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A lot of gullible people in all age groups drank the koolaid.
They believed they would get better service even with their program being cut.
They believed they would get all this "free" preventative care and not see their premiums increase.
They believed that someone else was going to pay their bills.
And now you know why so many parts of Obamacare were put off, modified, extended until AFTER Obama got back into office.
Cooler heads, reason and logic took a back seat to heated emotions and fear mongering (dying in the streets).
We're slowing evolving into a banana republic similar to those found in central and south America.
It's a more rapid decline than we all ought to be comfortable with. It IS definitely a "fundamental transformation" of the country.
Quote:
Originally Posted by Hoonose
So far Medicare has been too easy. Too easy to get testings, treatments, specialist referrals and surgeries. You don't have to call to get approval as per most private plans. And that's a large part of our over spending. This we hope will change with more evidence based decision making, but so far there has been no palpable change. Most likely the only rationing will be as it is now. With docs either taking on fewer Medicare patients or dropping out due to low reimbursements.
But not from primary care, as Medicare is now directing improved reimbursements.
It's not that easy to deal with the system. Often you do need to get pre-approval. I will agree there are too many tests, but that's because the doctors are covering their liability to make sure they didn't overlook something and --and this is a big problem -- they are ordering extra tests because they know that Medicare will pay something for it, thus increasing their revenue to make up for losses elsewhere. Medicare reimbursements are down, and patient co-pays are up, increasing the patient's expenses, bringing him/her closer to the dreaded 'donut hole', when serious illness can truly empty their wallets because, for a specified period of time, Medicare pays nothing.
It's a more rapid decline than we all ought to be comfortable with. It IS definitely a "fundamental transformation" of the country.
It's not that easy to deal with the system. Often you do need to get pre-approval. I will agree there are too many tests, but that's because the doctors are covering their liability to make sure they didn't overlook something and --and this is a big problem -- they are ordering extra tests because they know that Medicare will pay something for it, thus increasing their revenue to make up for losses elsewhere. Medicare reimbursements are down, and patient co-pays are up, increasing the patient's expenses, bringing him/her closer to the dreaded 'donut hole', when serious illness can truly empty their wallets because, for a specified period of time, Medicare pays nothing.
Please enlighten me as to the donut hole in Medicare you speak of.
Part B pays 80% just as always.
Part A Hospitalization is a deductible of a little over 1000 dollars and then Medicare pays the rest.
There are no maximum caps on how much medicare will pay.
If you're talking about Medicare Advantage or Supplemental Insurance, then you're not talking about Medicare. You're talking about private insurance.
Please enlighten me as to the donut hole in Medicare you speak of.
Part B pays 80% just as always.
Part A Hospitalization is a deductible of a little over 1000 dollars and then Medicare pays the rest.
There are no maximum caps on how much medicare will pay.
If you're talking about Medicare Advantage or Supplemental Insurance, then you're mot talking about Medicare. You're talking about private insurance.
So what exactly are you referring to?
Medicare Advantage plans are not "private" insurance in the same sense as Supplemental Insurance is.
Advantage plans are contracted with the government and cover ONLY the services that Medicare covers, in some cases paying a little more (or a little less) that straight Medicare coverage would be.
The 'donut hole' is a serious financial concern for those people who depend on prescription drugs for chronic illness.
It's a more rapid decline than we all ought to be comfortable with. It IS definitely a "fundamental transformation" of the country.
It's not that easy to deal with the system. Often you do need to get pre-approval. I will agree there are too many tests, but that's because the doctors are covering their liability to make sure they didn't overlook something and --and this is a big problem -- they are ordering extra tests because they know that Medicare will pay something for it, thus increasing their revenue to make up for losses elsewhere. Medicare reimbursements are down, and patient co-pays are up, increasing the patient's expenses, bringing him/her closer to the dreaded 'donut hole', when serious illness can truly empty their wallets because, for a specified period of time, Medicare pays nothing.
It is generally much simpler and easier dealing with Medicare than a typical private carrier. Medicare HMO's more so than fee for service.
Doctors order a lot of tests for all sorts of reasons. But the idea that they will gain on ordering tests that they themselves benefit from has been drastically reduced by Stark and other central cost controls.
With Medicare the patient generally is on the hook for 20%. And this has been that way for a long time. If Medicare lowers the reimbursement for a doctor's fee, then the 20% obligation from the patient naturally declines. With Obamacare some preventative testing and Wellness visits are 'free'. Meaning no patient co-pay.
With Obamacare there is no longer a limit on total coverage. Although rare in my 40 years experience, this should hold the numbers of patients/families financially devastated to a very bare minimum.
It's a more rapid decline than we all ought to be comfortable with. It IS definitely a "fundamental transformation" of the country.
It's not that easy to deal with the system. Often you do need to get pre-approval. I will agree there are too many tests, but that's because the doctors are covering their liability to make sure they didn't overlook something and --and this is a big problem -- they are ordering extra tests because they know that Medicare will pay something for it, thus increasing their revenue to make up for losses elsewhere. Medicare reimbursements are down, and patient co-pays are up, increasing the patient's expenses, bringing him/her closer to the dreaded 'donut hole', when serious illness can truly empty their wallets because, for a specified period of time, Medicare pays nothing.
Quote:
Originally Posted by mohawkx
Please enlighten me as to the donut hole in Medicare you speak of.
Part B pays 80% just as always.
Part A Hospitalization is a deductible of a little over 1000 dollars and then Medicare pays the rest.
There are no maximum caps on how much medicare will pay.
If you're talking about Medicare Advantage or Supplemental Insurance, then you're not talking about Medicare. You're talking about private insurance.
So what exactly are you referring to?
I cannot take a lot of generic medications because of the allergies to the fillers. I have to buy brand names which are minimally covered. I am almost to the donut whole which will make my meds run about $500 a month. I have a regular medicare plan, not an advantage plan.
Medicare Advantage plans are not "private" insurance in the same sense as Supplemental Insurance is.
Advantage plans are contracted with the government and cover ONLY the services that Medicare covers, in some cases paying a little more (or a little less) that straight Medicare coverage would be.
I'm aware of the Advantage plans. Basically, they administer the Part B portion of medicare privately. They recieve a premium from Medicare for doing so. Subsequently, they set the rate of reimbursement for doctors through their specific Advantage plan. In many cases, the rate of reimbursement for procedures is lower than Medicare would pay.
I was considering switching from a straight Part B Medicare administered plan to a Humana Advantage plan but my PCP flatly stated he would not accept the plan. When I asked him why, his exact words were, "I think I'm worth it at least to be reimbursed at the same rate as Medicare."
I think you are conveniently mixing the private insurance of Advantage and supplemental with the government portion of Medicare to paint a much bleaker picture of Medicare and the effects of Obamacare on it than is actually true. Pushing the agenda that Obamacare=Bad. Private Insurance=Good. When the only actual adjustments in Medicare for seniors is happening through the private portion of the Medicare program.
Medicare has no donut hole, nor is there any change in deductibles for Part A or Part B and the copay is still 20% to the patient. There is no maximum cap.
I have noted a disturbing trend among our medicare patients. Obamacare heisted $750 billion from medicare, which made necessary cuts in payments for medicare patients, in order to make Obamacare "practical" (assuming young people signed up as well). This trend has been reflected in offices of other specialists as well (my father -an Obama supporter- now has to wait 4 months for a cardiology appointment that previously has a three week wait). We are finding it very difficult to obtain total hip and knee replacements for our medicare patients (previously there was no problem). Reimbursement, of course, for total joints was markedly reduced as of Jan 1st.
The cuts in medicare payments to providers and hospitals mainly involved specialists and many procedures- primary care visits actually experienced a small increase in reimbursement.
As a result of payment to specialists (50% for us), we have had to limit medicare slots for patients, or experience insolvency, due to fixed overhead payments. Our "wait time" for someone with regular insurance is one to two weeks; the same "wait time" for medicare patient is 3 months. Medicare patients, of course, are upset about delays. However, Obama promised such delays and cuts in medicare programs; many senior democrats, however, ignored Obama's warnings and voted for him into a second term.
Were seniors really this ignorant and misinformed? Did they believe that their votes would have no consequences for THEM and only other people?
Take home message- one does not improve the quality of care and access for patients by reducing $750 billion of support. If this was true, we could simply cut Obamacare funding $1 trillion and "make it better"!
Don't be an idiot when you vote.
The left and AARP has been successful in scaring seniors into voting for them for decades. They tend to vote their pocketbook like most "victim" groups in society. Remember the march of the Grey warriors years ago and the screaming at the wall at how they are forced to eat dog food and choose between meds and soup? People are warned now and younger workers better start saving instead of buying homes and cars they can't afford. The elderly are simply useful fools as Stalin said regarding the poor farmers.....
The gov gives and the gov taketh away.
I think Medicare will be run just like the VA and don't we have something to look forward to there?
I cannot take a lot of generic medications because of the allergies to the fillers. I have to buy brand names which are minimally covered. I am almost to the donut whole which will make my meds run about $500 a month. I have a regular medicare plan, not an advantage plan.
Here are the actual facts in your circumstances concerning the Part D donut hole.
Are you saying that the donut hole for part D was better under the Bush Administration before Obamacare?
If I have to, I'll put the Part D donut hole payouts by Medicare side by side showing before Obamacare and after. You'll see a much better deal for part D users after Obamacare than before.
I think Medicare will be run just like the VA and don't we have something to look forward to there?
The very big and very important difference between the two is that Medicare is by and large delivered via the private sector. And IMO this should not change. Your doc is in a much better position to be your advocate as we have it now.
And with the graying of America I really doubt that this will change.
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