Political....Mediscare....WTF?

[G-Man]

OK, Obamacare cut half a Trillion, that's right $500,000,000,000 from Medicare and the Dems turn around and cry that the Repubs want to hurt the seniors? 

So now it's OK for one side to do the damage and then turn around and blame the other side before their ink is even dry and all of the waivers have come in.

[musclehead]

waivers, get your waivers here! the entire state of Nevada, most of pelosi's district.  mcdonalds, hey didn't they just hire 62,000 people. so that's how they got a waiver

[Bob E.]

I believe that the $500B was primarily cut from the part of Medicare in which private insurance companies participate and profit from (Medicare Advantage?).  The cuts were aimed at reducing the cost of this program by reducing the costs and overcharges that these for-profit private companies were making.  They were scamming the system with high overhead and excessive profits.  It was not aimed at reducing services to seniors.

As for the waivers, you do understand that the waivers are only temporary, right?  They are there to address existing contracts that many municipalities and companies have with their workers and citizens, many of which actually exceed the requirements of the Affordable Care Act.  Since unions are generally the ones with contracts with employers, it would make sense that they would mostly qualify for waivers, not that they are being "favored" as republicans like to accuse Obama of.  Also, as for Pelosi's district (which is in California by the way, not Nevada) the city (San Diego??) actually had created a universal health care program that normal citizens could buy into.  There were no provisions in the Affordable Care Act to deal with situations like this, so they get waivers.  However, they all will be required to be in compliance with the law when their current contracts and agreements run out.

[G-Man]

I believe that the $500B was primarily cut from the part of Medicare in which private insurance companies participate and profit from (Medicare Advantage?).  The cuts were aimed at reducing the cost of this program by reducing the costs and overcharges that these for-profit private companies were making.  They were scamming the system with high overhead and excessive profits.  It was not aimed at reducing services to seniors.

As for the waivers, you do understand that the waivers are only temporary, right?  They are there to address existing contracts that many municipalities and companies have with their workers and citizens, many of which actually exceed the requirements of the Affordable Care Act.  Since unions are generally the ones with contracts with employers, it would make sense that they would mostly qualify for waivers, not that they are being "favored" as republicans like to accuse Obama of.  Also, as for Pelosi's district (which is in California by the way, not Nevada) the city (San Diego??) actually had created a universal health care program that normal citizens could buy into.  There were no provisions in the Affordable Care Act to deal with situations like this, so they get waivers.  However, they all will be required to be in compliance with the law when their current contracts and agreements run out.

Then explain the 21% cut, across the board, that physicians (and providing facilities) received from medicare to their (my) reimbursements (if I were still in practice)?  And because every action has a reaction, providers are rationing care by limiting the number of Medicare patients seen in a day, in-office procedure and tests, etc.  This is info I receive from my continuing medical education conferences.  Where physicians by the droves are trying to figure out how the AMA let this happen. 

This is the real effect of Obamacare on medicine and the elderly, not the talking points they let you hear.

I read about waivers to low income unionized employers so they don't have to comply with the part about having kids on the plan until age 26.  How is this temporary?  Burger flippers and shelf stockers will never be at a payscale that could warrant their employers covering these peoples kids well into adulthood.  It would bankrupt those companies.  You'd have to bump up their pay to $45K so they can at least start to contribute to such a policy (but then union workers hate the word contribute) and burgers or a can of peas would have to cost $30.

[Dubsvalk]

Amen, Brother!
Dubs

[Bob E.]

Then explain the 21% cut, across the board, that physicians (and providing facilities) received from medicare to their (my) reimbursements (if I were still in practice)?  And because every action has a reaction, providers are rationing care by limiting the number of Medicare patients seen in a day, in-office procedure and tests, etc.  This is info I receive from my continuing medical education conferences.  Where physicians by the droves are trying to figure out how the AMA let this happen. 

This is the real effect of Obamacare on medicine and the elderly, not the talking points they let you hear.

I read about waivers to low income unionized employers so they don't have to comply with the part about having kids on the plan until age 26.  How is this temporary?  Burger flippers and shelf stockers will never be at a payscale that could warrant their employers covering these peoples kids well into adulthood.  It would bankrupt those companies.  You'd have to bump up their pay to $45K so they can at least start to contribute to such a policy (but then union workers hate the word contribute) and burgers or a can of peas would have to cost $30.

Is the 21% related to the "doc-fix" that congress passes on a regular basis?  I know this wasn't included in the bill and was a real (and valid) point about just how much the bill would cost.

As for the waivers, they are temporary because they will at some time, need to be in compliance when their current contracts are up.  As for the cost of covering 26 year olds, I'd wonder just how many burger flippers have kids that old when the fact is that most of those employees are high school and college kids themselves.  And I have worked as a burger flipper myself, so has my wife, brothers, etc. and none of the places we worked at ever offered health insurance.  Of course, now they will be required or pay the fine...given the cost of insurance vs the rather minimal fine, I'd bet they pay the fine and the employees are left to the public exchanges.

[Hoser]

Kool aid anyone?  hoser

[Bob E.]

Kool aid anyone?  hoser

Why, thirsty?? 

[Doc809]

A lot of major providers in this area have quit seeing Medicare patients because of the reductions in reimbursement rates.  I am not accepting any new pts on Medicare but will retain those existing patients just out of loyalty to them.  Pretty sure that the reduction in the number of providers is not "good" for the seniors.

[RoadKill]

If the price of oil is run up people will use less of it,so of course we will run the cost of medical treatment higher so people stay healthy and boycott growing old enough to need medicare. If we then tax the $hit outta peoples carbon foot print they will engage in group hugs to keep warm with body heat instead of burning things,saving the environment and insure world peace thru community warmth huddles and that will surely change a few minds about gay marriage,finally putting that issue to rest as a bonus !  WOW!   I see what all the hope and change is about now!  Thanx for the KoolAid refill !    

[Bob E.]

Here's my question...

What is your solution? 

Just ending medicare is not going to work without some dire consequences to alot of elderly folks.  Creating a voucher system and using the private insurance system?  Well, either there won't be any insurance available because it isn't profitable, or it would be so expensive, nobody would be able to buy it.  The average income of people on medicare is around $28,000, which means alot of people make far less than that.  The CBO says that the Ryan Plan would increase costs to seniors by over $6000/year.  That's nearly 25% of their income on top of what they are already paying towards medical expenses.  These REALITIES are why Medicare was created in the first place.  And any plan that does not address them is just not credible..., not to mention the fact that the elderly generally love Medicare.  In addition, Americans of all ages LOVE Medicare.  Recent polling suggests that 80% of Americans say that cutting/ending Medicare is not acceptable.  So, politically, it just isn't going to happen...look at the recent election in NY-26.  That is a district that has only elected 3 democrats since 1858 (pre-civil war)...but a democrat, who was something like 60 points down at the start ended up winning when the republican said they would support Paul Ryan's plan.

So...what is your solution?

[MP]

So.... What is Obabas and the Dems plan?  They not only have not offered one, Reid has said he will NOT offer one!

Medicare is bankrupting this country, and the Dems are far more worried about elections that fixing it.  There WILL have to be cuts.  In fact, there will be cuts as it is now.

You talk about cuts by the Repubs, but it will FAIL if we do nothing, which is what the Dems are doing.  They attack anything to do with it.  We need to find a solution, demagoging it will not fix it.

MP

[LandElephant]

Bob,
Here is one suggestion.  First, Increase the amount of FICA and SSN by 1% each and call it a cost of living increase.  This fee / tax hasn't been increased since I believe 1993.  It was Jimmy Carter and his administration to set in place the existing payment schedule and SSN requirements that we live with today.

Second, as the 1983 House tried to do(voted 496 - 12) is put a "Lock Box" on SSN and Medicare so that the government can not borrow the funds.  Go years there is a surplus, bad years there is excess funding to cover the short falls.  You now are placing the responsibility on all citizens because as you stated they want it.

How did I come up with 1%, its a number.  If you ake $60,000 a year that is $600 increase or $50 a month or about a little over $10 a week.  Increase the employers part by 1% and now its approximately $180 from them for a total of $780 a year. Or $78,000,000,000 to medicare.  Untouched by the HOGs in Washington and maybe it would make a difference. If you make more, you pay more.  Make less you pay less.

Get rid of the word "Voucher".  That in itself won't fly (look at the many attempts to get school vouchers).

Someone has to pay and now everyone gets their piece of the pie.


Charlie Morse
Land Elephant

[Bob E.]

Bob,
Here is one suggestion.  First, Increase the amount of FICA and SSN by 1% each and call it a cost of living increase.  This fee / tax hasn't been increased since I believe 1993.  It was Jimmy Carter and his administration to set in place the existing payment schedule and SSN requirements that we live with today.

Second, as the 1983 House tried to do(voted 496 - 12) is put a "Lock Box" on SSN and Medicare so that the government can not borrow the funds.  Go years there is a surplus, bad years there is excess funding to cover the short falls.  You now are placing the responsibility on all citizens because as you stated they want it.

How did I come up with 1%, its a number.  If you ake $60,000 a year that is $600 increase or $50 a month or about a little over $10 a week.  Increase the employers part by 1% and now its approximately $180 from them for a total of $780 a year. Or $78,000,000,000 to medicare.  Untouched by the HOGs in Washington and maybe it would make a difference. If you make more, you pay more.  Make less you pay less.

Get rid of the word "Voucher".  That in itself won't fly (look at the many attempts to get school vouchers).

Someone has to pay and now everyone gets their piece of the pie.


Charlie Morse
Land Elephant

I agree 100%.  Killing programs like SS and Medicare doesn't solve anything.  These are good and necessary programs that we need to figure out a way to pay for.  In addition to the ways you suggest, I'd also like to see the $106,000 cap lifted for SS tax, as well as see the SS and Medicare tax be attributed to all income such as dividends and such that the ultra rich hedge fund managers live off of, rather than just ordinary income.

[Bob E.]

So.... What is Obabas and the Dems plan?  They not only have not offered one, Reid has said he will NOT offer one!

Medicare is bankrupting this country, and the Dems are far more worried about elections that fixing it.  There WILL have to be cuts.  In fact, there will be cuts as it is now.

You talk about cuts by the Repubs, but it will FAIL if we do nothing, which is what the Dems are doing.  They attack anything to do with it.  We need to find a solution, demagoging it will not fix it.

MP

Medicare IS the Dems plan.  It just needs to be paid for.  And any savings that can be found of course should be investigated.  But eliminating Medicare is not a solution.  I actually think they should expand medicare to everyone. Yes...create a single payer health system for all Americans and the costs per enrollee would go down overall and then just watch Paul Ryan's head explode.

[LandElephant]

There can't be to many members on this board that were alive when SS was started.  It may have started with FDR, but all of us have invested into this program.

Sorry I forgot that I used 100,000,000 tax payers to get my figures.

So as a tax payer woud you accept that idea?I would.  It's non-partisan in nature.

Land Elephant

[Bob E.]

So as a tax payer woud you accept that idea?I would.  It's non-partisan in nature.

In a word...YES.

[G-Man]

So.... What is Obabas and the Dems plan?  They not only have not offered one, Reid has said he will NOT offer one!

Medicare is bankrupting this country, and the Dems are far more worried about elections that fixing it.  There WILL have to be cuts.  In fact, there will be cuts as it is now.

You talk about cuts by the Repubs, but it will FAIL if we do nothing, which is what the Dems are doing.  They attack anything to do with it.  We need to find a solution, demagoging it will not fix it.

MP

Medicare IS the Dems plan.  It just needs to be paid for.  And any savings that can be found of course should be investigated.  But eliminating Medicare is not a solution.  I actually think they should expand medicare to everyone. Yes...create a single payer health system for all Americans and the costs per enrollee would go down overall and then just watch Paul Ryan's head explode.

And then watch the physician's heads explode, along with the medical schools that will be exploding for the insurance money because nobody is gonna invest $200K+books+supplies+8 years after college to make what an average gov't employee makes.  And knowing how docs have been treated in the past by Gov't, the docs will be the only workers not allowed to unionize! 

We live in a capitolist society, but you want to marry in socialist ideas that won't fly.  Yes, it would be WONDERFUL if everyone was covered and nobody had to pay a dime.  But then who pays for all of the R&D and production for labs and lests and diagnostic machines, who pays for the education and experience from lab techs to nurses, medical assistants and physicians?  Who pays for the failures (only one in 60 compounds even makes it to clinical trials and then it's another 1 in 30 that makes it to the market from there).  Who pays for the $1,000 surgical text books and the office rent and for staff, payroll, raises?  Insurance?  Practices in expensive areas like NYC, Chicago, LA would be more like clinics with dozens of doctors treating 40 patients a day just to cover costs.  Where would be the incentive to go out and do medical talks and health fares if not to build up a practice to make a good living?   Oh right, in Obama world (he's for single payer too) the $38 office visit reimnursement from Medicare will cover ALL of these.

You see the Gov't created this system, designated to fail, and now they're just fighting over who will collapse it first.  It's like the hot potato.  Do nothing to actually help it along and hope it fails under the other guys watch.  Then you can boast about how the other guy sucks and the new guy will cry he inherited it for the next 4 years.

How about everybody pays ther own way like they've done for thousands of years.  Each system designed to the contrary has failed, but these guys will do it right????????? 

[Bob E.]

And then watch the physician's heads explode, along with the medical schools that will be exploding for the insurance money because nobody is gonna invest $200K+books+supplies+8 years after college to make what an average gov't employee makes.  And knowing how docs have been treated in the past by Gov't, the docs will be the only workers not allowed to unionize! 

We live in a capitolist society, but you want to marry in socialist ideas that won't fly.  Yes, it would be WONDERFUL if everyone was covered and nobody had to pay a dime.  But then who pays for all of the R&D and production for labs and lests and diagnostic machines, who pays for the education and experience from lab techs to nurses, medical assistants and physicians?  Who pays for the failures (only one in 60 compounds even makes it to clinical trials and then it's another 1 in 30 that makes it to the market from there).  Who pays for the $1,000 surgical text books and the office rent and for staff, payroll, raises?  Insurance?  Practices in expensive areas like NYC, Chicago, LA would be more like clinics with dozens of doctors treating 40 patients a day just to cover costs.  Where would be the incentive to go out and do medical talks and health fares if not to build up a practice to make a good living?   Oh right, in Obama world (he's for single payer too) the $38 office visit reimnursement from Medicare will cover ALL of these.

You see the Gov't created this system, designated to fail, and now they're just fighting over who will collapse it first.  It's like the hot potato.  Do nothing to actually help it along and hope it fails under the other guys watch.  Then you can boast about how the other guy sucks and the new guy will cry he inherited it for the next 4 years.

How about everybody pays ther own way like they've done for thousands of years.  Each system designed to the contrary has failed, but these guys will do it right????????? 

The problem is that we don't actually live in a capitalist society.  We live in a mixed economy that has sprinkles of capitalism, socialism, corporatism, etc.  Frankly, there are some things that just should not be run as for-profit businesses.  Defense, prisons, education, and health care are the big ones. And I never said nobody pays and everything is free.  What I said was that everyone should pay for universal health care through taxes.  And whatever that program costs, we as taxpayers should pay it.  The fact is that Medicare is more efficient than any private insurance company in that about 97-98% of every dollar collected goes to health care.  Not overhead, and not profits.  Hell, even BCBS which is supposed to be a non-profit pays out as little as 65% of revenues towards health care in some areas of the country.   Then, since they are not allowed to raise a profit, they take the excesses and invest in assets like huge new corporate offices and campuses and obscene CEO pay.  There is no way that a private insurance company would be able to operate cheaper than Medicare...they haven't yet.  Plus, profit being a motive completely corrupts the insurance company's decision making resulting in denied care.  I have a co-worker who just had back surgery and his doctor says that the most important thing for his recovery would be a nerve stimulation machine to help restore the nerve function that he has lost.  The insurance company has denied it...even though his doctor says that is essential. His care is already being rationed and denied...so anyones arguement that the government will ration care so therefore private insurance is better is ignorant. And the government's responsibility would be to control the cost of that program.  Failure to control costs would result in being voted out becaue they would be left with the unteneble position of either needing to cut services or raising taxes.

You make a good point about the cost of med school, and the actual costs of doing business.  And I do believe that Doctors should earn a good living given the amount of effort it takes to become a doctor and the effort it takes to stay on top of the field.  And those costs would need to be rolled into the cost of the program.  I'm an engineer and I feel the same way about my profession.  On the other hand, think of the savings in administrative costs if you only need to deal with one insurance company.  I was talking to my chiropractor and he said that up to 25% of his time is spent dealing with insurance companies.  Plus, he needs to hire an assistant to help with those administrative tasks.  Also, what if we got away from a "fee for service" type of system and just paid doctors a salary based on the number of patients seen or some variation?  I believe France's system works this way.  Engineers work based on salary, often working overtime without extra compensation.  It would be a huge change to the way health care is delivered, but, why wouldn't it work?

I'm not saying my ideas are the solution.  But those sort of out of the box ideas...major changes to the system, not just reductions in services...are what it will take to actually and truly reduce the rate of growth in  the costs.  For what we pay as a nation, we certainly are not getting the outcomes compared to many other countries around the world.  How do they do it?

[BigAl]

Obama Care Morons.

Pin Heads or Patriots.

I have already chosen.

[Bob E.]

Obama Care Morons.

Pin Heads or Patriots.

I have already chosen.

Yeah, what the republicans are suggesting is real patriotic.    Nice contribution to the conversation...I'll skip on the name calling.

[x]

Obama Care Morons.

Pin Heads or Patriots.

I have already chosen.

Yeah, what the republicans are suggesting is real patriotic.    Nice contribution to the conversation...I'll skip on the name calling.

Not to worry, Bob E.  There are really some considered people on this board... like Willow... I may not always agree, and he takes the time to present a foundation for his opinion based upon facts.
 
Then, we have 'Big Al'.  Big Al is apparently not large when it comes to the fact situation but nevertheless provides us an example of the things that must be overcome in order to legislate new policy.
 
Peace, Big Al... your posts are an asset to those wanting to understand what makes America tick.