Hospital Billing Varies Wildly…. Reply

SurgeonA hospital in Livingston, N.J., charged $70,712 on average to implant a pacemaker, while a hospital in nearby Rahway, N.J., charged $101,945.In Saint Augustine, Fla., one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while one in Orange Park, Fla., charged $91,000.

In one hospital in Dallas, the average bill for treating simple pneumonia was $14,610, while another there charged over $38,000…

Source: Hospital Billing Varies Wildly, U.S. Data Shows – NYTimes.com.

I must admit that I have been lazy in regard to studying and reporting on how hospitals are at least partially responsible for the runaway medical costs in our country…..

You might think that just because a hospital charges an amount for a procedure that they actually receive that payment. Fortunately that is not the case for single payer systems like Medicare, Medicaid, and veterans.  The article goes on to say:

Medicare does not actually pay the amount a hospital charges but instead uses a system of standardized payments to reimburse hospitals for treating specific conditions. Private insurers do not pay the full charge either, but negotiate payments with hospitals for specific treatments. Since many patients are covered by Medicare or have private insurance, they are not directly affected by what hospitals charge.

Experts say it is likely that the people who can afford it least — those with little or no insurance — are getting hit with extremely high hospitals bills that may bear little connection to the cost of treatment.

Now that I have been on Medicare for a couple of years now I have been exposed to these extreme differences.  I recently had an endoscopy for an esophagus problem and when I got the paperwork from Medicare I could see that the medical facility charged about $3,500 for the fifteen minute procedure but Medicare approved less than $700 of which they paid 80% and my Medigap coverage paid the other 20%.  Since I was on Medicare and knew that they paid the same to all facilities I did not shop around for the different costs for the procedure but if I had I probably would have encountered differences like shown in the article above.

If like so many on the radical right seem to wish, I had not had Medicare I’m sure I would have been billed and expected to pay the full amount. The sad fact about it is that those who can afford it the least are the ones who actually are charged the most simply because they have no power behind them.

The rest of the developed world is for the most part on a single payer system similar to Medicare. I know that the most famous doctors tend to migrate to the U.S. because of our extreme compensations but even that fact does not give us superior care to most other countries. In fact even with our ultra-expensive way of doing healthcare many other countries are ahead of us when it come to living longer and healthier. When will we ever learn this very basic fact??

I get the feeling that if lawn mowing services were run by hospital administrators I would be charged  $1,000 for every time they mowed my lawn. Too bad someone can’t come up with DIY pace makers.

Paul Ryan’s new Medicare plan… 8

Banner - Aside 2

Source: Paul Ryan’s new Medicare plan could be tip of the iceberg (+video) – CSMonitor.com.

A parallel factor is rising income. As a society grows richer, it tends to spend more of its income on health care. Add in demographics (an aging population) and a lack of competition among health-care providers in many markets, and you have a recipe for more people to consume more health-care services at higher prices.

For once I am not going to comment on Mr. Ryan’s seemingly enthusiasm to balance his budget on the backs of the poor while asking for increases in our bloated military budgets and more tax breaks for the rich. That continues to be insane to me but is not the focus of this particular post.  Instead this post is about fixing Medicare and Medicaid. The quote above is at the end of this news article but says much about how some view the problem of spending our healthcare dollars.

The quoted argument seems to say that we choose to go to doctors because we can.  I don’t know about you but I don’t sit down in the morning and try to decide whether I will go to the mall, the park, or to the doctor that day.  I go to the doctor when I am sick or have what I think might be a serious medical problem. I don’t use doctors as a form of entertainment! Yeah, I know about the hypochondriacs out there but I hope they are a very small group.

Of course the quote also deems that the lack of competition is the cause for increasing prices for healthcare.  We just don’t have enough McDoctors and McHospitals around yet I guess.  Maybe I am naive about all of this but I kind of  believe that competition is more of a cause than a solution.  When Hospital “A” gets the latest multi-million dollar piece of medical equipment then Hospital “B” has to get it too so they can compete.  It doesn’t matter that one machine could provide all the tests needed by the community. It doesn’t matter that hospitals will use the machines where they really aren’t necessary because they have them.

If we really want to get our healthcare costs down we need to do what the rest of the world already knows and that is a single payer regulated system.  We spend more than twice as much as everyone else and actually live shorter and less healthy lives. It continues to amaze me how we in the U.S. fail to understand this very basic approach to healthcare.

Being Denied Coverage…. 14

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Source: Top six myths about Medicare | Reuters.

hospitalMYTH FOUR: DOCTORS WILL NOT ACCEPT MEDICARE BECAUSE OF ALL THESE CUTS

Facts: Most Medicare patients do not have trouble finding doctors who will see them, but there is growing concern about access to primary care physicians.

This issue is monitored closely by the Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency charged with advising Congress on Medicare. The agency’s most recent annual survey of Medicare patients found that just 2 percent of beneficiaries had problems of any kind finding a new primary care doctor willing to accept Medicare – the same percentage of patients aged 50-64 with private insurance who report problems.

Likewise, just 2.1 percent report trouble of any kind finding specialists willing to accept Medicare, compared with 2.3 percent for patients with private insurance.

I recently got into a discussion with one of my frequent visitors to this blog about doctors not accepting Medicare patients so I did a little research on the topic. As seen above the difference between doctors accepting Medicare patients vs. private insurance patients is basically the same.  The statistics show that it is actually slightly easier for a Medicare patient to see a specialist than it is for someone on private insurance! How is that for knocking that myth!

We constantly hear about how government-funded healthcare will produce inferior care and denied patients but as usual these types of things are usually just fear tactics put out by political partisans. Given that the Internet is so prevalent in most of our homes (although not so much in rural areas) it is relatively easy to get information on just about anything you care to research. It took me about five minutes to find the facts above.  Granted I had to sift through dozens of political articles about death panels and such but that is the price we pay for making information so easy. Learning the trick about googling helps too.

One of my personal favorite posts on this blog is about Lazy Minds (click here to see it).  It is just too easy for people to believe  and then pass one the rhetoric from someone with a very biased agenda gives them on about something instead of taking a little time to research it on their own. Lazy minds are the primary cause for so much that haunts our world today.

So the next time someone give you a political line about Obamacare or any other topic take the time to research it on your own. The real answers are out there if you care to wade through all the garbage to know the facts. But then again finding the facts can also get you in trouble with some groups, particularly those pertaining to religion. But that is another story…

Living As Cheaply As The People……

Banner - Will Rogers

What the government has got to do is live as cheap as the people.           21 December 1932  Will Rogers

Speaking about money not being wisely spent this morning got me to thinking about Will’s quote above. If you have read much on this blog you will know that I am a proud social progressive but also a fiscal conservative. In that light I certainly agree with Will here. Our government needs to learn how to live as cheap as its people. That doesn’t seem to be possible anymore. There is always that new model of military drone the DOD wants to buy in the thousands of course. There is always some other group including many corporations that need some type of incentive to provide jobs. Besides getting the drilling rights at gut cheap prices from government land the money bloated oil companies say they need more bucks to help them find the oil. But when it comes time to sell the oil they will only give it back to us at world prices! There is always someone with their hand out and our government can’t seem to keep their wallet in its pocket. More…

Mr. 3.75 Percent

Source: Mr. 3.75 Percent – By Daniel Altman | Foreign Policy.

One political leader who likes to plan for the really long term is Paul Ryan, the Republican nominee for U.S. vice president. By 2050, Ryan’s budget plan would reduce federal spending outside health-care programs and Social Security to 3.75 percent of GDP, down from 12.5 percent last year, according to the nonpartisan Congressional Budget Office. So, what would it mean to chop away two-thirds of the federal government?

According to the World Bank, government spending minus health care was already lower in the United States than in all of the European Union, Japan, China, and India in 2009, the latest year with comprehensive figures. At just 3.75 percent of GDP, the United States would be one of the world’s lowest spenders. The only countries that spent less in 2009 were Equatorial Guinea, the Democratic Republic of the Congo (DRC), and the Central African Republic. More…

Military Spending Cuts……. 2

Here is another poll that shows when it comes to making cuts in Medicare or Social Security a big percentage of people think we should cut our bloated defense spending instead.  If we could somehow manage to get our war machine budgets in line with the rest of the world, yes I mean the other 95% of the world, then most of our budget and deficit problems would be almost immediately solved.

Why don’t the politicians listen to us? I’m sure the answer like always is mainly politics and power struggles. God didn’t rule that somehow we are supposed to be the policemen of the world. When we get that into our heads we will be on their way to prosperity again. Let’s give some of that responsibility back to the rest of the world. We just can’t afford it anymore if we ever really could in the first place.

But what do I know……

I Guess I Am One Of Them…. Or Maybe Two Of Them…. 4

Source: Mitt Romney video fact check: Is 47 percent of US ‘dependent’ on government? – CSMonitor.com.

That is one of the questions that has been raised after Mother Jones magazine on Tuesday released a video of Republican presidential candidate Mitt Romney speaking to donors at a $50,000-a-plate fundraiser May 17.

“There are 47 percent who are with him [President Obama], who are dependent upon government, who believe they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you name it,” Mr. Romney says in the video

According to the fact checker Mr. Romney is saying I think I am a victim and entitled to food and housing and YOU NAME IT… He includes me and every one else who are over 65 in that group. He wants to get all us freeloaders off the government doles.

I must admit that I do collect Social Security and am on Medicare (I think maybe he is including me twice for that) but I must tell Mr. Romney that I paid 6%+ of my wages and so did my employer for over forty years to get those payments.

Since he has been in the campaign mode for over five years I know Mr. Romney drastically wants to be President. It is a “power” thing to him so he will do whatever he has to do to take up residence in the Oval Office.

But please Mr. Romney take me off your list and put some real number up there. Don’t call all of us who are seniors freeloaders. That attitude won’t get you many votes. But I guess since he was talking to $100,000 donors everyone except the 1%ers are thought to be the “takers” as Mr. Ryan’s hero Ayn Rands says it….

Taste…..

Elections are a good deal like marriages, there’s no accounting for anyone’s taste. – May 10, 1925   Will Rogers

You did it again Will. You perfectly described an election eighty-seven years in the future. There is just no accounting for the taste of the people who will be voting Republican this year.  But then again we will have to wait to see just how many actually vote for that yahoo who will face Obama this year.  He does seem pretty good at accumulating wealth but doesn’t seem to have a clue of how people live on less than $1 million per year.

We know that over half the marriages now days end in divorce. I think the same thing will likely happen if by some remote change Mr. “Bain Capital” does get elected. It won’t be long before the one who voted for him are seeking a divorce. Looking at the statistics I know that about 25% of the population are die-hard Republicans. But that number seems to shrink daily so it might be lower than that now. Of course those guys, and for the most part they are guys, would vote for anyone on the Republican ticket so there is no accounting for their taste.

Now I’m not saying that the Democrat who now holds the White House is much better. He has been a major disappointment to me. But at least we know what he might be up to for another four years. We have no idea what the damage that the other guy might do. He, and all the super rich guys in the super pacs , and I do mean guys (ha)) who run all the commercials for him seem to want to put the final screw to us retired folks by taking away our Medicare and Social Security among many other “handouts” as they call them. But they are an equal opportunity screwer as they want to take food stamps and the likes away from poor folks. The only thing they seem to be for is more tax breaks for themselves. They claim they are the job producers and need every cent to accomplish that. What they don’t want you to remember is that they have had their big tax breaks for eight years now and have produced little in the way of jobs but lots in the way of personal income.

There is a saying that “their is power in numbers”. There are a lot more of us folks who are getting screwed than there are those who are doing the job on us. When will we realize that we can dump these guys, yes in both parties, anytime we want to. We just have to realize that in a democracy there is power in numbers.

But what do I know…..

Get Rid of It!!! 4

It was 1965 when Medicare was enacted. I was just entering college so I still have some vivid memories of what went on around it.  I remember the conservatives in congress were saying such things as:

We’ve got to repeal this law, it is bad for the country.

Its Socialism.

It takes away choice.

It will bankrupt the country

And the most typical comment that also goes with increasing the minimum wage

Businesses will fail because of this law.

Now almost a half a century later the same thing is being said about the Affordable Care Act that recently got a pass from the Supreme Court. For some reason they want to take the meager advances given to lower-income folks in this, like many other areas, away from them.  Maybe if they put out a comprehensive plan of their own their “get rid of it all” rants might get some traction. Without that they just seem to be against helping others less fortunate than they are, and that is almost everybody.

They seem to say that everything is fine the way it is in healthcare. They also seem to say if we got those 30+ million people any form of healthcare they would overwhelm our system. While that was true to an extent when Mitt Romney instituted universal healthcare in his State it looks like that is working its way out. I can remember pre-candidate Governor Romney bragging that his model of healthcare should be implemented across the country. When did it become so bad even for him??

It’s ironic that the conservatives in congress over the years have been against what most of us consider  many of our biggest successes. First it was Social Security in the 1930s, then civil rights in the 1950s and 60s, Medicare in 1965, and of course every time that we raised the minimum wage almost always in democrat administrations. They seems to be on the wrong side of so much I can’t understand why they have lasted as a viable party as long as they have?

I know those guys in congress are anti-socialism to their core and anything that has even a slight smell of socialism brings up their ire and their “get rid of it” mantra.  They need to get over that ;) We are first a diversified nation but our second biggest success is that we in the past have also be a pragmatic nation. We find out what works and then go about implementing it. We seem to have lost that ability in the last couple of decades. We desperately need to get that back.

But what do I know…

As Cheap As The People…. 2

What the government has got to do is live as cheap as the people. – December 21, 1933    Will Rogers

 I have often on this blog mentioned that I am a proud social-progressive but I probably don’t as often proclaim that I am a fiscal conservative. For that reason this post as a general rule rings very true to me.  Our government should learn to live as frugally as it’s citizens. There are obvious places where that is not the case.

One of those that I often pronounce here is our military budget but that is not the only one. It seems that our government just doesn’t have a lot of common sense when it comes to spending our tax dollars. A local case in point is that my local and State government is spending over $5 million to basically add  about a half a mile of sidewalks approaching our high school.  In the process they will also re-configure one traffic intersection and widen the berms of the road.  The basic trouble is that hardly any of the high school kids walk to school! For the most part, given the 500 or so parking spaces around a school of about 900, they drive themselves.  I’m sure that if it were analyzed we could have provided each of the ones who might actually walk to school a brand new car, and even with that cost we could have probably saved mucho dollars on this project.

A federal example is given the amount of fraud of our Medicare and Medicaid systems it seems that we could actually save billions and perhaps trillions of dollars by providing more investigators and more vigilant prosecutors to catch those individuals and especially private businesses and corporations who are gaming the system. They do catch some, for instance the major drug company that was recently fined $50 million for charging for drugs they never delivered, but even then the fine was probably a small fraction of the total profit gained. For many businesses the fines they pay are just part of doing business to them. If we put more in jail maybe that mentality would change.

The Medicare system is the most efficient healthcare system in our country but it could be much much better if our government viewed the dollars they spend as we normal folks do.   If my family started getting bills for non-existent family member or for knee replacements that never happened I’m sure none of us would not go ahead and pay the bill. Instead we would do what we could to catch the “perps” be they individuals or private businesses. Our government should do the same.

I took a couple of economics classes in college years  and years ago but I’m pretty sure they still apply to today. :)  One of the things we were taught is that when a country faces a sever downturn in the economy, as we have several times in my life, the government needs to step in to prevent the total collapse of our systems. Without that spending we would have to, like the proverbial Phoenix, rise out of total ashes after each serious downturn.  So, while I may be a fiscal conservative I am not a masochist that demands total frugality when spending is needed.

But what do I know….

Is the Republican Party Insuring Its Own Demise?? 6

Is the Republican Party insuring its own demise by it continuing to focus on a narrower and narrower core group.  I want to believe this is the case as the alternative is that we as a country are now dominated by exclusion.  Being against things, particularly different groups of people, is what has been driving the Republican primaries lately. It has pushed their final candidate over to the extreme right of the political spectrum. Can the Republicans maintain a party that far off the center of American Politics?

It seems like everyday the Republican party members alienate yet another group of voters.

  • They are for rounding up all the people in this country without the proper papers and shipping them out of the country.  They seem to have no compassion for those who are just trying to provide for their families. This is alienating most Spanish-speaking voters.
  • They are against birth control. This is alienating many women voters.
  • They are against continuing to fund Medicare. They want to turn it over to the private insurance companies. This is alienating many senior citizen voters (and they are the most active voters around)
  • They are against providing medical care via Medicaid to the poorest of the poor.  Even though this group is not a strong voting block there are those who do vote and have compassion for this group.
  • They are against religious diversity. They say this is a “Christian” nation. By this they are alienating Muslims, Hindi, Buddhists, and other non-Christian religious groups.
  • They are against Social Security. They want to make each person entirely on their own during their senior years. This is a double whammy for us seniors.

The Republicans seem to be against so much and for so little how can they maintain a Republican base? It seems that one of the only groups they are not alienating are white evangelical Christians , particularly those ironically who lack compassion for their fellow-man. Someday this group might even take to heart the commands of Jesus, their founder, and at least some a minimal amount of compassion for the “least of these”.

Another group who they are not presently alienating are those that see governments only role in society is to provide for our war machine.  Everything else to this particular group is deemed unconstitutional. We have a female who is running for congress in my district who proudly announces that she is home schooled on the constitution. She basically says after her self study she has determined that the federal government’s only role is to provide for defense. Everything else, according to her, is unconstitutional!

The last and maybe the biggest group of supporters to the current Republican party are those that just want the government out of their pocket books.  Today they are known as the “Tea Party” but have had many other names through the years. They don’t see  ”providing for the general welfare”, as a necessary role for their government to be involved in. They seem to care little about anyone but themselves.

Where will future Republicans come from? If they end up having no core support can they even exist?

Another Flash in the Pan….

I see the Republicans have yet another “front-runner”! This time it is Rick Santorum. This makes every one of the eight or so wannabes that has moved to the front of the pack. But when that happens they soon seem to fizzle out like a flash in the pan. They get on the front burner of public attention and the heat becomes too much for them. Maybe Mr. Santorum will be different but I kind of doubt it.  He has his flaws just like all the rest of them. The Republicans want the “perfect” candidate, at least according to their convoluted standards, to beat President Obama in the fall. Nothing else matters to them than to get that guy out of the Oval Office.  They will do anything and I mean anything to make that happen. But their version of the perfect candidate seems to be someone who is teetering on the very right fringe of their party. How did they manage to kidnap a previously viable institution?

But their total focus on getting someone out is the major problem. They don’t have any agenda for themselves other than removing the present holder and shutting down the government. Somehow I guess they see the totally innate goodness of man and are convinced that if we just leave everyone to their own goodness everything will be fine. Some call me naive but I think their approach is the epitome of naive.  I see way too much selfishness in the world around me to leave everyone to do whatever they want. I see too much greed to hope that the rich will somehow all become great humanitarians if only we let them do their thing.

They see a world without Medicare, Medicaid, Social Security, and all the watchdog agencies to reign in our dark sides.  If they should actually gain the Oval Office I see massive problems envelope us. The safety net would simply disappear and be replaced by a deep dark pit. The Christian idea of being our brother’s keeper will be replaced by “everyone for themselves”.

Of course the latest “front-runner” also seems to want to turn our country into a WASP theocracy. At least his version of that. He, like all the flashes before him, thinks that his view of the world will solve all our problems.  Several polls now show that if Mr. Santorum is the nominee he will not carry his home state of Pennsylvania.  So those most familiar with him don’t think he is up to the job? Why would I, or most anyone else, want to vote for him with that being the case?

Medicare Here I Come … (Part 2) 2

This is the second of two posts about my experiences with recently joining the Medicare System. The first post gave you the types of plans that are offered to those who turn 65. There are a number of decisions that have to be made during this enrollment process. I have to warn you up front that this is really pretty boring stuff. I put it off as long as I could and if you are not that close to Medicare I would probably advise you to just skip this post ;)

The first decision I had to make was to decide whether to enroll in my pension  Advantage Plan. This really ended up being no decision at all. Since I was a management employee my previous employer was under no contractual obligations as far as my health care plan was concerned.  Over these eleven years the cost of my healthcare insurance through them has increased over ten times what is started out. When I looked into their  Advantage plan it turned out to be nothing but a stripped down Part D coverage  and nothing else. If I join this Advantage plan it would preclude me from getting a Medigap policy. The decision was therefore easy to decline their coverage and go out on my own.

So, the next thing on the list was the Medigap policy. I spent over a three weeks on this task. I studied hundreds of pages of various insurer’s plans and then chose one. I will not say which one I chose but in reality there is generally not much difference  between one Medigap insurer and another. The real choice turned out to be which of the various Medigap plans I would choose. They are defined by Medicare and are identified by letters between “A” through “N”.   Some covered only when I would spend so many thousand dollars. Some have differing levels of co-pays.  Some cover almost everything Medicare does not cover.   When comparing what I paid last year for private coverage and what I would pay starting next month for Medicare coverage I choose Plan F.

The final decision was what Part D (prescription) plan I would choose.  Most of this decision process involved studying how much I would pay for my current prescriptions. Fortunately there are software programs that allowed me to enter my prescriptions and see what each plan would pay. Again most of the plans were pretty equal but I did save about 15% by going to one insurer.   One of the gotchas on Plan D is that the insurer can change anything he want anytime during the year so there is no guarantee as to what he will pay in the future.

So now I have my Medicare card with Part B, my Medigap policy, and my Part D cards in hand.  What is the final result?  Now that I am on Medicare and all these other plans my medical insurance costs will be about 50% less in 2012 than they were in 2011.   That is a far cry from the annual 25% increase year over year for the last eleven! Was it worth all the work to get here? Absolutely, but it certainly could have been easier.

So here I am  ready for October 1 and ushering in the final thing that makes me an “official” senior citizen.  Bring it on!!

Medicare Here I Come…. (Part 1)

I will soon move onto the Medicare roles. It has been quite a journey to get here so that is what this and the following post will be about. I hope the post might help some of you out there who will be going through the same thing in the coming months or years.

I want to make it very clear that I am not by any means an expert in this area so what you will be getting is an ordinary guy’s view of these plans. In this post I will try to explain the options. The next post will give you my personal experiences with the process of choosing and enrolling in the system.

First the basic definitions (from a pure layman’s understanding):

  • Medicare Part A –  This includes coverage for Hospital stays and the like. This basic plan is provided at no costs to me and covers approximately 80% of most hospital charges. I am left to pay the remaining 20% of out pocket.
  • Medicare Part B – This covers doctors, testing and things like that. Part B if I choose to enroll (which I and most others did)  costs a little more than $100/month to new enrollee’s. Again it covers about 80% of the costs and I am left with the remaining 20%.
  • Medicare Part D — This is the plan that was started  in 1993.  It focuses on prescription drug costs. Depending on which drugs you take it covers varying degrees of the total cost of my medicine. When I reach a certain level of costs it quits  paying anything. At a future point beyond that is starts up again. This area where I would pay 100% of the costs is called the “doughnut hole”.
  • Advantage Plans —  These plans, which are intended to take the place of Part D plans and usually cover some of the uncovered costs of Part A and B or even replace Part B. These plans are sometimes offered by companies as part of the their pension plans.  People who enroll in Advantage plans typically cost the Medicare system about 10% more than those who stick with the traditional plans. If a person chooses to enroll in an Advantage plan they are not eligible to enroll in Part D or any supplemental plan (see the next bullet).
  • Medicare Supplemental Plans (also called Medigap Plans) — These are plans that are offered by private companies, under Medicare rules and reviews. They cover to varying degrees the uncovered parts of Part A and B.  The Medicare system has defined almost a dozen options that companies can provide to those who choose to join them.

So that in my nutshell is what the Medicare system and plans are all about. Now on to some of the things I have learned about all these options. While Part A is basically free to me the 20% out-of-pocket can be very substantial. For instance when I had a heart event about five years ago the one hour spent in the angioplasty operating room and associated hospital stay and doctor’s charges cost about $40,000.  So my out-of-pocket would have been $8,000! Since my event was somewhat minor I’m sure the costs of other procedures can exceed $100,000 in many instances.  $20,000  out-of-pocket would put quite a hit on my or almost anyone’s retirement savings.

Given the above example of the costs for just one medical event I and most people choose to enroll in some sort of supplemental plan. Those plans vary in costs from about $100 to a few hundred a month depending on coverage.  Like the Part D plan, the costs of the supplemental plans is pretty much left to the private insurers. They can raise their charges with little or no review by others.

There are literally hundreds of companies who offer various plans for supplemental insurance as well as Part D coverage. It is up to each senior to determine what plans to personally have.

With all these basic definitions now covered, next time I will be talking about my personal experiences with navigating this system and how I came out in the end.

What To Do About Medicare??

No this post is not about how to gut Medicare as seems to be the topic of today. Instead it is about my personal travels of getting signed up for it. As I announced before I am at the head of the herd of the Baby Boomers so I will be joining Medicare this year. As a result I am starting to try to figure out all the ancillary policies I need to get.  The free side of Medicare is really only Part A. (Note: I don’t intend to bore you with what all these letters and things mean so maybe you will be inclined to hang around this post a while longer.) :)  Anyway I have to pay some for Part B and my pension plans says I need to get that so that is a done deal. But then comes the other things. Do I go out on my own and get Part D and a “supplemental” policy or do I continue to stick with the policy that my pension plan offers?  That is the primary question I guess I have to cover in the next few months.

I have been on my pension plan for about over ten years now. It has gone from about $40/month when I started to more than ten times that amount this year. I just don’t know how getting on Medicare is going to change their policy coverage and amounts. Since my birthday falls on the same month as the pension plan insurance renewal info is available I guess I will have to make some quick decisions about this change in my life.

Even though she might not like it I have to admit that my wife is older than I am so we have already addressed some of these topics before. For her it was cheaper to drop off the “covered spouse” portion of the policy and go it alone. Given the fact that my pension plan still frequently states that, since I was a management employee and not under a union contract as my hourly friends were, they are under no obligations to continue to provide me with healthcare assistance maybe I should just dump them and get it over with. But since they keep complaining about it maybe they do put in at least a little of their profits into my coverage.

Whoever said living in retirement was a simple life obviously never considered all the complications of senior healthcare.  I guess I should be thankful that Medicare will be even there for me. At least I think it will be unless the Republicans try to “fast track” replacing it. I paid into it for over thirty years so I think I should get something for all that money I paid in. I know the politicians borrowed it for other things but how is that so much different from the treasury bills I currently hold in my retirement portfolio? Oh boy, maybe I should be worrying about that too!!

I’m sure my Canadian friends who might be reading this post are getting a laugh out of all of this since they have universal coverage both before and after retirement these types of issues don’t exist for them. Maybe someday the U.S. might actually learn something about this for our northern neighbors. But I kind of doubt it.

And the journey goes on….

If It's So Great Then…..

A couple of posts ago was about the so-called Republican plan to change Social Security. It is championed by Congressman Ryan.  As I mentioned in that previous post this new social security is supposed to empower seniors to get the best plan available but they limit the choices to private insurance companies. I personally have had enough dealings with those for-profit insurance guys to know that profit, not the customers, is their far and away number one priority for them.

If as Congressman Ryan suggests that his new plan is an improvement that “empowers” us then why don’t they “empower” the recipients of Medicare to choose his plan or the current one?  I would not be opposed to having Mr. Ryan’s plan to be one of the options that I can choose if I buy into his rhetoric. But give me the option of going to the same plan that my father and grand-father used.  The Republicans say they are all for competition and the free market place. If that is really the case then put the “empowerment” plan alongside the current one and let the competition begin.

Just yesterday Congressman Ryan said that the Democrats are playing the fear factor with “Mediscare” and that actually his proposal would be just like today’s Medicare Advantage option in Social Security. But, that doesn’t make any sense to me? It is well know that Medicare presently has to pay a 15% premium for all those on the Advantage plans. That is one of the reasons the Advantage plan is eliminated by the Democratic proposals. They are just too expensive.  If his plan is the same then he must be proposing to increase Medicare costs not decrease them.

Most people who are at least minimally knowledgeable in this area know that Mr. Ryan’s proposal is a voucher system with the amount of the voucher covering much less of the expenses than the current system. After all it would have to cover the medical procedures as well as the increased paperwork costs AND the profits needed by the private insurers. But then again I’m sure the Republicans would enable the private insurance companies to weed out all those who are currently “unhealthy” via a pre-existing condition statement so maybe that is where they would make up for their 25% or so added costs.

Congressman Ryan and his fellow Republicans are not about to give seniors a choice of staying with the current system or moving to his experimental voucher system. They know if they did that  the majority of seniors would stay with the current system.

But what do I know….

Don't End It; Fix It…..

It is heartening to see that seniors medical care means something to the nation as a whole. After the Republican defeat in the very conservative district in New York on Tuesday maybe they will get the message. Why do so many politicians, almost all of them of the same party, think that the solution to Medicare is to end it and put seniors out on their own to individually battle the giant private insurers for healthcare?

It is beyond my comprehension as to why no one is talking about controlling the costs of medical care in this country instead of just reducing benefits! The rest of the industrial world spends less than half of what we do for medical care and most live longer than we do. Surely there is something we can learn from them?  Why isn’t anyone looking to their examples to find solutions to our current Medicare problems? I’m sure a big part of the reason for this is that they don’t like the solution that the rest of the world has discovered.

Everyone country that  has costs well below ours is on a single payer system. Of course there is one party in Congress who screams that this SOCIALISM and want nothing to do with it for solely that reason. Socialism abounds in many other parts of our country so why are some so resistant to accept it in our healthcare area?

  • Our police departments are controlled by the governments in each area
  • Our fire departments are controlled by the governments in each area
  • Our army, navy, air force and other military are controlled by the federal government
  • Our food safety is controlled by our governmental representative
  • Our banks are regulated by our government
  • Our electricity is regulated by our government

Almost everything that controls citizen safety is in one way or another controlled by our governmental representatives. I don’t hear too many, except maybe those on the extreme right of the political process like the recent KY Senator Rand, complain about any of these forms of socialism. So most of us are socialists in many areas so why not for healthcare?  It is a fact that Medicare is the most efficiently run healthcare agency in the country. The private insurers spend three times more for their paperwork than Medicare. Medicare pays usually only 60% of the private insurers for most medical procedures. The main thing that need addressing in Medicare to keep costs down is the fraud in the system. Why isn’t any of our politicians in Washington talking about any of this?

Why aren’t we talking about costs? Is it really necessary for a surgeon to earn more for a one hour surgery than most of his patients earn in two months? Those sort of issues are nowhere to be found in the public debate. Why not?

I read recently that diapers and politicians are things that need to be changed frequently; both for the same reason. Maybe it is time to keep voting them out until we finally find some one with some common sense in this area. Yes, I admit Medicare has some long-term problems but they are all fixable if we would only get off our high horse and recognize the solutions that the rest of the world has already discovered.

Don’t shut down Medicare; fix it!!

But what do I know……

Fix It Don't End It…. 2

It is heartening to see that seniors medical care means something to the nation as a whole. After the Republican defeat in the very conservative district in New York on Tuesday maybe they will get the message. Why do so many politicians, almost all of them of the same party, think that the solution to Medicare is to end it and put seniors out on their own to battle for healthcare?

It is beyond my comprehension as to why no one is talking about controlling the costs of medical care in this country instead of just reducing benefits! The rest of the industrial world spends less than half of what we do for medical care and most live longer than we do. Surely there is something we can learn from them?  Why isn’t anyone looking to their examples to find solutions to our current Medicare problems? I’m sure a big part of the reason for this is that they don’t like the solution that the rest of the world has discovered.

Everyone who has costs well below ours is on a single payer system. Of course there is one party in Congress who call this SOCIALISM and want nothing to do with it for solely that reason. Socialism abounds in many other parts of our country so why are some so resistant to accept it in our healthcare area?

  • Our police departments are controlled by the governments in each area
  • Our fire departments are controlled by the governments in each area
  • Our army, navy, air force and other military are controlled by the federal government
  • Our food safety is controlled by our governmental representative
  • Our banks are regulated by our government
  • Our electricity is regulated by our government

Almost everything that controls citizen safety is in one way or another controlled by our governmental representative. I don’t hear too many, except maybe those on the extreme right of the political process like the recent KY Senator Rand, complain about any of these forms of socialism. So most of us are socialists in many areas so why not for healthcare?  It is a fact that Medicare is the most efficiently run healthcare agency in the country. The private insurers spend three times more for their paperwork than Medicare. Medicare pays usually only 60% of the private insurers for most medical procedures. The main thing that need addressing in Medicare to keep costs down is the fraud in the system. Why isn’t any of our politicians in Washington talking about any of this?

Why aren’t we talking about costs? Is it really necessary for a surgeon to earn more for a one hour surgery than most of his patients earn in two months? Those sort of issues are nowhere to be found in the public debate. Why not?

I read recently that diapers and politicians are things that need to be changed frequently; both for the same reason. Maybe it is time to keep voting them out until we finally find some one with some common sense in this area. Yes, I admit Medicare has some long-term problems but they are all fixable if we would only get off our high horse and recognize the solutions that the rest of the world has already discovered.

Don’t shut down Medicare; fix it!!

And the journey goes on…….

Are Commitments to Social Contracts Dead??

I worked over forty years of my life. During that time I paid social security taxes on almost all my income. Of course I realized that much of those taxes were used to pay my father and grandfather’s social security income and medical expenses. That was fine; that was the way it was supposed to be. After all there is a social contract in our country that says we will take care of elderly who have helped give us our many years of prosperity. That was the way it was. But is that social contract about to be aborted? Are the people trying to find ways to break it?

There are those in Washington today who want to throw this contract out the window and they seem to have a base of support for that among at least some our population. Why after almost a century of commitments kept are we now ready to throw them aside and make it every man for themselves? Why? I think these are some of the answers:

  • There are those who once had well-paying middle class jobs who are now working a couple of minimum wage jobs just to get along. They are bitter because they have seen better times and they are now in our past. Now sadly they only want to think of themselves.
  • And then at the other end is greed. There are just too many who worship at the altar of money. That is their god.The more they have the more they want. They are not about to willingly give up any of it for anyone else.
  • We have wedged ourselves in a viewpoint of “Us” vs “Them”. Them being anyone who appears to be different from us.
  • Some are also ready to throw aside their social obligations to their mothers and fathers. They feel no moral obligation beyond themselves.
So many of us proudly boast that we are a Christian nation but we don’t seem to want to live up to the values taught us by Jesus Christ. Jesus taught us that, first and foremost, we are to be our brother’s keeper. That we are responsible for each other and if needed we should give the shirt off our backs to our neighbors in need.  How can we propose to throw away the safety net under the “least of these” and then call ourselves Christian? I just can’t understand that!
It is not as if the problems with our social security system and our means of giving medical care to the poor and elderly are in imminent peril. Even the most conservative pundits admit that it will be years down the road before we actually face any difficulties in this area and even those difficulties can be ameliorated by some rather minimal fixes. We don’t need to gut our commitments to stay afloat. Will we allow that one percent of our population who control almost half of our country’s wealth and are presently pulling the levers of our government to break this country’s moral  commitments? I am not optimistic about the answer to that question.
I am just a simple guy; what do I know…