Was struck today that I have heard very little about the role of Medigap in the current health insurance debate…despite massive discussion of Medicare, Medicare Advantage, payment reform…etc. In addition, it highlights how difficult it is to sort through the tangled web of money and influence…not sure how much I believe it, but its certainly food for thought.
This thought was triggered by Michelle Milkin’s post on AARP’s dependance on royalties from selling sponsored insurance plans:
A Hill source summed it up for me this way: “AARP has endorsed a huge reduction in funding of Medicare Advantage, which touches over 10 million middle-lower income seniors. If Medicare Advantage funding is reduced, and seniors are forced out of the program, they become potential buyers of the heavily-promoted and very profitable Medicare Supplement program sponsored by AARP (MediGap is 70% of AARP’s annual income). Medicare Supplement is a huge source of revenue to AARP. At a minimum, AARP should be required to disclose this every time they discuss Medicare Advantage.
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Sustainable health reform requires a solid foundation…unfortunately the proposals we’re seeing out of Washington create a more elaborate house of cards, as we continue to create an elaborate health care ponzi scheme. The House that built Medicare has already saddled our country with Trillions in unfunded liabilities. The proposals we see look to continue to reward a medical-industrial complex that creates and manages diseases rather than focusing on optimizing the health of people.
So what are the criteria of a sustainable health system? continue reading »
When I was a kid, I hit my head a fair bit, including getting knocked out once at football practice. Initial care involved an evaluation, but scans weren’t the norm. Now that they’ve become increasingly common in the evaluation of head injuries in youth, have we gained much?
The Value of CT Scans in Youths Is Questioned in this study in the Lancet (article in NYTimes). continue reading »
Interesting turnaround of the “boycott” created by government health reform suppporters…those supportive of Mackey’s stance have now created a “buycott” movement.
Tea Party Buycott in Support of John Mackey and Whole Foods.
Dana Loesch of the St. Louis Tea Party explained that a Tea Party Buycott asks supporters to gather [in this case] at the Whole Foods store to show economic support. “We are asking supporters to do all their week’s grocery shopping that night. Most tea party supporters are not regular customers of Whole Foods, and we want to show our support for Mr. Mackey’s championship of free market health care reforms.”
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Evan Falchuk makes a nice commentary on his blog on the latest facebook health reform memes
“No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day.”
How about just changing it to “no one should die, and no one should go broke”? I’d be in favor of that, too.
We need to take the discussion about health care past the broad platitudes and really ask ourselves what we want from health care and how we’re going to pay for it. To date, the debate has largely been about how I can get what I want and have someone else pay for it– and in the end we’re all paying anyway, which puts a crimp into that approach.
So, what do I want…I want a convenient and responsive everyday delivery system (that works like most retail services) and protection against unpredictable catastrophic events. I’d also like some help getting my weight down and my exercise up in a way that fits a hectic schedule. I’m willing to pay a few hundred dollars a month for this… What is it that you want and how much are you willing to pay?
David Goldhill’s piece highlights a personal journey of disbelief around how health care and hospitals work today in his essay, How American Health Care Killed My Father – The Atlantic (September 2009) .
For those who haven’t seen it, its a terrific read, and highlighted by David Brooks as the first thing he would ask President Obama to do in preparation for his health care speech. An excerpt below:
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Gold Plated Wheelchairs
Does low administrative cost or pooled purchasing lead you to the best values? When it comes to government purchasing, the results are surprisingly bad– the Medicare fee schedule rate for medical supplies can multiples higher than the cash price an individual can command. HHS’s Inspector General, Daniel Levinson, gives us the shocking details in his report on Power Wheelchair Acquisition Costs for the Medicare program (via CNN.com)
The Executive Summary is a fascinating rebuke of Congress’ ability to remove pork from the Medicare program, driving up costs for both taxpayers and beneficiaries. It also is a cry for help for a Medicare Administrator to take the steps required to appropriately run the government’s payor– we’ve missed the leadership a Mark McClellan can provide in the role (there hasn’t been a Senate-confirmed Medicare head since 2006). Is this the future of a govenment plan focused on minimizing administration?
Medicare’s fee schedule amounts are based on manufacturer-suggested retail prices. They include reimbursement for the power wheelchair acquisition cost and services performed in conjunction with providing the wheelchair, such as assembling and delivering it and educating the beneficiary about its use. Prior Office of Inspector General (OIG) reviews have found that consumers can buy power wheelchairs for lower prices than Medicare and its beneficiaries. In May 2006, the Centers for Medicare & Medicaid Services (CMS) proposed a revised methodology for setting new fee schedule amounts that would not rely upon manufacturer-suggested retail prices and is responsive to the market. As of May 2009, CMS had not finalized this proposal.
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