Obama has no clue about Medicare Advantage program and continues to lie

Here is a transcript of Obama on ” Face the Nation”  today.

Bob asks him about the Medicare Advantage program (also called private Medicare HMO), which is  several different programs run by insurance companies for Medicare eligible senior citizens.   One better know example is Secure Horizons.    About 20% of all Medicare eligible citizens are now covered under the private Medicare Advantage program. To be in an Advantage program, one must “opt out” of Medicare for at least one year .   Every year you can either re-join traditional  Medicare or stay with your Advantage program.   When the Advantage programs came out several years ago (a Republican idea),  seniors did not understand they were totally out of the Medicare program for that year which resulted in a lot of confusion in doctors’ offices.   Seniors like the MA programs because insurance companies often cover eyeglasses , hearing aids, and sometimes prescriptions.   When Obama says he is cutting “waste” out of Medicare, the numbers he quotes includes the amount CONGRESS has voted to give to insurance companies to take care of seniors who would otherwise be on traditional Medicare.    Medicare Advantage is not fraud, waste, or abuse–it was voted on by Congress.   Many doctors complained to their Republican congressmen when last year they  wanted to expand money for the Medicare Advantage program, which meant more money to the insurance company, while doctors were threatened with a 10% across the board cut in reimbursement.   Note that this was a time when Republican doctors did not agree with their  Republican representatives in Congress.

Obama makes the incorrect statement that the MA insurance companies are “overcharging.”    Insurance companies are given a subsidy  by the CONGRESS  for each senior in their MA programs;  the insurance companies can’t just send in a bill to Medicare/US government.   Obama brings up his usual line about the wicked insurance companies making huge profits on the Medicare Advantage program which is flat out false.    Again, if Obama thinks the insurance companies are paid too much,  all he has to do is tell Congress to appropriate less money for the program, pay the insurance companies less,  and let the free market work.   But no, the Democrats hate the evil Republican MA program, so they want to eliminate it altogether.   That is why it is a lie everytime  Obama tells seniors they will have no change in their benefits.   At least 20% of usually poor seniors who like their MA program will get screwed—they will be FORCED to go back to traditional Medicare with fewer benefits.

Mr. Obama, please get Ms. Sebelius to explain how the MA program works.

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10 Responses to “Obama has no clue about Medicare Advantage program and continues to lie”

  1. Richard Morgan Says:

    Ins., companies taking over an individuals Medicare program; they are reimbursed by Medicare – on a per-area determined rate. This allows the medicare provider,to monitor doctors and hospital charges, thus cutting out wasteful medicare being over charged. This is a very good system. Obama wants total control of your healthcare. This will not work, it can’t – this type of system is too costly and ultimately becomes corrupt and non-patient friendly.

  2. TxPharm Says:

    I unwittingly enrolled my parents in an advantage program two years ago, and believe you me, they are ripping off both the seniors enrolled in their programs and the American taxpayers. Medicar part D counts ALL Rxs toward donut hole, even those you pay cash for yourself. They’re just using your card to track your Rxs. If you want to pay cash for generic that’s less than a copay, Big brother’s got a record and counts it toward the donut hole. PART D IS A REPUBLICAN GIVEAWAY TO BIG PHARMA. Drugs cos get full price for their drugs while Medicare and private insurance screw dcotors and hosiptals out of payments, then blame them for the cost increases. MEDICARE ADVANTAGE IS A REPUBLICAN GIVEAWAY TO BIG INSURANCE.
    For example, some scumbag in Congress owned by Big Ins(has to be republican-will find out) got a provision in the DRA 2006 that requires 13 months payments for durable medical equipment. Why 13 months? So that a gaping loophole is created for advantage cos. If the member changes to a new advantage program bc the premiums go up, etc., then they come up 1 month short of owning their “capped rental.” Like a hospital bed. Then the next Advantage company bills starts the billing over. because all this billing for 1 hospital bed is unknown to medicare, successive advantage cos can technically bill for the same hospital bed indefinitely if the pt changes advtange plans every year. Oxygen machines are billed to medicare fo 36 mos, meaning taxpayers are paying $7,000 for a $750 machine. The patient pays the 20% coinsurance, for 36 months, or about $1,300, so the patient pays for the machine twice!! It is THEFT from the American taxpayer, and Republicans are completely aware of all this and ar fighting like hell to maintain the status quo. heck they’re on the road to creating ANOTHER giveaway to Big insurance, using taxpayer money to subsidize Big ins for absorbing 50 million uninsured. BTW, I am an independent, not a liberal Democrat.

  3. politicaldoc Says:

    Most of the waste you describe happens in both Medicare and Advantage programs as well as Medicaid. Both government and the public abuse the system. See https://politicaldoc.wordpress.com/2009/10/01/must-read-article-if-you-think-we-need-universal-healthcare-obamacare-the-poor-dont-live-the-lifestyle-of-the-poor/

    I propose Medicare cut out payment for most of the durable equipment purchases since Medicare itself admits millions of dollars of fraud each year in this part of Medicare.

    I don’t support Medicare Advantage, but Obama has NO CLUE what he is talking about. That was my point

  4. TxPharm Says:

    Medicare Advantage programs SHOULD be completely eliminated if we are to have any chance of salvaging the Medicare system as a whole, which will be out of funds in 2017. Medicare Advantage plans ARE making huge amounts of money, and beause they are private, they break the rules and get loopholes in place like the 13 month DME rule I discussed above. They have the gall to approach doctors and offer them 60% of the medicare rate (already under cost for most dctors) for payment. From my own exprience, the extra benefits are minimal and if you really crunch the numbers, especially on Rxs, Medicare Advantage programs are making huge money. They make deals with drug companies for lower prices on certain drugs, put that drug on their formulary, and pocket the profit. If can half seriously say they’d get rid of doctors and hire nurses to do your brain surgery if they could get away with it.
    What we need is INSURANCE REFORM. The thought of a BCBS 15 million/yr CEO giving an interview on his private learjet blaming doctors and hospitals for doubling premums over the last five years makes me sick, but it’s reality.

  5. TxPharm Says:

    “Originally, the private insurance companies claimed they would provide these services more efficiently than the “government.” But it turned out they required a 14% to 19% subsidy above the normal costs of Medicare.

    As the Economic Policy Institute has pointed out, “In a nut shell, Medicare Advantage plans are private plans funded through Medicare to provide similar benefits, but at a 14% higher cost on average, according to the Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency. Eliminating these overpayments would free up $157 billion over 10 years.” -Robert Creamer

    So Advantage plans cost 14% more than Medicare, running up premiums for everyone else in regular Medicare, hastening the bankruptcy of Medicare as a whole, and undercutting already abysmal Medicare rates to doctors and hospitals for more profit.

  6. politicaldoc Says:

    TxPharm, I get your message: you don’t like Medicare Advantage. I don’t either.
    The Congress and Obama should cut the reimbursement rate for the Advantage plans to equal (or less than) traditional fee for service Medicare.
    The lobbyists were powerful enough to get more funding for the Advantage plans. The Republicans in the Senate were at odds with doctors who did not want more money going to the insurance companies, while physician reimbursement is at 1990 levels.

    But again, the point of my article is that OBAMA LIED when he said no benefits would be lost for seniors, when he planned to eliminate the Advantage plans And Obama does not even understand how the Advantage plans were reimbursed by the federal government.

  7. TxPharm Says:

    I see your point, and I do not defend Obama. So much of this is about semantics games. Politicians have to come up with simple bumper sticker slogans as communications, or it goes right over most peoples’ heads. If you’re watching the hearins on CSpan you see that there are a lot of things in the Senate Finance bill that defy Obama pledges.

    If you want to say Obama lied when he said seniors would not lose benefits, in a straight sense I suppose that’s true. However, even bringing up that point suggests that Advantage Plans should be defended. They shouldn’t. They were a giveway by the Republican party to Big Insurance, part of their overall drive to privatize everything, payback for campaign contributions. Advantage programs rip off taxpayers (especially younger generations paying into the system about to be bankrupted) traditional medicare patients, doctors, and hospitals, all for stockholder/ CEO gain.It was a huge mistake and once they let that Entitlement Horse out of the barn, there’s going to be tremendous resistance to getting it back in at all. Seniors have money and they vote. But that’s exactly what should happen.
    Instead, it looks like they’re going to expand this!! Make another massive taxpayer subsidized huge entitlement that forces millions of young healthy people to even out risk, increase volume and profit margin for Big Insurance, with CEOs and stockholders skimming off the profits handed to them with taxpayer money. Same Advantage concept. Just what Big Insuance needs- more power. Our political system is hopelessly corrupt, I’m afraid. Those politicians prostitute themselves and our country for campaign contributions. They sell out our country to big business so they can stay in office. No better example than Health Care Reform.

  8. Peter Behson Says:

    I read the replies to Obama’s plan to eliminate the Medicare Advantage Program. It is obvious that none of these responses come from people on Medicare. Traditional Medicare is a quagmire of various different coverages labled A, B, C, E, etc. Each one is different plan A covers this, but not that. Plan B covers some of A but not all of Plan C. Most seniors do not understand the various plans nore does the average person. When a plan is chosen one than has to include Part D for drug coverage. Putting everything together the monthly premium (yes it costs seniors monthly premiums) they find a cost equal to or greater than the plan they had at work, but with less coverage and higher deductables.The Medicare Advantage Plan provides good coverage, including drugs, at a reasonable cost.

    Obama wants to eliminate the Advantage Plan causing a loss of coverage and higher premiums for 10 million seniors. He will use any savings to provide insurance to illegal aliens. Don’t forget Medicare recepients have been paying into the Medicare fund since 1965. We should get medical insurance that is affordable and comprensive as we get with Medicare Advantage Programs.

  9. politicaldoc Says:

    Peter: I agree with what you say. The only problem is when physicians are being paid the same as the early 1990’s by Medicare–and that is NOT inflation adjusted—you cannot justify taxpayers paying 14% extra for your extra benefits with an Advantage plan. If the Advantage plan knows how to give you the extra benefits with pay from the government/taxpayers that is the same as traditional Medicare, that is OK by me.

    Seniors are not going to have any doctors to go to except foreign medical graduates. Doctors will not lose money for the privilege of providing services to Medicare or Medicare Advantage patients. If anyone thinks doctors are getting rich seeing Medicare patients, he is nuts.

  10. TxPHarm Says:

    Yes, medicare is a Quagmire. Advantage is Part C, an effort by Repblicans to privatize Medicare since the privat sector is “more efficient.” But Advantage plans get paid huge subsidies for each patient by Medicare, making them cost 14-17% more than medicare. Then they go to your dcotor and ask him/her to accept LESS than medicare rates, which in many cases have not increased since the early 1990s. So Advatange plans get the big subsidy then they under cut medicare rates with your physician for even more profit. You may get free glasses from Advantage, but please believe me when I tell you your doctor is not happy to see you. Some of them will acutally all but run you out of their office if you show up with an Advantage card. They know their abysmal Medicare money is going to CEOs and stockholders of Advantage plans, and they are justifiably angry. The last time I took my father for a physical, his doctor was paid $12. It is just embarrassing. I pay the doctor out of pocket to make up for this insult.
    Those companies that pillage medicare have become quite sophisticated at recruiting senior beneficiaries ( sorry but like you Peter) to attack any unprosituted congressman who tries to reign in the pillage of medicare. Example # 1: Human’s recent letter to advantage beneficiaries to engage them in their defense in health care reform # 2 DME companys’ letters to their patients tellng them the govt was going to “let them die.” So seniors attacked the congressman from Ca (and anyone else) who was tring to ensure that DME cos “only” got $7,000 for a 36 month rental of an oxygen machine that retails for $900, rather than indefinite reimbursement at $200/month. Google “36 months oxygen machine” for verification. Look up Mike Ross of Arkansas, DRA 2006, MIPPA. It’s insane. Medicare’s bankrupt in 8 yrs and seniors are recruited by the pillagers to fight for the pillagers.
    I have been paying into medicare since 1974, about 10 years after it started. But it will be decimated by the time I am eligible.
    Last week I paid a plumber $400 to fix a leak in a wall. My husband, an anesthesiologist, literally saved a woman’s life who very nearly bled to death in the ER during that time. Medicare will pay him about $150. The plumber made 2.66 x medicare reimbursement for fixing a leak in the wall. If health care reform results in Medicare rates across the board, my husband and thousands of other doctors will simply quit, with 30 million more patients added to the “insured.” Make no mistake about it, there will be rationing, ladies and gentleman. Keep this up, and in 10 years we’ll have nurses doing brain surgery on the cheap. Ins cos would like nothing better than to get rid of doctors, use nurse practitioners and technicians, import lousy foreign doctors that will work cheap. You’re not going to get a professional who has done 15 years high degree of difficulty post high school training for $100,000 in debt to get up in the middle of the night and risk a malpractice suit to fix your aneurysm or deliver your baby for $50. Eventually you either have to decrease the training, or increase reimbursement.
    This is where we are with for profit medical care and a prostituted Congress. And it does not look good.

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