Once again lobbyists for the health insurance industry have gotten their way.
It is impossible to miss or ignore all of the commercials on television touting the Medicare plus plans. They go by many different names but are basically plans that claim to offer seniors more services than traditional Medicare plans. They usually offer some dental coverage and perhaps coverage for eyeglasses for the same cost as Medicare alone. That sounds like a winner.
What do they really offer?
First, they get the premium from Medicare that one usually pays. Are they so much more efficient than Medicare that they can include more services for the same premium? Not really.
Medicare not only gives them the regular premium but, on average, an additional $1,100. Ten million of the 40 million people on Medicare have bought into these plans. $1,100 times 10 million equals $11 billion. That is, Medicare is paying the insurance companies all of the premiums plus $11 billion. The commercials also fail to mention the co-pays.
Another little problem is that the companies squeeze the physicians and hospitals. There have been loud and constant complaints since the inception of Medicare from those two groups about the inadequacy of their remuneration. The insurance companies offer to reduce that even further.
Many physicians and hospitals find the offered compensation unacceptable. If your preferred physician or hospital refuses to accept the insurance company’s terms, you either go looking for an alternative or fork over the difference.
To let the reader know where I am coming from, I admit to being on Medicare and having had 31 physicians in the past 4-plus years. Signing up with one of these insurance companies would mean having to contact each one to confirm whether they had agreed to accept that company’s terms. How many alternate providers would I likely have to find? For some reason the commercials fail to cover that point. Perhaps it’s that there isn’t sufficient time.
Medicare, the other 30 million people on Medicare, the physicians, the hospitals and the taxpayer are subsidizing the insurance companies and those they have signed up.
Is it possible that the glut of commercials is a rough measure of how profitable these plans are to the insurance companies? I’m not going to attempt to quantify the value of the premiums, the co-pays and the reduced reimbursement to physicians and hospitals. That $11 billion alone might be adequate incentive.
The original promise was that these plans would provide more and better service to seniors at less cost. It hasn’t quite worked out that way. Studies have shown that those signed up for these plans are not receiving better service despite the additional costs. Adding in the co-pays means that seniors, as well as Medicare, are paying more. Seniors not signed on to these plans are paying higher premiums to subsidize the others that $11 billion.
Thankfully, President-Elect Obama and Tom Daschle, his nominee for Secretary of Health and Human Services, have indicated that this program is a probable target for elimination. In the meantime, warn any geezers you know to avoid those plans like the plague.
Something is wrong. It feels strange for one of my posts to end on an up beat.
{ 1 comment }
Awesome post, will be a daily visitor from now on!
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