And the Advantage goes to…

Yesterday was Yom Kippur.  The day of atonement.  Most of it was spent in our local Ojai synagogue, enumerating my sins, asking forgiveness, fasting, and thinking about food.  My pledge to be less critical, think before I speak, and to remember the guy without feet before I complain about my tight shoes lasted about twenty minutes following the close of services at sundown.

My resolutions were further tested this afternoon when I visited the Times website and saw this screaming banner…Senate Panel Rejects Pair of Public Options in Health Plan.

The article made a special note that the Finance Committee had just completed a three day weekend because of Yom Kippur.  With the exception of Chuck Shumer and Ron Wyden, my presumption is that 21 of the 23 committee members were somewhere else on Monday, other than in shul.

Those 21 folks were spared nine hours of exposure to sin talk, making the world a better place and being my brother’s keeper.  All without the benefit of food and water.  Please, no offense to my Christian brethren is intended.

So, perhaps they should be excused for trampling the only thing that will keep insurance moguls from making an even bigger fortune at taxpayer expense…while simultaneously failing to control the ever-spiraling cost of health care.

Not to be left out of the party, our congressman, Elton Gallegly, posted an article in today’s Ventura Star.  Headlined Pelosi’s Healthcare Plan Cuts Medicare ,  Elton devotes a quarter page to extolling the benefits of the Medicare Advantage program and the crisis that will befall the elderly if the subsidies provided to it by us taxpayers are reduced.  A pretty interesting position for a guy who voted against the expansion of the State Childrens Health Program, protected pharmaceutical companies by rejecting the government’s request to negotiate Medicare drug prices, and voted against repealing the restrictions on stem cell research.

What is Medicare Advantage?  And to whose advantage is it?

—It’s a program designed by Congress to help reduce the cost of care to the elderly.  It provides benefits, like reduced co-pays, not offered under the standard Medicare program.  Other benefits vary by plan and can include things like dental care and drug benefits.

—All Advantage plans are run by private companies, e.g. Aetna, Humana, Cigna.  They are generally paid a fixed monthly payment for each Medicare enrollee.

—Services under these plans are usually offered through a limited panel of providers, ala PPOs and HMOs but can also include Private Fee for Service.

—About 20% of Medicare enrollees are in Advantage plans.

—There is evidence that the plans have fewer hospital admissions and shorter lengths of stay.

—Currently, Advantage costs us taxpayers 14% more than standard Medicare.  About $10 billion per year.  So much for cost savings.

So to whose advantage are such plans?  Well, they provide better benefits than standard Medicare, so they can be of advantage to us old folks.  And they are profitable for the insurance companies, so they like ’em too.

So who’s to complain?  For one thing, me.  I pay for those sweetened benefits and insurance company profits through my contributions to the Medicare Trust Fund.  A fund that is about to go belly up without some kind of action.  Any kind of special treatment given to one class of beneficiaries eats into what’s available to me.  Me, one of the other 80% of old folks not enrolled in Advantage programs.

Now I don’t begrudge folks from picking one of those Advantage plans.  What I do object to is paying more for their choice.  And that’s what the argument is all about.  Max and his Finance Committee cronies, along with Nancy and her minions, want to reduce the special treatment given to Advantage folks in order to level the playing field and help pay for enrolling the other 50 million folks in this country who have zero health care coverage.

So why does Elton write these dumb, misleading articles?  Why does he predict that a holocaust will befall Advantage members and then conveniently ignore the other 80% of us…not to speak of the other 50 million have-nots.   First, he didn’t fast yesterday.  But more importantly, it’s another way of raising the hackles of old folks.  Folks who can go to tea parties and help defeat any kind of meaningful health care reform.  Folks who can help maintain the status quo and enrich the insurance companies.  Folks who care more about what they’ve got instead of what others don’t.

Ok, so I complained.  I promise to do better next year.

2C_Medicare_Advantage_Payments_Relative_to_Traditional_Fee_for_Service_Medicare_2009

2 Responses to “And the Advantage goes to…”


  1. 1 Sid Cohn September 30, 2009 at 9:18 am

    The trade off is choosing your own providers (Medicare) as compared to HMO (selected providers and lesser delivery of care).

    Like

  2. 2 Alice September 30, 2009 at 5:28 pm

    I am a user of the advantage plan …so far so good..if I stay out of the hospital this year. It saves me about 3000.00 per year in extra payments for medigap insurance and drug coverage…the number of cdoctors available for this plan is staggering…I will keep you informed of my progress.

    The dental part is a joke…

    Like


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