theabcsofmedicare

Seniors on United States Medicare: Right- and Left-Wing Propaganda Is All Wrong

All aspects of Medicare -- the history, the current status and suggested reforms -- have been thoroughly politicized. Almost every statement about Medicare you read anywhere is designed as propaganda. Everything from the silly right-wing chain letter that says President Obama is going to cut you off from Medicare when you turn 76 to the left wing claim that the Patient Protection and Affordable Care Act (PPACA) of 2010 as amended saves Medicare from "bankruptcy." It's all untrue -- much of it intentionally untrue -- and it can cost you money if you don't pay attention.

None of these lies piss me off more than the ones -- basically from the far left wing of the Democratic Party but from Republicans to a lesser degree -- that say:

• We seniors are stupid and need the goo goos and politicians to choose for us. We have been buying insurance of all types for 50-60 years you know.
• We didn't pay for our Medicare. We have been paying payroll and income taxes for 50-60 years you know. (The net present value of those payments plus the pooling effect of insurance in general plus an uplift at a market rate to compensate for what we lost in returns on that money more than pays for our Medicare, for those born after 1945).
• We don't care about the poor. Medicare is basically free for the poor you know paid for with our 50-60 years of taxes and our current premiums (that's right; no one ever tells you there are current premiums until you go on Medicare--thousands of dollars a year in current premiums).

Strong letter to follow... (actually what will follow will be more of my pox-on-all-their-houses opinions plus totally unbiased advice -- which you cannot even get from HICAP/SHIP/SHINE volunteers)

Exposing Looney Left Lie #23 about United States Medicare: Part C Does Not Cost 14% More Than Original Medicare

The most often repeated left wing lie about the public Part C Medicare Advantage health plan program is that it costs taxpayers 14% more than Original Medicare. The number is usually attributed to the so-called non-partisan Medpac group appointed by Congress to advise it on United States Medicare.

 

There are three errors in that single claim. Just to be accurate, the difference is between Part C and traditional medicare, not Original Medicare. And the difference -- which is not historically 14% -- is a per beneficiary number. And what Medpac actually says is that

 

"IN 2009 ALL PART C PLANS (NOT JUST Medicare Advantage plans) on average received a premium of about 14% over what beneficiaries would have cost had they stayed in traditional Medicare." 

 

In other words, 14% was the kicker in 2009, in just one year out of the almost 20 years of the program's existence. Before 2009, some years the kicker was negative 5%. Most years before and since 2009, it was single digit positive. This kicker was done to increase the availability of managed care particularly for the rural and urban poor. It worked. Such people now use Part C disproportionately.

 

 

 

Exposing Looney Left Lie #22 About United States Medicare: Not All Part C Plans Are Medicare Advantage Plans

We can never have a useful and productive change to Medicare (and American health care) when left- (and right-) wing ideologues cannot even agree on terminology and current United States Medicare program status. As I have noted elsewhere:

1. No Part of Medicare is private. The word Part means it is Part of Medicare and Medicare is publicly funded and mandated social insurance.
2. All Parts of Medicare are administered by private insurance companies and all Parts of Medicare paid for partially out of general revenues and partially by the beneficiary via income and payroll taxes and ongoing premiums (almost totally the latter if you were born after 1945 and paid these taxes to and past normal Medicare age).
3. No current proposal to reform United States Medicare (or ever that I can see) involves a voucher or coupon.
4. Traditional Medicare and Original Medicare mean two different things. 

In addition, not all Part C Medicare plans are Medicare Advantage plans. Public Part C Medicare HMO health plans provide better quality care on average because they are HMOs, not because they are part of Medicare Part C (not all Part C plans are HMOs but most are). Some Part C plans -- the part of Part C plans that drive the capitation fee up and allow Democrats to claim that insurance companies are cheating taxpayers -- are special needs plans. Some of these plans are called Cost and PACE and are not even part of Medicare Advantage. And if you prefer the managed care of almost all Part C supplements, you still need to sign up (and pay the premium for) Original Medicare. Part C is not a replacement for Original Medicare but a supplement to it.

No, Your United States Medicare Coverage Does Not Run Out When You Turn 76

I can't claim for sure that this is a looney-right lie about Medicare but it sure smells like one. It is based on a chain email (started by Warren Buffet according to some versions) that claims something like:

"Your hospital Medicare admittance has just changed under Obama Care. You must be admitted by your primary Physician in order for Medicare to pay for it! If you are admitted by an emergency room doctor it is treated as outpatient care where hospital costs are not covered. This is only the tip of the iceberg for Obama Care. Just wait to see what happens in this year and 2014!

"YOU ARE NOT GOING TO LIKE THIS... At age 76 when you most need it most, you are not eligible for cancer treatment * see page 272. What Nancy Pelosi didn't want us to know until after the health care bill was passed. Remember she said, "We have to pass the Bill so that we can see what's in it." Well, here it is.

"Obama Care Highlighted by Page Number THE CARE BILL HB 3200 JUDGE KITHIL IS THE 2ND OFFICIAL WHO HAS OUTLINED THESE PARTS OF THE CARE BILL. Judge KITHIL of Marble Falls , TX - highlighted the most egregious pages of HB3200 Please read this....... especially the reference to pages 58 & 59 JUDGE KITHIL wrote: ** Page 50/section 152: The bill will provide insurance to all non-U.S. residents, even if they are here illegally. ** Page 58 and 59: The government will have real-time access to an individual's bank account and will "

This chain letter is totally bogus, about 5 years old, refers to a law that was never passed (but was a precursor to the Patient Protection and Affordable Care Act), and is just so wrong in so many places that I am not going to bother correcting it. Just ignore it.

 

Seniors on United States Medicare: Now Is the Time... Unless It's Not

September is the time of year that the Medicare bureaucracy -- having received all its bids back from insurance companies that participate in Part C Medicare health plans and Part D standalone drug plans -- prints up the information, mails it out, and puts it up on the Medicare "exchange" marketplace/web site (actually called Medicare Plan Finder). So if you have not already done so because a former employer's or union's insurance compang uses a different time of year to straighten out insurance enrollment, now is a good time to begin thinking about 2015. And as explained here, it is NOT the time of year to sign up with your states' Original Medicare insurance company for Part A and B Medicare itself... unless you happen to be turning 65 around now. 

•  You will shortly receive your Medicare and You booklet unless you told the Medicare bureaucrats you'd use it online
• If you bought either a Part C Medicare plan -- almost always but not always a Medicare Advantage plan -- or a Part D drug plan for 2014, you will hear shortly about how it has changed (they almost always do).

In United States Medicare, How's that Death Panel Thingy Doing?

You hear a lot about death panels in United States Medicare. The left and the right mean two entirely different things when using the term "death panel." Both uses are highly propagandized but at least the Republican meaning actually involves a "panel" (that is, a group including more than one person).

Exposing Looney Left Lie #21 About United States Medicare: Medicare Will Work Just Great Under the Death Panel

There is a renewed discussion about the supposed Patient Protection and Affordable Care Act's (PPACA's) "death panel." The left -- as in the linked New York Times article -- claims that all its death panel idea is is PPACA's attempt to make seniors listen to their doctors about reasonable end of life decision making. That's bad enought. The word "make" in that sentence is something that everyone should disagree with.

 

But the whole "end of life talk" meme is moot. Since there is no panel involved in a left-wing-/goo-goo-forced discussion with your doctor,  that's not what "death panel" means in the PPACA context. By claiming otherwise the left is trying to divert discussion about death panels from its real inention. In PPACA, "death panel" obviously refers to a group of people and under PPACA that group is called the Independent Payment Advisory Board (IPAB). It's job -- once constituted -- will be to determine treatments that are most costly and almost automatically begin the rationing of them for Medicare beneficiaries.

 

Why does this matter?

More Good Reasons to Ignore Health Affairs and MedPAC's Hoadley on Medicare Part D

I have written before about why it's best for seniors to add Health Affairs and MedPAC Commissioner Hoadley to your Do Not Read list for Medicare information. In particular, it is unbelievalbe that the Obama administration has added a rabid senior hater like Hoadley to an organization that has some (not a lot) say over our health care.

The campaign of Mr. Hoadley's and others to repeal or greatly change Part D, something they have been trying to do for 10 years or more now, continues. In the winter of 2014 Mr. Hoadley was on the web supporting a decrease in the number of choices of plans we seniors get from the Part D program. He is also part of the constant chorus that claims we seniors are too stupid to make decisions about our insurance because it is complex to figure out what drugs we take and what drugstore we like to go to. Some say we should let the government do it for us (although I do not know if Mr. Hoadley is among that group).

Exposing Looney Left Lie #20 About United States Medicare: Obamacare Did Not Give Seniors Free Flu Shots

Here's just a minor but constant looney left lie about Medicare. Obamacare did not provide Medicare beneficiaries with "free full shots." "Free" flu shots have been part of United States Medicare since the 1990s, since shortly after flu shots were first covered by Medicare in 1993. Flu shots were not added to Medicare in 2010 as part of the Patient Protection and Affordable Care Act (PPACA) as the left often claims. Neither were "free" physicals or many other "free" things like lipid tests. 

Of course, nothing in Medicare is "free." That's just another looney left lie.

On United States Medicare? Add Columbia Journalism Review to Your "Do Not Read" List

The Columbia University journalism school has teamed up -- perhaps from the beginning -- with a flawed series of articles by a far left wing group called the Center for Integrity. The ignorance about Medicare and public Part C Medicare Advantage plans by the Integrity Center is breathtaking. In its ongoing attack on Part C the it does not appear to even have analyzed the data by separating PACE and other special-needs risks from basic public Part C Medicare Advantage risk coding (but we can't be sure because its analysis is so opaque).

 

The fact that the Columbia Journalism Review would find this ignorant series useful, on the other hand, is not surprising. Not that anyone would go to the Columbia Journalism Review for Medicare advice anyways but add it to your Do Not Read list just out of general principle.

Exposing Looney Left Lie #19 About United States Medicare: No One Is Proposing Vouchers

The far-left-wing folks that drink the Kool Aid and talk to themselves incessantly at Daily Kos have been all in a lather recently claiming that Congressman Paul Ryan lied about his Medicare vouhcer plan. But the Wyden-Ryan Medicare reform plan included no voucher and no coupon.  It would work the way Obamacare insurance and RomneyCare insurance work. And both of them work exactly the way President Clinton's now 15-year-old public Part C health plan program works (especially after 2003 amendments). And they all work the way your insurance from your employer works and has worked for over 75 years.

What is really incredible about the comments on this Daily Kos thread is that lefties seem to have no idea what they face once they are Medicare age if no changes are made.

Only In United States Medicare: Non Participating Providers Actually Participate in Medicare

United States Medicare is full of strange twists of the English language. But none is stranger than the terminology regarding providers who will treat you if you have Medicare.

Exposing Looney Left Lie #18 About United States Medicare: PPACA Does Not Make Big Cuts to Medicare Advantage

A constant refrain of the looney left is that the Patient Protection and Affordable Care Act (PPACA) of 2010 as amended does not make cuts to Medicare, just to Medicare providers and insurance companies.

When that statement is exposed for the looney left lie that it is, the far left's counter is that the PPACA cuts don't hurt seniors, they are just to Medicare Advantage insurance companies. This is just another looney-left distortion of the facts:

InsuranceNewsNet: "Does Medicare Advantage Spell Doom For Traditional Fee-For-Service Medicare?"

I kept waiting for the twist in this Insurancenewsnet story from the headline -- "Does Medicare Advantage Spell Doom for Traditional Fee-for-Service Medicare?" -- but it never came. This article appears to have been meant to be a straight story and an honest question.

If so, the answer is

"No, public Part C Medicare Advantage and other capitated Part C plans will not spell doom for fee-for-service Medicare. But yes the managed care model may become more popular than fee for service. There is still a place for both models of insurance in Medicare, just as there is in the non-Medicare market (which is run by almost all the same insurance companies after all). But there are changes the government could and should make to Original Medicare -- even if it raised Part B premiums more than they otherwise would be raised -- that will tend to cement the place of the fee-for-service payment model as a future option."

The reason for the answer relates to a few missing key facts in the InsuranceNewsNet article as follows:

Exposing Looney Left Lie #17 About United States Medicare: Obamacare Did Not "Fix" the Medicare Trust Fund

[Summer n the Northern Hemisphere is over at least figuratively. This "Exposing Looney Lefty..." post is picking up on a series that first began in the spring of 2014 and was last posted to here in June.]

A new refrain from the looney left and its cooperating bureaucrats at the Congressional Budget Office (CBO) is that the Patient Protection and Affordable Care Act (PPACA) of 2010 as amended has saved the Medicare Part A trust fund from... from... (actually from whatever is always unclear).  

Actually read the Medicare Trustees Report on which the latest CBO report calculations are based and you find that most of the difference in projected change from 2010 to 2014 -- as a percent of each Part of Medicare by far as well as almost absolutely -- is based on changes in Part D drug spending projections. And PPACA had nothing budget-wise to do with Part D.

Right-Wing Ideologues Just as Bad as Lefties When It Comes to United States Medicare

This right winger's column is interesting as illustrative that right-wing idelogues use tricky language and carefully parsed and inconsistent wording just as much as left wingers when it comes to trying to position United States Medicare for some spurious political advantage.