Sen. Sam Brownback, R-Kan., accused Democrats of playing political games with Medicare and said that the bill preventing funding cuts that passed the Senate Wednesday was “controversial.” If this was such a partisan, controversial bill, why did it pass the Senate 69-30 and the House 355-59? And why was Brownback the only member of the Kansas delegation to vote against it?
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21 Comments
Boo hoo, Brownback failed in his attempt to protect insurance company profits. If Brownback were such an advocate for health care he’d support universal health care, but he’d rather spend money on war.
It is “controversial” because Brownback’s patron saint Bush opposes it.
Your questions are easily answered. Brownback’s head isn’t on the chopping block, so he’s had to take the ‘point’ position.
It’ll switch next time when Brownback’s up, Roberts will one again relieve Brownback and take the Repub. lead position.
This was a complicated bill.
Actually, it relates more to PRIVATE Medicare or Medicare Advantage plans, more than anything else, as far as the debated changes go.
Remember when Newt Gingrich said traditional Medicare would “die on the vine”???
He MEANT that many people would choose Medicare Advantage “privatized” Medicare, rather than old fashioned, traditional Medicare with, perhaps, a traditional Medicare Supplement plan.
Now? Now the actual “subsidy” for some Medicare Advantage plans is turning out to be 18% higher, or more, than what the government pays out for people on “traditional” Medicare.
It is rather odd, to see the Democrats who attacked Gingrich, for his support of Medicare Advantage plans, now complaining about proposed “cuts” in Medicare Advantage plans, designed to bring the cost of Medicare Advantage in line with the cost of traditional Medicare.
For the record, I am biased towards traditional Medicare Parts A and B, with a private, old fashioned Medicare Supplement. I also think most people should take out a Medicare Prescription Drug Plan, when eligible. That would be Medicare D.
Medicare C? That is Medicare Advantage. That is PRIVATIZED Medicare.
Please understand, old fashioned Medicare A and B hire private contracting companies to process claims and do customer service duties.
However, in old fashioned Medicare, the Government sets the plan benefits.
In “Medicare Advantage” the government is not very involved in setting the benefits.
There are PPO Medicare Advantage Plans and there are Private Fee For Service Medicare Advantage plans.
The costs do seem to be out of line for the Medicare Advantage Private Fee for Service plans.
In all Medicare Advantage plans, the “Part B Preimium” — which is about $98 per month, is sent to a private insurance company instead of to CMS. (Part B is now “means tested” not everyone pays the same amount).
On top of that premium, Medicare also sends a “subsidy” to the private insurance company, based roughly on what Medicare is spending, on claims, for traditional Medicare participants in that geographic area.
The calculations of these payments are complex.
Medicare, at all levels, has used “cost shifting” to underpay claims, forcing non Medicare patients to bear the costs of Medicare patients.
Medical providers are getting upset with that habit of Medicare, and rightly so.
However, those reimbursment amounts also relate to how much Medicare has to pay to private Medicare Advantage plans when they figure out the “census” or subsidy for those plans.
For the record, this is what the government spends on the average Medicare beneficiary, per month:
Part A: $410
Part B: 270
Part D: 80
Part C subsidy = $760 PER MONTH to the private insurance companies, because this is what Medicare spends, when it retains these people in its own program.
I do think that Medicare Advantage makes sense, for some people, especially older clients, above age 70 or 75.
However, again, I prefer the traditional Medicare plan.
My advice to the public would be to be very slow to react, when Medicare issues are debated in Congress.
Case in point?
I was bombarded by insurance company lobbyists, begging me to fight this bill.
The insurnace companies OPPOSED Brownback on this one.
Let me be clear, the bill itself got changed a bunch.
The insurance companies were against Brownback on many issues.
The lobbyists were asking me to oppose any cost control measures.
Brownback supported the cost control measures.
Has to be more taxes and regulations here. If the Eagle likes it, must be something wrong.
Brownback . . . isn’t he the guy who thinks voting as a senator is a bad thing? I mean, he sure misses enough votes to make one think so, so why would his opinion carry any weight?
“The lobbyists were asking me to oppose any cost control measures.”
Why were lobbyists courting your vote?
:lol:
Well, well, well we have another “Augustus Stupidus Augers In” moment.
Commander Codpiece has promised a veto!
You gotta love it. McCain must be havin’ a cow, not to mention every Republican in Congress. :D
My guess is that Reid and Pelosi will try like hell to milk the override vote out long enough to maximize the damage to the GOP.
http://thehill.com/leading-the-news/bush-will-veto-medicare-bill-white-house-says-2008-07-10.html
That boy is just about as dumb at they come. How in the devil did ANYBODY ever vote for him?!?
Those who voted for Sam Brownback must be kicking themselves and screaming obscenities right now.
Franklin, you seem to be very knowledgeable about the subject of Medicare. I did find one thing you wrote confusing “It is rather odd, to see the Democrats who attacked Gingrich, for his support of Medicare Advantage plans, now complaining about proposed “cuts” in Medicare Advantage plans, designed to bring the cost of Medicare Advantage in line with the cost of traditional Medicare.”
The reason I am confused is because the 10.6% cut in payments were only going to the doctors who were treating traditional Medicare patients. That same cut was not going to be applied to doctors who treated patients under the Medicare Advantage Plan.
The so called reason that the Republicans gave for wanting to reduce payments to doctors was to bring down the raising cost of Medicare. If this were true, the payments would have been reduced across the board.
Funny how those 9 rats jumped ship when the saw Kennedy come in.
“Kennedy’s crucial vote brought the number of senators supporting the measure to 60, guaranteeing it would pass. Once that fact was apparent, nine Republicans who previously opposed the bill jumped aboard to bring the tally to 69-30. The House passed the bill last month, 355-59.
Franklin,
Thank you for bringing some brains to this forum. This was a bad bill and was grandstanded beyond belief. There was another bill that precluded these cuts. Brownback supported that bill. Anyone who wants any say-so in their own medical care after they reach the age of 65 is now SOL. No more even partial opting-out of DMV-style health care. Sam did the right thing here as we’ll all soon see.
Are we STILL giving Brownback a hard time for missing votes, in the Senate?
Has anyone noticed how many votes Obama has missed?
I guess it doesn’t matter.
When Obama DID vote, in the Illinois legislature, he often simply voted “present” anyway!
Maggot
Fair question.
Several lobbyists for health insurance companies spammed every “senior markets” health insurance agent in the country, with requests for us to call our members of Congress, on these issues.
I am licensed to sell Medicare Advantage Plans, but I also believe that the costs are out of wack, in these programs. I think that the governments contribution, per beneficiary, in these plans, should be about the same as the government’s contribution, per beneficiary, in the traditional Medicare plan.
I received emails from lobbyists with at least 4 different insurance companies.
I received a personal request, on the phone, from one insurance company.
I am and was luke warm on this issue.
It affects me directly, yet I am conflicted on the bill, as it is very complicated.
In answer to a question above, the formula that CMS uses, to reimburse Medicare Advantage Plans, needs some tweeking.
I agree that the Medicare Advantage Plans should be given the same taxpayer support, per beneficiary, as traditional Medicare.
The problem arrises when you try to come up with a formula to do just that.
I understand the current system better than 99% of the population, and I hesitate to call myself an “expert” in how the subsidy to Medicare Advantage Plans is calculated.
Now, having said that, I personally think that Medicare Advantage plans make sense when the client/beneficiary sees their Medicare Supplement plan (only available to those in traditional Medicare) getting close to $200.00 per month.
Medicare Advantage Plans are the same price, regardless of age.
However, Medicare Supplement plan premiums tend to go up with age. (Or at least, with claims experience.)
Since the Medicare Advantage plans tend to have an “out of pocket maximum” there is a “tipping point” where the advantages of traditional Medicare plus a supplement start to shift towards a Medicare Advantage Plan, with lower or NO premium, but HIGHER deductables.
—–
The advice I give MUST be based on what is best for my customers/clients/policyholders.
Still, I am also a taxpayer. I want these programs to be sound. Competition will only work, if we make sure that all the plans are on the same economic footing, as far as taxpayer support is concerned.
what did you figure of this
Every large bill is hard to comment upon.
The “devil is in the details” — which means, in the AMENDMENT process.
The heavy lobbying, this time, seemed to focus on cost control measures.
The method currently used, “Medicare Assignment” where CMS assigns a “value” to every medical procedure, in every geographic region of the country, might work ok under traditional Medicare.
We can argue that the “assignment” values are often too low, but the process is not a problem.
However, since Medicare Advantage plans are not bound, directly, by the Medicare Assignment tables, and since Medicare Advantage plans work hard to recruit health care providers into their plans (If you accept traditional Medicare, you must accept ALL Medicare patients, for ALL procedures, period! Medicare Advantage patients do not have this security. Providers can pick and choose patients and proceedures, and decline service to you at any time, for any service.)
Since recruiting providers is often the key to the success of Medicare Advantage plans, they sometimes find a way to promise to pay at least the “Medicare Assignment” amount, at least on paper. Providers will tell you the opposite, that the plans promise payments but, somehow, avoid paying them. Medicare Advantage plans will aslo promise to pay for some services that traditional Medicare would not pay for, at all. This is another story.
There is a “procedure code” directly linked to each routine medical proceedure. There is a “Medicare Assignment” or fee, predetermined by CMS, for each of these procedures.
I do not understand exactly why the Medicare Advantage plans are getting more money, per beneficiary, than standard Medicare. I do not know why the government does not just give them the “census” subsidy, or the amount spent on the average traditional Medicare patient. That is how it is supposed to work, but there are accounting allowances made, that seem to give the Medicare Advantage plans a bit of an unfair advantage, when determining the “census” subsidy figure.
I think, in this sausage making we call legislation, this is what happened:
Some in Congress wanted to revamp the entire “Medicare Assignment” system, and the way the “Medicare Advantage” subsidy was determined, at the same time.
This would make sense, in any business, to do it all at the same time.
However, this is the government, and this is an election year.
dang
I know I deleted some of those “e” entries.
Oh well.
“Are we STILL giving Brownback a hard time for missing votes, in the Senate?
Has anyone noticed how many votes Obama has missed?
No comparison, Obama is a serious contender. For Brownback it was nothing more than a lark, and a vacation from his regular job.
Phantom
Who gets to decide who is a “lark” and who is a “serious contender”?
When Obama missed his first vote, in the Senate, how many Americans would have rated Obama a “serious contender” at that time?
Your defense of Obama, missing votes, while attacking Brownback, for missing votes, is rather hypocritical.