How NOT to "fix" medicare!

[Gimpy]

How Not to Fix Medicare
By JACOB S. HACKER

FPRIVATE "TYPE=PICT;ALT=N"

EW HAVEN, Conn.
Today we remember Medicare's establishment in July 1965 as a ringing affirmation of the ideal of social insurance. Less well remembered is how close Washington came to creating a very different system. Not long before Medicare's passage, the Kennedy administration seemed on the verge of a compromise with Senator Jacob Javits, the moderate Republican from New York. Senator Javits and his allies wanted to give private insurance a leading place in the new program so government could play a smaller role ? an idea opposed by liberal Democrats and organized labor. The opposition won out, and the private insurance idea seemed consigned to the dustbin of history.
At least it was until last week, when both the House and Senate passed bills that would give private health plans a huge new stake in Medicare as well as provide prescription drug benefits. With pressure from President Bush to pass legislation, Congress stands on the threshold of the biggest overhaul of Medicare since its inception. But unless crucial aspects of the Senate and House measures are rethought, such an overhaul will come at the peril of America's elderly and disabled.
If this warning seems apocalyptic, that's only because most Americans are under the impression that the measures on the table are centrist compromises that would protect everyone's interests. In reality, neither the Senate nor the House legislation would achieve this. And while the Senate bill is indeed an attempt at compromise, albeit a deeply flawed one, the House bill is a radical measure directly at odds with Medicare's longstanding aims. It threatens to cripple the program for generations to come.
Bluntly put, the House legislation is a ruse. The bill delivers a prescription drug benefit, but this benefit is simply the attractive window dressing for the legislation's ultimate aim: fundamentally revamping Medicare to create a competitive system based on private health plans. Consider the bill's major features. Private health insurers would be given increased government payments so that they could sweeten their benefits to lure the elderly and the disabled out of the traditional Medicare program. Beneficiaries choosing private plans with lower premiums would get a rebate from the government; those choosing plans with higher premiums would have to pay more. In 2010, the traditional program would be forced to compete with private plans. From then on, the amount that beneficiaries paid for Medicare would be set not by law, but by market forces.
This might sound like a great way to encourage consumer choice ? until one realizes that the cost of alternative insurance options would be mainly determined by the health of those enrolled. Since the least healthy enrollees would most likely stay in traditional Medicare rather than brave the private market, the program's premiums would likely rise substantially. This would encourage healthier beneficiaries to seek lower premiums in the private sector, leaving only the sickest behind.
The problems don't end there, nor are they confined to the House bill. Neither the House nor Senate legislation, for example, provides what the majority of Americans want: a drug benefit within Medicare itself. Instead, beneficiaries would be forced to turn first to private insurers, which would be able to set their own premiums for drug coverage. (The Senate bill allows for a drug benefit directly through Medicare only if a beneficiary does not have access to more than one private drug insurance plan in his region.)
Because drug costs are risky and expensive to cover, few insurers seem eager to sign up for this complex and untested idea. But even if private plans emerged, the likely result would be chaos as insurance companies continually dropped coverage and altered their benefits ? which is precisely what has happened to millions of Medicare beneficiaries enrolled in private H.M.O.'s over the past five years.
Perhaps these risks would be tolerable if the standard drug benefit authorized by the bills were generous. It is not. Both bills feature an upfront deductible of $250 or more, require significant co-payments above that amount and force beneficiaries to pay a huge amount out of pocket before catastrophic protection kicks in. As a result, an elderly woman with $6,000 in total drug costs would end up paying more than $4,000 of her own money under the Senate bill, and even more under the House legislation.
A recent study by Consumers Union underscores the meagerness of the benefit. According to the report, beneficiaries with average drug costs and no private coverage will spend roughly $2,300 this year. If either the Senate or House bill takes effect in 2007, they will pay at least $2,500. In other words, Medicare beneficiaries would spend more, not less, on prescription drugs after Congress came to the rescue.
The real solution is no secret: make the drug benefit a part of Medicare and, yes, spend more money on it. The $400 billion over 10 years that Republicans have pledged for drug coverage may sound like a lot, but it's just a fraction of the nearly $2 trillion in pharmaceutical expenses that beneficiaries are expected to incur over the next decade. Of course, a larger benefit would cost more. But, in the end, somebody is going to pay; the question is how the burden is distributed. The whole point of social insurance is to spread the responsibility across rich and poor, sick and healthy, rather than letting the burden fall on individuals and their families alone.
At a minimum, defenders of Medicare should insist that a prescription drug bill truly is a prescription drug bill ? and not a vehicle for tearing down the existing system. If history is indeed any guide, Congress needs to resolve all these issues before rushing a compromise bill to the president's desk. In 1965, Medicare advocates thought they could wait until after the legislation was passed to revise the measure and expand coverage for the nonelderly. Of course, that never happened. In 2003, more than 40 million Americans remain uninsured. If today's Medicare advocates allow themselves to be steamrollered, they will be living with the fallout for decades.
Not coincidentally, perhaps, none of this will become clear until after the 2004 election. Republicans may ride a prescription drug benefit back into office. But the bills on the table now are mainly a prescription for resentment and dashed expectations ? and, most fearful of all, for the unraveling of the social compact that has made Medicare an integral part of American social policy for nearly 40 years.
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Jacob S. Hacker, assistant professor of political science at Yale University and a fellow at the New America Foundation, is author of "The Divided Welfare State: The Battle Over Public and Private Social Benefits in the United States."
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NUFF SAID!

[HARDCORE]

GIMPY MY FRIEND-

By the governments own reasoning, as I stated in a previous piece, they have placed a merit system upon our lives. This is governed by age, health, ability to serve (again) in time of national peril (re: Afghanistan, Iraq, Iran, North Korea and now Liberia, did I miss anyone?), the amount of taxes we have left in our aging bones, our political bent etc.

Ya know, I once (1995) wrote a book (700 pages, copyrighted LOC) entitled "Civilution" that covered a similar scenario to George Orwell's 1984. My book, however, takes place staring in about 2005 AD.

I sent the damned thing (rough draft) out to several publishers, all of whom told me to take a hike, although some did enjoy the "What If" concepts.

Well, I don't know if the book was (or was not) worth a crap, but you would be amazed at how much of the thing has already come to pass in the 8 or so years since I first penned it?!

Of course, most said that the political/military happenings depicted there-in could never occur in the world of the second millennia, and it (Civilution) was far too politically painful to put into print? But if one has followed the news in the last few years, they would have noted that my fictional accounts are fast becoming cold-hard facts!

Oh well, at least I got my inflammatory ideas off of my puny little brain! "I Guess that this is something to be thankful for!!"

"Gimpy"- keep "RAISING" Hell, as by doing so, many in international politics won't have so far to travel in the end!

VERITAS

[judyvillecco]

The Republicans are trying to undo everything that has protected seniors and the disabled and turn back the clocks to the time of the poor houses and Robber Barons and our growing Federal debt and troops dispersed all over the world spread so dangerously thin proves the failing policy. Capitalism as we know it will fail if it keeps going and jobs keep going elsewhere. What happens when America goes broke from Capitalistic greed and crime takes over? Are we not seeing it? The haves and have nots are growing ever wider and when the elderly have to die because they can't get care are the gas chambers far off?

[SuperScout]

If more governmental involvement in Medicare, Pharmacare, or any other taxpayer provided benefit is best for our country, simply re-think all the wonderful programs and benefits the government has already given us: public housing, where crime, poverty, drug usage, prostitution and other plagues are the norm. Public health, where bureaucracy, fraud waste and abuse are doled out more frequently then good medicine. Public assistance, where fraud waste and abuse siphon off money to crooks, thugs and slum lords. Public policy towards Native Americans, where reservations are usually rural ghettos, peaks of unemployment, alcoholism, and wasted lives. Public transportation, where near empty buses roam the streets, while the bureaucracy fills their pockets.

For all its ills, the private sector solves problems best. The Social Security system is a colossal ambush, just about to be sprung on an unsuspecting public, with actuarial tables almost inverted, a system that is hemmoraging money on drug addicts, drunks, and other frauds. Providing Rx benefits for all Americans is unwarranted, unnecessary, and not a genuine function of the federal government, Constitutionally speaking.

And before any of you start accusing me of being heartless, kindly note that I'm all for taking care of the truly needy, but our present system, and the delusional attempts to add more government involvement are simply that: more good money being pored down the rathole of inefficiency, empire-building and vote buying.

[blues clues]

SS why not just have a cut off date for the old we'll say about 70 years old that way we can do away with the whole thing, and while we're at it just let the poor of the country just starve but if people like you play your cards right maybe you can get at least a good six months to a year out of them before the end comes at least we hope so don't we!
I just hope that you and yours never need the help of the inefficency government program that you and other repblican seem to hate so much.
hope you have a nice day.
razz

[Andy]

There is a deal called C.O.B.R.A. that we have around here. If you pay into it while your working, when you retire you have to continue paying anywhere from 10 to 50% of the monthly health insurance you had while working, however you get to keep the insurance plan you had when you worked. In my case I have HMO Blue, very good. The rates just increased from $5.00 to $10.00 but that's all I pay for a visit to the doctor, to fill a prescription, to be injected with a $14,000 experimental drug. It's just ten bucks.
Pay now, get the bennies for the rest of your life seems a lot like social security. My God, is Massachusetts ahead of the curve on this one????
Oh, different organizations have different contracts. That's why the former employee pays anywhere from 10 to 50% for the coverage. In my case I pay 50% (poor contract) for the family plan. But $340 a month to pay for the drugs they have put in my body over the last 6 years means I'm paying about 3 maybe 4% of the cost.
Stay healthy, ya sort of have to,
Andy

[reconeil]

You might be right my-man. But, and since everyone knows (or at least should know) that during campaign times (never ending for Dems/Libs/Socialists),...numbers tallied FOR ANY GOVERNMENTALLY PROPOSED agenda or project don't mean diddly-squat. But then, estimates, guesstimates, and/or just: "Pie in the sky" wishful thinkings historically never do mean very much to The People (naturally excluding those wishing to control most everything). Also, has there been anything in government that didn't end-up costing 4-5 (or better) times more than initially stated? I don't know of any.

Regardless, and since Medicare is part of MY/OUR National 401K, lifelong contributed to EQUALLY by both employees and employers, I don't believe ANY POLITICOS should be toying with same in the first place. Both Conservative and Liberal Politicos worried about The Poor, foreigners or even caring for Illegal Aliens should do so out of Tax Revenues,...NOT FROM MY/OUR lifelong contributed RETIREMENT FUND & MEDICARE. In The Private Sector corporate officials go to jail for playing fast and loose with such retirement funds.

Also, and since about 10 years ago Senator Patrick Daniel Moynihan of New York and cohorts damn-near killed each other by patting themselves on the backs for FIXING Social Security & Medicare up to the year 2025 (Yeah, that's right 2025),...why-the-hell have The Dems/Libs/Socialists been still foolishly trying to FIX what DOESN'T NEED FIXING year after after year?

Besides, and the proposed RX package aside, why-the-hell would ANY POLITICO want to continually fix F.I.C.A (Medicare inclusive) and/or that having an annual 15 BILLION DOLLAR EXCESS?
I personally believe that given the annual 15 BILLION DOLLAR EXCESS in The Social Security System,...that it's criminally-sinful for managers of The System to even deduct a $56 Monthly Premium for Medicare from MY/OUR monthly SS Checks.

So, and if there is a point to be made here, it's that politicos of WHATEVER BENT or FANATICAL IDEOLOGY,...should just keep their grubby little and greedy mitts off of MY/OUR RETIREMENT MONIES. Want to return more of The Peoples very own money and/or TAXES back to The People as The Republicans try doing,...I've got no problem with that. Seems fair and righteous enough to me.

Though, I'll never understand why The Dems/Libs/Socialists have such a hang-up about giving back some Tax Monies back to The Very People that paid The Taxes in the first place? Not being totally honest here,...since the word: "Socialists" explains it all for me.

Not wanting to give back tax monies to The Rich is ALSO NONSENSE,...since most all Dems in high office are millionaires and have loop-holes up-the-wazoo. It's just show-biz and/or open politics. Covertly, In Committee and/or in Back Rooms, and that's where ones true stripes of power and control above else come out.

Neil :cl:

[SuperScout]

Now, take a deep breath, relax, and re-read what I wrote. Did I say anything about cutting off benefits to current seniors? No. Did I say starve the poor? No. Did I make any idiotic claims like judywhatever about how capitalism is going to bankrupt the country? No. BTW, Judy, if the country goes broke, it won't be from greedy capitalist, it will probably be from liberals trying to create an entitlement program for every voting block. The utter height of your paranoia is seen in the remarks about the gas chambers. You people are truly scary! :cl:

[judyvillecco]

Scout admit it unemployment is the highest it's been since 1994! These are not my statistics but the labor department and interest rates are the lowest in 50 years! Economies don't keep going like that we just don't call them depressions anymore because it isn't politically correct . I'm not advocating that the democrats are any better with spending but I think there has to be a balance between social programs and capitalism. I don't know about you but I paid into social security and I don't want to feel like I have to beg to get it back or that I'm not entitled to it after paying in since I was 15! That's not welfare and no one's giving me anything I don't deserve!

Same with disability insurance. I paid close to 800 a month to Blue Cross and 400 a month for my medications and when I got too sick they canceled me and I don't have anything to show for that. They quit paying bills when I really needed them. When my husband came down with cancer they raised my premium so high I couln't work enough to pay the bills and we are being told it may be two years before social security will get around to hearing our claims. That's what insurance company's do. They wanted that money every month though until that for years.

Meanwhile my husband lost all his retirement and savings and we find ourselves after working over 70 years between us feeling like outcasts and beggars and it isn't right for two vets and two seniors. He's 60 and I'm 55 and both of us are disabled. Hope you are so lucky nothing like this happens to you because if it does you can't count on GWB.

You damn right I'm bitter that all capitalism does is take with it's greedy hand out. I could use a little socialism or just a little of what I paid into the system right now. I think I'm entitled. I've supported my share of beurocrats and politicians and insurance tycoons and corporate shitheads my whole life. If that's being crazy then I'm not as crazy as people thinking the Robber Barons are going to take care of them with compassionate conservatism.
All I've seen lately is let them eat cake mentality for us vets and older seniors.

[Gimpy]

The "PRIVATE SECTOR"????? Kinda like the ones you've got there is Texas,, HUH? Those like Enron, Halliburton, and so on, and so on? Yeah, I'm REALLY gonna TRUST the "private sector alright!

It appears that SuperSours boy GEE-DUBYA is ready and willing to fill up the POCKETS of more of his coporate cronies in big business with the hard earned pensions and social security monies of the sick & disabled, retirees that will be paying for this "benefit" offered by his numb-nutted friends who could give-a-$hit less if they have enough $$$ to eat or pay their rent and afford their "alternative" plan!

Yeah--right-- "PRIVATE SECTOR" has the "answers" alright---Just like they have recently with the so-called "successes" with DE-regulation of natural gas and energy throughout the country.

TALK ABOUT SCARY!!! It's folks like SuperSarcastic, with his SuperScenarios of SuperSaintliness of the SuperScatterbrained rightwinged, rightheaded nincompoops currently promoting THIS "horsehockry" to start with that is REALLY frightening!

I believe (decidedly so in fact) that a Yale professor of political science and well read authoritative research professional in "Public" & "Private benefits" is far more adept and able to "provide" an "expert" "opinion" than is old SuperStick-in-the-Mud, don't you???

TA, TA. And, more to come later!