Do you feel we should end Medicare, Social Security and Medicaid?

[Too Tall]

.

Yes, we should end Medicare and Medicaid. They should be replaced with (1) a Medicare-For-All health care delivery chassis that provides low-cost or no-cost preventive and diagnostic services to keep the populace healthier and therefore dramatically reduce the overall cost of health care delivery in America, (2) a robust and competitive free market-based insurance supplement menu based roughly on the current Medicare Supplement and Medicare Advantage systems, opening up a massive 300 million-plus market to the insurance companies at lower operating costs due to (1), (3) the creation and utilization of other obvious cost-cutting measures such as tort reform, national supplemental plans, Value-Based Insurance Design and global, coast to coast electronic records, and (4) low income subsidies for (2) above which will keep costs down in the long run due to decreased utilization by the demographic that historically is significantly less healthy.

Yeah, so get rid of Medicare and Medicaid and replace them.

No, we should not end Social Security. And anyone who thinks we should is so completely blinded by simplistic partisan ideology that they simply cannot see the damage it would do, top to bottom, across the country. Eliminating or significantly increasing the current Social Security income cap for payroll deductions (currently around $110,000) would create a de facto means testing apparatus and make Social Security solvent for a very long time.

Easiest freakin' question I'll answer all day.

.

Since Soc Sec benefits payouts are calculated on the amount paid in, how will the benefits paid out be affected?

For example, for a worker retiring at age 66 in 2012, the amount is $2,513. This figure is based on earnings at the maximum taxable amount for every year after age 21.

A worker that had average earnings of $15,000 year would get $673 a month.

The I in FICA stands for Insurance. Normally, the premium of a life insurance policy is determined by the face amount of the policy. What you are you suggesting is that the premium, determined by the amount someone earns is unlimited, but the payout remains the same. A million dollar policy costs a helluva lot more than a thousand dollar policy, but it pays out a million dollars.

Yes, that's why I referred to it as a "de facto means testing apparatus". Social security income would be capped at the top level it's at, with increases annually. And actually, the maximum contribution level would not even need to be unlimited, but it could be raised and bring in significantly more money than it is now. So, for example, it could be $200,000 instead of $110,000.

.

No argument that raising the maximum contribution would bring in more money, and if you haven't noticed, they do raise it every year. But as in any ponzi scheme, there will become a time that it is unsustainable. There are fewer paying in and more taking out every year and that will eventually bankrupt the system.

 

[JakeStarkey]

Not at all. Raise the maximum income to $250,000 for SS taxation, raise the retirement age by two years, and keep SS taxes in the SS fund. No problem.

 

[onecut39]

Ho hum....

You can find this on the net. It was from 2009. Of course Mayo didn't drop all those seniors...you can bet there was negotiating on that one.

What constitutes a "loss" is also not defined. Was it a real dollar loss or was it an opportunity cost.

President Obama last year praised the Mayo Clinic as a "classic example" of how a health-care provider can offer "better outcomes" at lower cost. Then what should Americans think about the famous Minnesota medical center's decision to take fewer Medicare patients?

Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors.

Mayo says it lost $840 million last year treating Medicare patients, the result of the program's low reimbursement rates. Its hospital and four clinics in Arizona—including the Glendale facility—lost $120 million. Providers like Mayo swallow some of these Medicare losses, while also shifting the cost by charging more to private patients and insurers.

Of course, only governments can lose that much money and pretend they don't have to change. "Mayo Clinic loses a substantial amount of money every year due to the reimbursement schedule under Medicare," the institution said. "Decades of underfunding and paying for volume rather than value in Medicare have led us to this decision."

Mayo is a high buck clinic.

 

[Mac1958]

Not at all. Raise the maximum income to $250,000 for SS taxation, raise the retirement age by two years, and keep SS taxes in the SS fund. No problem.

Yep, Social Security is a relatively easy fix.

Medicare is the problem.

.

 

[onecut39]

What constitutes a "loss" is also not defined. Was it a real dollar loss or was it an opportunity cost.

Mayo is doing an experiment with its Arizona facility. As of January of this year there are still no results to speak of from that experiment:



That said, it's a rather limited experiment:



So the broader point you continually try to make from this simply isn't supported by this pilot. Certainly not at this stage.



The point isn't to send everyone to the Mayo, it's to make more Mayos. Which is what the new payment incentives in Medicare to enable and encourage the sort of delivery system innovations that make places like Mayo so good are doing:




And, as I've already pointed out, these kinds of models are already showing they can save money while improving care where they've been implemented.

"Decades of underfunding and paying for volume rather than value in Medicare have led us to this decision."

Exactly the philosophy of the ACA. Value, not volume, is the future of payment policy in this country. That's why it's landmark legislation.

landmark....? they appear to be just a regurgitation of HMOs....with a coupla differences....

There in nothing wrong with HMOs if they are not run like Bain Capital searching only for the almighty buck. Back in the 90s they were considered the plan for the future.

Almost all medical plans now are PPOs. A less restrictive HMO.

 

[LogikAndReazon]

Every need and want should be supplied by central planning statists with confiscated tax dollars to redistribute to those they deem most worthy..........

Childcare, pre-school, public school, university, food, transportation, energy, healthcare, housing, and retirement should all be provided ......Not to mention a guranteed civil servant "job".........

These are basic Human "Rights" that we are owed !!!!! LOL

 

[onecut39]

obummer stole 500 billion dollars from medicare,, so cry us a fucking river whydonchya? what good does it do to put money into the system for 40 years if obummmer is going to steal it? how is that bit of compassion working for ya?

Geez! Don't nobody know nothing?

The 500 billion was not taken from medicare. It was taken from the medical advantage PRIVATE INSURANCE PLANS.

FYI (and you need it)

Medicare stays exactly the same. Nothing happens to it or its budget.

When I enroll in a medicare advantage plan (private insurance) medicare gives that private insurer "X" number of dollars per month for me. The private insurer then agrees to be totally responsible for my health care under the terms of medicare and the advantage plan.

The 500 billion came from that "X" number of dollars. I have a medicare advantage plan. In the wake of the bill my premium increased by 20 bucks a month. So you see I and others who have private insurance are paying this bill. I have no objection. The medicare advantage companies, at least in my state, are rolling in cash.

But that's another story.

Rolling in cash ?

Please share a link.

I'd like to see their profit as a function of how much we spend on medical care.

All health companies in Minnesota must be non profit. (however profits can become "non" in many interesting and creative ways) Raising management salaries being just the easiest and most obvious.

Minnesota Medicaid HMOs Refund $73M To State, Feds - Kaiser Health News

 

[onecut39]

5/10/12

Today, about 25 percent of Medicare beneficiaries are enrolled in Medicare Advantage plans.

In a report I prepared with Robert Book for the Heritage Foundation, we found that Obamacare will cut Medicare Advantage payment rates by an average of $3,700 per beneficiary in 2017, or 27 percent below the payment rates that would have been made without Obamacare. These cuts will translate directly into higher health-care costs for seniors. Seniors who remain in Medicare Advantage will face higher costs, because the cuts will force the plans to cut back on the benefits they offer and to charge higher cost-sharing for the services they do cover. Further, seniors who will be pushed out of Medicare Advantage and back into the traditional program will lose entirely the added benefits provided by most Medicare Advantage plans. None of this is captured in Fidelity’s analysis.

This is no small matter. Seniors losing $3,700 per year from enrollment in Medicare at 65 until their deaths at age 77 or 78 would lose about $44,000 in benefits over their lifetimes, all because of Obamacare’s cuts.

Obamacare Hurts Seniors - James C. Capretta - National Review Online

ROFLMAO!!!!!

This cut to medicare advantage plan was made because these companies (mine for sure) are rolling in cash. In short they are getting paid way too much.

But I only know what happens to me. I am in a medical advantage plan.

I have lost nothing in benefits. They remain the best I have ever had. There is no way I can pay more that a couple of hundred bucks no matter what catastrophe occurs.

No deductible, no limit. Physician co pay, none. specialist copay $15. Hospital copay $100 Emergency room copay, $150, waived if I am admitted. Drug copay $10. I have yet to have a test, procedure or treatment that was not fully covered. I have an eyeglass benefit of $75 per year and I can get a hearing test every couple of years. There is some kind of allowance for a hearing but I don't want one yet.

Not bad huh? Continuing.

My premium was raised $20 per month, $240 per year. This was about a 13% increase.

If one is "forced off" of a plan that means they must no longer pay a premium. (I have no idea how that would happen) I did not see that in your calculations. Push comes to shove I could drop down a couple of notches in coverage, pay half the premium and still have insurance you probably just dream of.

As I said my company is rolling in cash. So much so that they voluntarily returned several million bucks to the state. (they are contracted for medical payment management for various state plans) They even sent me a $35 gift card.

If the twenty buck a month extra charge to me allows someone else, via Obamacare, to get some insurance they might not otherwise have had then I am glad to pay it.
I attend
Why are you so cheap? Go scare someone else.

did you miss post #154....?

Actually I did. These articles are all over the web and they ar mostly bullshit. The one you posted was factual enough it just wasn't very informative being quite figure free.

I suppose any cut could be considered to be "hurtful" but without specifics it is just so much hot air.

I attend the yearly meetings where my medical advantage plan seeks new customers. They will be firing up around election time. When this year's happen I will let you know.

Meanwhile I have inquired of the management as to what is going on. I assume they have to be fairly well informed. They tell me that anyone signing up now faces no increase and that they do not look forward to any "significant" increases due to the new law.

Are they lying? We will see.

 

[Full-Auto]

Do you feel we should end Medicare, Social Security and Medicaid?

End............. Hell no


But it should be properly managed, which is what democrats are fighting.

 

[Greenbeard]

landmark....? they appear to be just a regurgitation of HMOs....with a coupla differences....

Yes, landmark. First of all, as a side note, HMOs helped to bend the cost curve in the '90s. That's why the issue of rising health costs disappeared from the national discussion shortly after Clinton's failed reform effort and didn't emerge again until the early-to-mid 2000s. The problem was how they accomplished that (or at least the perception of how they accomplished that).

Accountable care organizations (ACOs) are groups of health care providers (e.g. doctors and hospitals), they're not health insurers. They take on more risk for their patient populations but in turn they're rewarded for it. Instead of the dangerous fragmentation that costs lives and money now (except in places like Mayo or Kaiser or Geisinger, i.e. those usually held up as models of how a well-functioning delivery system ought to work), they link providers together through shared information and shared incentives for improving the quality and value of services provided, not just meeting a bottom line. They link together to provide a level of care coordination for patients, starting with a robust primary care experience and moving outward from there, that's not particularly common today, and they're incentivized financially to continuously improve quality.

Better incentives, better service delivery, better care. And all while dialing back the perverse payment incentives that exist now for more and more volume, and thus more and more spending. That's why these are exciting in a way HMOs were not.

Some, like Ekeziel Emmanuel, have suggested that the rise of ACOs will spell "The End of Health Insurance Companies"--that is, the elimination of insurers as a middleman between patient and health care provider. I think that's a minority view but it's one worth noting. Regardless, we're entering a new era where we pay for and expect value in the health sector. So yes, landmark stuff.

 

[Too Tall]

Not at all. Raise the maximum income to $250,000 for SS taxation, raise the retirement age by two years, and keep SS taxes in the SS fund. No problem.

The maximum Soc Sec benefit for a worker retiring at age 66 in 2012 is $2,513 a month. This figure is based on earnings at the maximum taxable amount for every year after age 21.

Since the maximum taxable income is presently $110,100 it stands to reason that raising it to $250,000 will cause the benefit to be increased to well in excess of $5,000 a month. Of course the lower benefits will have to be raised as well and there is NO net difference. I suggest that raising the retirement age will result in 10's of thousands of people getting SSI for disabilities. Not a lot of construction workers can work at their trade until they are 66, let alone 68.

 

[Too Tall]

Not at all. Raise the maximum income to $250,000 for SS taxation, raise the retirement age by two years, and keep SS taxes in the SS fund. No problem.

Yep, Social Security is a relatively easy fix.

Medicare is the problem.

Medicare is easy. Raise the 2.9% premium, half paid for by the employee, half by the employer to 4 or 5%. It is already assessed on every penny of earned income, even though someone that worked for minimum wage his/her entire life and a millionaire get the same coverage.

 

[Skull Pilot]

Social security is nothing but mandated dependence on government.

How many times do I have to show you people that even only earning the median income of about 45K that anyone if allowed to keep the 15% of their lifetime income confiscated by the government could retire a millionaire and also leave the beginnings of true generational wealth to his family?

Here we go again

A 22 year old just out of college gets a job making 45K a year. He works that job for 45 years never getting a raise.

Now if he saves the 15% of his income he would be saving 6750 a year or 563 a month for 45 years he would have:

At 6% average growth 1.64 million

At 7% average growth 2.3 million

At 8% average growth 3.3 million

Before you say those returns are too optimistic you should know that the sock market has averages in the long term, 40 to 50 years, about 10% so you see my estimates are quite conservative.

Now just so you can see what kind of income that will provide let's say that in retirement he lives on 5K month ( More than he did while he was working not less)

1.64 million earning 3% with 5K a month income would last 58 years he could live on more or he could leave what's left to his wife and kids

2.3 million would last basically forever because you would be earning more than you took out every year.

Now your maximum SS benefit is 2500 a month.

Tell me which would you rather have?

And please realize that this example is only the money taken for SS if you were to add another 5 to 20% to your savings you could retire even richer and leave a real legacy to your family.

It's no wonder the fucking government wants to force economic bondage on us because if we had the option outlined above people wouldn't need the fucking government now would they?

 

[Oddball]

Do you feel we should end Medicare, Social Security and Medicaid?

End............. Hell no


But it should be properly managed, which is what democrats are fighting.

They'll never be properly managed when there are votes to be bought, from any excess funds that are collected to ostensibly fund them.

They were two terrible ideas that are now poised to consume every dollar that the fed takes in and should be ended altogether with all due haste.

 

[JakeStarkey]

Skull and Odd are merely mumbling.

 

[CrusaderFrank]

landmark....? they appear to be just a regurgitation of HMOs....with a coupla differences....

Yes, landmark. First of all, as a side note, HMOs helped to bend the cost curve in the '90s. That's why the issue of rising health costs disappeared from the national discussion shortly after Clinton's failed reform effort and didn't emerge again until the early-to-mid 2000s. The problem was how they accomplished that (or at least the perception of how they accomplished that).

Accountable care organizations (ACOs) are groups of health care providers (e.g. doctors and hospitals), they're not health insurers. They take on more risk for their patient populations but in turn they're rewarded for it. Instead of the dangerous fragmentation that costs lives and money now (except in places like Mayo or Kaiser or Geisinger, i.e. those usually held up as models of how a well-functioning delivery system ought to work), they link providers together through shared information and shared incentives for improving the quality and value of services provided, not just meeting a bottom line. They link together to provide a level of care coordination for patients, starting with a robust primary care experience and moving outward from there, that's not particularly common today, and they're incentivized financially to continuously improve quality.

Better incentives, better service delivery, better care. And all while dialing back the perverse payment incentives that exist now for more and more volume, and thus more and more spending. That's why these are exciting in a way HMOs were not.

Some, like Ekeziel Emmanuel, have suggested that the rise of ACOs will spell "The End of Health Insurance Companies"--that is, the elimination of insurers as a middleman between patient and health care provider. I think that's a minority view but it's one worth noting. Regardless, we're entering a new era where we pay for and expect value in the health sector. So yes, landmark stuff.

Zeke Emanuel, there's a familiar name, isn't he the guy who said we're not to worry about healthcare because we're not "untermenschen"? What a lovely thought coming from a Eugenicist, what could possibly go wrong taking advise from a genuine Neo-Nazi?

 

[Skull Pilot]

Skull and Odd are merely mumbling.

If you can refute my claims feel free to try little sheep.

 

[grunt11b]

Do you feel we should end Medicare, Social Security and Medicaid?

Yes or no?

If you say yes, then what happens to the people who depend on it? If you say no, then do you disagree with your leaders and if you do, then why you support them?

Being that Obama care will become law I dont see any reason to keep medicare and medicaid around. Everybody could be lumped into the obamacare system and nothing would change other than getting rid of two programs that are bloated. Unless of course the intention is to over bloat the economy and sink it, which is what the intent is with all of these programs.
If Obama pushed his healthcare by saying "I will replace medicare and medicaid with this new health program that will cover everybody" I might not have been against it so much because it would not have changed the cost to the program, it may have actually saved some money by eliminating the two programs for the sake of the one. But to just add another program to an already huge list of government failures was senseless, unlesss it was done with malicious intent "Which it was".

 

[Politico]

Absolutely. And give me the freaking money I paid in back so I can do something better with it.

 

[initforme]

Sure. End them. Give all that money to the 1 percent. Then raise taxes on the middle class. Also, make sure employers are forced to lower wages and benefits. There you go. Problem solved. I'm sure they will create alot of $7 an hour jobs. We should be thankful for those jobs. The working class had better wake up.