in zero-premium/Part-B-rebate Part C Medicare Advantage plans

Harvard Professors Waste Taxpayer Dollars Proving Democratic-Party/LBJ Medicare Sucks

A bunch of taxpayer-money-wasting¹ Harvard research people in a recent article entitled PREMIUM TRANSPARENCY IN THE MEDICARE ADVANTAGE MARKET: IMPLICATIONS FOR PREMIUMS, BENEFITS, AND EFFICIENCY has proven with great specificity and academic rigor that Original Democratic-Party Medicare is really lousy insurance. With all kinds of probably quasi-experimental methodologies and the usual academic dependence on useless years-old data, the quartet demonstrated that even when the government tries to just about give Original Democratic-Party/LBJ Medicare away for free, few of those eligible for it take up the offer. Of course, us plain old real people -- who have been forced into the terrible Democratic-Party Medicare system for 50-plus years -- could have told the Harvard guys that so the fact that they spent my tax dollars to arrive at that conclusion is a bit irritating.

The gist (or is it jist) of the Harvard research was that us stupid seniors² don't choose so-called zero premium public Part C Medicare Advantage health plans with Part B rebates in any substantial number. Aren't we stupid? Zero-premium Part C plans are the plans most like Original Democratic-Party/LBJ Medicare in terms of its high co-pays and deductibles, lack of an annual out of pocket (OOP) spending limit, a restricted list of services covered (albeit most of the important ones except drug coverage, an annual physical and direct admittance to skilled nursing care), and other major disadvantages.³ Those zero-premium Part C plans with a Part B rebate basically reduce the cost of Original Democratic Party/LBJ Medicare to zero or near zero (in that the senior also gets back the $105 a month Part B premium typically deducted from his or her Social Security deposit). Clearly, Harvard contends, we are  stupid for not signing up in droves for this crap and are being misled by blood-sucking insurance companies and medicare.gov promotional material to sign up for more expensive insurance we do not need.

Other errors in the research paper (possibly that mislead Harvard to its conclusion that we seniors are stupid) follow. But thanks for proving what we already knew: Original Democratic-Party/LBJ Medicare sucks. 

Exposing Looney Left Lie 16: We Seniors Pay For Our Medicare Advantage Too

No part of Medicare gets attacked more by the looney left than the public Part C Medicare Advantage health plan program. When public Part C Medicare Advantage gets lumped with claims by lefties that we seniors are blood-sucking stupid hypocrites (see here, here and here), the deceit by the left is deafening and constantly repeated by the so-called mainstream press.

 

Do not be fooled by the despicable claims by the likes of The Incidental Economist (which recently compared seniors to some kind of corrupt politicians at the end of the Civil War), The New York Times, The Doctors Against Insurance Companies group, and so forth. You pay your own way¹.

Exposing Looney Left Lie 15: We "New" Seniors Pay For Our Healthcare Providers Too

As explained in an earlier post, we seniors really really pay for our hospital costs. Maybe Harry Truman and all those people who originally began immediately drawing Medicare benefits in 1965 -- who were born in the 19th century -- didn't really pay their way¹. But in terms of Part A those born after about 1930 surely did and perhaps even those born in the 1920s. So the next thing to look at is Part B of Medicare.

My one deviation from illustrating the flow of Medicare funds purely in the image above and in a whole series of related posts is that the "Medicare income tax contribution" shown does flow through the general fund (green in image).

Exposing Looney Left Lie 14: We Seniors Really Really Pay For Our Medicare Hospital Services

In a previous post I laid out the complete flow of funds in the United States Medicare system illustrating how anyone fully under Medicare since its beginning in 1965 is paying his or her own way.

As the bold parts of the illustration show, this is particularly true of the funds that go from the Part A trust fund to pay for fee for service procedures in acute-care hospitals (if admitted) and rehabilitation services in skilled nursing facilities.

Quack Wharton School Lefty's Crazy Medicare Advantage Theories--Part 3

As decribed here and here, some wacky lefty at the University of Pennsylvania's Wharton School has come up with a completely nutty theory about how the public Part C Medicare Advantage health plan works. It appears to me to show a significant misunderstanding of Medicare in general, so bad that you can hardly believe the person works in an academic institution.

To be clear, as I have written here multiple times, I’m all for the cuts to the 3% higher reimbursements currently given to the disproportionately poor and minorities on Part C.

Exposing Looney Left Lie 13: We Seniors Pay For Our Medicare

One of the favorite lying left¹ deceptions about Medicare is that we seniors do not pay for our health care costs.

The above illustration² explains how Medicare funds flow from we seniors to our providers

• facilitated by the Internal Revenue Service and Social Security Administration and
• administered by about 50 insurance companies in the United States, depending on whether Part A or Part B fee for service payments are involved or Part C capitated fees or a Part D vouchers are used.

Exposing Looney Left Lie #12 about Medicare: Medicare Advantage Covers Absolutely the Same Things as Original Medicare

Absolutely the same things at a minimum and typically much more.

And that just drives the looney left looney... that Medicare Advantage can deliver the same benefits and a lot more for just about the same cost to the government... and typically (but not always) at less cost to the Medicare than Original Medicare and private Medigap plan.

How do they do that, the left asks. It's called the marketplace, lefty.

Exposing Looney Left Lie #11 About Medicare: Millions of Poor Seniors Can Change Plans As Often As They Want

One of the typical lefty lies about public Part C Medicare Advantage health plans is that seniors -- particularly the poor and minorities that disproportionately use Medicare Advantage -- are locked into their choice for a year.

That is not true.

Brilliant Harvard Professors Breathlessly Propose Medicare Program That Has Existed for 15 Years

A brilliant new Harvard-based goo-goo academic paper has been released¹ with the breathless conclusion that the government should start an advice program for Medicare beneficiaries. In general the goo goos lack the perspective of a Medicare beneficiary like myself but because I am also a certified SHIP counselor, I really find the conclusion weird. The goo goos claim specifically that the public Part C Medicare Advantage health plan program should have a PPACA-Navigator-like function. What are they thinking of? 

Exposing Looney Left Lie #10 About Medicare: Medicare Advantage Covers All Medicare Services

Typically the looney left, which has gone bonkers over the increasing popularity of what the left considers George Bush's Medicare, tells seniors that Medicare Advantage does not cover all the same services as Original Democratic-Party/LBJ Medicare.

As the Medicare and You booklet (see image) shows, nothing could be farther from the truth than this looney left lie.

Exposing Looney Left Lie #9 About Medicare: You Don't Lose Original Medicare When You Choose Medicare Advantage

A common looney left lie about Medicare Advantage is that you lose Original Medicare when you choose Original Democratic-Party/LBJ Medicare. This is an especially deceitful trick of the Reids and Pelosis and Obamas because it scares senior citizens.

The left's leadership gets its minions to spread this lie because you will get a letter when you sign up for a public Part C Medicare Advantage health plan that says use your Medicare Advantage insurance card, not your Medicare card, when you go to the doctors or to a hospital.

Exposing Looney Left Lie #8 About Medicare: Part C Covers Everything Original Medicare Covers

A common looney left lie about public Part C Medicare Advantage is that the person who signs up for Part C does not get all the benefits of Original Democratic-Party/LBJ Medicare (which sucks but that's another post).

See this page in Medicare and You (image above) for the truth on this issue. Do not believe the lies from the looney left.

Exposing Looney Left Lie #7 About Medicare: Medicare Advantage if Part of Medicare

One of the typical looney left lies about Medicare is that if a beneficiary chooses Medicare Advantage he or she is giving up Medicare. (See other looney left lies about Medicare here, here and here.)

As illustrated in Medicare and You (see image above), Medicare Advantage is Part C of Medicare.

Exposing Looney Left Lie #6 About Medicare: No Protection from Financial Catastrophe

As I said in exposing looney left lie number 5, there is no upper limit on how much you can spend a year under Original Democratic-Party/LBJ Medicare. In this image from the Medicare and You booklet, we see that fact sort of spelled out as an afterthought.

The lefty bureaucrats bury the bad news in a section that leads off with the bad news on the low side: high deductibles, co-pays and co-insurance.

Exposing Looney Left Lie #5 About Medicare: Original Democratic-Party/LBJ Medicare Is Not Very Good Insurance

Part of the typical looney left argument against public Part C Medicare Advantage health plans and reforms such as those proposed by Oregon Senator Wyden and Wisconsin Republican Ryan is that LBJ Medicare is great insurance. The Medicare bureaucracy tells you otherwise in the book they send you every year (see image below)

The real problem isn't in the book though... at least directly.

Open Letter to New MedPAC Commissioners: Do a Better Job Than the Current Crop of Advisors

We Medicare beneficiaries depend on a hidden group of nameless academic goo goos and healthcare-/insurance-company executives to be our representatives to the government. The group is called the Medicare Payment Advisory Commission or MedPAC for short. As stupid as that sounds (not very representative of us), that's the best we'll get so I sent the following letter to two or three of the newly named MedPAC respresentatives (MedPAC itself cannot be reached unless you go by their office in Washington).

Exposing Looney Left Lie #4 About Medicare: Medicare Is Already Means Tested

One of the favorite lies about Medicare from the looney left¹ (see other examples here, here and here) is that it is unfair to poor seniors. The leftist income-redistributionist argument goes that Medicare should be means tested like Social Security and Medicaid. But it already is.

As the 2014 Medicare and You booklet clearly shows (see image above), Medicare is already means tested.

Quack Wharton School Lefty's Theories about Medicare Advantage--Part 2

On June 2 I outlined the first of about a dozen errors in a recent University of Pennsylvania Wharton School Issues Brief by Senior Hater Amanda Starc. The list of errors continues here (the list is not in order of appearance but simply in order in which they appear in the hateful document written by Starc):