Monday, February 22, 2010

About Those Medicare Advantage Plans and Me

AboutMost of you probably know that our government pays more per beneficiary to private insurance companies to provide Medicare Advantage plans than it spends per person on original Medicare.
Medicare In October 2009, here's how Sen. Jay Rockefeller described the Medicare Advantage plans:
"It's a wasteful, inefficient program and always has been," Sen. John D. Rockefeller IV (D-W.Va.) said at a recent hearing. At its core, Rockefeller added, Medicare Advantage is "stuffing money into the pockets of private insurers, and it doesn't provide any better benefits to anybody."
Yes, the for-profit add-on plans the Republicans pushed through under Bush heavily subsidize services. (So much for "pay as you go," huh?)
A study released yesterday by a major consulting firm found that premiums for Medicare Advantage plans offering medical and prescription-drug coverage jumped 14.2 percent on average in 2010, after an increase of 5.2 percent the previous year. Some 8.5 million elderly and disabled Americans are in the plans, which provide more comprehensive coverage than traditional Medicare, often at lower cost.
Lee Durrwachter, a retired chemical engineer from Grand Marais, Mich., said his premiums more than doubled this year - even though he switched plans to try to save money. "It doesn't bode well," he said. "It's unaffordable."
The Medicare findings are bad news for President Obama and his health-care overhaul that is bogged down in Congress. That is because the higher Medicare Advantage premiums for 2010 followed a cut in government payments to the private plans last year. And the Democratic bills pending in Congress call for even more cuts, which are expected to force many seniors to drop out of what has been a rapidly growing alternative to traditional Medicare.
Republicans have seized on the Medicare Advantage cuts in their campaign to derail the health-care bills, and seniors are listening. Polls show seniors are more skeptical of the legislation than the public as a whole, even though Democrats would also reinforce original Medicare by improving preventive benefits and narrowing the prescription-coverage gap.
… [emphasis original]
Inserted from <Crooks and Liars>
In the interest of full disclosure, let men begin by saying that I subscribe to a Medicare Advantage plan.
Rockefeller’s statement is incorrect.  My plan offers many preventive services that traditional Medicare does not cover,  I can’t speak for other plans, but the increase in premium for my plan was 5.4%.  Of course, I do not (and would not use) one of the giant killer companies like Cigna or Wellpoint.  I use Providence, a local Oregon company.  Other than guilt over the destruction of half a rainforest to make the endless stream of paperwork I receive from them, I’m thoroughly satisfied with their service.
While I agree that government ought not to give Medicare Advantage plans an unfair advantage, I justify my own participation, because I was denied health care for years while the Social Security Administration unjustly denied my disability claim.  I need the additional services just to make my health care current after years of enforced neglect, so I figure I have it coming.  I do support cutting payments to private insurers’ Medicare Advantage plans to the same level that government spends on Medicare.  While that may be against my own self-interest, I am not so hypocritical as to support policies for my personal benefit over the good of the nation as a whole.  However, including more preventive services in traditional Medicare and closing the prescription coverage gap are necessary reforms.


the walking man said...

I was forced into an advantage plan as a part of my group coverage. I don't know what will happen this year with the premiums but like you tom the increases of this locally run plan have been marginal enough.

Most of this whole controversy over health care reform seems to me to be stuck on them forced to buy individual policies as opposed to group coverage. If we can't have single payer them I do believe the majority of reform should be focused on them in the individual market while holding the line on costs for groups.

Groups are a guaranteed source of income and little of the rescission happens in them. If they make the law such that I will not lose medical coverage through my group for any reason existing or emerging then I would willingly pay a marginal tax on ,my group plan IF it goes to make insurance more affordable for them who are forced into the individual market.

Lisa G. said...

I am too young for Medicare so I know virtually nothing about it. Seems to me that you would need a masters degree just to pick your plan from basic Medicare.

I hope that HCR will make it better for all of us. Otherwise, my husband will be working until I qualify for Medicare which is a long way off.

TomCat said...

Mark, I like what you have to say on this. It makes perfect sense.

Lisa, in my case, making the choice took over 30 hours of online research. I found a few plans with comparable benefits costing slightly less, but they were companies with whom I could not do business in good conscience. I hope so too, Lisa. Nobody should have to go through what I did for six years.