Obama Care Mess

[Flopper]

I do agree with some of your points, but I'm not confident that a free market approach is the answer because most of our healthcare dollars go to treatments of serious medical problems. Most people can't afford to pay those cost and thus must rely on insurance. When that happens, the patient isn't in control and there goes the free market.

Again, and I'm sorry to keep repeating myself, but you're mixing up concerns. The amount of health care we consume isn't what's causing price inflation. Volume tends to make prices go down, if anything. So, the fact that most of "our" health care dollars go to serious medical conditions, or last-gasp end-of-life treatments, has nothing to do with that fact that ordinary health care is artificially expensive.

When it comes to dealing with serious medical conditions or catastrophic accidents, there's nothing wrong with setting up 'safety nets' - whether via private insurance or public welfare - to cover us. But it should be a backstop and not our primary plan for financing our health care. The problem comes when we see insurance as a ticket to 'free health care' - which is what most of us seem to expect out of health insurance. It's that delusion that's killing us.

The simple fact is you can't market healthcare like TVs and cars. You don’t know when or whether you’ll need care but if you do, the care can be extremely expensive.

Again, you're focused on the catastrophic stuff, and that's simply a different problem than routine care. Ordinary health care (colds, infections, broken bones, etc...) is no different economically than any other service we expect to use.

I still say we're dealing with two disctinct problems:

1. What to do about people who can't afford the health care they need.

and

2. What to do about the fact that health care is simply too expensive in the first place.

The key point I'd like to make here is that if we solve the second problem, the first one will be much easier to deal with. If, on the other hand, we ignore the second problem and simply focus on the first, we're rapidly approaching a point where very few of us can afford even basic health care. We'll have to build safety nets big enough to hold everyone.

The problem I see with your argument is you seem to believe that if we put the customer in the driver's seat when dealing with minor healthcare problems, that will be enough to drastically reduce costs. That simply isn't true, because minor health care problems are a small part of the nation's healthcare cost.

Catastrophic health insurance is synonymous with a high deductible and or high co-insurance until the patient reaches a maximum yearly expense.

Let's say the average family has a $1,000/person deducible. The idea is of course most people will be reluctance to go to the doctor for common problems, such as headaches. 99 times out of a hundred that serve headache isn't a serious condition, so there's a savings of say $10,000 in doctor visits but then there's the 1 in hundred that is a serious condition. Once that patent's pain becomes so serve, the patient visits the doctor and learns he has cancer which is fairly advance since he's been reluctant to go the doctor. So instead of radiation or just chemotherapy, or a simple operation, he's dealing with some very expensive healthcare that may well cost hundreds of thousands of dollars or more. So just what did we really save? nothing. In fact, we probably increased the healthcare cost.

Even if putting the responsibly on the patient for minor costs would save some money, it wouldn't be enough to make a major dent in rising healthcare cost because as I said before, that's not where major cost are. It's in hospital cost, diagnostics, surgeries, and specialize treatments, not trips to the doctors office to treat the common cold.

Catastrophic insurance sends the wrong message to the patient. Ignore the small problems and save money. Unfortunately small problems often grow into big very expensive problems. Not only is this a bad idea from a cost saving standpoint, but it's a bad idea medical.

 

[HomeInspect]

ATR Mobile: Obamacare?s Tax Hike Train Wreck

Obamacare’s Tax Hike Train Wreck

Tuesday, April 30, 2013 8:05 PM | John Kartch

The most destructive Obamacare tax increases are just around the bend

Asked about Senator Max Baucus’s (D-Mont.) recent “train wreck” comments, President Obama today said, “A huge chunk of it [Obamacare] has already been implemented.” Unmentioned was the wave of destructive Obamacare tax increases that will begin to hit Americans during the next tax filing season and beyond:

Starting in tax year 2013:

Obamacare Surtax on Investment Income: A new, 3.8 percent surtax on investment income earned in households making at least $250,000 ($200,000 single). This tax hike results in the following top tax rates on investment income:





Capital Gains

Dividends

Other*



2013+

23.8%

43.4%

43.4%

 

[Underhill]

But the problem isn't any of those things. Sure baby boomers are a short term problem but aside from that the problem is several things.

First, the system is incredibly inefficient. Now this has been the case for decades, but the problem is amplified in light of the second, and largest, problem.

Second, people are simply using health care a hell of a lot more. Around half are on maintenance medications. The average person goes to the doctor 2-3 times as much as they used to. The number of procedures the average person endures in their lifetime has gone up dramatically too. This isn't an entirely bad thing, as people are living longer as a result, but it is the number one reason cost have increased so dramatically over the last few decades.

The third, and easiest to deal with, is the uninsured.

The first problem is hard to fix without single payer. Without control of the system, we cannot manage it properly. There are things we can do, but it's a losing proposition.

The second, and largest, is damned near impossible to 'fix' because it isn't a problem, so much as a evolution in the industry that is generally positive. There is room to improve with better record keeping (less testing etc) but the vast majority of the cost increase is not going away.

This third problem will largely go away under Obamacare. And most of these people won't cost us much. In fact, they will probably save us money. Of course these savings under Obamacare will be offset by the additional coverage many Americans will receive. The bigger problem with bringing these people into the fold is the shortages of doctors and physicians assistance out there. But that is no excuse for not caring for people... If anything, it means we need to invest more in our medical schools and future doctors.

The sooner we recognize these facts the sooner we can deal with them. But here is the bit people need to pay attention to.

The cost will never be even close to what they were in the 70's or 80's even when adjusted for inflation. That is reality.

I agree with you.

Obviously, I don't. Insurance is the problem, not the solution.

I get that.

Every civilized country on the planet disagrees with you. But of course you have the right to your opinion.

 

[Flopper]

I agree with you.

Obviously, I don't. Insurance is the problem, not the solution.

I get that.

Every civilized country on the planet disagrees with you. But of course you have the right to your opinion.

There is really no question in most people's minds about the need for insurance. The debate always comes back to who provides it, government or the private sector and how much responsibly of paying for healthcare services should fall on the patient. Unfortunately that's not what the debate should be about.

 

[lynn63]

Most states right now are contracted with private insurance plans to manage their Medicaid population and their senior population which is Medicare Advantage Plan. According to the last stats of enrolled members is over 20 million that have Medicare Advantage and over 50 million that on Medicaid but through a private insurance plan.

These insurance companies had to place a bid to the government to win in insuring their population. The top big most profitable insurance companies won it of course. The number of manufacturing jobs lost due to expansion to global markets had a big impact on the health insurance companies since they lost a big pool of the healthy population that were once previously insured.

They fully supported and helped get this mandate for insurance into law as well as the pharmaceutical companies who had a big stake in it too. It is this reason why decreasing costs was never going to happen. Obama knew this and he shouldn't have said to the public that cost would decrease with the ACA.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S. while eliminated the ones that have no income at all. It was never about the government wanting a single payer system because if it was it would not be organized in the manner it is today.

The insurance companies, the pharm co, and the hospital industry paid lobbying costs and contributions to politicians to get this mandate into law. None of them wanted a reduction in costs. The age of technology that has enabled them to obtain large amounts of statistical data of its society's population is extremely a powerful tool in terms of increasing profits by capitalizing based on that information.

We have no privacy anymore and have become increasingly transparent to the vultures that want our money. While everyone thinks it is great to have health insurance, they soon realize its only good if you don't have to use it, except of course if you are on Medicaid.

Over half of the population is on government assisted healthcare that has been contracted out to private insurance. This is where we are getting screwed and so is our government by private insurance. For the life of me, I don't understand why our government is empowering them with most of our population when it would be much cheaper if they eliminated them altogether.

 

[Flopper]

Most states right now are contracted with private insurance plans to manage their Medicaid population and their senior population which is Medicare Advantage Plan. According to the last stats of enrolled members is over 20 million that have Medicare Advantage and over 50 million that on Medicaid but through a private insurance plan.

These insurance companies had to place a bid to the government to win in insuring their population. The top big most profitable insurance companies won it of course. The number of manufacturing jobs lost due to expansion to global markets had a big impact on the health insurance companies since they lost a big pool of the healthy population that were once previously insured.

They fully supported and helped get this mandate for insurance into law as well as the pharmaceutical companies who had a big stake in it too. It is this reason why decreasing costs was never going to happen. Obama knew this and he shouldn't have said to the public that cost would decrease with the ACA.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S. while eliminated the ones that have no income at all. It was never about the government wanting a single payer system because if it was it would not be organized in the manner it is today.

The insurance companies, the pharm co, and the hospital industry paid lobbying costs and contributions to politicians to get this mandate into law. None of them wanted a reduction in costs. The age of technology that has enabled them to obtain large amounts of statistical data of its society's population is extremely a powerful tool in terms of increasing profits by capitalizing based on that information.

We have no privacy anymore and have become increasingly transparent to the vultures that want our money. While everyone thinks it is great to have health insurance, they soon realize its only good if you don't have to use it, except of course if you are on Medicaid.

Over half of the population is on government assisted healthcare that has been contracted out to private insurance. This is where we are getting screwed and so is our government by private insurance. For the life of me, I don't understand why our government is empowering them with most of our population when it would be much cheaper if they eliminated them altogether.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S.???

There are a couple of inaccuracies in your post.

There is no bidding for Medicare Advantage Plans. They must be approved by Medicare and they have a contract with Medicare, not the states; however, they must be certified by the state. Anyone who is eligible for Medicare can join one of these plans. By law, the level of coverage must be at least equal to Medicare, however in most cases it's better. Medicare pays the company and the company pays the service provider. Most of the plans require that you use the contracted providers in the company's network to get maximum benefits. With Medicare, you can go to any doctor in the US that accepts Medicare but you will probably pay more.

With Medicare, you pay 20% of most services. With Medicare Advantage you usually pay a fixed amount for services. These plans often pay for some additions services such as dental, vision, and some other things Medicare does not pay, but the ones that offer these benefits charge a premium, which is in addition to the Part B Medicare premium. In the state I live, there're 10 companies that offer Medicare Advantage Plans. They compete against each other and also compete with Medicare Supplement programs. BTW The number of members in these plans is closer to 12 million than 20.

Medicaid is jointly funded by the state and the federal government. The state is responsible for administering the program and coverage may vary between states . I believe most states contract out the administration of the program to insurance companies. In my state there are three, maybe 5 such companies. I'm pretty sure that these companies are selected by competitive bid. When you are approved for Medicaid, you select which company you want to deal with. The premiums paid by the client start at zero and increase with increases in income level.

Medicare Advantage - Wikipedia, the free encyclopedia

 

[Underhill]

Most states right now are contracted with private insurance plans to manage their Medicaid population and their senior population which is Medicare Advantage Plan. According to the last stats of enrolled members is over 20 million that have Medicare Advantage and over 50 million that on Medicaid but through a private insurance plan.

These insurance companies had to place a bid to the government to win in insuring their population. The top big most profitable insurance companies won it of course. The number of manufacturing jobs lost due to expansion to global markets had a big impact on the health insurance companies since they lost a big pool of the healthy population that were once previously insured.

They fully supported and helped get this mandate for insurance into law as well as the pharmaceutical companies who had a big stake in it too. It is this reason why decreasing costs was never going to happen. Obama knew this and he shouldn't have said to the public that cost would decrease with the ACA.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S. while eliminated the ones that have no income at all. It was never about the government wanting a single payer system because if it was it would not be organized in the manner it is today.

The insurance companies, the pharm co, and the hospital industry paid lobbying costs and contributions to politicians to get this mandate into law. None of them wanted a reduction in costs. The age of technology that has enabled them to obtain large amounts of statistical data of its society's population is extremely a powerful tool in terms of increasing profits by capitalizing based on that information.

We have no privacy anymore and have become increasingly transparent to the vultures that want our money. While everyone thinks it is great to have health insurance, they soon realize its only good if you don't have to use it, except of course if you are on Medicaid.

Over half of the population is on government assisted healthcare that has been contracted out to private insurance. This is where we are getting screwed and so is our government by private insurance. For the life of me, I don't understand why our government is empowering them with most of our population when it would be much cheaper if they eliminated them altogether.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S.???

There are a couple of inaccuracies in your post.

There is no bidding for Medicare Advantage Plans. They must be approved by Medicare and they have a contract with Medicare, not the states; however, they must be certified by the state. Anyone who is eligible for Medicare can join one of these plans. By law, the level of coverage must be at least equal to Medicare, however in most cases it's better. Medicare pays the company and the company pays the service provider. Most of the plans require that you use the contracted providers in the company's network to get maximum benefits. With Medicare, you can go to any doctor in the US that accepts Medicare but you will probably pay more.

With Medicare, you pay 20% of most services. With Medicare Advantage you usually pay a fixed amount for services. These plans often pay for some additions services such as dental, vision, and some other things Medicare does not pay, but the ones that offer these benefits charge a premium, which is in addition to the Part B Medicare premium. In the state I live, there're 10 companies that offer Medicare Advantage Plans. They compete against each other and also compete with Medicare Supplement programs. BTW The number of members in these plans is closer to 12 million than 20.

Medicaid is jointly funded by the state and the federal government. The state is responsible for administering the program and coverage may vary between states . I believe most states contract out the administration of the program to insurance companies. In my state there are three, maybe 5 such companies. I'm pretty sure that these companies are selected by competitive bid. When you are approved for Medicaid, you select which company you want to deal with. The premiums paid by the client start at zero and increase with increases in income level.

Medicare Advantage - Wikipedia, the free encyclopedia

I would add a bit about Medicaid.

It varies widely by state. So some are administered directly by the state, others by private insurers paid by the state. Some cover virtually everything. Others offer varied coverage (that are required to meet federal minimum guidelines).

Spot on about Medicare.

 

[lynn63]

Most states right now are contracted with private insurance plans to manage their Medicaid population and their senior population which is Medicare Advantage Plan. According to the last stats of enrolled members is over 20 million that have Medicare Advantage and over 50 million that on Medicaid but through a private insurance plan.

These insurance companies had to place a bid to the government to win in insuring their population. The top big most profitable insurance companies won it of course. The number of manufacturing jobs lost due to expansion to global markets had a big impact on the health insurance companies since they lost a big pool of the healthy population that were once previously insured.

They fully supported and helped get this mandate for insurance into law as well as the pharmaceutical companies who had a big stake in it too. It is this reason why decreasing costs was never going to happen. Obama knew this and he shouldn't have said to the public that cost would decrease with the ACA.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S. while eliminated the ones that have no income at all. It was never about the government wanting a single payer system because if it was it would not be organized in the manner it is today.

The insurance companies, the pharm co, and the hospital industry paid lobbying costs and contributions to politicians to get this mandate into law. None of them wanted a reduction in costs. The age of technology that has enabled them to obtain large amounts of statistical data of its society's population is extremely a powerful tool in terms of increasing profits by capitalizing based on that information.

We have no privacy anymore and have become increasingly transparent to the vultures that want our money. While everyone thinks it is great to have health insurance, they soon realize its only good if you don't have to use it, except of course if you are on Medicaid.

Over half of the population is on government assisted healthcare that has been contracted out to private insurance. This is where we are getting screwed and so is our government by private insurance. For the life of me, I don't understand why our government is empowering them with most of our population when it would be much cheaper if they eliminated them altogether.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S.???

There are a couple of inaccuracies in your post.

There is no bidding for Medicare Advantage Plans. They must be approved by Medicare and they have a contract with Medicare, not the states; however, they must be certified by the state. Anyone who is eligible for Medicare can join one of these plans. By law, the level of coverage must be at least equal to Medicare, however in most cases it's better. Medicare pays the company and the company pays the service provider. Most of the plans require that you use the contracted providers in the company's network to get maximum benefits. With Medicare, you can go to any doctor in the US that accepts Medicare but you will probably pay more.

With Medicare, you pay 20% of most services. With Medicare Advantage you usually pay a fixed amount for services. These plans often pay for some additions services such as dental, vision, and some other things Medicare does not pay, but the ones that offer these benefits charge a premium, which is in addition to the Part B Medicare premium. In the state I live, there're 10 companies that offer Medicare Advantage Plans. They compete against each other and also compete with Medicare Supplement programs. BTW The number of members in these plans is closer to 12 million than 20.

Medicaid is jointly funded by the state and the federal government. The state is responsible for administering the program and coverage may vary between states . I believe most states contract out the administration of the program to insurance companies. In my state there are three, maybe 5 such companies. I'm pretty sure that these companies are selected by competitive bid. When you are approved for Medicaid, you select which company you want to deal with. The premiums paid by the client start at zero and increase with increases in income level.

Medicare Advantage - Wikipedia, the free encyclopedia

You are right its only 11-12 million on Medicare Advantage Plan. My source is incorrect on its facts. However it is true that insurance companies have to place a bid to Medicare to get chosen for the job.

In Arizona, Medicaid or we call it AHCCCS has the normal FFS model that State takes care of and a few of the private carriers are contracted to insure our population of Medicaid or AHCCCS. The providers of healthcare are contracted with the plan and are paid at a capitation rate.

 

[HomeInspect]

When you have a supporter and a writer of Obama Care now calling it a train wreck, one would be conerned, no? Funny how NBC and ABC tried to avoid the topic.

CBS Notices Senate Dem's 'Train Wreck' Label of ObamaCare; ABC, NBC Ignore | NewsBusters

 

[dblack]

Obviously, I don't. Insurance is the problem, not the solution.

I get that.

Every civilized country on the planet disagrees with you. But of course you have the right to your opinion.

There is really no question in most people's minds about the need for insurance. The debate always comes back to who provides it, government or the private sector and how much responsibly of paying for healthcare services should fall on the patient. Unfortunately that's not what the debate should be about.

Most people don't understand what insurance is. They want it to be something else.

What should the debate be about in your view? Because I'd agree with you that confusion over what we're debating is rampant. The corporatists use that confusion to build ever more power.

 

[Flopper]

Most states right now are contracted with private insurance plans to manage their Medicaid population and their senior population which is Medicare Advantage Plan. According to the last stats of enrolled members is over 20 million that have Medicare Advantage and over 50 million that on Medicaid but through a private insurance plan.

These insurance companies had to place a bid to the government to win in insuring their population. The top big most profitable insurance companies won it of course. The number of manufacturing jobs lost due to expansion to global markets had a big impact on the health insurance companies since they lost a big pool of the healthy population that were once previously insured.

They fully supported and helped get this mandate for insurance into law as well as the pharmaceutical companies who had a big stake in it too. It is this reason why decreasing costs was never going to happen. Obama knew this and he shouldn't have said to the public that cost would decrease with the ACA.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S. while eliminated the ones that have no income at all. It was never about the government wanting a single payer system because if it was it would not be organized in the manner it is today.

The insurance companies, the pharm co, and the hospital industry paid lobbying costs and contributions to politicians to get this mandate into law. None of them wanted a reduction in costs. The age of technology that has enabled them to obtain large amounts of statistical data of its society's population is extremely a powerful tool in terms of increasing profits by capitalizing based on that information.

We have no privacy anymore and have become increasingly transparent to the vultures that want our money. While everyone thinks it is great to have health insurance, they soon realize its only good if you don't have to use it, except of course if you are on Medicaid.

Over half of the population is on government assisted healthcare that has been contracted out to private insurance. This is where we are getting screwed and so is our government by private insurance. For the life of me, I don't understand why our government is empowering them with most of our population when it would be much cheaper if they eliminated them altogether.

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S.???

There are a couple of inaccuracies in your post.

There is no bidding for Medicare Advantage Plans. They must be approved by Medicare and they have a contract with Medicare, not the states; however, they must be certified by the state. Anyone who is eligible for Medicare can join one of these plans. By law, the level of coverage must be at least equal to Medicare, however in most cases it's better. Medicare pays the company and the company pays the service provider. Most of the plans require that you use the contracted providers in the company's network to get maximum benefits. With Medicare, you can go to any doctor in the US that accepts Medicare but you will probably pay more.

With Medicare, you pay 20% of most services. With Medicare Advantage you usually pay a fixed amount for services. These plans often pay for some additions services such as dental, vision, and some other things Medicare does not pay, but the ones that offer these benefits charge a premium, which is in addition to the Part B Medicare premium. In the state I live, there're 10 companies that offer Medicare Advantage Plans. They compete against each other and also compete with Medicare Supplement programs. BTW The number of members in these plans is closer to 12 million than 20.

Medicaid is jointly funded by the state and the federal government. The state is responsible for administering the program and coverage may vary between states . I believe most states contract out the administration of the program to insurance companies. In my state there are three, maybe 5 such companies. I'm pretty sure that these companies are selected by competitive bid. When you are approved for Medicaid, you select which company you want to deal with. The premiums paid by the client start at zero and increase with increases in income level.

Medicare Advantage - Wikipedia, the free encyclopedia

You are right its only 11-12 million on Medicare Advantage Plan. My source is incorrect on its facts. However it is true that insurance companies have to place a bid to Medicare to get chosen for the job.

In Arizona, Medicaid or we call it AHCCCS has the normal FFS model that State takes care of and a few of the private carriers are contracted to insure our population of Medicaid or AHCCCS. The providers of healthcare are contracted with the plan and are paid at a capitation rate.

Do you have any information about bidding to offer Medicare Advantage Plans? Haven't been able find any reference to this. I do know that the insurance company signs a contract with Medicare and must meet a number of requirements.

 

[Flopper]

I get that.

Every civilized country on the planet disagrees with you. But of course you have the right to your opinion.

There is really no question in most people's minds about the need for insurance. The debate always comes back to who provides it, government or the private sector and how much responsibly of paying for healthcare services should fall on the patient. Unfortunately that's not what the debate should be about.

Most people don't understand what insurance is. They want it to be something else.

What should the debate be about in your view? Because I'd agree with you that confusion over what we're debating is rampant. The corporatists use that confusion to build ever more power.

Medicare Advantage Plans have been a boon to health insurance companies. These plans were suppose to save Medicare in 1997 and again in 2006. The idea is seniors eligible for Medicare would sign over their Medicare benefits to the insurance company and the company would provide them a plan equivalent to Medicare but not exactly the same. Most of the plans were constructed like group insurance with copays instead of Medicare co-insurance. Medicare would pay the insurance company a fix fee which was suppose to be the same amount Medicare spend on Medicare enrollees. Things didn't go so well for the insurance companies so congress began subsidizing them which meant Medicare was now paying more per patient for Medicare Advantage plans than it was paying for regular Medicare. Remember this was the plan that was going to save Medicare. As a part of Obamacare, the subsidies were to be phased out over several years. Now it seems that the phaseout is being extended. Congress doesn't seem to have any interest in the fact that we are paying more per patient on the plan that was to save Medicare than we do on Medicare.

 

[dblack]

There is really no question in most people's minds about the need for insurance. The debate always comes back to who provides it, government or the private sector and how much responsibly of paying for healthcare services should fall on the patient. Unfortunately that's not what the debate should be about.

Most people don't understand what insurance is. They want it to be something else.

What should the debate be about in your view? Because I'd agree with you that confusion over what we're debating is rampant. The corporatists use that confusion to build ever more power.

Medicare Advantage Plans have been a boon to health insurance companies. These plans were suppose to save Medicare in 1997 and again in 2006. The idea is seniors eligible for Medicare would sign over their Medicare benefits to the insurance company and the company would provide them a plan equivalent to Medicare but not exactly the same. Most of the plans were constructed like group insurance with copays instead of Medicare co-insurance. Medicare would pay the insurance company a fix fee which was suppose to be the same amount Medicare spend on Medicare enrollees. Things didn't go so well for the insurance companies so congress began subsidizing them which meant Medicare was now paying more per patient for Medicare Advantage plans than it was paying for regular Medicare. Remember this was the plan that was going to save Medicare. As a part of Obamacare, the subsidies were to be phased out over several years. Now it seems that the phaseout is being extended. Congress doesn't seem to have any interest in the fact that we are paying more per patient on the plan that was to save Medicare than we do on Medicare.

Uh... ?

Was that meant to be a response to another post perhaps?

 

[lynn63]

The ACA will provide the top 5 insurance companies to insure the entire population of the U.S.???

There are a couple of inaccuracies in your post.

There is no bidding for Medicare Advantage Plans. They must be approved by Medicare and they have a contract with Medicare, not the states; however, they must be certified by the state. Anyone who is eligible for Medicare can join one of these plans. By law, the level of coverage must be at least equal to Medicare, however in most cases it's better. Medicare pays the company and the company pays the service provider. Most of the plans require that you use the contracted providers in the company's network to get maximum benefits. With Medicare, you can go to any doctor in the US that accepts Medicare but you will probably pay more.

With Medicare, you pay 20% of most services. With Medicare Advantage you usually pay a fixed amount for services. These plans often pay for some additions services such as dental, vision, and some other things Medicare does not pay, but the ones that offer these benefits charge a premium, which is in addition to the Part B Medicare premium. In the state I live, there're 10 companies that offer Medicare Advantage Plans. They compete against each other and also compete with Medicare Supplement programs. BTW The number of members in these plans is closer to 12 million than 20.

Medicaid is jointly funded by the state and the federal government. The state is responsible for administering the program and coverage may vary between states . I believe most states contract out the administration of the program to insurance companies. In my state there are three, maybe 5 such companies. I'm pretty sure that these companies are selected by competitive bid. When you are approved for Medicaid, you select which company you want to deal with. The premiums paid by the client start at zero and increase with increases in income level.

Medicare Advantage - Wikipedia, the free encyclopedia

You are right its only 11-12 million on Medicare Advantage Plan. My source is incorrect on its facts. However it is true that insurance companies have to place a bid to Medicare to get chosen for the job.

In Arizona, Medicaid or we call it AHCCCS has the normal FFS model that State takes care of and a few of the private carriers are contracted to insure our population of Medicaid or AHCCCS. The providers of healthcare are contracted with the plan and are paid at a capitation rate.

Do you have any information about bidding to offer Medicare Advantage Plans? Haven't been able find any reference to this. I do know that the insurance company signs a contract with Medicare and must meet a number of requirements.

www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRat

Here is one of the sites

 

[Flopper]

Most people don't understand what insurance is. They want it to be something else.

What should the debate be about in your view? Because I'd agree with you that confusion over what we're debating is rampant. The corporatists use that confusion to build ever more power.

Medicare Advantage Plans have been a boon to health insurance companies. These plans were suppose to save Medicare in 1997 and again in 2006. The idea is seniors eligible for Medicare would sign over their Medicare benefits to the insurance company and the company would provide them a plan equivalent to Medicare but not exactly the same. Most of the plans were constructed like group insurance with copays instead of Medicare co-insurance. Medicare would pay the insurance company a fix fee which was suppose to be the same amount Medicare spend on Medicare enrollees. Things didn't go so well for the insurance companies so congress began subsidizing them which meant Medicare was now paying more per patient for Medicare Advantage plans than it was paying for regular Medicare. Remember this was the plan that was going to save Medicare. As a part of Obamacare, the subsidies were to be phased out over several years. Now it seems that the phaseout is being extended. Congress doesn't seem to have any interest in the fact that we are paying more per patient on the plan that was to save Medicare than we do on Medicare.

Uh... ?

Was that meant to be a response to another post perhaps?

Yes, Sorry.

I think the debate should be about delivery of services, not how we pay for them. Granted insurance whether government or private, adds to the cost and certainly medical assistance to the poor also adds to the cost, but I believe these services will not go away or even be substantially decreased because the vast number of people want these services.

 

[Flopper]

You are right its only 11-12 million on Medicare Advantage Plan. My source is incorrect on its facts. However it is true that insurance companies have to place a bid to Medicare to get chosen for the job.

In Arizona, Medicaid or we call it AHCCCS has the normal FFS model that State takes care of and a few of the private carriers are contracted to insure our population of Medicaid or AHCCCS. The providers of healthcare are contracted with the plan and are paid at a capitation rate.

Do you have any information about bidding to offer Medicare Advantage Plans? Haven't been able find any reference to this. I do know that the insurance company signs a contract with Medicare and must meet a number of requirements.

www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRat

Here is one of the sites

Something is wrong with the link. The CMS web site says page not found.