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I keep not hearing it in the debates, and in the general discussions in the media (except for here, of course; Kossacks are brilliant). Occasionally, including last night, there is a passing reference to the idea, but it is almost never actually discussed in living color detail.

I am 54 years old. After a half-century of not taking care of myself but being healthy anyway, the piper has started demanding his payment. In the past couple of years, I've

~been hospitalized twice,

~ had a heart attack,

~ discovered that I might have COPD but it's more likely asthma (and in either case it's treated with daily inhaled steroids),

~ been diagnosed with sleep apnea and had to start using a CPAP machine at night,

~ had blood sugar readings that put me just barely into the prediabetes range, and most recently

~ had a routine colonoscopy that indicates a possibility of Crohn's disease.  

I am a teacher, used to be a lawyer, and have scored in the 99th percentile on every standardized test I've ever taken in my life. When I was married, I was the one who handled the family finances. I know how to read insurance policies and medical procedure disclaimers, do online research regarding my medical conditions and medications, and do comparison shopping for products in the financial, medical and insurance markets. I've been in sales, and I've taught communications, so I know what to listen for in sales pitches and how to wade through the BS during sales negotiations to get to the bottom line.

And I am frankly scared shitless at the idea of having to shop around for health insurance 20 or 25 years from now, when my health problems are worse and my mental faculties are in decline and I'm living on whatever meager resources the Republicans decide to let me retire on as a public employee.

Just the task of looking through the materials that I get through my employment every year during open enrollment is enough to exhaust me even now, in my relatively vigorous "youth." There are only 3 or 4 choices, and either the full cost will be covered or at most I'll have to pay about $50/month, depending on which plan i choose. And my current plan, which I've had for about 5 years, is serving me very well, so the default position of sticking with that plan is really easy.

And yet, even the thought of looking at that paperwork stresses me out so much that this year I didn't even bother. I just stuck with what I've got. Maybe I could have improved my position slightly by switching to the new plan they added to the menu this year, but honestly it wasn't worth it to me to find out.

I wish the Democrats would emphasize this as much as they emphasize the $6400 per year that the original Ryan plan would add to medical costs. The problem with vouchers is not just that they won't keep up with rising medical costs, it's that they will throw seniors into the lion's den of having to negotiate their way through the insurance market, with commission-hungry salespeople lurking around every corner -- and for those who are less computer-literate, those salespeople will be the primary source of available information.

Of all the hundreds of millions of people in this country, I am among the elite: the ones whose education, background, and inclination best suit them to be able to make good healthcare choices for themselves in their golden years.

And I am scared to death at the prospect of having to do it.

The next time Paul Ryan extols the virtues of "choice" for seniors in their healthcare, I hope some cute little gray-haired granny walks up to him and slaps him in the face.

And the next time there is a presidential debate, I really need to hear the President ridicule the idea of choice in Medicare for the bilgewater that it is.

Originally posted to NWTerriD on Fri Oct 12, 2012 at 07:37 AM PDT.

Also republished by Community Spotlight.

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  •  Tip Jar (206+ / 0-)
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    "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

    by NWTerriD on Fri Oct 12, 2012 at 07:37:30 AM PDT

  •  Well watch out for eligibility age too (22+ / 0-)

    I believe even under ACA they can discriminate premiums based on age.  At 69 your premium ought to be a heck of a deal.

    •  Age is a huge cost factor (31+ / 0-)

      Older people have much higher claim costs than younger people do.

      If we completely removed age as a rating factor, then young healthy people would not buy health insurance, mandate or no mandate.  As it is, ACA does limit the variation based on age to a factor of 3:1, which means that younger people will be subsidising older people (which I do not have a problem with btw).

      Of course all of this could be made even simpler with single payer.

      Numbers are like people . . . Torture them enough and they'll tell you anything.

      by Actuary4Change on Fri Oct 12, 2012 at 07:53:20 AM PDT

      [ Parent ]

      •  I wonder what the impact is (18+ / 0-)

        Of kicking people in their sixties off of Medicare. Don't premiums go up for everyone?  It just seems like we keep getting screwed and screwed again.  And it is always the middle class who gets screwed and I mean those with median incomes not the $250k crowd.

        •  If they raised the eligibility age to 70 from 65 (15+ / 0-)

          Then the total cost of Medicare would go down because their would be fewer people covered.  Average cost per person would go up, but premiums would not have to, because the government subsidy that keeps the premiums as "low" as they are would be able to go up because they would be subsidizing fewer people.

          It would really extend the life of the Medicare trust fund, and would not hurt those who got medicare.  Of course those who couldn't work until they were 70, or didn't have health insurance in the first place would be screwed, but Medicare would be O.K.

          It would also tend to increase, not reduce, the total amount spent on health care in this country, which is the real problem, but let's sweep that under the rug, because ObamaCare = Socialism, which means death-panels.

          Numbers are like people . . . Torture them enough and they'll tell you anything.

          by Actuary4Change on Fri Oct 12, 2012 at 08:55:44 AM PDT

          [ Parent ]

          •  Yes but assuming the 65-70 try to buy insurance (13+ / 0-)

            Either they pay enormous premiums or costs go up for everyone to even them out.  Maybe if we have some history with ACA we can see how we cover this but otherwise I think you just destroy many people in their 60's with health costs.  

            •  With a pre-existing condition such (7+ / 0-)

              as cancer.  The ACA would allow my husband to be covered by at what cost?

            •  It's outrageous (6+ / 0-)

              Rates for people in the 55-65 category are already absurdly high; I"m paying about $25k/year for a high deductible plan!  That's in Massachusetts, as a small business plan (age rated), and it's lower than the Romneycare rates.

              The 65-70 group is as desirable to private insurance companies as bedbugs are to the Hilton Corp.  They don't want these high-cost patients, especially if not backed up by the government.  So raising the age of Medicare will probably throw a lot of 65+ people off insurance, and/or bankrupt them.  It would "extend" the trust fund, but so would just killing anyone who got sick.  Come to think of it, that would be much of the impact.

              Remember, too, how the basic Ryan (not Romney's modified and-doesn't-add-up version) plan saved the most.  Because it required the senior to pay the difference between the groupon value and the private insurance rate, millions would have gotten absolutely no coverage.  Romney's version claims that there will still be some residual basic Medicare, but it's not clear what it could be if he's also giving money to private insurance.  There's already some of that in Medicare Advantage, so any additional privatization would have to come at the expense of the current Medicare public option.

          •  They really only care about the cost to govt. (21+ / 0-)

            That is what "entitlement reform" is all about: making that cost go down. They don't care if the cost to seniors goes up.

          •  If you are 62 you can receive SS (11+ / 0-)

            at a reduced rate. Why not increase that age to 65 and not raise it to 67.   Believe me I was an ER nurse for years and there is no way I could be doing that at age 65 and the patients wouldn't want me treating them after 3 twelve hour shifts.   I know many people who started or are planning to take SS at 62 because they think it is going broke and  won't be there for them.  To us baby boomers SS and Medicare is scared.  
            Bring all of our troops home and use that money to shore up medicare and expand treatment for those vets who need treatment from Bush's wars.

            •  Because that woudln't save money (12+ / 0-)

              The value that you get by retiring at 65 vs. taking a smaller payment at 62 is approximately the same, so taking that option away would not save the govt any money.

              BTW, the current law already says that the age will slowly raise to 67, so anyone talking about increasing the SS retirement age is talking about something more than 67.

              Numbers are like people . . . Torture them enough and they'll tell you anything.

              by Actuary4Change on Fri Oct 12, 2012 at 10:25:50 AM PDT

              [ Parent ]

            •  It is easier than that, eliminate the income cap o (9+ / 0-)

              SS tax and with both Medicare and SS tax all income including investments. Jan 1 this year investment profits will be taxed at 3.8% for medicare for the first time. A lot of us already pay on everything or virtually everything we earn. This could provide a good basis for Medicare for all which is IMO the smart way to go.

              •  cherie clark - there is no cap on Medicare (8+ / 0-)

                and as you note investment income will now also be taxed for Medicare starting 1/1/13.

                Your proposal for SocSec would end the program as it was intended and has operated to this point. It was designed as "wage insurance" with its own funding mechanism and not funded by general tax revenue. It is not an income redistribution plan, but rather a program where people earn a benefit by the contributions they make into the system, as well as their employers. There is a reason why there is a cap. The thought is that people at higher incomes likely have other retirement assets and don't need to "insure" all of their income. Investment income isn't included because investment income isn't tied to employment and doesn't end when we retire. Therefore, there is no logic to "insure" it. There are two issues with eliminating the cap, one is that if all the extra income is included the benefit formula, SocSec payments to very high income earners could be six figures per year. If you take the cap off of contributions, and cap the benefits, you have changed SocSec as we know it and violated every principal that FDR set out for it when it was started. The program shares such bipartisan support because people think it is fair and your benefits are tied to your contributions. That link cannot be broken or you have an income redistribution program that FDR warned us would be perceived as welfare, he called it the "dole".

                I favor raising the cap, and allowing benefits to rise to reflect the higher contributions. A staged increase in the cap solves nearly all of SocSec's financial problems.

                "let's talk about that"

                by VClib on Fri Oct 12, 2012 at 03:45:29 PM PDT

                [ Parent ]

                •  You just made me learn something! nt (4+ / 0-)
                  Recommended by:
                  VClib, NWTerriD, marina, cherie clark

                  I was wise enough to never grow up while fooling most people into believing I had. - Margaret Mead

                  by fayea on Fri Oct 12, 2012 at 04:27:44 PM PDT

                  [ Parent ]

                •  How much would it help? (2+ / 0-)
                  Recommended by:
                  NWTerriD, cherie clark

                  I don't know enough about SS finances to know how much raising the cap and benefits would help.

                  Numbers are like people . . . Torture them enough and they'll tell you anything.

                  by Actuary4Change on Fri Oct 12, 2012 at 07:38:17 PM PDT

                  [ Parent ]

                  •  A4C - I don't know the math (0+ / 0-)

                    But the system stays in balance if about 90% of wages and salaries are subject to withholding. We are now in the low 80s. We need to stair step the amount up until we hit 90%. That might require us to take the cap close to $200,000. The current maximum cap is $110,000 and the max benefit is under $3,000/mo. If someone had 40 quarters at $200,000 plus my guess is that the benefit would be about $5,000/mo. There are some formulas on the SocSec website to play with and you are just the type of person with the expertise to work on a few examples.

                    "let's talk about that"

                    by VClib on Sat Oct 13, 2012 at 10:46:42 AM PDT

                    [ Parent ]

                •  That is fine too, it would be nice to raise (1+ / 0-)
                  Recommended by:
                  VClib

                  benefits because the average benefit barely keeps one above the poverty level. What makes me crazy is this idea it can't be fixed. I did know that there was no cap on medicare just forgot., one of the reasons I retired, memory issues. I paid in for 56 years, from the time I was 12 years old and it isn't an entitlement, someone needs to drive a stake thru the heart of that meme. When you work and pay into a benefit it isn't the DOLE, it isn't a hand out, it is a contract we make with the government. Simpson Boles saw the merit in raising the cap and raising the monthly benefit amount to something that would allow seniors to retire with dignity.

                  •  cherie - I think there are two issues (0+ / 0-)

                    We completely agree that SocSec is an earned benefit.

                    The issue of raising the monthly payment at the bottom is expensive and complex. The formula that determines benefits is currently modestly weighted in a progressive fashion, that is a low income person receives higher benefits per dollar contributed than a person contributing at the cap amount. There is certainly strong support from Dems to tweak the formula to make that low income benefit higher, but it is very expensive because of the sheer number of SocSec checks that go to people who were low income workers. I would hope that if we significantly raised the cap, say from $110,000 to $200,000 over the next ten years, that we could continue to shave some return on those higher income participants and bolster the current and future benefits to lower income workers.  

                    "let's talk about that"

                    by VClib on Sat Oct 13, 2012 at 10:54:12 AM PDT

                    [ Parent ]

          •  And it would make it very very hard (11+ / 0-)

            for people in the 65-70 range to buy health insurance.

            It would mean people younger than 70 - or people with a spouse younger than 70 - would not retire if they could possibly help it, even if they're to the point where their health interferes with job performance. Perhaps especially if their health is creating problems. So instead of these people retiring gracefully, private and public employers have to spend a lot of time and energy documenting, disciplining, and firing these workers.

            And don't forget that study that shows that people who are 64 and appear in ERs die at a much higher rate than people who are 65 and appear in ERs.

            Fry, don't be a hero! It's not covered by our health plan!

            by elfling on Fri Oct 12, 2012 at 10:03:47 AM PDT

            [ Parent ]

            •  Do you have a link to that study? (2+ / 0-)
              Recommended by:
              ladybug53, NWTerriD

              it would be helpful.

              Shop Liberally this holiday season at Kos Katalog

              by JamieG from Md on Fri Oct 12, 2012 at 10:52:03 AM PDT

              [ Parent ]

              •  I think this is it (5+ / 0-)
                Recommended by:
                JamieG from Md, kurt, NWTerriD, marina, splashy

                http://people.ucsc.edu/...

                Does Medicare Save Lives?
                David Card, Carlos Dobkin and Nicole Maestas*
                 June 2008
                Abstract

                The health insurance characteristics of the population changes sharply at age 65 as most people become eligible for Medicare. But do these changes matter for health? We address this question using data on over 400,000 hospital admissions for people who are admitted through the emergency department for “non-deferrable” conditions—diagnoses with the same daily admission rates on weekends and weekdays. Among this subset of patients there is no discernable rise in the number of admissions at age 65, suggesting that the severity of illness is similar for patients on either side of the Medicare threshold. The insurance characteristics of the two groups are very different, however, with a large jump at 65 in the fraction who have Medicare as their primary insurer, and a reduction in the fraction with no coverage. These changes are associated with small but statistically significant increases in hospital list charges and in the number of procedures performed in hospital. We estimate a nearly 1 percentage point drop in 7-day mortality for patients at age 65, implying that Medicare eligibility reduces the death rate of this severely ill patient group by 20 percent. The mortality gap persists for at least nine months following the initial hospital admission.

                I recall there may be another study, because I recall a finding that the lower mortality rate is apparent even when you drop the 64 year olds who had no health insurance.

                Fry, don't be a hero! It's not covered by our health plan!

                by elfling on Fri Oct 12, 2012 at 02:56:38 PM PDT

                [ Parent ]

          •  Alternatively... (12+ / 0-)

            Drop the minimum age to 50, or 45.  Allow companies or older individuals to buy in before 65, for a standard premium, keep the full premium subsidies only for 65 and up.

            Average cost of a medicare patient goes down.  Average cost of private insurance patients goes down as well - we're moving the more expensive segment of the private market, who are still less expensive than the retirees.

            This my require a trivial tax increase to bring the premium in line with private insurance for the healthy crowd, but under this plan the diarist spends at least half a decade subsidizing the rest of the medicare population before his health deteriorates.

            Of course, this presumes that the populace will react sanely to the creeping socialization of medical care, and I admit that this would be a step toward single payer healthcare.

            This also presumes that the purpose of insurance for our retirees is to provide them with medical care, not just take the money for their premiums.

            •  Fascinating! (2+ / 0-)
              Recommended by:
              ladybug53, NWTerriD

              Move Single Payer Forward? Join 18,000 Doctors of PNHP and 185,000 member National Nurses United

              by divineorder on Fri Oct 12, 2012 at 11:13:16 AM PDT

              [ Parent ]

            •  Stop confusing "insurance" with "medical care" (9+ / 0-)

              > Of course, this presumes that the populace will react
              > sanely to the creeping socialization of medical care...

              No one is talking about socialized MEDICAL CARE. Even
              a single-payer "Medicare-for-all" system only socializes
              medical insurance -- NOT the doctors and hospitals.

              ...not that there'd be anything wrong with that,

              CBG

              I think you're some kind of deviated prevert.

              by ColBatGuano on Fri Oct 12, 2012 at 11:15:58 AM PDT

              [ Parent ]

              •  Good point (3+ / 0-)
                Recommended by:
                Actuary4Change, NWTerriD, splashy

                Socializing the cost structure really isn't the same as starting a NHS.  

                Not that I'd be against that either.

                •  But it would be a good idea (1+ / 0-)
                  Recommended by:
                  WheninRome

                  to just get it over with and start an NHS!  The cost would fall tremendously for better coverage.

                  Bain capital has of course invested heavily in proprietary hospitals, so they want costs to stay high.

                  •  KSLV - we need to build a surplus of primary care (4+ / 0-)
                    Recommended by:
                    fayea, mudfud27, Actuary4Change, NWTerriD


                    clinicians first. We have a severe shortage of primary care physicians and it will get worse and more people acquire health insurance. I just read an article in a medical journal with just with the advent of the ACA half the primary care physicians won't take new Medicare patients (25% have no Medicare patients) and a shocking number are reducing hours or planning to transition to a concierge practice by 2014 just as new patients come to into the system. If we tried to impost a NHS on physicians today 75% of those over 60 would retire and we have no one to take their place. It takes ten to twelve years post college to train physicians and five years post college to train nurse practitioners and at present they pay those costs themselves. If we want to drive down healthcare costs we need to dramatically increase the number of medical school students and graduate level nurses and change the economics for them.

                    Even in the UK there is now a parallel private pay market and the US medical societies are a strong opponent of any NHS type program.  Moving to a Canadian style single payer is the next likely step and like Canada it may start in the states. It would actually be good to have a few states try it and see what works so that a national program could learn from their mistakes.

                    "let's talk about that"

                    by VClib on Fri Oct 12, 2012 at 04:35:25 PM PDT

                    [ Parent ]

                    •  Excellent point (5+ / 0-)
                      Recommended by:
                      VClib, kurt, Actuary4Change, NWTerriD, marina

                      I'm a specialist (and we take Medicare) but can easily see how primary care docs have to limit their care of Medicare patients. Reimbursement is so poor that many physicians actually lose money on them.

                      Look, if I wanted to get rich I'd have become a banker but that's crazy...

                      Squeezing providers for reimbursement has its limits, and there are plenty of people who are, as you correctly point out, getting out of the primary care business altogether in part because they can't afford it.

                      A better plan would be to increase reimbursement rates and look for savings elsewhere, such as on pharmaceuticals , imaging, and devices. We need to encourage primary care but instead we're doing the opposite.

                      •  mudfud - my primary care physician (1+ / 0-)
                        Recommended by:
                        Actuary4Change

                        stopped taking new Medicare patients five years ago. He does, thankfully, keep his long term patients as they turn 65. Because I am also in the life science business, but not as a clinician or payer, we have very candid conversations about practice economics and technologies. I believe him when he tells me that, even on a marginal cost basis, he loses money on Medicare. Fortunately for me he is not only one of the premier internal medicine diagnosticians in my area, and primary care physician to many other doctors, but feels a real sense of obligation to his aging patient population and continues to see me. I am very lucky.

                        "let's talk about that"

                        by VClib on Fri Oct 12, 2012 at 06:40:38 PM PDT

                        [ Parent ]

                    •  An NHS would encourage primary care (2+ / 0-)
                      Recommended by:
                      Actuary4Change, NWTerriD

                      The idea of NHS would be to put the doctors on salary, not on fee-for-service.  Then the disparity between underpaid primaries and overpaid specialists could be reduced.  It's service-based insurance reimbursements that encourage the current mess.

                      The US used to have a lot more public care than now.  Before WW II made insurance common, many cities and states had public hospitals offering free care.  That's pretty much gone now, replaced by emergency room unreimbursed care, and by some community health centers (expanded by the ACA) that take insurance but also serve the uninsured.

                      •  KSLV - most physicians don't want to be on salary (1+ / 0-)
                        Recommended by:
                        Actuary4Change

                        or have a boss who tells them what hours they have to work. Those that do work for Kaiser, or other similar groups, and there is nothing wrong with that at all. However, most US physicians like being economically independent and have no interest in being a US government employee earning US government employee compensation.  

                        "let's talk about that"

                        by VClib on Fri Oct 12, 2012 at 07:02:28 PM PDT

                        [ Parent ]

                        •  May be changing (0+ / 0-)

                          Kaiser Permanente has about ten applicants for every opening, at least in NorCal. So that means there are 9 physicians who would like to be in a large group practice for every one who gets a spot in KP.

                          •  MP - the 9:1 number is misleading (0+ / 0-)

                            I know the Kaiser people well. Every time a physician applies for an available job they are counted as a new applicant, even if the same person has applied 25 times. That being said Kaiser is attracting top flight physicians, particularly young doctors who don't want to take the risks of private practice. Kaiser is the future healthcare model, they actually make more money if they keep you well or they can take care of you on the Internet or by phone. Every time you don't come to see them saves them money, which is the opposite of the fee for service model. The Kaiser physicians have their own corporation who provide services to Kaiser facilities. This structure gives them more autonomy than one might think.

                            There is no doubt that healthcare delivery is consolidating. My primary care physician, a top internal medicine practitioner, recently joined one of the mega groups in the SF area. He is in his early 50s, has a full practice and does not take new patients. He has no Medicaid patients, and stopped taking new Medicare patients five years ago, so his payer mix is well above average. With increasing downward pressure on reimbursement he decided to accept a salary for the first time in his professional career. He based his selection of which group to join based on several factors, his autonomy, work schedule, and total compensation. As part of the change he is earning somewhat less, but has reduced his hours trading off free time for less cash. If someone told him he would be working for the US government, he would retire. And that is why the Canadian model is the only transition for us.  

                            "let's talk about that"

                            by VClib on Sat Oct 13, 2012 at 10:33:57 AM PDT

                            [ Parent ]

            •  Recall that it was Lieberman that killed medicare (1+ / 0-)
              Recommended by:
              WheninRome

              for younger people.

          •  and by the logic noone wants to talk about (8+ / 0-)

            if we have a medicare BUY IN for people 55- 65
            it would LOWER cost per person

            This buy in could be bore mostly by employers of these middle age  people so it wouldn't add any cost to medicare and probably extend the life of medicare.

            "Although it is not true that all conservatives are stupid people, it is true that most stupid people are conservative." - John Stuart Mill

            by smartone on Fri Oct 12, 2012 at 10:49:43 AM PDT

            [ Parent ]

            •  Lots of people would grab this (8+ / 0-)

              There are lots of people 55-65 with employer provided health care who actually could afford to retire or switch to contracting/ independent consulting but they can't bc they have PECs and need to keep their employer plan.

              ACA SHOULD take care of this but an early Medicare buy in would be great.  These folks want to pay for insurance, the problem is the insurance companies don't want them at any price.  It is more lucrative to charge less but insure 30 year olds.

              Newt Gingrich: Believes marriage is between one man and a series of ever younger women. Wife #1 born ~ 1936, divorced when in her mid-40s...Wife #2 born ~1947, divorced when in her mid-40s...Wife #3 born ~1966.

              by trillian on Fri Oct 12, 2012 at 11:37:09 AM PDT

              [ Parent ]

          •  And more people would die before reaching 70 (12+ / 0-)

            so Medicare wouldn't need to cover them.

            I think republican leadership might view this as a plus.

            Shop Liberally this holiday season at Kos Katalog

            by JamieG from Md on Fri Oct 12, 2012 at 10:50:10 AM PDT

            [ Parent ]

          •  Not necessarily. Those who enter (2+ / 0-)
            Recommended by:
            kurt, NWTerriD

            Medicare having been continuously covered by health insurance cost Medicare significantly less than those who enter without prior insurance.  Unless you raise the age to whatever number it might be that enough people die off and never get to Medicare age, you simply have more expensive people entering Medicare by raising the age.  

            I was wise enough to never grow up while fooling most people into believing I had. - Margaret Mead

            by fayea on Fri Oct 12, 2012 at 04:14:13 PM PDT

            [ Parent ]

          •  Screwed=dead nt (1+ / 0-)
            Recommended by:
            NWTerriD
        •   (1+ / 0-)
          Recommended by:
          elginblt

          Then the total cost of Medicare would go down because their would be fewer people covered.  Average cost per person would go up, but premiums would not have to, because the government subsidy that keeps the premiums as "low" as they are would be able to go up because they would be subsidizing fewer people.

          It would really extend the life of the Medicare trust fund, and would not hurt those who got medicare.  Of course those who couldn't work until they were 70, or didn't have health insurance in the first place would be screwed, but Medicare would be O.K.

          It would also tend to increase, not reduce, the total amount spent on health care in this country, which is the real problem, but let's sweep that under the rug, because ObamaCare = Socialism, which means death-panels.

          Numbers are like people . . . Torture them enough and they'll tell you anything.

          by Actuary4Change on Fri Oct 12, 2012 at 08:55:51 AM PDT

          [ Parent ]

        •  greenbell - there is no proposal to "kick" anyone (1+ / 0-)
          Recommended by:
          NWTerriD

          who is on Medicare off of the program. Their are two issues being discussed, moving the eligibility from 65 to a later starting date or changing the program for people currently 55 or younger to a voucher program. Everyone on Medicare is allowed to stay.

          "let's talk about that"

          by VClib on Fri Oct 12, 2012 at 03:27:12 PM PDT

          [ Parent ]

  •  we've been down this road before (39+ / 0-)

    It's called Medicare Advantage, an insurance program subsidized by taxpayers, concocted by Bush & Republicans to "compete" with Medicare.
    Major FAIL, since Med. Adv. provides no better outcomes than traditional Medicare and costs MORE, as anything privatized usually does.
    The Insurance companies kept seeking MORE government funding so Obamacare gradually ends funding Med. Adv. held by 20% of Seniors.
    If those wealthy Seniors want more coverage than traditional Medicare, they should pay for it themselves.

    "Tax cuts for the 1% create jobs." -- Republicans, HAHAHA - in China

    by MartyM on Fri Oct 12, 2012 at 07:49:56 AM PDT

    •  Just what I was about to say (20+ / 0-)

      And with "Medicare part D" - Which had about a bazillion possible prescription plans.  

      I had an elderly relative meet a very charming saleswoman for a Medicare Advantage company.. And sign all of his health care away...

      He woke up about 6 months later after the company was going bankrupt, and wondered what he had done... But she was so nice, she said that all kinds of things would be covered that medicare didnt...

      What happens when these private companies which people have put their vouchers into go bankrupt?

      Are they just out of luck?

      "We have always known that heedless self-interest was bad morals; we know now that it is bad economics" - F.D.R.

      by biscobosco on Fri Oct 12, 2012 at 09:15:25 AM PDT

      [ Parent ]

    •  Everyone I know here in Florida has a Medicare (1+ / 0-)
      Recommended by:
      ladybug53

      Advantage plan and no one has traditional Medicare which as I understand only pays 80%.

      So if Obama plans to do away with Medicare Advantage, that will be a big problem for them.

      Obamacare gradually ends funding Med. Adv. held by 20% of Seniors.

      "Who are these men who really run this land? And why do they run it with such a thoughtless hand? David Crosby.

      by allenjo on Fri Oct 12, 2012 at 09:19:46 AM PDT

      [ Parent ]

      •  Ending funding (20+ / 0-)
        So if Obama plans to do away with Medicare Advantage, that will be a big problem for them.
        Obamacare ends funding of Medicare Advantage. It does not end Medicare Advantage. It getting out of the business of subsidizing it just like it got out of the business of subsidizing banks that provided student loans in favor of offering the loans directly to students at a lower rate.

        The choice of our lifetime: Mitt Romney, It Takes A Pillage or President Barack Obama, Forward Together.

        by FiredUpInCA on Fri Oct 12, 2012 at 09:33:39 AM PDT

        [ Parent ]

      •  Remember "midnight basketball?" (1+ / 0-)
        Recommended by:
        RJDixon74135

        The catch-phrase of the right that supposedly showed the waste of any social spending?

        Well, the rights' equivalent is "Silver Sneakers," the Medicare Advantage Program that covers gyms for seniors.  That apparently has been subsidized under Medicare Advantage.

        The GOP: "You can always go to the Emergency Room."

        by Upper West on Fri Oct 12, 2012 at 10:10:05 AM PDT

        [ Parent ]

        •  Hey, Midnight Basketball WORKED. (2+ / 0-)
          Recommended by:
          ladybug53, susanala

          That stimulus bill was just the thing to jump-start us in the early 1990s.

          I've always thought it strange that people forgot this recent, well-documented example of a successful stimulus.

          •  Not only did it work (0+ / 0-)

            but before Clinton it was part of Bush's "Thousand Points of Light."

            But the phrase was pounded by Rush et al. for years so, in the make-believe world of wingnut unsubtle racism (after, who plays midnight basketball?) it is an unassailable example of welfare-queenism run amok.

            That it worked is not even a footnote in that world.

            The GOP: "You can always go to the Emergency Room."

            by Upper West on Fri Oct 12, 2012 at 12:26:07 PM PDT

            [ Parent ]

      •  Actually, allenjo, traditional Medicare has two (24+ / 0-)

        main parts. Part A pays for hospitalization expense less a deductible of a little more than $1,000. Part B pays for 80% of the  cost of doctor visits, lab work, imaging, etc., outside a hospital stay. Part A is available at no cost to Medicare eligible people, Part B costs $99/mo. For this reason, most people get a "supplemental" policy from a for-profit health insurance company to pay deductibles and what Part B doesn't cover. Mine costs $27/per month.

        Also, I have Part D that pays for drugs. The drug plan I have costs $27/month and has a $140 annual deductible and then, most of my prescriptions cost $0, no co-pay. I save about $100/month. But, there are literally hundreds of plans to choose from and they vary from state to state. Each plan has its own "formulary" that says what drugs are covered and in which "tier" with older generics being in tier 1 and newer, more expensive, more exotic stuff being in tier 3 or 4 with higher co-pays. OR, you can choose a plan like my husband's which costs more than $100 per month but includes more of the expensive drugs in their tier 1. His plan costs a lot more than mine per month but saves him about $400 per month.

        So, it's really complicated which is one reason many people choose an Advantage plan sold by a for-profit insurance company which incorporates everything.

        However, many of the Advantage plans are HMOs and participants can't choose when to see a specialist or which one to see. Their primary care physician, aka "gatekeeper," makes all those choices. Usually, for acting in the gatekeeper role, a physician gets a monthly payment from the Advantage plan rather than a "fee for service." Supposedly, this would cost less to the government because of the "superior" management the private sector would offer, but it didn't work out that way. The for-profit insurance companies have so much more administrative costs to cover (executives, sales and marketing, profits to shareholders, etc.), these plans turned out to cost about 20% more than tradititonal medicare with no better health outcomes for the participants. Shaving down that 20% is a big factor in the cost savings the Obama administration plans to achieve. Yes, some companies may leave the business if they can't make as much as tthey want, but it'll be up to them.

        Eliminate tax breaks that stimulate the offshoring of jobs.

        by RJDixon74135 on Fri Oct 12, 2012 at 10:24:11 AM PDT

        [ Parent ]

        •  Thanks for explaining how things work for you (6+ / 0-)

          and your husband on Medicare. I'll qualify for it in just under a year from my medical disability, and already I feel overwhelmed by the looming decisions about what options to choose to minimize my out-of-pocket costs (which are already sinking us).
          I have a lot of work to do to suss it all out.

          •  Medicare has a site online that's pretty good (6+ / 0-)

            I suggest you visit there soon and start familiarizing yourself with how the site works. Also, the people at Medicare are good on phone calls, although you may have to wait 10 minutes or longer to get through to someone when you call, but I've never talked to anyone there who wasn't happy to explain something or acted like I was a bother. But, you can also feel free to KOSmail me if you think there's something I can do to help.

            You want to get an early start because there are some penalties for missing critical deadlines.

            It may not work this way for you, but I got the feeling that somehow every insurance company in my state knew when I was about to turn 65 and had something to sell me -- something that required about 2 lbs of papers to explain. One of my happiest days was when I had finally made all my decisions, signed everything I needed to sign, and could toss all that extra paper into the recycle bin!

            Eliminate tax breaks that stimulate the offshoring of jobs.

            by RJDixon74135 on Fri Oct 12, 2012 at 11:39:18 AM PDT

            [ Parent ]

            •  Thanks for the tip and the offer; I may take you (0+ / 0-)

              up on it sooner than later.
              Since my eligibility isn't age-related, I might not get as much "helpful" material. But there are also some good non-profit senior centers in town that I think will be of some help.

              •  Just had this discussion this week with my (1+ / 0-)
                Recommended by:
                peregrine kate

                benefits center.  I'm retired and collecting SS.  Will turn 65 in 2013.  Our age info is tied to our SSN, so the government knows when we are turning 65.   About 6 months prior to turning 65 you will receive information on medicare eligability.  I have a HMO thru my employer.  Medicare will become my first coverage and my employer provided coverage will cover what Medicare does not.  

                I feel very lucky that my employer has not only a benefits hotline to help with questions, but medicare specialists to help walk me thru all the in's and out's of Medicare enrollment.  

                I like that this diary has been a Medicare primer for many of us.

                We are better informed and smarter together!

                "Liberals feel unworthy of their possessions. Conservatives feel they deserve everything they've stolen." Mort Sahl

                by maggiemae on Fri Oct 12, 2012 at 04:45:23 PM PDT

                [ Parent ]

                •  Thanks, but I'm 54 and will be Medicare-eligible (0+ / 0-)

                  next year at 55 because I have advanced cancer. (I am, fortunately, now in remission.) It's possible that I'll get some info from the feds since my SSDI qualification is what will get me into Medicare, but I haven't yet started getting any indications of how that will work. I will start asking around about the process soon.
                  It might also be possible to get some information out of my husband's insurer--but they're not providing very comprehensive coverage, so I am not sure about that, either. We hope that our premiums will decline once I'm on Medicare, since now we pay 80% of our family coverage out of pocket (or $1250/month for a family of three).

                  •  Ouch! That is draconian in it's impact on (0+ / 0-)

                    your life.  I'm so sorry to hear about your cancer, but so glad to know you're in remission.  My dearest friend is starting chemo/radiation for her uterine cancer.

                    I hope this turns out well for you re: SSDI.  I'd certainly call and ask for assitance in understanding your options.

                    I've always enjoyed your posts on dkos, and look forward to getting more involved again as the election nears.  Went dark for about a year due to the loss of my only child last year.

                    Take care of yourself!

                    "Liberals feel unworthy of their possessions. Conservatives feel they deserve everything they've stolen." Mort Sahl

                    by maggiemae on Wed Oct 17, 2012 at 11:22:53 AM PDT

                    [ Parent ]

        •  Although it's complicated, Medicare.gov (6+ / 0-)

          has a very good -- and not difficult to understand -- "Plan Finder" that allows you to compare the plans available in your area.

          You enter the drugs you take, including the dosages, and the software displays your options.

          You can select to compare just Rx plans (in combination with "original" Medicare), or Medicare Health Plans (definition below) with or without Rx coverage.

          For example, for my zip code, I get 30 Rx plans, 14 Medicare Advantage plans with Rx coverage, and 2 Medicare Advantage plans without Rx.

          A Medicare health plan is offered by a private company that contracts with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan. This term is used throughout this handbook to include all Medicare Advantage Plans, Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE).  

          .... Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

          We must drive the special interests out of politics.… There can be no effective control of corporations while their political activity remains. To put an end to it will neither be a short not an easy task, but it can be done. -- Teddy Roosevelt

          by NoMoJoe on Fri Oct 12, 2012 at 11:28:49 AM PDT

          [ Parent ]

          •  There's also a "medigap" plan finder (4+ / 0-)

            here.

            Medigap insurance is used in conjunction with "original" Medicare to pay the 20% co-pays and deductibles.  There are a number of standard policies defined by Medicare (currently 11).

            First you have to decide what benefits and coverages you want and then the software shows what plans are available in your area, which companies offer them, and how much they charge.

            As Medicare says dryly,

            The cost of Medigap policies can vary widely. There can be big differences in premiums that insurance companies charge for exactly the same coverage. As you shop for a Medigap policy, be sure you are comparing the same Medigap policy (for example, compare a Plan A from one company with Plan A from another company).

            We must drive the special interests out of politics.… There can be no effective control of corporations while their political activity remains. To put an end to it will neither be a short not an easy task, but it can be done. -- Teddy Roosevelt

            by NoMoJoe on Fri Oct 12, 2012 at 11:39:56 AM PDT

            [ Parent ]

          •  Yes, NoMoJoe, I agree about the Medicare sites (3+ / 0-)
            Recommended by:
            ladybug53, NWTerriD, NoMoJoe

            Plus, when I was almost ready to make my decision on a drug plan, I had one small question left and since I hadn't picked an agent, I phoned Medicare to ask. Not only did the Medicare person answer my question, but he then signed me up for the plan I'd chosen, so I didn't have to contact another insurance agent, make any appointment, etc. It saved me both time and aggravation.

            Eliminate tax breaks that stimulate the offshoring of jobs.

            by RJDixon74135 on Fri Oct 12, 2012 at 11:45:23 AM PDT

            [ Parent ]

            •  I have found both the Medicare and Social (0+ / 0-)

              Security people to be extremely helpful and about as far from the caricature of a government agency as it's possible to be.

              We must drive the special interests out of politics.… There can be no effective control of corporations while their political activity remains. To put an end to it will neither be a short not an easy task, but it can be done. -- Teddy Roosevelt

              by NoMoJoe on Fri Oct 12, 2012 at 10:48:32 PM PDT

              [ Parent ]

          •  Not comprehensive listings (3+ / 0-)
            Recommended by:
            ladybug53, revsue, NWTerriD

            I've been looking at the medicare site. The Plan finder is by no means comprehensive. It didn't show Cigna or Aetna or several other companies which offer plans in Scottsdale.

            Also, my retirement plan has cooked up something entirely different -- and it seems to be similiar but not exactly and you can't have it and a Medicare Advantage plan, too.

            I can't wrap my mind around any of it so my PhD son and master's of Accounting daughter are going to decide for me.

    •  Heavy HMO'S (9+ / 0-)

      In areas like mine, Sacramento, with state government, we have large HMO's and few "fee for service" doctors who can not compete well with HMO's.  Medicare Advantage is obtained through HMO's.  It is slightly more expensive for me than medicare my friends have been able to maintain with a family doctor they had for many years.  But the HMO's usually offer more broad coverage.  Also there are co-pays.  I have $100 deducted from my social security for medicare.  I pay another $100/mo to the HMO.  Every thing I do there cost $30/each for a basically healthy person.  The difference is that before 65 I was paying over $400/mo for the same plan.  If Romney returns us to the health care cartel who do not want us and allows them to do what is best for their Wall Street bottom line, I die early.  It is as simple as that.

      •  That's quite a bit more than I pay for (3+ / 0-)
        Recommended by:
        divineorder, ladybug53, NWTerriD

        traditional Medicare plus a supplemental policy from a for-profit insurance company, LillithMc. See above.

        Eliminate tax breaks that stimulate the offshoring of jobs.

        by RJDixon74135 on Fri Oct 12, 2012 at 10:29:46 AM PDT

        [ Parent ]

        •  The 1st $100 (1+ / 0-)
          Recommended by:
          NWTerriD

          comes out of your social security check for everyone.  You may not be counting that.

          •  Also (1+ / 0-)
            Recommended by:
            NWTerriD

            I do pay more than some of my friends on traditional medicare, but it is hard to find a doctor who accepts traditional medicare where I live.  They have long time Doctors, but when those Doctors retire they have a problem.

            •  Yes, I've had the same primary care physician (2+ / 0-)
              Recommended by:
              NWTerriD, LillithMc

              for about 10 years now and they didn't bat an eye when I went on Medicare. We went through a period about 10 years ago when several of our doctors retired. Now, when I get referred to someone new for anything, I want someone who's going to last as long as I am.

              I am counting the $100 that comes out of my check. What I have that's cheap are my supplemental and drug plan at $27/mo. each. But, I can pass along the advice our primary care physician gave us for my husband: get the best policy you can afford.

              Eliminate tax breaks that stimulate the offshoring of jobs.

              by RJDixon74135 on Fri Oct 12, 2012 at 02:05:46 PM PDT

              [ Parent ]

    •  MartyM - my understanding (1+ / 0-)
      Recommended by:
      NWTerriD

      is that Medicare Advantage is used more by low income seniors because they receive significant benefits, above Medicare A&B,  without having to purchase a supplemental plan.

      "let's talk about that"

      by VClib on Fri Oct 12, 2012 at 04:41:28 PM PDT

      [ Parent ]

      •  No - low income Seniors have traditional Medicare (0+ / 0-)

        Only 20% of Seniors have (or can afford) Medicare Advantage.

        "Tax cuts for the 1% create jobs." -- Republicans, HAHAHA - in China

        by MartyM on Sun Oct 14, 2012 at 03:17:02 AM PDT

        [ Parent ]

        •  MartyM - I don't think Medicare Advantage (0+ / 0-)

          has any out of pocket cost beyond any participant's regular Medicare payment. That's why it is favored by low income seniors.

          "let's talk about that"

          by VClib on Sun Oct 14, 2012 at 07:26:32 AM PDT

          [ Parent ]

          •  Seniors with Med. Adv. pay for Insurance coverage (0+ / 0-)

            and taxpayers have been paying part of it.
            But Obamacare gradually ends taxpayer subsidies for Med. Adv. - yet another reason the 1% oppose Obama.

            "Tax cuts for the 1% create jobs." -- Republicans, HAHAHA - in China

            by MartyM on Sun Oct 14, 2012 at 08:31:37 AM PDT

            [ Parent ]

  •  There have been a lot of studies about choice (26+ / 0-)

    and most conclude that having too many choices for anything tends to decrease overall satisfaction.

    We should, at the very least, strictly regulate what insurance plans cover, so they are forced to compete on price and service on an apples to apples basis.

    Numbers are like people . . . Torture them enough and they'll tell you anything.

    by Actuary4Change on Fri Oct 12, 2012 at 07:55:59 AM PDT

    •  It makes me want to cry to think about (9+ / 0-)

      people in their 80s trying to negotiate health insurance with the vipers at the for-profit insurance companies. I took care of all the Medicare stuff for my MIL about 10 years ago when she moved here from California and had to leave her Kaiser policies behind -- no problem. I handled it all again for my husband a few years ago when his private insurance expired (he's a retired teacher and had 7 years of insurance after he retired) -- it was all a little more confusing to me. Then, this year, I turned 65 and had to arrange my own coverage, I was surprised to discover how much I'd forgotten, how long it would take me to wade through all the choices, and what a general pain it was.

      For people in their 80s, if it comes to that, it's going to be as bad as a death panel. I'm certain that many people would miss critical deadlines and other requirements and end up without any coverage at all.

      Eliminate tax breaks that stimulate the offshoring of jobs.

      by RJDixon74135 on Fri Oct 12, 2012 at 11:24:05 AM PDT

      [ Parent ]

      •  It's really easy to miss critical deadlines ... (3+ / 0-)
        Recommended by:
        RJDixon74135, ladybug53, NWTerriD

        and you end up paying for that, sometimes substantially.

        We must drive the special interests out of politics.… There can be no effective control of corporations while their political activity remains. To put an end to it will neither be a short not an easy task, but it can be done. -- Teddy Roosevelt

        by NoMoJoe on Fri Oct 12, 2012 at 11:41:59 AM PDT

        [ Parent ]

  •  I don't think either the President or Joe (23+ / 0-)

    Biden made the case for Medicare. Biden came the closest last night by saying, "Are you going to trust them to fix Medicare or are you going to trust us?"

    I know Senior Citizens are just one segment of our society, however, Medicare is promised to every American when they turn 65, so it is an issue that sooner or later will effect evey single American.

    What I find so disengenous about Romney/Ryan and their rhetoric is that they completly ignore the fact that Medicare already offers people choices. With your Medicare you have the right to chose your doctor, and the right to chose to get additional coverage if you choose to do so.

    I would actually like to see a full and honest debate on Medicare. I think if people heard more than sound bites and rhetoric, they would understand providing Medicare is costly and might just understand the reasons why. Turning over Medicare to health insurance companies as Romney/Ryan's voucher plan would do would do nothing to bring down the costs, it would simply shift the cost from the federal budget to the backs of seniors, the ones who can least likely afford to pay for it.

    •  And when seniors cannot afford the premiums (12+ / 0-)

      You are right back covering the difference one way or another.  If they force down premiums then young people pay anyway because their premiums go up.  All you achieve is humiliating elderly Americans.

    •  I have to remind myself that this is not what (11+ / 0-)

      Obama had in mind when the planning of The Affordable Care Act began.

      The Republicans and duped Democrats are very much responsible for this turkey. Our health care system was so broken that just to get it back on track , this less than perfect Frankenstein monster was created. How many patches can old Frank take? He looks like a cross quilt as it stands.

      I wish we could junk the whole thing and create the kind of system that we deserve.

      •  While what you say is true, just look at what the (10+ / 0-)

        G.O.P. is doing to Medicare, which in my opinion is a perfect system, and I would love to see it applied to all Americans. It would never happen, so the best we can do is to maintain it for the most vulnerable Americans. I think if we have hopes of ever acheiving Universal Healthcare for all Americans, we need to fight hard to keep "Medicare as we know it", because in truth it is universal healthcare for seniors. You know that dreaded monster, "socialized medicine".

        The poor and weak are not allowed to survive. Since these seniors no longer pay taxes, they are not entitled to what the" tax payers "are.  That is just fucking wrong!!!!!!!!!!!!

        •  I also think very highly of traditional Medicare, (10+ / 0-)

          Vera Lofaro, and I also support single payer for everyone. I'm disgusted by the notion that some minor functionary at an insurance company can get a bonus for refusing to authorize treatment to someone who needs it. And, yes, that absolutely DOES happen.

          I went back to school in my 50s and worked part time in the office of a physician friend of mine to finance it. I billed Medicare, insurance companies, and got pre-authorizations for the people whose policies required it. Ugh, I got out of that job as quickly as I could, so I'm by no means an expert, but I did see some hair-raising refusals to authorize treatment.

          Also, I saw that the for-profit insurance companies would drag out payment, especially on larger bills, for as much as 6 months or even a year by requesting special reports on this or that, "losing" claims, etc., while Medicare engages in no such nonsense. My friend, a pretty savvy business man as well as a physician, convinced me that getting the quick, albeit generally lower, payment from Medicare had its benefits over wrestling with a for-profit company. In fact, more and more for-profit insurance companies actually insist on negotiating cut rate deals with physicians before they'll pre-authorize so the rate differential is no longer as great as some people believe.

          Eliminate tax breaks that stimulate the offshoring of jobs.

          by RJDixon74135 on Fri Oct 12, 2012 at 10:44:27 AM PDT

          [ Parent ]

          •  And nobody including the doctor has any idea (1+ / 0-)
            Recommended by:
            NWTerriD

            how much a procedure or test costs.

          •  As a physician (1+ / 0-)
            Recommended by:
            NWTerriD

            I can tell you the most frustrating parts of my job usually revolve around talking to some uneducated insurance company hack on the phone for pre-authorization or somesuch, who is trying as hard as he can to deny care I know my patient needs.

            Whenever some GOP talking head references the 'death panels' or more recently the Payment Advisory Board I wish someone would point out we already have much worse than that in the greedy insurance companies, making de facto treatment decisions. Do people really trust them more than a government agency which at least theoretically has transparency and responsiveness to voters?

    •  Now Rmoney promises premiums wont exceed vouchers (9+ / 0-)

      In his latest response to the argument that costs to seniors will gradually rise under his plan because vouchers will not keep up with increases in premiums, Rmoney now says he will guarantee that the vouchers will cover actual costs!  It seems to me this gives the insurance companies a free hand to raise premiums without restraint, totally defeating the argument that competition among insurers will keep premiums down.

      If Rmoney's plan doesn't shift the cost to seniors, it becomes unworkable. It simultaneously makes seniors dependent on the government and on the marketplace, while federal money fills insurance company coffers.  And who will determine the amount of the voucher each person gets each year? Death panels?

      •  I didn't see this (1+ / 0-)
        Recommended by:
        ManhattanMan

        I don't think that Ryan said that last night. Do you have a link?

        Shop Liberally this holiday season at Kos Katalog

        by JamieG from Md on Fri Oct 12, 2012 at 10:55:07 AM PDT

        [ Parent ]

        •  He did (6+ / 0-)
          MS. RADDATZ: Let me ask you this: what is your specific plan for seniors who really can't afford to make up the difference in the value of what you call a premium support plan and others call a voucher?

          REP. RYAN: A hundred percent coverage for them.

          Transcript

          But don't worry. If you can't make up the difference between the Romney/Ryan "premium support" and the actual cost of health insurance, Mitt will just come over on Christmas with his boys and his wife and promise to pay for it himself.

          We must drive the special interests out of politics.… There can be no effective control of corporations while their political activity remains. To put an end to it will neither be a short not an easy task, but it can be done. -- Teddy Roosevelt

          by NoMoJoe on Fri Oct 12, 2012 at 11:51:34 AM PDT

          [ Parent ]

          •  such BS (2+ / 0-)
            Recommended by:
            greenbell, NWTerriD

            100% covered! Sounds great!

            Devil being in the details and all...about where do you draw the line to say who can afford to pay the difference and who can't?

            To me, that looks like a situation custom-made to put the elderly in the same situation many working poor find themselves in: too rich to qualify for Medicaid and not rich enough to actually pay the premium.

            Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read. - Groucho Marx

            by Joe Bob on Fri Oct 12, 2012 at 01:56:01 PM PDT

            [ Parent ]

      •  Don't forget, Romney lies (4+ / 0-)

        He also said that under his plan, people with pre-existing conditions could get insurance. That was NOT true. Under his plan, people with CONTINUOUS COVERAGE changing from one company to another could get coverage with a pre-existing condition, but people who don't have insurance because they can't get it now or can't afford it are just screwed.

        I wouldn't bet a nickle on anything he says.

        Eliminate tax breaks that stimulate the offshoring of jobs.

        by RJDixon74135 on Fri Oct 12, 2012 at 11:53:00 AM PDT

        [ Parent ]

    •  Turning Medicare private can ONLY increase costs (4+ / 0-)

      We have a certain number of seniors in this country who are going to need a certain amount of medical care on average per person (unless we really are willing to have people die for want of insurance) so the outflow- cost of health care for that population is what it is.  It is just a question of how we pay for it.  If it is Medicare, it will cost the cost of health care plus Medicare's 3% admin.  If it is private it is the same cost of health care plus the health insurance company's 20%+ overhead and profit.

      Newt Gingrich: Believes marriage is between one man and a series of ever younger women. Wife #1 born ~ 1936, divorced when in her mid-40s...Wife #2 born ~1947, divorced when in her mid-40s...Wife #3 born ~1966.

      by trillian on Fri Oct 12, 2012 at 11:48:21 AM PDT

      [ Parent ]

      •  True, except that the overhead plus profits to (4+ / 0-)

        shareholders at many of the for-profit insurance companies hits 30% and even higher.

        As Bill Clinton said, it's the math.

        Eliminate tax breaks that stimulate the offshoring of jobs.

        by RJDixon74135 on Fri Oct 12, 2012 at 11:55:27 AM PDT

        [ Parent ]

        •  But Math Has A Well Know Liberal Bias (1+ / 0-)
          Recommended by:
          NWTerriD

          Hey, thanks for the explanation above about Medicare.  I don't know the percentage of American that could answer simple questions about Medicare, but I would bet that it is pretty low.  If more people had the basic facts, I gotta believe it would be a lot harder for the Republicans to get away with all their BS.  

          I guess that is why Republicans are so against public education!

          Poor man wants to be rich. Rich man wants to king. And the king ain't satisifed until he rules everything. B.Springsteen

          by howd on Fri Oct 12, 2012 at 02:52:08 PM PDT

          [ Parent ]

  •  Don't Worry About Shopping (19+ / 0-)

    With that list of pre-existing conditions combined with added age, no insurance agency is going to take your voucher even with an ungodly amount of cash added from you.

    And that's how the plan works -- Repubs can then say, "See, the whole idea of caring for these wretches was untenable," wash their hands of the matter, and retire to one of their homes in the Caymans.

  •  I'm not grey enough (8+ / 0-)

    yet, but I'd gladly volunteer to do the slapping.

    I'll even don a wig. (There's some grey but not enough to be effective, I fear.)

    Great diary.

    Words can sometimes, in moments of grace, attain the quality of deeds. --Elie Wiesel

    by a gilas girl on Fri Oct 12, 2012 at 08:32:25 AM PDT

  •  I hear you. I want things to be easier for me (10+ / 0-)

    no have a caveat emptor experience yearly. Europeans have a much more sensible approach to their commitment to healthcare. If you have to pay a lot but never have to worry about access to healthcare regardless of whether you work or not it is a relief. You also don't have to save up some big nest egg to cover youself in decline.

    Slow thinkers - keep right

    by Dave the Wave on Fri Oct 12, 2012 at 08:52:33 AM PDT

    •  Even the 'horrid' socialized medicine system (5+ / 0-)

      in England is much, much MUCH better than ours. Orders of magnitude better.

      You have a doctor. Who is, almost always, not far away. If you need to see them, you call, and, almost always, get seen within a day or two. Or, if you're really sick or an invalid, they may even come to you.

      If you need medication, it's available at a reasonable cost. If you need to be hospitalized, the cost doesn't enter your mind. If you need mental health treatment, you get it for a s long as you need it. Drugs, in patient, out patient, therapy, monitoring, the works.

      If you're pregnant, you don't worry about anything other than having a healthy baby. And when you do have that baby, you get home visits from a nurse for the first few weeks, and 6 mos paid maternity leave.

      SOCIALIZED MEDICINE provides home visits, mental health care, appointments in a few days, and no worries about how you're going to pay for it.

      I want it. Yesterday. If it means an increase in my taxes, it's sooooooooooooo worth it.

    •  And, no criptic paperwork piling up hopelessly. (1+ / 0-)
      Recommended by:
      NWTerriD
  •  We just went through purchasing Life Insurance (4+ / 0-)

    in our mid-30s and that is disturbing enough.  Can't imagine having to shop around for health insurance when I'm 70.  Not that there would be any real options.  Great diary.

  •  If Ryan's plan is so damn good (9+ / 0-)

    for folks 55 and older, what is the matter with it for 54 and younger?  It is easy to see and should be brought up like you say, over and over again.  Most younger Americans do not understand how much $6,400.00 bucks really is and how hard it will hit them when they need it the most.  Keep in mind, this is in today's dollars and not what it would be 15, 20 or 30 years down the road.  The question should be directed to all Republicans, just like I framed it.

  •  seriously (6+ / 0-)

    someone needs to call out this right wing generational war for what it is. as if it's somehow OK to screw people out of their benefits down the line because they're younger.

  •  Current Medicare is already a nightmare of forms (7+ / 0-)

    My wife just went on Medicare this past year.

    The free portion of Medicare is easy.. sign up and get your card.

    But you are definitely going to want to get supplemental... and that is through a private insurer.

    Then you most definitely want to get Medicare Part D.  That is also through a private insurer.

    Wading through the forms with all the options for even a handful of insurers is daunting, to say the least.  My wife and I got lucky in finding an insurance agent that specializes in supplemental Medicare plans.  She helped us through the worst of it.

    So.. Romney/Ryan Medicare plan could possibly be worse, but I do not see how.

    And.. their plan let's you choose classic Medicare as one of the choices anyway.

    The voucher system would likely be used only by younger, healthier retirees.  It will be a way of reducing their co-pays and out of pocket costs.

    As mentioned above, with all your problems it might be hard to find a private insurer if they are allowed to reject applicants for health reasons.

    Vouchers is a really stupid idea.  Even if Romney gets elected, I don't see how they would ever get them passed through Congress.

    •  This so true (8+ / 0-)

      My husband just went on Medicare this year: what a single health plan did last year now takes four separate "plans" to do: Basic Medicare Part A (free); Part B ($100/mo); Part D (the drug plan); and his wrap-around or supplemental insurance which as it turns out we get from the same insurer we had before he was on Medicare (it's actually the same plan minus first-line responsibbilty for drug costs, which are paid by the Part D drug plan).

      Annual cost is about $300/year more than we paid last year for the same coverage, and than I pay this year for the same plan.

      But it's more than four times the hassle to figure out which amalgamation of policies is the best mix for us.

      Many of my older neighbors have been convinced by Medicare Advantage/Part D plans that there is no traditional Medicare any longer.  

      One thing that seems clear to me is that by separating the drug coverage from the payment for treatments, doctors and hosiptals you have set up a situation where profits for drug insurance companies are in competition against insurance companies who woud bear the cost of the care required if certain drugs are denied.  When a single plan covers both then there's no upside to skimping on medicine if it would result in better (healthier AND cheaper) outcomes.

      I'm for all-age Single Payer. Let's just more on to this. Tax us for it and end the whole rotten mess. And most importantly kick the entire for-profit medical insurance model to the curb.  Whatever use it may have had initially it has long since over-stayed its welcome.

      Araguato

  •  Other people your age with your issues (7+ / 0-)

    probably have it even worse right now - if they lose their job for whatever reason (often smaller businesses fire people with medical conditions to keep their plan costs lower) then they are pretty much screwed.  Medicare is very difficult to get early, and no one else would touch you with a 100 foot pole.  

    We desperately need to make Medicare available to everyone at a reasonable price, no matter what age or what conditions they have.

    Atheism is a religion like Abstinence is a sexual position. - Bill Maher, 2/3/2012

    by sleipner on Fri Oct 12, 2012 at 09:34:36 AM PDT

  •  this gray-haired granny (9+ / 0-)

    would like to pop them a good one...including a few Democrats who don't seem to "get" that most of us seniors are as concerned about our kids' and grands' well-being in their "sunset years" as we are about our own.

    I find it damned insulting when a politician leaps in breathlessly waving his hands in front of our faces with the disclaimer: "oh it won't effect current recipients or anyone approaching 55!" as if we're all that self-absorbed fercripessake...

    and yea, this too -- anyone having to wade through a bunch of health-related insurance documents in order to make yet another decision? needs a far stronger constitution than I. Why not just waterboard us and be done with it?

    "Show up. Pay attention. Tell the truth. And don't be attached to the results." -- Angeles Arrien

    by Sybil Liberty on Fri Oct 12, 2012 at 09:36:35 AM PDT

  •  Nicely Done (3+ / 0-)
    Recommended by:
    ladybug53, smiley7, NWTerriD

    I read a post here a month or so ago on this topic. What kind of company would sell insurance to a sick old human.
    How can some in their sevenities &pat ill do this for themselves?

    Thanks for this post

  •  There are a LOT of choices in Medicare (7+ / 0-)

    I just signed up this month for Medicare and Social Security since I turn 65 in December.  There are lots of deadlines and choices to be met and made or you could be penalized.  I filled out the application on line but since my middle name was spelled differently( have not used it since I married 44 years ago) I had to take an original birth certificate to the SS office within 10 days of receiving the letter. It  gets very confusing.  You have a choice of drug plans and then you have to choose  a  supplemental plan and the premiums can increase each year.  Since they used my 2010 tax returns to calculate my Medicare payment, my payment is higher than my work healthcare and I find it much more complicated.  I am a college graduate and I felt so stupid filling out all the forms and I wondered how less educated manage.  

  •  Amen (7+ / 0-)

    Shopping for health insurance in my 30s was bad enough, and I had lots of time to pore over it all and read the fine print.

    I still made mistakes, though, or missed things that I didn't understand.

    For example, there was the year when the plan only covered X-rays in the hospital.

    I read that as, X-rays had to be taken in the hospital.

    No: X-rays only if you are ADMITTED to the hospital.

    So, for example, when DH was x-rayed (outpatient at the hospital) and they found pneumonia, those x-rays weren't covered.

    For example, when I went to the ER and they x-rayed me and found broken ribs, that wasn't covered either. I wasn't ADMITTED. As it turns out, few people with actual broken bones are. They stabilize the fracture and send you home.

    It was "only" a few hundred dollars. But boy did I feel (a) stupid and (b) hoodwinked. And I'm someone accustomed to reading difficult technical and legal documents. I don't know how any ordinary person would have caught it... which was precisely the intent. To save the insurance company a few hundred dollars per enrollee with no one suspecting in advance.

    Fry, don't be a hero! It's not covered by our health plan!

    by elfling on Fri Oct 12, 2012 at 09:59:55 AM PDT

  •  Another option for funding Medicare... (5+ / 0-)

    ... let those of us between the ages of 50-65 -- who the insurance companies really don't want to cover anyway, because we're more likely to NEED health care now and then -- BUY INTO medicare, like it was a regular health insurance policy.  Pay a premium -- more than is deducted now from our paychecks for medicare (or share the cost with our employers, however it works out).

    That means the private insurance costs for employers will go down -- because insurance companies don't have to cover us older-middle-aged people.  

    It'll be better for businesses, because the cost of insurance for older employees will be predictable and not go up the way it does now.  

    And because the majority of us are relatively healthy -- those premiums can help extend Medicare for the rest of us.

    (Not to mention it's one step closer to Medicare for All, but we'll not say that too loudly... yet.)

    Choosing between healthcare plans is pretty damned confusing even now -- I can just imagine what it would become if seniors had to pick their own plans from the private market.  And none of them would cover as well as Medicare does -- at a time when people need health care support the most, they are likely to find that their options cover less and less, or cost more and more.

  •  I agree (3+ / 0-)
    Recommended by:
    peregrine kate, ladybug53, NWTerriD

    I have to look through the plans for my mom's part B and D,  it is stressful for just these supplements,  ratings of the companies' service, pricing,  options on what is covered, and then you hit  the formularies, pages of drugs, generic vs. the brand names, what does Mom take, given her condition, what might she need in the next year.

    The packages arrive and my heart sinks just thinking about it.

  •  The danger is to sound Patronizing. (2+ / 0-)
    Recommended by:
    ladybug53, NWTerriD

    I totally agree with your point but it is difficult to sound-bite without committing a costly gaffe.

    It should be framed in a way that condescends over older or less-educated people, and doesn't smell as "Big Brother Government".

  •  You pinpoint a flaw in all marketplace solutions. (8+ / 0-)

    While Republicons promote the marketplace as the better alternative to government programs, the fact is that many people - perhaps most of us and certainly most seniors - are not equipped to make the best decisions in the face of the advertising and paperwork that private businesses generate.

    Having helped an elderly relative with Medicare, supplemental health insurance, long term care insurance, retiree health benefits, and catastrophic health insurance, I know that understanding the policies, amassing the documentation required for reimbursement, and satisfying all the paperwork deadlines is a daunting undertaking. I doubt that anybody who needs to use these insurance benefits is actually in good enough shape to meet the requirements.

    This is, in my mind, a compelling reason for universal single-payer health coverage.

  •  You're worries are wll-founded. (9+ / 0-)

    My wife and I turned 65 in 2010, and went onto Medicare. We had been counting on "gap" coverage from her public employees' benefit plan from the State of Nevada, which abruptly switched that year from funding its own (decent) health plan to offering the equivalent of the Romney-Ryan "coupon" plan. At least PEBP offered transition counseling with stacks of data on available gap plans, but we spent many, many hours trying to compare plans and estimate our likely needs. We were systematic, drawing up charts and poring over them. And this wasn't a one-time deal. We must go through this every year, since plans add and drop provisions. They all raise prices, but at different rates. We've already had to change plans once. We're now in another enrollment period, and will have to run this gauntlet again within the next month. And we still have - despite occasional senior moments - most of our faculties intact. What will we face in 10-15 years, especially if we're searching not just for supplemental coverage, but for all of our health insurance?
      I should add that we're still healthy enough that the plans still think they want us, so we are bombarded with mail and phone messages asking us to switch. (Actually, if we accepted one of these offers without going through the Nevada re-enrollment process, we would lose our Nevada voucher, something my wife fortunately picked up on, but which the insurance companies wouldn't have told us!
     By the way we face these decisions not just on medi-gap coverage, but on prescription drug and dental plans. I dearly wish we could rely on a single payer system for all our health needs. Barring that Medicare - and "Obamacare" - are all that's providing us any protection from the insurance jungle. You are right to be fearful of what the Republicans are likely to do. I know we are!

    "If a nation expects to be ignorant and free, it expects what never was and never will be." - Thomas Jefferson

    by Blue Boomer on Fri Oct 12, 2012 at 10:16:54 AM PDT

  •  Yikes! (8+ / 0-)

    Just got to work (we have a no-kids day today, so the schedule is more relaxed), and discovered that this diary is on the Rec List. Unfortunately, I can't respond to comments using my work computer – it isn't allowed, and also our technology is so outdated that the computer doesn't have the capability. I am posting this comment through my iPhone, but won't be able to do anymore commenting until I get home from work this evening. (And even on the iPhone, I couldn't figure out a way to edit the diary.)

    Thanks to whoever rescued the diary; I feel pretty strongly about this.

    "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

    by NWTerriD on Fri Oct 12, 2012 at 10:28:48 AM PDT

  •  This was exactly my wife's comment (3+ / 0-)
    Recommended by:
    RJDixon74135, ladybug53, NWTerriD

    We have enough complicated paperwork as it is, and we hardly have any compared to most people our age.   Just keeping the car tabs current is getting to be a chore.

  •  The repub idea of choice is a false promise (7+ / 0-)

    The plan is to get the voucher system in place any way they can.  Once in place they can scale back the coupon year by year until it becomes an insignificant budget item. The goal is to remove this expense from the budget.  The reason? Protect the wealthy from tax increases that help support social programs. It all starts with protecting the wealthy class.

    I absolutely understand why the 1,000,000+ crowd would vote republican, but why would regular folk?  Totally mystifies me.  

  •  I immediately think of my grandparents (6+ / 0-)

    One Grandmother suffered from Alzheimer's for 15 years. How would it be possible for her to pick-a-plan? Another aunt recently passed away with another brain ailment and, again, how in the world would she be able to shop for a policy? She had no recollection for the past 5 years.
    I wish this point would be brought up. Yes, we hope to be infallible in our old age. But, we are surrounded by truth.

  •  Romney won't let you die... (4+ / 0-)
    Recommended by:
    RJDixon74135, ladybug53, smiley7, NWTerriD

    Just call 911 and go the the ER.

    It's time to go Mormon on Romney. Tell America what Romney really believes. Otherwise, we're losing. And I can't imagine why.

  •  The twenty-something children of today's (9+ / 0-)

    fifty-something generation should be concerned about having to shore up their aging parent's medical costs out of their own pockets.

    The 'Pub's attempts to drive wedges between the generations on this issue are truly despicable.

    Have you noticed?
    Politicians who promise LESS government
    only deliver BAD government.

    by jjohnjj on Fri Oct 12, 2012 at 10:50:02 AM PDT

  •  Support single payer then...or else! n/t (2+ / 0-)
    Recommended by:
    ladybug53, NWTerriD
  •  Another thing I am not hearing (3+ / 0-)
    Recommended by:
    ladybug53, smiley7, NWTerriD

    So you are going to move Seniors into private insurance?

    Please tell me the Private insurance company that is going to cover a person over 65?

    Umm old people get sick! it is a reality of being old.  

    What insurance company is going to cover a Senior knowing that all the premiums they collect  from that senior are going right out the door immediately to pay for medical fees .

    The only Insurance companies that dare to enter this market are going to be the sleaziest most corrupt bottom of the barrel insurance companies

    "Although it is not true that all conservatives are stupid people, it is true that most stupid people are conservative." - John Stuart Mill

    by smartone on Fri Oct 12, 2012 at 10:54:32 AM PDT

  •  and what I keep not hearing about the tax plan (2+ / 0-)
    Recommended by:
    ladybug53, NWTerriD

    of mittwit and lyan is not only no details of the plan other than it would be reached with an agreement with congress, but also HOW MUCH MORE COMPLICATED THIS MITTWIT/LYAN PLAN would be.  

    Isn't the idea of tax policy (at least in theory) to make it simpler?  I don't see how the rethugs present position is anything but more complicated.  

  •  Paperwork gets harder and harder and Wheat? (3+ / 0-)
    Recommended by:
    peregrine kate, ladybug53, NWTerriD

    My husband and I are both retired scientists and it certainly seems to me that the amount of complex information related to health care and finances and the use of electronic toys is increasing faster than we are aging.  I've already started worrying about how long I can keep dealing with it competently.  

    Dear poster -- your set of symptoms (possible Crohn's, possible diabetes, etc.) sound like those that have been reliably tied to consumption of modern wheat.  It you haven't already read the book "Wheat Belly" you should do that and also check out the cardiologist author's blog. Best wishes.

  •  Maybe a chart would do it (2+ / 0-)
    Recommended by:
    ladybug53, NWTerriD

    Of everything that an individual, couple or family would have to do to gain coverage, by which I mean:

    1) Coverage for hospitalization/major medical
    2) Coverage for routine office visits, lab work, minor ailments, testing (including specialists if needed, like, say, an OB/GYN or a dermatologist).
    3)  Prescription drug coverage
    4)  Dental coverage -- 2 cleanings a year, non-emergency work like fillings/crowns/dentures
    5)  Vision coverage -- at least 1 exam a year, glasses allowance

    That's a complete medical care package as I see it -- feel free to add if I left something out.

    So, first, the Republican voucher plan: what will it take a person/family to get this coverage?

    In the middle, current Medicare coverage, and what a person/family needs to do to gain coverage.

    Next, Obamacare.  What does a person/family need to do to gain coverage?

    And just for grins, on the far side, Medicare-for-all, single-payer, progressive dream plan. What does a person/family need to do to get this coverage?

    I really think it would be pretty powerful.  

    "There isn't a way things should be. There's just what happens, and what we do." — Terry Pratchett (A Hat Full of Sky)

    by stormicats on Fri Oct 12, 2012 at 11:04:40 AM PDT

  •  Wish I had your plan... (1+ / 0-)
    Recommended by:
    pee dee fire ant

    What a curious, bewildering post.  My health insurance, for just me and my wife, costs $400 monthly, not $50, but then again, it's funded by a company rather than the government.  I also have an open enrollment period each year and the health problems that come with age, and you can bet your life I study every scrap of information they provide to pick the best deal and the best coverage.  If your own health doesn't motivate you to do a little digging, what will?  Maybe this is what some people mean when they talk about others not taking responsibility for themselves.  

    •  I pay a lot more than that (3+ / 0-)
      Recommended by:
      peregrine kate, ladybug53, WisePiper

      for a family of 4, but I wouldn't dare to presume to tell you whether I think you're living healthy or "taking responsibility." Who knows what you do behind closed doors or when the computer's off. Do a little digging? Are you for real? You really think there's some treasure trove of private plans that will rival the diarist's employment provided coverage?

      And here's a news flash. People who live according to your stern admonitions get sick and die anyway, eventually, no matter how they've tried to protect themselves. Bad things sometimes happen to good people. Take the judgement out of it, because I'll bet if you anatomized your life choices for us, we'd find plenty to find fault with.

    •  Huh? (0+ / 0-)
      My health insurance, for just me and my wife, costs $400 monthly, not $50, but then again, it's funded by a company rather than the government.
      If I had a spouse, I'd be paying a lot more than $50 too. The amount that our district contributes covers the full premium for a single person. It doesn't cover it for a couple.

      When I worked in the private sector, on the other hand, my then-husband and I were both covered by my employer's plan at no additional cost to us.

      If your own health doesn't motivate you to do a little digging, what will?
      "Digging" wouldn't have any effect on my health. As I stated in the diary, I have good health care coverage. The only thing the digging would accomplish is that IF I found a plan that would allow me to maintain that same coverage, with my current provider, at a less expensive rate, then it would save me a little bit of money. When I have done the "digging" in past years, I haven't found any plan that would meet those conditions.
      Maybe this is what some people mean when they talk about others not taking responsibility for themselves.

      Silly me. I kind of thought that by working my ass off 14 hours a day on teaching math to struggling middle school students, and spending most of the rest of my waking hours on exercising, buying and preparing healthy food, researching and implementing other lifestyle changes to maintain and improve my health, and educating myself about the political issues facing our country, that I was not only taking responsibility for myself, but also taking responsibility for my share of the future of the nation. But I guess I must be wrong about that, because you know so much more than I do about what I should be doing with my time.

      "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

      by NWTerriD on Fri Oct 12, 2012 at 10:09:04 PM PDT

      [ Parent ]

  •  Is it true that places like John Hopkins or (2+ / 0-)
    Recommended by:
    ladybug53, NWTerriD

    Mayo Clinic do not accept medicare.  I heard that on Tv one day. I know it does not pay for things that do not meet their criteria.  I have a friend aged 69 who needs a hysterectomy because of bleeding.  She does not meet the criteria because her blood work never indicates she is bleeding to the point of being dangerous so every year for the last 3 years she has had a D&C . Although it is a completely different procedure. It does involve pre op workup , anesthesia and monitoring after surgery.  At some point wouldn't it be cheaper to just do the hysterectomy. Who makes these stupid decisions? Is it non medical personnel?  And Dick Cheney gets a heart transplant that cost over a million dollars.  
     However, after saying all that, I know that some  Drs.'s order unnecessary test and procedures  to make money for the hospital that pays their salary and to cover their buts.  

  •  Fine diary, thanks. (4+ / 0-)

    Good to have discussion of yet another of the many key flaws in the bogus proposal to "save" Medicare. Reminds me of the unconscionable strategy in Vietnam--having to level a village to "save" it....

    I'm sorry you're having so many health problems, and hope that you get some good resolution of them soon.

  •  What would be so awful... (3+ / 0-)
    Recommended by:
    sponson, ladybug53, NWTerriD

    ...about extending Medicare to all Americans? After all, it was built to scale.

  •  I am sick about the discussion of (7+ / 0-)

    raising the age.  They should be LOWERING the eligibility age to 55 and let people buy-in sooner based upon income and health.  

    The pool would get larger which could drive the costs down.

    They keep going backwards.

  •  Medicare facts (5+ / 0-)

    I was disabled at 58 after working 42 years.  Disabled due to being unable to unwork due to rhematoid arthritis.

    Joe Biden is exactly correct.  Medicare now has more benefits than it did a couple months ago.  Small case in point......Shingles vaccations were not previously covered by Medicare.  Now they are.  $215 if I had to pay for it.

    Wellness testing.  Free.  This is to find disease and illnesses before it becomes a major expensive.  Finds early stages of cancer, thyroid disease, diabetes.....whatever.

    Social security has worked for 77 years and Medicare for 47 years.  Every election, some Republican wants it to disappear.

  •  Chris Matthews gets your point (2+ / 0-)
    Recommended by:
    ladybug53, NWTerriD

    Almost every time the Romney-Ryan vouchers plan comes up, he beats on this drum so some are giving attention to it.  Also, as someone noted, Eastwood's performance at the RNC was a convincing argument that some people are in no condition to carefully sort out complicated health care options due to their age and mental state.

  •  The GOP knows that: (4+ / 0-)
    Recommended by:
    ladybug53, shopkeeper, howd, NWTerriD
    And I am frankly scared shitless at the idea of having to shop around for health insurance 20 or 25 years from now, when my health problems are worse and my mental faculties are in decline and I'm living on whatever meager resources the Republicans decide to let me retire on as a public employee.
    It is much easier to swindle the elderly. Easier than children. And unlike children, the elderly might have a nest egg to siphon from.

    "Til you're so fucking crazy you can't follow their rules" John Lennon - Working Class Hero

    by Horace Boothroyd III on Fri Oct 12, 2012 at 12:37:00 PM PDT

  •  your diary reminded me that i needed to call HR (1+ / 0-)
    Recommended by:
    NWTerriD

    I am about to turn 65 and will be medicare eligible.

    my therapist just informed me that i will lose coverage, not gain it because michigan law requires that medicare become the primary insurer.

    i was looking forward to having less deductibles as my blue cross coordinates with medicare as my out of pocket medical is over 6,000 a year.

    i also have to negotiate a bewildering array of new benefits available at work which much be added by oct 19th except the ones which can't be added till later and try to figure that one out, never mind what all these 'benefits' which should be standard in medicare anyway, will cost me.

    i absolutely do not blame you for not going there.

    Donate to Occupy Wall Street here: http://nycga.cc/donate/

    by BlueDragon on Fri Oct 12, 2012 at 01:10:20 PM PDT

  •  Obama should stress in his next debate (1+ / 0-)
    Recommended by:
    NWTerriD

    the Romney plan, throwing Seniors to the Insurance Industry will also toss them out to be scammed.  They are scammed easily.  We hear stories every day.  You don't think the scammers aren't getting ready?

    To be undecided in this elect​ion is to pause​ for a moment and then ask how the chick​en is cooked.” ― David Sedaris

    by Paddy999 on Fri Oct 12, 2012 at 01:51:35 PM PDT

  •  I am sure that Ryan et al. assume ... (1+ / 0-)
    Recommended by:
    NWTerriD

    ... all elderly Americans have progeny who will read through all the fine print and "choices" and make sure Mom/Grandma/whoever doesn't fall through the cracks.

    For myself, everyone I know with kids assumes that very thing at some level and in some way, shape, or form.

    Not everyone has kids, though.  Knowing I will probably have to figure this all out on my own does not inspire me with confidence.  And every time I take a look at the kinds of things I'll have to think about, I have to fight the urge to pull back and pretend I have all the time in the world.

    So yes, NWTerriD, while I'm not scared shitless yet, I don't want to be.

    "The fears of one class of men are not the measure of the rights of another." ~ George Bancroft (1800-1891)

    by JBL55 on Fri Oct 12, 2012 at 01:53:30 PM PDT

  •  What I would like to hear Obama say (2+ / 0-)
    Recommended by:
    George Hier, NWTerriD

    is simpler and more effective:

    "Nobody will touch Medicare, not over my dead body."

    Categorical, clear, simple, and forceful.  And it would reassure me to know he's not planning to do it and to hear it in plain English that would haunt him if he broke his promise.

  •  I'm not hearing what appeals to 80%++ of us normal (1+ / 0-)
    Recommended by:
    NWTerriD

    people

    medicare to 55, or

    medicare for all, or

    single payer.

    the clinton-obama-crats can all go piss up a rope - I'm f'king done with their excuses.

    BTW - I'm 52 and have been a teacher for 8 years and I worked in software support at Microsoft for 5 years and I was a cook for 15+ years and I have voted Democratic POTUS 8 times in my life --

    and ALL my life the top 1% and 10% of bubble test takers have had their cake and their nice homes in their nice hoods and their well paying jobs,

    and their excuses for losing to fascists,
    and their fucking lies for selling us out to fascists.

    "funny" how out here in Seattle, The Best people can come up with for obama is a laundry list of penny ante accomplishments, a avoidance of the sell outs, and

    LESSOR OF TWO EVILS!!!

    The fascists will never change cuz they're fascists, get over it. I knew that when I was a 20 year old 4 buck an hour cook in 1980, with a 6 night a week 2 six packs a night drinking habit.  

    The Democratic Party isn't going to change until we're rid of these yuppie sell out bipartisanship fucks.

    They're quiet on Medicare cuz they're setting us up to fuck us so their thieving buddies at AHIP can rip us off. Period.

    rmm.

    Yond Cassius has a lean and hungry look; He thinks too much: such men are dangerous

    by seabos84 on Fri Oct 12, 2012 at 02:49:22 PM PDT

  •  I agree that the subject needs to be brought up (0+ / 0-)

    as an aside, developing these conditions in mid-50''s

    been hospitalized twice,

    ~ had a heart attack,

    ~ discovered that I might have COPD but it's more likely asthma (and in either case it's treated with daily inhaled steroids),

    ~ been diagnosed with sleep apnea and had to start using a CPAP machine at night,

    ~ had blood sugar readings that put me just barely into the prediabetes range, and most recently

    ~ had a routine colonoscopy that indicates a possibility of Crohn's disease.  

    is not an indication of being 'healthy' until they started to be diagnosed by doctors. They were developing for years. I bring this up to point out the problems with the health 'care' industry, just figuring out who's going to pay for it is not the solution. With real health 'care' these things would have been noticed or even prevented, long before becoming the problems they now are.

    "I'm sculpting now. Landscapes mostly." ~ Yogi Bear

    by eXtina on Fri Oct 12, 2012 at 02:55:04 PM PDT

    •  Yeah, I know -- (0+ / 0-)

      I've educated myself a LOT about health issues in the past couple of years, and you're right -- this stuff, esp the heart disease, was in the pipeline for years, probably decades. But I was going for simplicity in that part of the diary, because it was just background for the main point I wanted to make.

      "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

      by NWTerriD on Fri Oct 12, 2012 at 10:15:10 PM PDT

      [ Parent ]

  •  Another Factor (1+ / 0-)
    Recommended by:
    NWTerriD
    And I am frankly scared shitless at the idea of having to shop around for health insurance 20 or 25 years from now, when my health problems are worse and my mental faculties are in decline and I'm living on whatever meager resources the Republicans decide to let me retire on as a public employee.
    Obamacare means the insurance companies can't dump you if you get sick.  Medicare means you won't get dumped when you get sick (for the elderly, it isn't a question of "if" but more akin to "when" and "what").

    Both are designed to keep families out of the poor house if something happens.

    So you Romney supporters, listen up.  No matter how good you think your insurance is, under the Romney plan when something serious happens to you, your insurance company can (and will) wash their hands of having to deal with you.  Think about that long and hard, and get past your personal hate of Obama, because eventually the bell will toll for you, and you better hope Obamacare and Medicare are both alive and well.

  •  I'm with you! (1+ / 0-)
    Recommended by:
    NWTerriD

    All those papers, in detail, with all kinds of loopholes, traps and other creepy things the vultures put in there.

    I'm not that cognitively challenged either, but I really really don't want to have to do that at 70, 80 or above.

    I think they want people, especially the women, to just give up, crawl away, and die in the ditch. That way the younger men can keep everything for themselves and have more to buy more girls and women.

    Women create the entire labor force.

    by splashy on Fri Oct 12, 2012 at 09:27:01 PM PDT

  •  Ed shultz (0+ / 0-)

    Talks about this all the time

    Those who make peaceful revolution impossible will make violent revolution inevitable. ~JFK

    by TheUrbanRevolution on Fri Oct 12, 2012 at 10:53:34 PM PDT

  •  Seniors Swindled by VoucherCare (0+ / 0-)

    I totally agree with you. We need to come up with a buzz word(s) for this concept. At 54 I have been shopping and buying my health insurance since end of 2007.  It's a nightmare our here already. God forbid you want the freedom to move to a new State and you find out you start from scratch.

    Between my mothers Medicare Advantage and my high deductible health care ... it makes me sick to even think about the headache, heartache, telephone time, follow up time etc I have had for both of our bills. My mom passed away last year and with two 'billing errors' it took me forever to clear up the bill.

    IT ALREADY IS A NIGHTMARE. It will only get worse. It's impossible to stress how difficult dealing with this was.

    I am fairly young, had time due to not working, had a telephone billing background and am sturdy and it's been very difficult.

    VoucherCare is a cruel and ugly concept. It's only the ignorant and the heartless that would promote this.

    Medicare must evolve.  The first step is to put in strict fraud prevention procedures that include checks and balances.

    Last but not least I recommend anyone still on Medicare Advantage don't wait till it goes away to get off it. From our experience if you have a critical event all the benefits of the 'advantage' fly out the window as you learn that you have signed you medicare rights away and are under 'managed' care...managing their profit and not you or your loved ones health.  imho.

    A thought Why not practice mindful speech by using Socrates' triple filter. Ask yourself: Is is true? Is it kind? Is it helpful?

    by thatwhichisgood on Fri Oct 12, 2012 at 11:36:46 PM PDT

  •  It is a monstrous absurdity to declare (0+ / 0-)

    that 80+ year-olds should be expected to shop for health insurance.  But then practically everything said by republicans is absurd, cruel, and morally degenerate.  The corporate press works overtime to normalize this nonsense.  

    I found it particularly refreshing to see Joe Biden actually act with appropriate emotion at Ryan's predictable lies.  We need more derision and ridicule at every public turn.  Democrats and press acting like crazy-talk is reasonable just pushes the boundaries toward crazy for the low-information voters who are taking queues about what is reasonable.  Notice how the Rethugs got all upset at Biden's behavior; that tells you that it is the right way for Dems to behave.

    The Long War is not on Iraq, Afghanistan, or Iran. It is on the American people.

    by Geonomist on Sat Oct 13, 2012 at 06:08:53 AM PDT

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