The Herald reported that Obama’s health plan “trims $500 billion from Medicare Advantage over a decade.” It doesn’t. The health reform law did cut some $500 billion from the Medicare program—but almost all of it in the form of payment reductions to hospitals and other medical providers. The cut to sellers of Medicare Advantage plans was $136 billion, not the $500 billion the Herald told its readers. To explain: With a Medicare Advantage plan, seniors get their benefits from private insurers, which in turn are paid by the government. The government had been paying insurers more than it costs to provide the same benefits under traditional Medicare. The health reform law eliminated those extra payments on the grounds they are a waste of money.
There were no cuts in the basic hospital and doctor benefits under Medicare, but that has not stopped Republicans from using the $500 billion “cut” to scare seniors and win points.
When the press gets it wrong, it compounds the misinformation the public gets in the heated rhetoric of the campaign. In my next post, I will explain more about what the Affordable Care Act did and didn’t do to Medicare.
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They unfairly question Our Leader. We shall defend his humanitarian fascism.
#1 Posted by Dan A., CJR on Thu 26 Jul 2012 at 10:33 AM
When you write your next post I hope you yourself do some research to understand first Medicare and second the effect of PPPACA on Medicare. (For the former I suggest a simple booklet on the Medicare website called "Medicare and You." For the latter I suggest John Schatto's memo of October 2010.)
You post the following paragraphs in your article above as if you have checked them out and that they are correct. All three are incorrect as explained after each quote. There are many similar errors elsewhere in the article above.
1. "A critical question is whether enrolees will be able in the future to afford coverage as good as Medicare provides." No one on any side of the debate would ever argue that Medicare offers good coverage. Medicare is terrible insurance with no catastrophic coverage, no drug/physical-exam/vision/dental/aural benefits, high deductibles and co-pays, and severe geographic restrictions. Medicare is so bad that according to the June 2012 Medicare Data Book, Medicare only pays for half of beneficiary health care costs. What kind of insurance has no coverage for early-incident expenses, no catastrophic coverage, and covers only half of the buyer's expenses?
2. "Congressional Budget Office had concluded, after years of research, that a voucher system would raise the cost of providing Medicare equivalent policies. “In this context,” Baker wrote, “President Obama’s assertion that Romney’s plan would leave seniors unable to afford traditional Medicare is not just an empty claim. It’s a fact.”" The problem with this analysis are the words "Medicare equivalent policies." In looking at the 2011 Ryan plan, the CBO did price out what it would cost to provide insurance with no upfront coverage and no catastrophic coverage. But no one would buy such coverage. Very few people buy it today; 92% of us according to the 2012 Data Book supplement Medicare, almost totally with private insurance.
But still, Ryan at the urging of Senator Wyden included this option in the 2012 Wyden/Ryan proposal. Oddly -- and tellingly -- you do not mention Wyden/Ryan anywhere in your article above but most press coverage I saw criticising the President for misleading Florida seniors based their criticism on the fact that the President -- like you -- ignored the current plan.
And what "years of research?"
3. "To explain: With a Medicare Advantage plan, seniors get their benefits from private insurers, which in turn are paid by the government." This is not unique to Medicare Advantage. This is the way it works for all Medicare.
-- The government is the payer.
-- Private insurers administer the benefits whether Parts A, B, C or D.
If you refuse to acknowledge this fundamental of Medicare, how can you possible compare it to PPACA.
#2 Posted by Dennis Byron, CJR on Thu 26 Jul 2012 at 01:08 PM
Trudy, excellent piece. I do wish, though, you had pointed out the insidious role of the "fact checkers," notably PolitiFact, in enabling the news media in this bogus, false-equivalence coverage of the Medicare issue. PolitiFact's most recent piece got a key fact wrong. It said the latest Ryan Medicare plan would cap Medicare spending at GDP plus 1%. In fact, Ryan's budget bill -- which the House passed earlier this year and which supersedes Ryan's "bipartisan" Medicare proposal with Democrat Ron Wyden-- would cap Medicare spending at GDP plus .5%, a difference which adds up fast. In addition, Henry Aaron has pointed out that talking with Ryan's staff, it's not clear whether that cap would apply to Medicare spending in total or to per capita Medicare spending, which makes a huge difference because if you cap total Medicare spending without adjusting for the large increase in Medicare enrollment over the next 20 years, you get a really really big cut in per capita Medicare spending, which would mean much poorer coverage. PolitiFact and the other "fact checkers" have consistently called the Democrats' statements about Ryan's and Romney's Medicare proposals last year and this year false, when they are quite factually accurate. The NY Times, in its recent story quoting Romney saying Obama's statement was dishonest that Romney's Medicare proposal was a "voucher" plan, cited PolitiFact saying Obama's ads were "mostly false." In fact, as Trudy notes, Romney's and Ryan's proposals, which are quite similar, are precisely voucher plans. PolitiFact also missed the fact that Ryan's proposal is no longer "bipartisan" because Wyden reportedly has refused to support it, on the basis that the GDP plus .5% cap is too low, Ryan's plan would raise the Medicare eligibility age to 67, and Ryan's block granting of Medicaid would hurt Medicare dual eligibles.
To Dennis Byron, I could write a whole essay pointing out problems in his comments. But I'll just say that the Ryan-Wyden plan has been superseded, as I said before, by the Ryan House bill, which Wyden does not support. Second, Medicare beneficiaries in traditional Medicare get their benefits from the government program, which pays all the costs. Private insurers get fees merely for administering the claims. That's entirely different from private insurers providing the benefits and taking the financial risks under Medicare Advantage. False comparison.
#3 Posted by Harris Meyer, CJR on Thu 26 Jul 2012 at 02:05 PM
to harris
1. OK, have it your way., Trudy should have mentioned the Ryan House budget but not a two-year old superceded plan. (Isn't the .5% growth rate the same as PPACA?#
2. I don't see the false comparison but that was not what I was referring to Trudy made multiple claims that are not correct, including one about the involvement of private insurers in Medicare. All Medicare parts are administered by private insurance companies and paid for by the government. Period.
-- Medicare beneficiaries in traditional Medicare get their benefits from the government program, which pays all the costs, as you say.
-- Medicare benefiiciaries in Medicare Part C get their benefits from the government program, which pays all the costs.
(I actually don't believe the MACs get "a fee." I think it's a cost-plus. But I haven't looked at them in a while).
3. So that leaves the essay you were going to write. Give me 100 words on what great inurance traditional Medicare is. Counter the arguments to the contrary of everyone from Wyden to MedPAC to Coburn. Give me a list of all the people who think healthcare insurance with no catastrophic coverage, high deductibles and co-pays, no vision/dental/annual-physical/drug coverage, etc -- and that pays only half the beneficiary's expense --.is good insurance.
#4 Posted by dennis byron, CJR on Thu 26 Jul 2012 at 03:27 PM
The Affordable Care Act caps Medicare spending PER CAPITA at GDP plus 1%.
See my article analyzing the Romney and Ryan-Wyden plans.
http://managedhealthcareexecutive.modernmedicine.com/mhe/article/articleDetail.jsp?id=757580&pageID=1&sk=&date=
Polls consistently show Medicare beneficiaries are more satisfied with their coverage (granted, that often does include private Medicare supplemental coverage) than people with private health coverage are. See this new survey:
http://bucks.blogs.nytimes.com/2012/07/26/comparing-medicare-and-employer-health-insurance/?emc=eta1
#5 Posted by Harris Meyer, CJR on Thu 26 Jul 2012 at 03:41 PM
Really. The flawed Commonwealth Fund survey is your best shot? I was hoping I was going to learn something new about Medicare and find that its lousy benefits were actually a good thing if one just thought about them differently.
The CommonWealth Fund research you referred is the most deceitful Medicare information ever released. According to the report’s own Methodology section, It is based on two-year-old smiling and dialing.
As for your condescending "granted that often does include private Medicare supplemental coverage," you're totally wrong. It doesn't include private insurance "often." It includes privtate insurance almost always. Eighht out of 10 Seniors have some kind of private Medicare supplement according to the June 2012 Medicare Data Book (another 14% have Medicaid; only 8% risk their health on Medicare).
And oh by the way, the Methodology section of the Commonwealth Fund research also shows the same thing: over 80% of the seniors surveyed by Commonwealth Fund volunteered that they depend on private insurance such as from a former employer or on a private Medigap or Medicare Part C plan.
Only in this parallel universe inhabited by people who must not use Medicare, CommonWealth Fund incredibly says these Medicare beneficiary opinions in favor of and overwhelming choice of private insurance instead of Medicare proves government-run Medicare is better than private insurance. How could you or they reach that conclusion after talking to hundreds of seniors who choose private insurance over Medicare?
#6 Posted by Dennis Byron, CJR on Thu 26 Jul 2012 at 05:16 PM
Higher satisfaction among Medicare bennies than among private insurance subscribers has been a consistent finding in public opinion surveys. Bennies already have broad choice of plans, and 75% still choose traditional Medicare.
BTW, good Jackie Calmes NY Times piece on the Medicare issue today. Definitely a cut above the usual media coverage of the issue.
http://www.nytimes.com/2012/07/07/us/politics/mixed-message-as-republicans-claim-health-law-cuts-medicare.html?src=rechp
#7 Posted by Harris Meyer, CJR on Thu 26 Jul 2012 at 05:41 PM
"Medicare is so bad that according to the June 2012 Medicare Data Book, Medicare only pays for half of beneficiary health care costs. What kind of insurance has no coverage for early-incident expenses, no catastrophic coverage, and covers only half of the buyer's expenses?"
You want to cite that Dennis? Can't seem to find the offending data:
http://www.medpac.gov/document_TOC.cfm?id=617
"including one about the involvement of private insurers in Medicare. All Medicare parts are administered by private insurance companies and paid for by the government. Period."
Wait a sec, Mr. Dennis. Are you saying that the "HOLY GEEZ SOCIALIST MEDICARE OMG HAZ MORE FRAUD THAN ALL OF THE UNIVERSE COMBINED!" claim about the government system is actually a private contractor's fault?
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/downloads/contact_list.pdf
And, just out of curiosity, do the fee for service contractors define the benefits, charge the premiums, and keep the profits? Or do they receive orders from doctors and hospitals and process reimbursements? I thinks you're doing a bit of apples to oranges stuff there.
Oh and this is neat. Captcha is asking me to type brsht, I believe, in Hebrew. Can captcha get committed to the alphanumeric set of letters? The sanskrit is a bit tricky to reiterate.
#8 Posted by Thimbles, CJR on Thu 26 Jul 2012 at 05:59 PM
Medicare currently represents a losing equation for young and old, seniors and taxpayers. Medicare is spending taxpayers’ money faster than any other government program. It is facing insolvency in its hospitalization program, and it is generating trillions of dollars of massive long-term debt.
Congress and the American people will have to make a choice. Medicare’s current course is disastrous, for seniors and taxpayers alike. There are finite resources available to reverse the current course, but the faster that policymakers act, the less difficult the task will be.
There is a better alternative. That alternative rests in harnessing the market forces of choice and competition, and making them the centerpiece of reform, while targeting aid to those who need it most.
#9 Posted by Carly EngageAmerica, CJR on Mon 30 Jul 2012 at 02:55 PM
thimbles (huh--on an academic site?)
The information on the percent beneficiaries pay vs the amount Medicare pays can be found in multiple places in the June 2012 MedPAC Data Book, if that is the question. If you are questioning whether Medicare has catastrophic coverage, read anything ever written about Medicare
I don't understand your rambling about fraud but as to what I think is your third question, yes the MACs both define and administer benefits (and I assume make good profits since most of them are publicly traded companies although some are mutuals)
to Harris Meyer
No, you are wrong about 75% of Medicare beneficiaries choosing traditional Medicare and what is scary - given that you seem to make your living opining about it -- is your not understanding why. Spend some time with the Medicare MedPAC Data Book (or just talk to a person on Medicare)
#10 Posted by dennis byron, CJR on Tue 7 Aug 2012 at 05:41 AM
I don't have all the citations and references for resources in reporting. Wording is easily manipulated by the writers political preference, but I am a Medicare part A and B recipient on an advantage plan. Medicare does not provide the care I need without additional expensive copays and deductables. However, I have been on various advantage plans since their inception and every year they get worse. Many are misleading to say the least, and the closer we get to complete implementation of the Health Care Act the more hidden costs appear. For instance, I pay a monthly premium with this particular advantage plan. Plus, I have to pay for all of my doctor visits until I reach a $1000 deductable! I expected a $150 deductable when I signed up but, somewhere in the legal jargon I signed up for $1000. The advantage plans were better in the beginning. They covered generics while I'm in the donut hole. Now I am in a plan that the agent promised paid for generics in the donut hole, but one medication, a generic, costs me $43 a month, I have four generics that fall into the tier two level. Nothing was explained to me about this. Oh sure, it's there in writing, but it is confusing! That is why I spoke with an agent. I repeat, the closer we get to full implementation of the Health Care Act the smarter and sneakier these advantage plans get in finding ways to charge seniors for services. There should have been a cap written in somehow preventing all private insurers from increasing the copays and deductibles for services rendered so they will still receive high dollar payoffs. Original Medicare A and B are jokes but, better than nothing and the advantage plans are jokes as well. A senior needs an attorney to decipher what the actual plan will and will not pay and at what rate. In addition, we must stumble through this legal jargon every year. The private insurance companies are going to protect their profit margin one way or another and the government should have been smart enough to block the increases. I am not a scholar, but I know when I am being gouged. I depend on this coverage and have to accept what I can get. Sad when I paid into medicare during 40 years of employment.
#11 Posted by Eadie Rowell, CJR on Thu 9 Aug 2012 at 10:26 AM