Saturday, December 17, 2011

It ain't broke. Let's fix it.

Sometimes you have to ask "are people actually this stupid?" And then, of course, the obvious answer comes back - "yes. Yes, they are."

Paul Ryan's plan to scrap Medicare has proven to be just massively unpopular with the average American (especially among those who don't watch Fox "News," or who actually use Medicare themselves). So now, of course, they need to get the focus back to Medicare "reform."

One of the chief problems with Medicare, from the industry's view, is that the government can just set prices and the industry has to go along with it (as opposed to raising prices just because they can). That is, in fact, the primary complaint in most anti-Medicare rants (at least the ones that don't devolve into "death panels"): "the game is rigged against private insurers!"

So, somebody went out and found themselves a "Democratic" Senator from Oregon, Ron Wyden, and convinced him to co-sponsor a new plan to "reform" Medicare (where "reform" is defined as "gut and destroy").

Let's see how quickly you can spot the landmines built into this plan:
Under the proposal, known as premium support, Medicare would subsidize premiums charged by private insurers that care for beneficiaries under contract with the government.

Congress would establish an insurance exchange for Medicare beneficiaries. Private plans would compete with the traditional Medicare program and would have to provide benefits of the same or greater value. The federal contribution in each region would be based on the cost of the second-cheapest option, whether that was a private plan or traditional Medicare.

In addition, the growth of Medicare would be capped. In general, spending would not be allowed to increase more than the growth of the economy, plus one percentage point — a slower rate of increase than Medicare has historically experienced.

To stay under the limit, Congress could cut payments to providers and suppliers responsible for the overspending and could increase Medicare premiums for high-income beneficiaries, the lawmakers said.
You got that? The problem is that Medicare is usually the cheapest plan around. So, first off, you make it so that it has to be, by law, the second cheapest plan around. That's step one.

Then, you force the government to funnel some of the Medicare money to the private insurers (a business that is traditionally astonishingly lucrative for the people who run it), leaving less money available for the Medicare program itself.

Then, you put spending caps on Medicare and increase some of the Medicare premiums, making the program less flexible, less able to respond to market pressures, and (just by the way) less popular among the people whose premiums just went up.

And those are just the obvious problems: this plan basically says "well, the game is rigged toward the government. The only way to fix that is to rig it in the other direction."

Now, just for fun, let's put our tinfoil hats on for just a second. Can you see any way that this system could be manipulated by the healthcare industry? Is there, maybe, a simple backdoor that somebody could sneak through to kill off Medicare entirely? (You know, pretty much what Big Pharma and the GOP have been trying to do for decades?)

Try this idea on for size. A couple of the health insurance companies (not working together! Oh, no!) set up some brand-new private insurance plans to "compete" with Medicare. And one of them is obviously cheaper than the rest.

(Can these plans lose money in the long run? Of course they can! In order to be a growth industry, you don't just look at short-term losses - you have to figure out long-term gains!)

And if you advertise that new plan like mad, people will change over to it. Meaning that there are, by definition, less people in Medicare. And less money coming in.

Remember, all the big insurance companies are already getting Medicare money directly from government subsidies under the new plan. And the government is still paying for the remaining Medicare patients.

So the money is still going out under the current plan, and damned little is coming in. And the industry can just quietly poke Congress in the ribs and say "Look! We can do it just as cheaply. And save the government money in the process. What do you think we should do about this? Oh, and would you like more Cabernet?"

But that's just paranoia, right there. Right? There's no way that could ever happen.

Is there?

9 comments:

  1. I'm perfectly happy with my Medicare -- so far.

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  2. Nameless,

    Yes, they are indeed. Or at least there's a generation-gap issue going on. The Republicans have been rehearsing and modifying the same lies about every social program since FDR and LBJ, and they always get some traction because the myths they spin about "the free market" sound so fresh to each new crop of whippersnappers. Yes! Let's just privatize everything -- we could do SO much better than Social Security. And of course if we just allowed "the market" to work unfettered in health insurance and health care, why, it would be a brave new world out there! And the citizens who buy this bunkum seem to have no collective memory of WHY we came up with "socialist" programs like SS and Medicare in the first place.

    In my line of work, I sometimes come across indications of just how successful the GOP has been in battering the sensibilities of young people: if the issue of social programs ever comes up, you're sure to hear that "that stuff isn't going to be around when I'm old, so what's the use?" Of course -- that's exactly the defeatist line the Republicans have been feeding them since they were in their cribs.

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  3. What most amazes me is why people who can afford guilded medical insurance plans are eligible for Medicare. Aside from the obvious that they are paying premiums.

    Often these well off recipients of Medicare holler the loudest about socialism. Go figure.

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  4. Now, Ratty, let me just assume that you mean "gilded" medical insurance plans, since the Guild plan is basically "eat your Cheetos and die offstage."

    Anyway, let's go to the source, shall we?
    Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medical Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.

    Huh. Funny. It's almost like Medicare is a benefit available to people who've paid into it for a while, or something available for people who would be ineligible for most medical insurance, under the standard free-market rules.

    Wow, I wonder why that is? Could it have something to do with the fact that people would be dying in the streets if they didn't have it?

    Is that what you want, Ratty? Mass die-offs of poor people?

    I'm just curious.

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  5. Yes you are indeed a curious sort oh Nameless One.

    Forgive my typo. Not that I'll lose any sleep over it if you choose not to..

    As my wife is 65, enrolled in part A, currently opting out of part B as I have coverage through the company I work for I can safely say I don't need an education session on the matter from you.

    As to my remark with respect to the well to do who don't need Medicare, well, I'll leave it to your obviously superior intellectual clarity to figure it out all by yourself.

    Curiosity is s good thing Nameless One. I'm glad for you that you have it.

    Merry Christmas and Happy New Year. Or, if you prefer, Happy Holidays.

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  6. I don't think anyone here will lose sleep over your comical pretensions either. Mediocrity shows as clearly as baldness and there isn't a damned thing you can do about either. I used to have the second biggest insurance agency in a very big city and I don't need your intellectual clarity about how insurance works either, you cheap, dishonest, inconsequential, blowhard shit.

    Actually you can't safely say anything without exposing yourself as an angry, stereotypical Righty snarksucker trying unsuccessfully to act dispassionate -- so take your Fox tropes and your stupid slogans and talking points and all the other strings that connect your puppet ass to the loony fringe and leave that Bullshit Christmas shit alone or I'll delete every damned arrogant thing you post here and there's nothing you can do about that either.

    Go home so you can brag about how the "liberals" abused you to the rest of the parrot pack and tell them what a fucking genius you are.

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  7. Capt. - It appears you are the angry one here. Which as always is fine. Chose as you wish.

    As to bragging to, what's that you said, oh yes, "the rest of the parrot pack" you will have quite a fun time finding evidence of your assumption happening anywhere. I have no need to brag. Nor axe to grind.

    If you think I came here as a troll looking for a fight you're mistaken. I will refrain from such activity and respect your "turf" when I visit.

    So Capt. If you wish to persist in your current mood you can feel free take the fight to my site. I have no desire to bring a fight to yours.

    As to Christmas do have Very Merry one. After all, the holidays should bring out the best in humanity.

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  8. OK, OK - a truce it is and I'll tell Santa to look for a porta-potty instead. I'm so used to dealing with trolls it's possible that I've developed Post Trollmatic Stress Syndrome.

    et in Terra Pax and all that.

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  9. @ Capt. who said... "I'm so used to dealing with trolls it's possible that I've developed Post Trollmatic Stress Syndrome."

    Smiling and understanding! ;)

    Thanks, a Merry Christmas and Happy Holidays!

    ReplyDelete

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