theabcsofmedicare

When Will the Left Stop Lying... about "Medicare for All"

When will the left stop lying... about "Medicare for all?"

This far left California Congressperson supposedly¹ said:

“Medicare is far, far more efficient than private insurance companies. Using the tax system to collect money for healthcare delivery is extremely efficient. No profits. No commissions. No advertising.”

Is this Congressperson really so clueless?
Forgetting the fact that even the Obama administration’s leading Medicare bureaucrat stated that Medicare is twice as INeffecient as commercial insurance (all insurance companies are private), is he or she not aware of the huge profits and commissions involved in United States Medicare. Is the Congressperson so out of touch with real Americans that he or she has never seen an ad for Medicare from AARP?  

United States Medicare is run lock, stock and barrel by the insurance industry. That includes all four Public Parts of Medicare (A, B, C and D) and all the numerous private supplementary options that almost everyone not on Part C or Medicaid use because Parts A, B and D of Medicare provide such poor financial protection.

And Medicare is only about 20% funded by payroll taxes. More than half of Medicare beneficiary healthcare spending is funded by the Medicare beneficiary out of pocket (and that’s not counting what he or she paid in payroll taxes for 50 years). Most of that out of pocket spending is to buy supplemental insurance from insurance companies like AARP (understanding that around 85% of the money ends up with doctors and hospitals)

This dominance of United States Medicare was baked into the Original 1965 Medicare law -- Sections 1816 for Part A and 1842 for Part B if you want to read it -- and LBJ could not have passed Original 1965 Medicare without the buy in of the insurers. No civil servants are involved in United States Medicare other than to issue contracts to insurers and to theoretically make sure the insurers (and a group of non-insurance-company sponsors of Part C) follow the contract.

At least the public Part C Medicare health plan program, passed in 1997, took away some of the insurers' power because most Part C plans are run by integrated health delivery systems and non-profit charities, eliminating the middlemen to some extent. But even Part C is dominated in terms of number of subscribers by two for-profit insurers and AARP, which although a non-profit, uses a for-profit insurer. And my integrated health delivery system decided it did not want to be in the insurance business and spun out its claims handling department into a separate insurance company, which at least is a non profit charity.

¹I say supposedly because left wing journalists have a habit of putting words in people's mouths.

When Will The Left Stop Lying... about Tens of Thousands of Deaths Per Year?

When will the left stop lying...

... about lack of health insurance causing "Tens of Thousands of Deaths" among Americans under age 65 per year?

Happily there are relatively few (compared to the U.S. population of over 300,000,000) deaths related to any cause among Americans under age 65 per year¹:

• about 150,000 among those under 45 in 2015 (only 25-45 shown in visual)
• about 500,000 among those between 45-65

Deducting accidents, homicides, and let's call them "lifestyle-choice deaths," the number is well less than 500,000 for everyone under 65. Also happily, as percent of overall population, the number is down dramatically since 1980, when the population was 100,000,000 less (33%) than it was in 2015.

To claim that 10%, 15%, or more of these relatively few but unfortunate early passings have anything to do with insurance is just an unbelievable example of how far the left will go in terms of deception, corruption, deceit and outright ugliness.

¹United States Department of Health and Human Services, 2016 Chartbook

 

 

Leftist Advisory Board Economists Seem to Have Flunked Economics 101

Wow, this Advisory Board article is full of total non sequiturs in addition to the usual liberal nonsense about Medicare. The Advisory Board is a left wing crony capitalism group that supposedly does economics research. If this article is any indication, its economists flunked Economics 101.

The article begins:

“Although Medicare Advantage (MA) was created as a way to reduce federal spending, the federal government generally pays MA insurers more than the plans actually pay for patient care.”

Those two statements are unrelated. The “although” is total nonsense. It

1. could be true that the public Part C Medicare health plan program reduces federal spending and
2. also true that the federal government pays Part C plan sponsors (only a minority of Part C plan sponsors are insurers) more than the sponsors pay providers.

In fact the first statement is undeniably true according to years and years of Annual Medicare Trustee reports (see table directly above--the 2016 numbers are now out and the right hand percentage continues to run under 100%).

And, separately, while there have certainly been some public Part C plan sponsors that paid out more than they took in, such sponsors don’t last long.

There are at least another half dozen outright errors or silly sentences similar to the first in this short article.

Lefty Health Affairs Ties Itself in Knots over Failed Obamacare, Original Medicare

A very revealing article is currently appearing on Health Affairs. This article is a devastating indictment – by three second-string leftists — of both the left’s failing 5-year-old healthcare financing program for the poor and the left’s failing 50-year-old Original Medicare program (which was — at least initially — for seniors). This article also features the most tortured circular lefty logic I have ever seen.

Follow these leftists’ proposal in detail.

• 1. Our healthcare financing program for the poor, particularly for the working poor, is failing. So let’s give the working poor access to our failing healthcare financing program for seniors instead.
• 2. But… Our healthcare financing program for seniors – Original Medicare – actually provides fewer benefits and worse financial protection than our healthcare financing program for the poor.
• 3. So… “(Original) Medicare… plans would have to provide the essential benefits of (our healthcare financing program for the poor) and meet other requirements…, so the benefit packages—perhaps at the gold and silver levels—(of this new proposed Medicare for the poor) would need to be different from the (benefits) Medicare offers to seniors… (today).”
• In other words, we realize that today the left’s Original Medicare program is basically a Tin Plan on the current law’s Bronze-Platinum scale. The left’s Original Medicare is terrible insurance, with lifetime and per-incident limits on benefits, no catastrophic coverage, no out of pocket spend limit, and many other problems (lack of drug coverage, which is mentioned, is the least of the left’s Original Medicare’s problems). Original lefty Medicare is so bad that 98% of the people who use Original Medicare have to buy two, three or more mostly private insurance policies to actually be… you know… insured.
• 4. So… Instead let’s give the poor the Republican’s 20-year-old Medicare program, Medicare Advantage (see Note), and ruin it too. Oh by the way, the current Bronze-Platinum program of healthcare financing program for the poor, which has failed, is pretty much a copy of the Republican’s Medicare program, which is successful because it is designed for seniors.
• 5. So… Return to Point 1.

NOTE: The term Medicare Advantage is a government artifact and most beneficiaries of a public Part C Medicare health plan, of which Medicare Advantage is only one of multiple types, would not see the term Medicare Advantage on a card, promotional document or other policy document they are ever likely to look at. However the words “Medicare Advantage” do appear (or should) in the fine print of the 300-page Evidence of Coverage document, if their Part C plan is a Medicare Advantage plan

New York Times Continues Decades-Long Attack on Medicare Choice for Seniors

On August 7, the New York Times continued its decades-long attack on the idea that seniors should have a choice in the kind of Medicare they use: fee for service or capitated fee. The article was titled deceitfully "Medicare Advantage Spends Less on Care, So Why Is It Costing So Much?" The New York Times was deceitful because the article was based on this report, which basically said the opposite of what the Times reported: The Times deceitfully glommed onto the questionable claim circled in red concerning 30% overhead while making no mention of all the report's meaningful data underlined in blue that came before it. The third paragraph of the Times deceit begins:

"The study released in January, found that the revenue Medicare Advantage plans received in 2010 exceeded the amount they paid out for medical care by a hefty 30 percent. At more than $2,000 per enrollee per year, that probably topped $20 billion dollars, nearly all from federal payments, not enrollee premiums....."

Apparently the author of this blog and the New York Times is assuming you will not follow the link to the report, which actually says on page 1 (splitting up the two different thoughts in the underlined section above):

"… average spending per enrollee-month in TM was…$771 paid... by the Medicare program (per service)… The MA plans in the HCCI data received on average $767 per enrollee-month…”

So the Medicare Trustees (what the blogger calls "federal payments") paid $50 less per year on people on Medicare Advantage than people on traditional Medicare. The report, if you follow the link, also explains that people on traditional Medicare pay over $1200 more per year out of their own pocket (see Note 1) than people on a public Part C health plan, as explained in this further edit of the convoluted academic wording:

"We calculate that MA spending per enrollee-month totaled $642, of which $590 was paid by MA insurers and the rest by enrollees out-of-pocket. In contrast, average spending per enrollee-month in TM was $911, of which $771 was paid directly by the Medicare program to providers."

The report at the link also explains that the claim of a 30% overhead is highly speculative. But naturally that is what this opponent of senior choice glommed onto. The biggest reason that the 30% claim is likely wrong is that it does not account for the benefits in public Part C health plans such as eyeglass discounts or an annual physical exam that are not covered at all by traditional Medicare and that therefore are not tracked in the almost-10-year-old HCCI data concerning Medicare Advantage.

The reason for the Times' deceit is that the Democratic Party viciously attacked the Part C health plan program and the poor people like myself who use these plans (see Note 2) from the formal creation of the program in 1997 (and even before 1997 when what became Part C was in demonstration status) until 2014. The Democratic Party stopped its attacks on we seniors in 2014 given Part C's popularity but the venom the Party spewed for 30 years continues on. And people like the author of this New York Times article and the New York Times in general has apparently not gotten the word that the Party line has changed.

NOTE 1: This $1200 difference only applies on average as if no one bought expensive private Medicare supplemental insurance. In fact, people on traditional Medicare typically buy expensive private AARP-like supplemental insurance which costs over $2000 more per year than Part C plans on average

NOTE 2: Public Part C health plans, of which Medicare Advantage is one type, are not for everyone. The most important factor in Medicare choice is what insurance does your favorite provider accept. Most providers do not accept a public Part C health plan, a program mostly benefiting poor seniors. A secondary concern for rich seniors that live in different parts of the United States at different times during the year is that Part C plans are geographically based (there is an exception to that rule for rich seniors in Minnesota that can afford to live in different parts of the United States at different times during the year.