Cecile Sangiamo,... a 72-year-old Clearwater, Fla., resident had been on the federally subsidized, privately run Medicare Advantage policy through WellCare Inc. for about three years when she started having pain that made it hard to walk... And when Sangiamo needed surgery, she said, WellCare offered some unexpected medical advice.
"Take pills and use a walker," Sangiamo remembered being told by the insurer, which declined to comment on the case. "I wanted to say, 'I'll take the walker and bang you in the head with it.'"
The Advantage plan is costing taxpayers $111 billion a year and 14 percent more per patient than traditional Medicare.
Even Advantage backers acknowledge one of its toughest problems is few seniors understand the essential difference in private plans: Even services covered by traditional Medicare that doctors deem medically necessary routinely need the insurers' advance approval and are sometimes denied.
Yes, make sure you get clearance from a Corporate mediary between you and your doctor, before you get that pacemaker tuned up.
"There are so many hoops to run through, there are so many rules, it's just mind-boggling," said Mary Johnson, policy analyst for The Senior Citizens League, a nonpartisan, 1.2-million-member group. "Woe is you if you have any kind of chronic problem, and woe is you if you're ever hospitalized."
(my emphasis)
So, basically, government subsidized private insurance, even with that federal subsidy that will cost taxpayers over $1 TRILLION over the next 10 years, aint cuttin the mustard.
Isn't that the same amount the GOP is (incorrectly as usual) bitching about with the House's health care reform?
Reform that is
deficit neutral over the 10-year budget window – and even produces a $6 billion surplus. CBO estimated more than $550 billion in gross Medicare and Medicaid savings. More importantly, the bill includes a comprehensive array of delivery reforms to set the stage for lowering the future growth in health care costs.
Net Medicare and Medicaid savings of $465 billion, coupled with the $583 billion revenue package reported today by the House Committee on Ways and Means, fully finance the previously estimated $1.042 trillion cost of reform, which will provide affordable health care coverage for 97% of Americans.