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Re: Note to Seniors from Dems

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Message 1 of 68

@MaVolta wrote:

@GailL1 wrote:

 

Medicare Advantage plans have a pretty high deductible and out of pocket cost - they also work in networks, with plenty of services which have to be pre-approved for coverage.  They use step therapy.  But here again, they also offer other services not offered in traditional Medicare.  Medicare has to approve each of these designs - the reason we have Medicare Advantage plans is it is a way to manage the care of these beneficiaries.  For the areas that have this option, seniors are opting for them and that % is growing.  Ever ask yourself WHY?

 


MA works very well for a lot of people. I do not have a high deductible and my co-pays, including drug co-pays, are very reasonable. There is a large network here, and both HMO ($0 premium) and PPO ($15/mo on drugs) are available. It includes far more than Medicare. My total expenses for the year are waaaaay less than I'd pay for a Medicare supplement.

 

While MFA would cover everything (great! I like that), it's hard for me to wrap my head around paying for a program where estimates run from $33 trillion to $40 trillion (does anyone really know?) Assuming Trump leaves office in 2020, the national debt will be over $23 trillion, and we still have climate change, infrastructure, cyber security, homeland security, and all those things $$$$$$$$$$$$$$ to deal with. How far can we tax our way out of it? 


Keep in mind the Advantage plans were created to bring Insurance Cos. into the basic medicare mix. Medicare pays a private insurance co. the average amount of money it spends on loss payments to a person on medicare plus at the start something like 15 to 20% more (I forget the exact %). The ACA was dropping that payment to 0% over a time period. I think it could be down to 10 to 12% now. (Some one can look it up). That means the total cost of Medicare went up for everyone, but they do not realize it. The Carrier had a  good bit of money to play with and still make a profit due to the increase in payment they got. Now the Insurance Co has to add some additional benefits. What the Carriers do is add gym membership, discount programs, dental, drug etc. A lot of the added benefits cost the carrier nothing as they already use them in their group insurance programs programs. You find adv programs mostly in cities or populated areas. The Carrier can add them to a Co insurance program for retires. The one difference is a provider does not have to accept the Adv program if they choose. They have to accept medicare. They can work fine for some people, but all should keep in mind they increase the cost of  Medicare to all even though all can not have them.

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Re: Note to Seniors from Dems

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Message 2 of 68

@GailL1 wrote:

 

Medicare Advantage plans have a pretty high deductible and out of pocket cost - they also work in networks, with plenty of services which have to be pre-approved for coverage.  They use step therapy.  But here again, they also offer other services not offered in traditional Medicare.  Medicare has to approve each of these designs - the reason we have Medicare Advantage plans is it is a way to manage the care of these beneficiaries.  For the areas that have this option, seniors are opting for them and that % is growing.  Ever ask yourself WHY?

 


MA works very well for a lot of people. I do not have a high deductible and my co-pays, including drug co-pays, are very reasonable. There is a large network here, and both HMO ($0 premium) and PPO ($15/mo on drugs) are available. It includes far more than Medicare. My total expenses for the year are waaaaay less than I'd pay for a Medicare supplement.

 

While MFA would cover everything (great! I like that), it's hard for me to wrap my head around paying for a program where estimates run from $33 trillion to $40 trillion (does anyone really know?) Assuming Trump leaves office in 2020, the national debt will be over $23 trillion, and we still have climate change, infrastructure, cyber security, homeland security, and all those things $$$$$$$$$$$$$$ to deal with. How far can we tax our way out of it? 

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Re: Note to Seniors from Dems

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Message 3 of 68

Just a few more thoughts for all. 1. Long Term Care Insurance - This is part of our expenses for health care. It is a separate area for insurance due to what it covers which is mostly  total living expenses. It is that area the generates a lot of the cost. It can be from home care, to living in apts, or bed ridden as in a hospital. Few buy it, but most who do use it so the cost is high. If it were part of a medicare  for all plan and all paid into it the cost would come down. Most people who use it now get it through the VA or Medicaid. The spend down requirements can be moved around and that is why there are lawyers who are in the business. In the end we are all paying for it now in taxes as few using it pay all the true costs.

2. In medical insurance you get the cheapest costs when everyone is in the pool. Medicare needs 2 or 3% more than what they pay out for losses. Insurance Cos. want around 40% or more (ACA capped them at 20%). I have seen Insurance Cos. want to make 18% profit on this line(that included income from Reserves like loss, IBNR, etc).

3. Medicare for all approach using a trust fund could allow for other sources of money. Tobacco Cos. pay money to states etc for damage their products cause people health. States use this money as part of the general fund (health care money supporting things like pre school educ.) That money could go to the Trust fund and help offset health care costs. Other items like this are auto accidents, chemicals hurting people, etc. There are experts who could really work these areas big time.

4. Medicare already sets what it will pay providers, and you expand that to costs in the entire system. It will work as it does now, and you will have the very few that will not accept payments. The payments should be fair.

5. Look at holding Cos. for Hospitals. There is a problem in that area. High salaries for exc is one of them. We might break that up by going for a locally owned hospital non profit. We have one where I live and it does a great job.

6. What is covered by Insurance now is controlled by each state so if you think you can choose what you want dream on. In group Insurance from employer the employer takes the plan or plans they want to pay for from the Insurance Co. The employees has no say in what is offered, they might have some choices within the plans.

 

As I have said before you have to look at the entire system not just the insurance end. Last but not least this is a very complicated area, and few have any idea of how it really works. There are experts in this country who can fix this area if they are used. The end result will be a medicare for all  type plan, and it will come in to operation by building on the ACA if Trump does not destroy the ACA.

The first step is to not vote for Trump or anyone with an R behind their name.

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Re: Note to Seniors from Dems

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Message 4 of 68

   If there is a will there is a way...and GOP say no-way.

 

   The primary health insurance coverage reforms of the Affordable Care Act took effect on January 1, 2014. Between 2013 and 2016, the uninsurance rate for nonelderly Americans from birth to age 64 fell every year, and 18.5 million more Americans had health insurance coverage in 2016 than in 2013. However, these coverage gains stalled in 2017. Using the American Community Survey, we find that uninsurance increased by 0.2 percentage points between 2016 and 2017 despite a strong economy, meaning 700,000 more uninsured Americans. Increases in uninsurance were concentrated in states that did not expand Medicaid eligibility under the Affordable Health Care Act.

 

Urban Institute

PRO-LIFE is Affordable Healthcare for ALL .
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Re: Note to Seniors from Dems

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Message 5 of 68

@gordyfl wrote:

Canadian emergency room...

 

 

 

_______________________________

Are you now endorsing the UK system - basically where the government owns the medical infrastructure and providers work for the government.

 

______________________

 

The video was a hospital waiting room in Canada. But since you brought up the UK....

 

A young American woman in the UK needed emergency care while she was in the UK.

 

Here is her story....

 

https://twitter.com/_geeky_cat_/status/1160942754169544706


Here's the bottom line that Regressives pretend does not exist:

AFFORDABLE UNIVERSAL HEALTH CARE IS A RIGHT OF EVERY CITIZEN OF EVERY DEMOCRACY EXCEPT THE USA.

 

While it is true Regressives are too ignorant to provide such a system (they can't even improve Obamacare) it is FALSE that such a system cannot be provided to all Americans - first we have to get rid of the Republicans who are sworn to keep it from happening.

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Re: Note to Seniors from Dems

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Message 6 of 68

Canadian emergency room...

 

 

 

_______________________________

Are you now endorsing the UK system - basically where the government owns the medical infrastructure and providers work for the government.

 

______________________

 

The video was a hospital waiting room in Canada. But since you brought up the UK....

 

A young American woman in the UK needed emergency care while she was in the UK.

 

Here is her story....

 

https://twitter.com/_geeky_cat_/status/1160942754169544706

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Re: Note to Seniors from Dems

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Message 7 of 68

Seems the real problem is Regressives not recognizing Corporations are creatures of Government, created to serve the common good. Should they no longer serve the interests of We the People, they can be disbanded as easily as they were incorporated. Likewise the Government protection of their products (patents) can be revoked if they continue to be used to milk the public.

 

Medicare overhead runs at 2% of their operating costs. Private Insurance is at or above 20% and the insurance industry rakes in hundreds of billions in profits each year while the Government Option needs to just break even.

 

As for what the care providers will accept, once again they operate at the sufferance of We the People, and if they can't accept a reasonable profit, then they can be replaced by an organization that will, such as the Public Option.

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Re: Note to Seniors from Dems

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Message 8 of 68

@gordyfl 

 

Are you now endorsing the UK system - basically where the government owns the medical infrastructure and providers work for the government.

 

There are many different healthcare systems in the world - but NONE of them provide for as big a population or in as vast geographical area as the U.S.

Since health care is pretty local most of the time - those two things matter a whole lot.  

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Note to Seniors from Dems

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Message 9 of 68

Back to the Long Term Care part of the discussion -

 

if if we ever need such - it is available.

We can pay out of pocket for those who have the funds or the assets -

We can buy LTC insurance to pick up some of the cost

Some can utilize the VA - veterans and widows

For those with limited or no funds or assets - there is Medicaid 

 

Do you know about Fillial Laws?

There are still about 29 states where these laws are on the books - each varies a bit from one another.

The Balance - 10/08/2018 - How Fillial Responsibility is Defined

 

So if under the right circumstances - your kids could pay for it.

 

A person who has accumulated some wealth and/or assets needs to spend it on their own care.

 

If their home is all that remains and there is no spouse or dependent child or dependent adult - Medicaid just gets a payback from the home when it is sold in many states after the person's death.  Whatever might be left over, if any, goes to the estate.

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: Note to Seniors from Dems

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Message 10 of 68

@Olderscout66 

 

Why do you think that a publix option would be that much cheaper?

The plan would still have to negotiate with the same medical services in an area to build up their network of provider.  if insurers are paying a higher rate, why would you think the providers would take a lower government (Publix option) rate?

 

Washington state just passed their Publix option to begin in a few years - they estimate that they will have to pay providers at least 160% of the Medicare rate or higher.  They are saying that their Publix option would be about 5 % cheaper in premium cost, THEY HOPE!  

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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