[QUAD-L] Re: Medicare bills you might be interested in reading about
Asclepios Your Weekly Medicare Consumer Advocacy Update Once We're Dug Out February 11, 2010 • Volume 10, Issue 6 Back-to-back blizzards have frozen progress this week on a jobs bill that will likely include important provisions for people with Medicare. When the roads are plowed and Congress returns to work, it is critical that lawmakers pass this legislation as soon as possible. The legislation’s main goals—getting Americans back to work and extending unemployment assistance and help to pay health insurance premiums for those who still can’t find work—are urgent, and two Medicare provisions are critical for older adults and people with disabilities to maintain access to their health care. The Senate jobs bill circulated this week would prevent a 21 percent Medicare pay cut for doctors from taking effect on March 1. A pay cut this drastic could seriously harm the ability of people with Medicare to maintain relationships with their doctors. This provision is a stop-gap measure—it delays the cut, which is mandated under the current Medicare payment formula, until October—and does not change the formula for the long term. That change, which is necessary to avert a series of annual pay cuts required under current law, will have to wait for passage of additional legislation. The second key provision in the Senate jobs bill would reinstate a policy allowing exceptions to an annual cap on outpatient rehabilitation therapy for people with Medicare. The exceptions policy expired at the end of 2009, which means that people with Medicare who need extensive therapy—to recover from a stroke, for example, or for treatment of Parkinson’s disease—could be denied coverage for the full course of therapy they need. Many people with Medicare are now hitting the $1,860 cap; the sooner Congress reinstates the exceptions policy, the sooner these people can receive coverage for their treatments. The House jobs bill passed in December does not include these Medicare provisions, but there is strong support in the House for dealing with both the therapy cap and the doctor payment issues. (The House passed a permanent repeal of the Medicare doctor payment formula last year. Both the House and Senate health reform bills extended the exceptions policy for rehabilitation therapy.) People with Medicare have a lot staked on prompt passage of legislation that puts off the doctor pay cut slated for March 1 and allows exceptions for people who need rehabilitation therapy above the cap. Lawmakers should not seek to delay or derail this legislation to score political points. Medical Record “The Senate bill could also include a short-term patch to Medicare's physician payment formula, which must be adjusted in order to avoid steep decreases in Medicare reimbursements to doctors. If the formula remains unchanged, the payment rate would drop by roughly 21% in March.” (_Jobs Bill Likely to be Delayed in Senate_ (http://www.kintera.org/TR.asp?a=lrKTIVODLjISKcJs=cnKBINPqE8LBKRNDGm=iqIOL2OCJeJYEaf=y) , Wall Street Journal, February 2010) “Effective January 1 of this year, people with Medicare face a $1,860 cap on the amount of physical and speech therapy they can receive during the year, as well as a separate $1,860 cap on occupational therapy. The therapy caps limit treatment for older adults and people with disabilities who need extensive therapy as they recover from a stroke or other acute episode, or suffer from chronic conditions such as Parkinson’s disease or multiple sclerosis.” (_Congress Must Extend Exceptions to Medicare Therapy Cap_ (http://www.kintera.org/TR.asp?a=okIZJ4PPKmLZImIs=cnKBINPqE8LBKRNDGm=iqIOL2OCJeJYE; af=y) , Medicare Rights Center, February 2010) Learn More About _Health Reform and Medicare_ (http://www.kintera.org/TR.asp?a=hnJLKJNnEfKMK2Ls=cnKBINPqE8LBKRNDGm=iqIOL2OCJeJYEaf=y) * * * * The Medicare Rights Center is now on Twitter. Follow us at _www.twitter.com/medicarerights_ (http://www.kintera.org/TR.asp?a=kgLRKSOzGiJTIcKs=cnKBINPqE8LBKRNDGm=iqIOL2OCJeJYEaf=y) . * * * * Medicare Part D Appeals Help for Advocates Is Here! Medicare Part D Appeals: An advocate's manual to navigating the Medicare private drug plan appeals process by the Medicare Rights Center offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources. _Download a FREE copy_ (http://www.kintera.org/TR.asp?a=qwK3JaMXIpJXJlLs=cnKBINPqE8LBKRNDGm=iqIOL2OCJeJYEaf=y) of this great resource. * * * * The Louder Our Voice, the Stronger Our Message * * * * Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece— is a weekly e-newsletter designed to
[QUAD-L] Re: MEDICARE AND MEDICAID from DAANOO
I am subscribed to the biweekly electronic newsletter MEDICARE WATCH and so should most people rather than getting it from here. It is usually just a bunch of bureaucracy but this one caught my eye. *Notice #3 below* regarding nursing homes. 91% is a huge number and might as well be 100%. Further, notice that the nursing homes were only cited for Deficient Care rather than having anything done about it other than a slap on the wrist. Then, look at #4 where the topic is --* MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS. * *It SHOULD READ or SAY* Medicare Stops Paying Hospitals for Medical Errors *AND* Hospitals Will Not Be Allowed to go after the patient for ANY balances. If ALL that occurred (to protect the patient) -- hospitals would probably not want to take Medicare patients. But since it is federal I don't think they would be allowed to do that. In any case, what I added above Re: #4 -- it should be recognized and included in the Medicare policy. But apparently it is not. Sometimes it is so laughable to read A Patient's Bill of Rights. I know they hang on the walls of assisted living facilities and probably on nursing home walls as well but as you can see above -- that is a joke. Lori On Tue, Oct 14, 2008 at 10:59 PM, [EMAIL PROTECTED] wrote: Welcome to MEDICARE WATCH, a biweekly electronic newsletter of the Medicare Rights Center Vol. 11 , No. 21 : October 14, 2008 Contents: *1. FAST FACT* ** *2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS RISE * *3. NURSING HOMES WIDELY CITED FOR DEFICIENT CARE* *4. MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS* *5. CASE FLASH: SWITCHING PRESCRIPTION COVERAGE FROM A MEDIGAP PLAN TO PART D * -- *1. FAST FACT* According to Douglas Holtz-Eakin, Senator John McCain's senior policy adviser, the health care reform plan offered by Sen. McCain will have major cuts for Medicare and Medicaid. The nonpartisan Tax Policy Center, a Washington think tank, estimates that the McCain plan would cost the government $1.3 trillion over 10 years. The McCain campaign has not disputed these figures or offered their own. (McCain Plans Federal Health Cuts, *Washington Post*, October 2008) http://www.kintera.org/TR.asp?a=glKSK6PQJfIYLrKs=fqLHJWMCIbLHI0NPGm=kkJWLaOPLfJ3Faf=y *2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS RISE* At least 1.3 million low-income people with Medicare will be reassigned to a new prescription drug plan in 2009, as the number of drug plans that qualify for a full premium subsidy dropped from 495 in 2008 to 308 in 2009, according to Avalere, a health consultancy firm. Low-income people who qualify for full Extra Help can receive premium-free drug coverage, but only in a plan that charges a premium below the regional average. When a drug plan's premium rises above that average, which is reset every year, the Centers for Medicare Medicaid Services reassigns most Extra Help recipients in that plan to a new drug plan with a premium below the average. Because reassignment is random, and plans vary greatly in the drugs they cover and the coverage restrictions they impose, low-income people will face new coverage restrictions under their new plan. In all but one state, Wisconsin, the number of drug plan offerings for low-income Medicare enrollees decreased. In six states – Arizona, Florida, Hawaii, Maine, Nevada and New Hampshire – there will be five or fewer drug plans available to automatically enroll low-income people with Medicare in 2009. Nevada will have only one drug plan for those people automatically reassigned by CMS, eliminating any choice of stand-alone drug plans for low-income enrollees unless individuals can pay for part of the premium cost from their limited incomes. Arizona has the second fewest options for low-income enrollees, with only two zero-premium drug plans for Extra Help recipients. Humana completely withdrew from the low-income market, offering no plans with premiums below the benchmark. However, United Healthcare increased the number of PDPs it will offer to low-income people with Medicare after it lost nearly 600,000 low-income enrollees last year. The number of people reassigned by CMS has increased annually since Part D went into effect in 2006. In 2007 CMS reassigned 250,000 people; the number steeply jumped in 2008, when CMS reassigned 1.2 million people. *3. NURSING HOMES WIDELY CITED FOR DEFICIENT CARE* From 2005 to 2007 more than 91 percent of nursing homes surveyed were cited for deficiencies, the Health and Human Services Department Office of Inspector General (OIG) reports. Nearly 17 percent of nursing homes had deficiencies that caused residents actual harm or immediate jeopardy of harm, with a greater percentage of for-profit nursing homes cited for these serious violations than not-for-profit nursing homes. The most common deficiency categories
Re: [QUAD-L] Re: MEDICARE AND MEDICAID from DAANOO
I am sending just in case everyone is not subscribed to this. Sorry my sending it bothers you, Lori. Dana In a message dated 10/15/2008 6:14:46 P.M. Central Daylight Time, [EMAIL PROTECTED] writes: I am subscribed to the biweekly electronic newsletter MEDICARE WATCH and so should most people rather than getting it from here. It is usually just a bunch of bureaucracy but this one caught my eye. Notice #3 below regarding nursing homes. 91% is a huge number and might as well be 100%. Further, notice that the nursing homes were only cited for Deficient Care rather than having anything done about it other than a slap on the wrist. Then, look at #4 where the topic is -- MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS. It SHOULD READ or SAY Medicare Stops Paying Hospitals for Medical Errors AND Hospitals Will Not Be Allowed to go after the patient for ANY balances. If ALL that occurred (to protect the patient) -- hospitals would probably not want to take Medicare patients. But since it is federal I don't think they would be allowed to do that. In any case, what I added above Re: #4 -- it should be recognized and included in the Medicare policy. But apparently it is not. Sometimes it is so laughable to read A Patient's Bill of Rights. I know they hang on the walls of assisted living facilities and probably on nursing home walls as well but as you can see above -- that is a joke. Lori On Tue, Oct 14, 2008 at 10:59 PM, [EMAIL PROTECTED] (mailto:[EMAIL PROTECTED]) wrote: Welcome to MEDICARE WATCH, a biweekly electronic newsletter of the Medicare Rights Center Vol. 11 , No. 21 : October 14, 2008 Contents: 1. FAST FACT 2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS RISE 3. NURSING HOMES WIDELY CITED FOR DEFICIENT CARE 4. MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS 5. CASE FLASH: SWITCHING PRESCRIPTION COVERAGE FROM A MEDIGAP PLAN TO PART D 1. FAST FACT According to Douglas Holtz-Eakin, Senator John McCain's senior policy adviser, the health care reform plan offered by Sen. McCain will have major cuts for Medicare and Medicaid. The nonpartisan Tax Policy Center, a Washington think tank, estimates that the McCain plan would cost the government $1.3 trillion over 10 years. The McCain campaign has not disputed these figures or offered their own. _(McCain Plans Federal Health Cuts, Washington Post, October 2008) _ (http://www.kintera.org/TR.asp?a=glKSK6PQJfIYLrKs=fqLHJWMCIbLHI0NPGm=kkJWLaOPLfJ3Faf=y) 2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS RISE At least 1.3 million low-income people with Medicare will be reassigned to a new prescription drug plan in 2009, as the number of drug plans that qualify for a full premium subsidy dropped from 495 in 2008 to 308 in 2009, according to Avalere, a health consultancy firm. Low-income people who qualify for full Extra Help can receive premium-free drug coverage, but only in a plan that charges a premium below the regional average. When a drug plan's premium rises above that average, which is reset every year, the Centers for Medicare Medicaid Services reassigns most Extra Help recipients in that plan to a new drug plan with a premium below the average. Because reassignment is random, and plans vary greatly in the drugs they cover and the coverage restrictions they impose, low-income people will face new coverage restrictions under their new plan. In all but one state, Wisconsin, the number of drug plan offerings for low-income Medicare enrollees decreased. In six states – Arizona, Florida, Hawaii, Maine, Nevada and New Hampshire – there will be five or fewer drug plans available to automatically enroll low-income people with Medicare in 2009. Nevada will have only one drug plan for those people automatically reassigned by CMS, eliminating any choice of stand-alone drug plans for low-income enrollees unless individuals can pay for part of the premium cost from their limited incomes. Arizona has the second fewest options for low-income enrollees, with only two zero-premium drug plans for Extra Help recipients. Humana completely withdrew from the low-income market, offering no plans with premiums below the benchmark. However, United Healthcare increased the number of PDPs it will offer to low-income people with Medicare after it lost nearly 600,000 low-income enrollees last year. The number of people reassigned by CMS has increased annually since Part D went into effect in 2006. In 2007 CMS reassigned 250,000 people; the number steeply jumped in 2008, when CMS reassigned 1.2 million people. 3. NURSING HOMES WIDELY CITED FOR DEFICIENT CARE From 2005 to 2007 more than 91 percent of nursing homes surveyed were cited for deficiencies, the Health and Human Services Department Office of
Re: [QUAD-L] Re: MEDICARE AND MEDICAID from DAANOO
Nope -- doesn't bother me at all. I didn't mean to word it that way. My intent was to point out what I did because, like I said, most of them are filled with bureaucracy or baffle them with bullsh*t things where you have to read between the lines. It is still that but this one stuck out to me more so I wanted to comment. Lori :-) On Wed, Oct 15, 2008 at 5:27 PM, [EMAIL PROTECTED] wrote: I am sending just in case everyone is not subscribed to this. Sorry my sending it bothers you, Lori. Dana In a message dated 10/15/2008 6:14:46 P.M. Central Daylight Time, [EMAIL PROTECTED] writes: I am subscribed to the biweekly electronic newsletter MEDICARE WATCH and so should most people rather than getting it from here. It is usually just a bunch of bureaucracy but this one caught my eye. *Notice #3 below* regarding nursing homes. 91% is a huge number and might as well be 100%. Further, notice that the nursing homes were only cited for Deficient Care rather than having anything done about it other than a slap on the wrist. Then, look at #4 where the topic is --* MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS. * *It SHOULD READ or SAY* Medicare Stops Paying Hospitals for Medical Errors *AND* Hospitals Will Not Be Allowed to go after the patient for ANY balances. If ALL that occurred (to protect the patient) -- hospitals would probably not want to take Medicare patients. But since it is federal I don't think they would be allowed to do that. In any case, what I added above Re: #4 -- it should be recognized and included in the Medicare policy. But apparently it is not. Sometimes it is so laughable to read A Patient's Bill of Rights. I know they hang on the walls of assisted living facilities and probably on nursing home walls as well but as you can see above -- that is a joke. Lori On Tue, Oct 14, 2008 at 10:59 PM, [EMAIL PROTECTED] wrote: Welcome to MEDICARE WATCH, a biweekly electronic newsletter of the Medicare Rights Center Vol. 11 , No. 21 : October 14, 2008 Contents: *1. FAST FACT* ** *2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS RISE * *3. NURSING HOMES WIDELY CITED FOR DEFICIENT CARE* *4. MEDICARE STOPS PAYING HOSPITALS FOR MEDICAL ERRORS* *5. CASE FLASH: SWITCHING PRESCRIPTION COVERAGE FROM A MEDIGAP PLAN TO PART D * -- *1. FAST FACT* According to Douglas Holtz-Eakin, Senator John McCain's senior policy adviser, the health care reform plan offered by Sen. McCain will have major cuts for Medicare and Medicaid. The nonpartisan Tax Policy Center, a Washington think tank, estimates that the McCain plan would cost the government $1.3 trillion over 10 years. The McCain campaign has not disputed these figures or offered their own. (McCain Plans Federal Health Cuts, *Washington Post*, October 2008) http://www.kintera.org/TR.asp?a=glKSK6PQJfIYLrKs=fqLHJWMCIbLHI0NPGm=kkJWLaOPLfJ3Faf=y *2. LOW-INCOME PEOPLE WITH MEDICARE FACE REASSIGNMENT AS DRUG PREMIUMS RISE* At least 1.3 million low-income people with Medicare will be reassigned to a new prescription drug plan in 2009, as the number of drug plans that qualify for a full premium subsidy dropped from 495 in 2008 to 308 in 2009, according to Avalere, a health consultancy firm. Low-income people who qualify for full Extra Help can receive premium-free drug coverage, but only in a plan that charges a premium below the regional average. When a drug plan's premium rises above that average, which is reset every year, the Centers for Medicare Medicaid Services reassigns most Extra Help recipients in that plan to a new drug plan with a premium below the average. Because reassignment is random, and plans vary greatly in the drugs they cover and the coverage restrictions they impose, low-income people will face new coverage restrictions under their new plan. In all but one state, Wisconsin, the number of drug plan offerings for low-income Medicare enrollees decreased. In six states – Arizona, Florida, Hawaii, Maine, Nevada and New Hampshire – there will be five or fewer drug plans available to automatically enroll low-income people with Medicare in 2009. Nevada will have only one drug plan for those people automatically reassigned by CMS, eliminating any choice of stand-alone drug plans for low-income enrollees unless individuals can pay for part of the premium cost from their limited incomes. Arizona has the second fewest options for low-income enrollees, with only two zero-premium drug plans for Extra Help recipients. Humana completely withdrew from the low-income market, offering no plans with premiums below the benchmark. However, United Healthcare increased the number of PDPs it will offer to low-income people with Medicare after it lost nearly 600,000 low-income enrollees last year. The number of people reassigned by CMS has increased annually since Part D went into effect in 2006. In 2007 CMS
Re: [QUAD-L] Re: Medicare Racketeers
If Canadian or British health care was based on Medicare as a model, they would both have a surplus. Nobody ever wants to discuss Germany's healthcare or Sweden, or Denmark, or even Japan. These are all successful and their life expectancy is higher than Americans. America is the only country where a triage question includes insurance type. To say socialized medicine doesn't work is simply denying reality. A major outlay of funds for hospitals is to keep huge legal staffs on hand, not just for lawsuits, but to find new ways to force money out of insurance and Medicare. Insurance companies and Medicare hire lawyers to avoid paying medical costs and create new codes every few years so nobody understands them in time to bill them properly for 6 months. With all the lawyers involved, how about we cut all health care payments to lawyers by 10 percent until the budget is balanced. I also think a jury should be able to fine people and their lawyers that bring frivolous lawsuits against Dr.s and hospitals. Ask any doctor and they will tell you that malpractice insurance is a major health care cost. we are at a point where we will need to decide if we want a healths system or feed an insurance parasite. Some studies have concluded that between 40-65 percent of health care is just insurance. We are SHEEP! john - Original Message From: [EMAIL PROTECTED] [EMAIL PROTECTED] To: quad-list@eskimo.com Sent: Saturday, June 28, 2008 9:57:00 AM Subject: Re: [QUAD-L] Re: Medicare Racketeers Back in the 1960s, Claude Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies. The government followed his advice, leading to his modern-day moniker: the father of Quebec medicare. Even this title seems modest; Castonguay's work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast. Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in crisis. We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it, says Castonguay. But now he prescribes a radical overhaul: We are proposing to give a greater role to the private sector so that people can exercise freedom of choice. Canadian-Health-Care Einstein once said The height of insanity is doing the same thing over and over again and expecting different results. Both the Canadian and the British national health care systems are literally medical disasters--and also monetary black holes. Plus they are losing all of their finest doctors who don't want to work for peanuts. Those who can afford it, seek medical care out of country. The US life expectancy just increased to 78 years; Canada's fell to 75 years and Britain's to 73 years. Does this not tell you that we are doing something right? In a message dated 6/27/2008 9:35:17 P.M. Eastern Daylight Time, [EMAIL PROTECTED] writes: Bad news for persons with disabilities and elderly. In July 1, doctors will get a 10 percent payment cut, a disaster for both patients and doctors that the bill would have averted. None of the senators' excuses for this vote hold water: The bill was a partisan exercise. Not so. The bill passed 355 to 59, a veto-proof majority, in the House of Representatives. More Republicans voted for HR. 6331 than against it. President Bush would have vetoed it anyway. So what? If enough Republican senators put the interests of people with Medicare ahead of their loyalty to President Bush, there would have been enough votes to override a veto in the Senate. Senators will be back home attending fundraisers and marching in Independence Day parades. We need to tell them to show a little more independence from President Bush and a little more backbone to the insurance company lobbyists. Medicare belongs to the American people. It is not a racket for the insurance industry. Asclepios Your Weekly Medicare Consumer Advocacy Update Medicare Racketeers June 27, 2008; Volume 8, Issue 26 The Medicare bill defeated in the Senate last night would have improved coverage for mental health and preventive services and helped pay medical and drug costs for more people with Medicare living on fixed incomes. The Bush administration objected to these improvements, which were paid for with a modest cut to some of the excessive subsidies Medicare pays to insurance companies. Administration officials opposed this reduction in subsidies, they claim, because it would result in reduced benefits for people with Medicare enrolled in private health
Re: [QUAD-L] Re: Medicare Racketeers
Back in the 1960s, Claude Castonguay chaired a Canadian government committee studying health reform and recommended that his home province of Quebec — then the largest and most affluent in the country — adopt government-administered health care, covering all citizens through tax levies. The government followed his advice, leading to his modern-day moniker: the father of Quebec medicare. Even this title seems modest; Castonguay's work triggered a domino effect across the country, until eventually his ideas were implemented from coast to coast. Four decades later, as the chairman of a government committee reviewing Quebec health care this year, Castonguay concluded that the system is in crisis. We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it, says Castonguay. But now he prescribes a radical overhaul: We are proposing to give a greater role to the private sector so that people can exercise freedom of choice. _Canadian-Health-Care_ (http://www.ibdeditorials.com/IBDArticles.aspx?id=299282509335931) Einstein once said The height of insanity is doing the same thing over and over again and expecting different results. Both the Canadian and the British national health care systems are literally medical disasters--and also monetary black holes. Plus they are losing all of their finest doctors who don't want to work for peanuts. Those who can afford it, seek medical care out of country. The US life expectancy just increased to 78 years; Canada's fell to 75 years and Britain's to 73 years. Does this not tell you that we are doing something right? In a message dated 6/27/2008 9:35:17 P.M. Eastern Daylight Time, [EMAIL PROTECTED] writes: Bad news for persons with disabilities and elderly. In July 1, doctors will get a 10 percent payment cut, a disaster for both patients and doctors that the bill would have averted. None of the senators' excuses for this vote hold water: The bill was a partisan exercise. Not so. The bill passed 355 to 59, a veto-proof majority, in the House of Representatives. More Republicans voted for HR. 6331 than against it. President Bush would have vetoed it anyway. So what? If enough Republican senators put the interests of people with Medicare ahead of their loyalty to President Bush, there would have been enough votes to override a veto in the Senate. Senators will be back home attending fundraisers and marching in Independence Day parades. We need to tell them to show a little more independence from President Bush and a little more backbone to the insurance company lobbyists. Medicare belongs to the American people. It is not a racket for the insurance industry. Asclepios Your Weekly Medicare Consumer Advocacy Update Medicare Racketeers June 27, 2008; Volume 8, Issue 26 The Medicare bill defeated in the Senate last night would have improved coverage for mental health and preventive services and helped pay medical and drug costs for more people with Medicare living on fixed incomes. The Bush administration objected to these improvements, which were paid for with a modest cut to some of the excessive subsidies Medicare pays to insurance companies. Administration officials opposed this reduction in subsidies, they claim, because it would result in reduced benefits for people with Medicare enrolled in private health plans offered by these companies. Translation: No one gets better Medicare benefits unless our pals in the insurance industry get a cut off the top. It's as if the Medicare program had been taken over by Mafia goons. Numerous independent, nonpartisan studies have shown it cost taxpayers substantially more—about $1,000 a head, according to one study—to provide coverage through a Medicare private health plan instead of through Original Medicare. Just this week, the Government Accountability Office reported that, in 2005, insurance companies pocketed as profit $1.14 billion in subsidies that the companies had told Medicare would go toward medical benefits. Last night, 39 Republican senators joined President Bush in opposing HR. 6331, the Medicare Improvements for Patients and Providers Act. As a result, the benefit improvements in HR. 6331 will not take effect, and on July 1, doctors will get a 10 percent payment cut, a disaster for both patients and doctors that the bill would have averted. None of the senators' excuses for this vote hold water: The bill was a partisan exercise. Not so. The bill passed 355 to 59, a veto-proof majority, in the House of Representatives. More Republicans voted for HR. 6331 than against it. President Bush would have vetoed it anyway. So what? If enough Republican senators put the interests of people with Medicare ahead of their loyalty to President Bush, there would have been enough votes to
[QUAD-L] Re: Medicare Racketeers
Editorial Worlds Best Medical Care? Published: August 12, 2007 Many Americans are under the delusion that we have the best health care system in the world, as President Bush sees it, or provide the best medical care in the world, as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care. Michael Moore struck a nerve in his new documentary, Sicko, when he extolled the virtues of the government-run health care systems in France, England, Canada and even Cuba while deploring the failures of the largely private insurance system in this country. There is no question that Mr. Moore overstated his case by making foreign systems look almost flawless. But there is a growing body of evidence that, by an array of pertinent yardsticks, the United States is a laggard not a leader in providing good medical care. Seven years ago, the World Health Organization made the first major effort to rank the health systems of 191 nations. France and Italy took the top two spots; the United States was a dismal 37th. More recently, the highly regarded Commonwealth Fund has pioneered in comparing the United States with other advanced nations through surveys of patients and doctors and analysis of other data. Its latest report, issued in May, ranked the United States last or next-to-last compared with five other nations Australia, Canada, Germany, New Zealand and the United Kingdom on most measures of performance, including quality of care and access to it. Other comparative studies also put the United States in a relatively bad light. Insurance coverage. All other major industrialized nations provide universal health coverage, and most of them have comprehensive benefit packages with no cost-sharing by the patients. The United States, to its shame, has some 45 million people without health insurance and many more millions who have poor coverage. Although the president has blithely said that these people can always get treatment in an emergency room, many studies have shown that people without insurance postpone treatment until a minor illness becomes worse, harming their own health and imposing greater costs. Access. Citizens abroad often face long waits before they can get to see a specialist or undergo elective surgery. Americans typically get prompter attention, although Germany does better. The real barriers here are the costs facing low-income people without insurance or with skimpy coverage. But even Americans with above-average incomes find it more difficult than their counterparts abroad to get care on nights or weekends without going to an emergency room, and many report having to wait six days or more for an appointment with their own doctors. Fairness. The United States ranks dead last on almost all measures of equity because we have the greatest disparity in the quality of care given to richer and poorer citizens. Americans with below-average incomes are much less likely than their counterparts in other industrialized nations to see a doctor when sick, to fill prescriptions or to get needed tests and follow-up care. Healthy lives. We have known for years that America has a high infant mortality rate, so it is no surprise that we rank last among 23 nations by that yardstick. But the problem is much broader. We rank near the bottom in healthy life expectancy at age 60, and 15th among 19 countries in deaths from a wide range of illnesses that would not have been fatal if treated with timely and effective care. The good news is that we have done a better job than other industrialized nations in reducing smoking. The bad news is that our obesity epidemic is the worst in the world. Quality. In a comparison with five other countries, the Commonwealth Fund ranked the United States first in providing the right care for a given condition as defined by standard clinical guidelines and gave it especially high marks for preventive care, like Pap smears and mammograms to detect early-stage cancers, and blood tests and cholesterol checks for hypertensive patients. But we scored poorly in coordinating the care of chronically ill patients, in protecting the safety of patients, and in meeting their needs and preferences, which drove our overall quality rating down to last place. American doctors and hospitals kill patients through surgical and medical mistakes more often than their counterparts in other industrialized nations. Life and death. In a comparison of five countries, the United States had the best survival rate for breast cancer, second best for cervical cancer and childhood leukemia, worst for kidney transplants, and almost-worst for liver transplants and colorectal cancer. In an eight-country comparison, the United States ranked last in years of potential life lost to circulatory diseases, respiratory
[QUAD-L] Re: Medicare Racketeers
Bad news for persons with disabilities and elderly. In July 1, doctors will get a 10 percent payment cut, a disaster for both patients and doctors that the bill would have averted. None of the senators' excuses for this vote hold water: The bill was a partisan exercise. Not so. The bill passed 355 to 59, a veto-proof majority, in the House of Representatives. More Republicans voted for HR. 6331 than against it. President Bush would have vetoed it anyway. So what? If enough Republican senators put the interests of people with Medicare ahead of their loyalty to President Bush, there would have been enough votes to override a veto in the Senate. Senators will be back home attending fundraisers and marching in Independence Day parades. We need to tell them to show a little more independence from President Bush and a little more backbone to the insurance company lobbyists. Medicare belongs to the American people. It is not a racket for the insurance industry. Asclepios Your Weekly Medicare Consumer Advocacy Update Medicare Racketeers June 27, 2008; Volume 8, Issue 26 The Medicare bill defeated in the Senate last night would have improved coverage for mental health and preventive services and helped pay medical and drug costs for more people with Medicare living on fixed incomes. The Bush administration objected to these improvements, which were paid for with a modest cut to some of the excessive subsidies Medicare pays to insurance companies. Administration officials opposed this reduction in subsidies, they claim, because it would result in reduced benefits for people with Medicare enrolled in private health plans offered by these companies. Translation: No one gets better Medicare benefits unless our pals in the insurance industry get a cut off the top. It's as if the Medicare program had been taken over by Mafia goons. Numerous independent, nonpartisan studies have shown it cost taxpayers substantially more—about $1,000 a head, according to one study—to provide coverage through a Medicare private health plan instead of through Original Medicare. Just this week, the Government Accountability Office reported that, in 2005, insurance companies pocketed as profit $1.14 billion in subsidies that the companies had told Medicare would go toward medical benefits. Last night, 39 Republican senators joined President Bush in opposing HR. 6331, the Medicare Improvements for Patients and Providers Act. As a result, the benefit improvements in HR. 6331 will not take effect, and on July 1, doctors will get a 10 percent payment cut, a disaster for both patients and doctors that the bill would have averted. None of the senators' excuses for this vote hold water: The bill was a partisan exercise. Not so. The bill passed 355 to 59, a veto-proof majority, in the House of Representatives. More Republicans voted for HR. 6331 than against it. President Bush would have vetoed it anyway. So what? If enough Republican senators put the interests of people with Medicare ahead of their loyalty to President Bush, there would have been enough votes to override a veto in the Senate. Next week, these senators will be back home attending fundraisers and marching in Independence Day parades. We need to tell them to show a little more independence from President Bush and a little more backbone to the insurance company lobbyists. Medicare belongs to the American people. It is not a racket for the insurance industry. Medical Record Senate vote to invoke Cloture on the Motion to Proceed on HR. 6331 fell short of the 60 votes needed. Yea votes indicate support for passage of HR. 6331. No votes indicate opposition. Majority Leader Harry Reid, Democrat of Nevada, voted No to preserve the right to bring the bill up for a vote again (Roll Call vote on HR. 6331 (http://www.kintera.org/TR.asp?a=hhKWI5OFLdIPKcJs=qtJ3JcMJJbKWJ7MSFm=guKSIaMVKkL2Faf=y), June 2008). On average, [Medicare Advantage] organizations' self-reported actual profit margin was 5.1 percent of total revenue, which is approximately $1.14 billion more in profits in 2005 than [Medicare Advantage] organizations projected (Medicare Advantage Organizations: Actual Expenses and Profits Compared to Projections for 2005 (http://www.kintera.org/TR.asp?a=kkI2JePRKgLWImIs=qtJ3JcMJJbKWJ7MSFm=guKSIaMVKkL2Faf=y), Government Accountability Office, June 2008). I am an elder advocate with an Area Agency on Aging. Even though several Medicare Advantage plans, including four PFFS plans, are listed as plans accepted in our county, that is actually not the case. Once a beneficiary enrolls in one of these Advantage plans, they find out that providers in this county actually do not accept the plans. If the beneficiary cannot see a provider in this county, they are forced to leave the county to find providers. Some have to
Re: [QUAD-L] Re: Medicare Racketeers
wat danar u drinkin the kool-aid? Eric W Rudd [EMAIL PROTECTED] - Original Message - From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] ; quad-list@eskimo.com Sent: Friday, June 27, 2008 8:34 PM Subject: [QUAD-L] Re: Medicare Racketeers Bad news for persons with disabilities and elderly. In July 1, doctors will get a 10 percent payment cut, a disaster for both patients and doctors that the bill would have averted. None of the senators' excuses for this vote hold water: The bill was a partisan exercise. Not so. The bill passed 355 to 59, a veto-proof majority, in the House of Representatives. More Republicans voted for HR. 6331 than against it. President Bush would have vetoed it anyway. So what? If enough Republican senators put the interests of people with Medicare ahead of their loyalty to President Bush, there would have been enough votes to override a veto in the Senate. Senators will be back home attending fundraisers and marching in Independence Day parades. We need to tell them to show a little more independence from President Bush and a little more backbone to the insurance company lobbyists. Medicare belongs to the American people. It is not a racket for the insurance industry. Asclepios Your Weekly Medicare Consumer Advocacy Update Medicare Racketeers June 27, 2008; Volume 8, Issue 26 The Medicare bill defeated in the Senate last night would have improved coverage for mental health and preventive services and helped pay medical and drug costs for more people with Medicare living on fixed incomes. The Bush administration objected to these improvements, which were paid for with a modest cut to some of the excessive subsidies Medicare pays to insurance companies. Administration officials opposed this reduction in subsidies, they claim, because it would result in reduced benefits for people with Medicare enrolled in private health plans offered by these companies. Translation: No one gets better Medicare benefits unless our pals in the insurance industry get a cut off the top. It's as if the Medicare program had been taken over by Mafia goons. Numerous independent, nonpartisan studies have shown it cost taxpayers substantially more—about $1,000 a head, according to one study—to provide coverage through a Medicare private health plan instead of through Original Medicare. Just this week, the Government Accountability Office reported that, in 2005, insurance companies pocketed as profit $1.14 billion in subsidies that the companies had told Medicare would go toward medical benefits. Last night, 39 Republican senators joined President Bush in opposing HR. 6331, the Medicare Improvements for Patients and Providers Act. As a result, the benefit improvements in HR. 6331 will not take effect, and on July 1, doctors will get a 10 percent payment cut, a disaster for both patients and doctors that the bill would have averted. None of the senators' excuses for this vote hold water: The bill was a partisan exercise. Not so. The bill passed 355 to 59, a veto-proof majority, in the House of Representatives. More Republicans voted for HR. 6331 than against it. President Bush would have vetoed it anyway. So what? If enough Republican senators put the interests of people with Medicare ahead of their loyalty to President Bush, there would have been enough votes to override a veto in the Senate. Next week, these senators will be back home attending fundraisers and marching in Independence Day parades. We need to tell them to show a little more independence from President Bush and a little more backbone to the insurance company lobbyists. Medicare belongs to the American people. It is not a racket for the insurance industry. Medical Record Senate vote to invoke Cloture on the Motion to Proceed on HR. 6331 fell short of the 60 votes needed. Yea votes indicate support for passage of HR. 6331. No votes indicate opposition. Majority Leader Harry Reid, Democrat of Nevada, voted No to preserve the right to bring the bill up for a vote again (Roll Call vote on HR. 6331 (http://www.kintera.org/TR.asp?a=hhKWI5OFLdIPKcJs=qtJ3JcMJJbKWJ7MSFm=guKSIaMVKkL2Faf=y), June 2008). On average, [Medicare Advantage] organizations' self-reported actual profit margin was 5.1 percent of total revenue, which is approximately $1.14 billion more in profits in 2005 than [Medicare Advantage] organizations projected (Medicare Advantage Organizations: Actual Expenses and Profits Compared to Projections for 2005 (http://www.kintera.org/TR.asp?a=kkI2JePRKgLWImIs=qtJ3JcMJJbKWJ7MSFm=guKSIaMVKkL2Faf=y), Government Accountability
[QUAD-L] Re: Medicare Privatization in DEEP Trouble
FYI Dear Dana, Back in 2003, when the so-called Medicare Modernization Act was being debated in Congress, we warned that this latest round of Medicare privatization contained severe flaws that would hurt consumers and taxpayers while lining the pockets of special interests. With nearly two years of hindsight, we can safely say we were right: The MMA has been a major disappointment for consumers and taxpayers, but a windfall for private insurance and drug companies. We've laid out the extent of the MMA's failures in a new report: Medicare Privatization: Windfall for the Special Interests. The report chronicles the failures of the MMA in three key areas: Medicare Advantage overpayments, subsidies to regional PPOs, and drug prices. View the report here Among the key findings: Under the MMA, Medicare has been significantly overpaying private plans under Medicare Advantage. In 2005, Medicare overpaid private plans by at least 7% per beneficiary, costing taxpayers: $2.7 billion. In 2006, overpayment reached 11% per beneficiary, costing taxpayers $4.6 billion. Under the MMA, Congress set aside $10 billion for an unnecessary subsidy (or"stabilization fund") to regional PPOs. This year, however, 88% of beneficiaries have access to a regional PPO, before the so-called "stabilization fund" was even tapped--no subsidy was necessary. Medicare Part D drug prices are substantially higher than the prices obtained by the Department of Veterans Affairs (VA), which negotiates prices on behalf of consumers. For all of the top 20 drugs prescribed to seniors, the lowest price charged by any Part D plan was higher than the lowest price secured by the VA. Yet Congress refused to let Medicare negotiate directly with the drug companies, as the VA does. View the report here Bottom line: this report shows that, unfortunately for consumers and taxpayers, the MMA has not even come close to meeting the high expectations set for it by Congress. Consumers are getting hurt and taxpayers fleeced, while insurance companies and drug manufacturers are raking in money faster than they can count it. Congress needs to move away from this deeply flawed privatization model, and instead focus on strengthening Medicare. We urge you to disseminate this report far and wide and to use it aggressively in your advocacy efforts. Luis HestreseAdvocacy Coordinator, Families USA Use the "Tell-a-Friend" link below to spread the word about this new report: Tell-a-friend! If you received this message from a friend, you can sign up for Families USA. This message was sent to [EMAIL PROTECTED] Visit your subscription management page to modify your email communication preferences or update your personal profile. To stop ALL email from Families USA, click to remove yourself from our lists (or reply via email with "remove or unsubscribe" in the subject line). Families USA | 1201 New York Ave., NW, Suite 1100, Washington, DC 20005www.familiesusa.org | [EMAIL PROTECTED]
[QUAD-L] Re: MEDICARE
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[QUAD-L] Re: MEDICARE
Was on Medicaid with SSI. After my dad died I began collecting SSDI since I was injured before age 22. Medicare kicked in 18 months after I began getting SSDI. BillC6 Incomplete since 7/20/68Leesburg, FLStress is when you wake up screaming and then you realize you haven't fallen asleep yet. - Original Message - From: ~LittleQuad~ To: Bill_J Sent: Wednesday, February 22, 2006 7:15 PM Subject: Re: MEDICARE how did you get both??? age plz???Bill_J [EMAIL PROTECTED] wrote: Medicare and Medicaid here. BillC6 Incomplete since 7/20/68Leesburg, FLStress is when you wake up screaming and then you realize you haven't fallen asleep yet. - Original Message - From: ~LittleQuad~ To: Quad-list post Sent: Wednesday, February 22, 2006 12:45 PM Subject: [QUAD-L] MEDICARE How many of you are on Medicare and Medicaid?
[QUAD-L] Re: MEDICARE
I'm 55. BillC6 Incomplete since 7/20/68Leesburg, FLStress is when you wake up screaming and then you realize you haven't fallen asleep yet. - Original Message - From: ~LittleQuad~ To: Bill_J Sent: Wednesday, February 22, 2006 7:15 PM Subject: Re: MEDICARE how did you get both??? age plz???Bill_J [EMAIL PROTECTED] wrote: Medicare and Medicaid here. BillC6 Incomplete since 7/20/68Leesburg, FLStress is when you wake up screaming and then you realize you haven't fallen asleep yet. - Original Message - From: ~LittleQuad~ To: Quad-list post Sent: Wednesday, February 22, 2006 12:45 PM Subject: [QUAD-L] MEDICARE How many of you are on Medicare and Medicaid?
[QUAD-L] Re: MEDICARE
I have both Medicare and Medicaid ever since I've been hurt. Well it was started right after my primary Insurance paid all my hospital bills while I was there at Santa Clara Valley Medical Center here in California.Chet ( Cquad7 ) Brings words and photos together (easily) with PhotoMail - it's free and works with Yahoo! Mail.
Re: [QUAD-L] Re Medicare
Hi Stacy, I buy my meds now so I'm hoping that with the increase of volume in sales that the prices will go down. I'm hoping but will believe it when I see it. I don't understandwhy the government didn't tell the pharmaceutical companiesthat unless they sold their meds at a set discountrate, the government would buy elsewhere. Guess that would have been too easy. With Love, CtrlAltDel aka DaveC4/5 Complete - 29 Years PostTexas, USA Stacy Harim [EMAIL PROTECTED] wrote: How is everyone gonna handle the new law starting next year when you have to buy scripts. It's even going for some on Medicaid if they have Medicare as well. Stacy - Original Message - From: [EMAIL PROTECTED] To: quad-list@eskimo.com Sent: Sunday, May 08, 2005 2:11 AM Subject: [QUAD-L] Re Medicare Well re: Medicare being pushed on us...seems it is automatic after you've been disabled 2 years whether you want it or not. John did a lot better just having his High risk private pay Insurance thru the state of KY along with Medicaid than he does now with Medicare. Because everyone else follows Medicare rules.Whe he didn't have Medicare he could get a lot more things and most of his prescriptions were just $1.00. Medicaid pays what the insurance Co. doesn't but now we have to go by what Medicare allows and there is a lot of stuff they won't pay for. And attendant care is one thing they DON'T pay for.Carol
Re: [QUAD-L] Re Medicare
How is everyone gonna handle the new law starting next year when you have to buy scripts. It's even going for some on Medicaid if they have Medicare as well. Stacy - Original Message - From: [EMAIL PROTECTED] To: quad-list@eskimo.com Sent: Sunday, May 08, 2005 2:11 AM Subject: [QUAD-L] Re Medicare Well re: Medicare being pushed on us...seems it is automatic after you've been disabled 2 years whether you want it or not. John did a lot better just having his High risk private pay Insurance thru the state of KY along with Medicaid than he does now with Medicare. Because everyone else follows Medicare rules.Whe he didn't have Medicare he could get a lot more things and most of his prescriptions were just $1.00. Medicaid pays what the insurance Co. doesn't but now we have to go by what Medicare allows and there is a lot of stuff they won't pay for. And attendant care is one thing they DON'T pay for.Carol
Re: [QUAD-L] Re Medicare
I'm a dual eligible and losing Medicaid prescription drug coverage and getting switched to Medicare drug coverage is going to be a nightmare. Hopefully there will be a plan that covers all my medications. If a plan that covers all your medications doesn't exis, what do you think is our government's brilliant idea is? Talk to your doctor about switching medications! Stacy Harim wrote: How is everyone gonna handle the new law starting next year when you have to buy scripts. It's even going for some on Medicaid if they have Medicare as well.
