The Medicare Killers

http://www.nytimes.com/2016/11/18/opinion/the-medicare-killers.html?_r=0

During the campaign, Donald Trump often promised to be a different kind of Republican, one who would represent the interests of working-class voters who depend on major government programs. “I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” he declared, under the headline “Why Donald Trump Won’t Touch Your Entitlements.”

It was, of course, a lie. The transition team’s point man on Social Security is a longtime advocate of privatization, and all indications are that the incoming administration is getting ready to kill Medicare, replacing it with vouchers that can be applied to the purchase of private insurance. Oh, and it’s also likely to raise the age of Medicare eligibility.

So it’s important not to let this bait-and-switch happen before the public realizes what’s going on.

Three points in particular need to be made as loudly as possible.

First, the attack on Medicare will be one of the most blatant violations of a campaign promise in history.

Some readers may recall George W. Bush’s attempt to privatize Social Security, in which he claimed a “mandate” from voters despite having run a campaign entirely focused on other issues. That was bad, but this is much worse — and not just because Mr. Trump lost the popular vote by a significant margin, making any claim of a mandate bizarre.

Candidate Trump ran on exactly the opposite position from the one President-elect Trump seems to be embracing, claiming to be an economic populist defending the (white) working class. Now he’s going to destroy a program that is crucial to that class?

Which brings me to the second point: While Medicare is an essential program for a great majority of Americans, it’s especially important for the white working-class voters who supported Mr. Trump most strongly. Partly that’s because Medicare beneficiaries are considerably whiter than the country as a whole, precisely because they’re older and reflect the demography of an earlier era.

Beyond that, think of what would happen if Medicare didn’t exist. Some older Americans would probably be able to retain health coverage by staying at jobs that come with such coverage. But this option would by and large be available only to those with extensive education: Labor force participation among seniors is strongly correlated with education, in part because the highly educated are healthier than the less educated, and in part because their jobs require less physical effort. Working-class seniors would be left stranded, unable to get the health care they needed.

Still, doesn’t something have to be done about Medicare? No — which is my third point. People like Paul Ryan, the speaker of the House, have often managed to bamboozle the media into believing that their efforts to dismantle Medicare and other programs are driven by valid economic concerns. They aren’t.

It has been obvious for a long time that Medicare is actually more efficient than private insurance, mainly because it doesn’t spend large sums on overhead and marketing, and, of course, it needn’t make room for profits.

What’s not widely known is that the cost-saving measures included in the Affordable Care Act, a.k.a. Obamacare, have been remarkably successful in their efforts to “bend the curve” — to rein in the long-term rise in Medicare expenses. In fact, since 2010 Medicare outlays per beneficiary have risen only 1.4 percent a year, less than the inflation rate. This success is one main reason long-term budget projections have dramatically improved.

So why try to destroy this successful program, which is in important respects doing better than ever? The main answer, from the point of view of people like Mr. Ryan, is probably that Medicare is in the cross hairs precisely because of its success: It would be very helpful for opponents of government to do away with a program that clearly demonstrates the power of government to improve people’s lives.

And there’s an additional benefit to the right from Medicare privatization: It would create a lot of opportunities for private profits, earned by diverting dollars that could have been used to provide health care.

In summary, then, privatizing Medicare would betray a central promise of the Trump campaign, would specifically betray the interests of the voter bloc that thought it had found a champion, and would be terrible policy.

You might think this would make the whole idea a non-starter. And this push will, in fact, fail — just like Social Security privatization in 2005 — if voters realize what’s happening.

What’s crucial now is to make sure that voters do, in fact, realize what’s going on. And this isn’t just a job for politicians. It’s also a chance for the news media, which failed so badly during the campaign, to start doing its job.

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Obamacaid... in part... was built upon cuts from medicare and medicare advantage spending.

It was basically a fascist (progressive) redistribution construct. A clear collusion of govt and corporations.

Obamacaid... in part... was built upon cuts from medicare and medicare advantage spending.

It was basically a fascist (progressive) redistribution construct. A clear collusion of govt and corporations.


Complete nonsense. Never in American history have more Americans had access to health care, and the best part is you won the election and got what you wanted.........the destruction of the ACA........but hold on......this awful program which you insist incorrectly has anything to do with fascism, will remain for the most part after telling the world you were going to gut the ACA......it is comical. No original thought.....no great ideas......just the ability to whine, and then cough....cough........bring back most of the ACA.......you just cannot make this stuff up.

The mandate must go. I don't give a damn what Roberts ruled. The govt clearly overreached.

http://obamacarefacts.com/obamacare-medicare/

The Medicare Cuts
First off, while the cuts to Medicare under the Affordable Care Act (ObamaCare) were estimated at $716 billion, those cuts didn’t hurt Medicare, they improved it.

The Medicare cuts contained in the law were aimed at improving care by limiting fraud, waste, and abuse. The money saved from those cuts has been being reinvested back into Medicare and ObamaCare to improve care for seniors. Improvements include closing the Medicare Part D “donut hole”, reducing overpayments to hospitals, and more.

We’ll examine all the details below and try to address any questions you may have regarding your senior’s responsibilities under the Affordable Care Act.

FACT: As of early 2015 8.2 million seniors had saved more than $11.5 billion on their prescription drugs since 2010 – an average of $1,407 per beneficiary. And that’s only part of what the ACA means for Seniors. We explore the cuts, benefits, and changes below.

Is Medicare Part of ObamaCare?
ObamaCare makes some changes to Medicare (discussed below), but ObamaCare doesn’t replace Medicare. Medicare isn’t part of your State’s health insurance marketplace (sometimes called an exchange), so if you have Medicare keep it. You will still get all the new benefits, rights and protections ObamaCare offers on your current Original Medicare or Medicare Advantage Plan.

Exceptions:

If you have retiree insurance, aren’t old enough for Medicare, and don’t like it, you may choose to use the marketplace to replace that insurance. Find out more about retiree insurance.
If you are over 65 you can only get ObamaCare if you don’t have access to Medicare or employer based coverage. Learn what to do if you don’t have access to Medicare.
Is Medicare “Minimum Essential Coverage”?
If you have Medicare Part A (Hospital Insurance) or Medicare Part C (Medicare Advantage), you’re considered to have “minimum essential coverage” and won’t owe the fee for not having health insurance in 2014.

Having Medicare Part B (Medical Insurance) alone doesn’t count as minimum essential coverage. Having Medigap insurance or a Part D drug plan doesn’t affect whether or not you owe a fee for not having insurance under the Affordable Care Act (ObamaCare), as they both require you already have Medicare Part A.

TIP: You can still owe the fee if you are over 65 and don’t have minimum essential coverage, or if you have a dependent who doesn’t have minimum essential coverage. Learn more about the individual shared responsibility payment rules.

Medicare and the Health Insurance Marketplace
Medicare isn’t part of ObamaCare’s Health Insurance Marketplace, no one has to replace their Medicare coverage with Marketplace based health insurance. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now. You won’t have to make any changes.

Can I get a Marketplace Plan in Addition to Medicare?
No. It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan. This is true even if you have only Part A or only Part B.

Can I get a Marketplace Plan in Addition to Medicare?
No. It’s against the law for someone who knows that you have Medicare to sell you a Marketplace plan. This is true even if you have only Part A or only Part B.

If you want coverage designed to supplement Medicare you’ll want to look at Medigap policies, Medicare Advantage Plans, and Part D drug coverage. More information can be found on Medicare.gov.

ObamaCare Medicare Insurance Premiums For Seniors
ObamaCare doesn’t raise premiums for seniors; the AARP has predicted that it could hold the costs of Medicare Part B premiums down, if not lower them. The official formula for determining Medicare Part B premiums was established by Congress years ago and has not been negatively affected by ObamaCare.

Despite the fact that ObamaCare does not affect seniors premiums, premiums for high income seniors who earn more than $85,000 or couples with incomes in excess of $170,000 are set to rise, as they would have done with or without ObamaCare.

If you have heard any talking points on how Medicare costs are negatively impacted by the Affordable Care Act you can find them debunked here and here.

ObamaCare Medicare Reform
Even though ObamaCare “cuts” Medicare; it isn’t really a cut, it’s health care reform aimed at improving care for seniors and their families. The fact is, millions more seniors will be covered under the Affordable Care Act. Here are some things that the program does to improve Medicare:

• ObamaCare closes the “donut hole” that was causing Seniors not to be able to afford their prescriptions. (The Medicare “donut hole” is the Part D drug coverage limit where seniors must start paying out of pocket for their prescriptions.) In 2012, seniors got a 50 percent discount when buying brand name drugs and 14 percent discount on generic drugs covered by Medicare Part D. This reform gets stronger every year, increasing coverage and closing the donut hole until it disappears in 2020. From that point on, seniors will only pay usual drug co-pays.

• ObamaCare expands existing coverage for seniors, including preventive care and wellness visits without charging you for the Part B co-insurance or deductible. Seniors will no longer need to put off preventive care and check-ups due to costs. This reform has been active since 2011 and gives seniors better access to cancer screenings, wellness visits, personalized prevention plans, vaccines, flue shots and more.

• New initiatives to support care coordination, your doctor may get additional resources to make sure that your treatments are consistent.

• ObamaCare does not cut any benefits from Medicare Advantage.

• ObamaCare reduces payments to Medicare advantage rewarding those providers who increase the quality of their coverage. Medicare Advantage payouts are now be more in line with other areas of Medicare.

• ObamaCare reins in excess spending on Medicare Advantage, which is currently causing a burden on the tax payer that is disproportionate to the amount of people it helps. Medicare Advantage is run by private insurers and costs $1,000 or more per person.

• According to the CMS Medicare beneficiaries are expected to save, on average, about $4,200 over the next 10 years due to lower drug costs, free preventive services, and reductions in the growth of health spending.

• The protection of Medicare is ensured for years to come. The life of the Medicare Trust fund will be extended to at least 2029—a 12-year extension due to reductions in waste, fraud and abuse, and Medicare costs, which will provide you with future savings on your premiums and coinsurance.

The fact is, Medicare Reform under the Affordable Care Act does a lot to help seniors. The law addresses Medicare more than any other single issue. Many of the attacks against ObamaCare in regard to Medicare are unfounded. Although the program isn’t perfect, one only needs to look at how seniors have benefited from the care and protections of Massachusetts health care reform under Governor Romney and how the Affordable Care Act has affected seniors so far to see what the long term implications are.

Children under the age of 26 are able to be covered under their parents insurance. The caveat, however, is that if your parents are over 65 and therefore receive Medicare you are no longer eligible to be covered under their insurance. While this may “make sense” it comes as a low blow to those who took the law at face value.

Most Medicare Prescription Drug Plans have a coverage gap (also called the “donut hole”). This means there’s a temporary limit on what the drug plan will cover for drugs. Seniors in the Medicare Part D “donut hole” can now get a 50% discount when buying Part D-covered brand-name prescription drugs and a 14% discount on generic drugs covered by Part D. The discount is applied automatically at the counter of the pharmacy—so seniors don’t have to do anything to get the discount. By 2020, the donut hole will be eliminated completely. Read more about the Medicare Part D Coverage Gap (Donut Hole).

ObamaCare is Improving Medicare: Updates From 2014
When we started this website the law had not gone into full effect and there was a lot of “what if scenarios” thrown out there to scare seniors. By 2014, with a solid 4 years of healthcare reform, America starting see proof that the Affordable Care Act is living up to its promises and even exceeding expectations in some cases. According to a July 2014 report by the Medicare program’s Boards of Trustees:

• Medicare’s trust fund is extended 13 more years, to 2030, under the ACA.

• Projected Part B premiums for 2015 will not increase for the second year in a row.

• The laws provisions to reduce waste and fraud, strengthen benefits, and to promote value-based payments are working to reduce hospital spending, prevent admissions, and lower hospital costs. All of which help to extend the life of the trust fund by lowering spending.

• Per capita cost growth has slowed.

• Overall the trajectory of Medicare spending has seen a dramatic decline compared to what was expected before the ACA.

• Seniors have saved over $10 billion by the gradual closing of the Part D “donut hole”.

• The Partnership for Patients and other efforts to improve patient safety are estimated to have helped avoid 15,000 deaths and more than 560,000 patient harms over the past two years. This work is thanks to partnerships between HHS and hospitals, doctors, nurses, and others, and shows how we can save money while improving outcomes for patients.

• Patient safety efforts and new payment incentives for hospitals are estimated to have helped avoid 150,000 readmissions to hospitals over 2012 and 2013, providing better outcomes for patients and saving money for Medicare.

• More than 340 Accountable Care Organizations have been launched in Medicare in the last three years, providing care for more than 5 million Medicare beneficiaries. These organizations are accountable for the quality and cost of care they provide and have already saved hundreds of millions of dollars.

• The Departments of HHS and Justice have organized a concerted crackdown on health care fraud, saving a record $19 billion over the past five years and putting in place innovative tools to prevent fraudulent claims from being paid.

Medicare Overview
We give a detailed overview of Medicare on our “what is Medicare?” page. But here is a quick primer to help you understand Original Medicare (Parts A and B), Medicare Advantage (Part C), Medicare Prescription (Drug Coverage Part D), and Medigap supplemental insurance.

Medicare Part A is hospital insurance and part of Original Medicare. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B is medical insurance and part of Original Medicare. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Medicare Part C is Medicare Advantage and is a supplemental insurance. An Advantage Plan essentially replaces Part A and Part B while offering additional benefits and cost coverage.

Medicare Part D is Medicare Prescription Drug Coverage and is a a supplemental insurance that pairs with Original Medicare, Medigap policies, and Advantage Plans without drug coverage.

Medigap (Parts A through N) is a supplemental insurance which requires Part A and Part B and includes many choices to help you better meet your medical needs and costs.

Part C, Part D, and Medigap are sold by private companies and are not part of Original Medicare.



While Medicare Advantage plans were expected to save the Medicare program money it has increased it on a national average of 2%.

I am not an economist but what Ryan is trying to push would cost the Medicare program more than any savings he thinks may be realized. Plus the older one gets the sicker, therefore under Ryan's plan if you lived to be 85 and up until that point fairly healthy and you had something catastrophic and were on the poorer end of the spectrum you would simply not be able to afford treatment leading to death. There would be no dual eligible's (medicaid/Medicare). Sounds like the Republican version of a death panel. These voucher's he speaks of is nothing but subsidies that they were against for obamacare. They really do think the American public are nothing but idiots.

There is approximately 57 million on Medicare Advantage plans at the moment and the rest on supplements where that individual pays his/her own premium.

There would be absolutely nothing wrong with it's present form if they took more fraud, waste and abuse out of it.