Bogus claims that just keep getting repeated

[The Rabbi]

What Ryan proposes (except for current Seniors), is NOT Medicare.

Indeed! The giveaway should be that enrolling in Medicare would be prohibited after a date certain. Sorry, gramps, try Aetna or Anthem!

Depends on what you call Medicare.

If it is a particular configuration.....it might be correct.

If it is a way to get health care to seniors.....then maybe not.

It is unfortunate that the left is so close minded as to not recognize that our health care delivery system has many excellent aspects.

The Left is fixated on the idea that if we just throw more money at something it will all be OK. But which president has been consistently cutting Medicare appropriations? Gov't coverage is meaningless if you have to line up for an aspirin, which is where the present system is headed. Ryan's plan actually insures people will get medical coverage instead of promises of medical coverage.

 

[Greenbeard]

Depends on what you call Medicare.

It's a cute rightwing game these days to pretend there's some ambiguity as to what Medicare is. So let's be clear. Medicare is a health insurance plan. I have an Anthem insurance card because I have an Anthem plan; folks with Medicare have a Medicare insurance card. It looks like this:

.

More to the point, Medicare is a public health insurance program whose benefit is guaranteed in statute. Under Medicare, the federal government acts as a payer (an insurance company), reimbursing hospitals and physicians for services rendered to seniors. Through that mechanism they do a number of things, like funding residencies for most physicians in this country and ensuring that emergency departments provide life-saving services without regard to ability to pay.

All of that goes away under Ryan's proposal. That's not a semantic difference, dismantling Medicare is actually an enormous change. Doing that has implications far beyond just the effects on future seniors (to whom it shifts costs, denies the option of enrolling in Medicare, strips of their guaranteed benefits, and pushes into private insurance plans if they can afford them). It raises questions about access to emergency services, recoupment of money spent on the uninsured (which Medicare supports through DSH payments), financing of health information technology, financing of graduate medical education, and so on.

It is unfortunate that the left is so close minded as to not recognize that our health care delivery system has many excellent aspects.

It certainly does. And those should be built upon and improved still further.

 

[The Rabbi]

Given that Medicare's costs have skyrocketed and the only way to control them is to institute price controls, which result in rationing, what would you suggest?

 

[Listening]

Depends on what you call Medicare.

It's a cute rightwing game these days to pretend there's some ambiguity as to what Medicare is. So let's be clear. Medicare is a health insurance plan. I have an Anthem insurance card because I have an Anthem plan; folks with Medicare have a Medicare insurance card. It looks like this:

.

More to the point, Medicare is a public health insurance program whose benefit is guaranteed in statute. Under Medicare, the federal government acts as a payer (an insurance company), reimbursing hospitals and physicians for services rendered to seniors. Through that mechanism they do a number of things, like funding residencies for most physicians in this country and ensuring that emergency departments provide life-saving services without regard to ability to pay.

All of that goes away under Ryan's proposal. That's not a semantic difference, dismantling Medicare is actually an enormous change. Doing that has implications far beyond just the effects on future seniors (to whom it shifts costs, denies the option of enrolling in Medicare, strips of their guaranteed benefits, and pushes into private insurance plans if they can afford them). It raises questions about access to emergency services, recoupment of money spent on the uninsured (which Medicare supports through DSH payments), financing of health information technology, financing of graduate medical education, and so on.

It is unfortunate that the left is so close minded as to not recognize that our health care delivery system has many excellent aspects.

It certainly does. And those should be built upon and improved still further.

Well, that is interesting.

You are aware that the Mayo in the Phoenix area stopped taking medicare patients some (under limited circumstances). Patients were told to show up with their checkbooks. So, you now pay for the Mayo if that is what you want. So just what was is that was guaranteed ? There are not enough GP's in the Phoenix area as it is. So, in essence, there could potentially be no one to go to.

Now, that's the kind of guarantee I want.

 

[Listening]

The Left is fixated on the idea that if we just throw more money at something it will all be OK. But which president has been consistently cutting Medicare appropriations? Gov't coverage is meaningless if you have to line up for an aspirin, which is where the present system is headed. Ryan's plan actually insures people will get medical coverage instead of promises of medical coverage.

I missed this one...sorry.

I just pointed out that in Phoenix, the Mayo quit taking medicare at some point. I have not heard an update on the situation.

 

[Greenbeard]

Given that Medicare's costs have skyrocketed and the only way to control them is to institute price controls, which result in rationing, what would you suggest?

Your premise is false on multiple counts. Medicare's growth has fallen substantially over the last two years (Medicare claim costs were rising at an annual rate of 2.16% in the last S&P health care index), despite the fact that the slowing of the market basket updates to certain Medicare reimbursements under the ACA hasn't happened yet.

That said, I haven't exactly been secretive about the kinds of things I want to see happening system-wide (not confined to Medicare, as if that were possible--Medicare pays the same health services as other health insurers) to go after rising costs. I've emphasized again and again that I want to see improvements in value, drastic improvements in the quality-to-cost ratio. And I've left a long enough trail of threads and posts that I can point to some of the key components of that transformation just by pointing to my own threads:

• More emphasis on primary care and prevention, particularly through various advanced models of primary care that are gaining steam
• A more holistic philosophy of systems-minded, patient-centered care instead of the disjointed, impersonal mess (and all the havoc it wreaks) we have today
• Better use of information to support clinicians and improve care delivery: that covers a lot of ground, likepoint-of-care clinical studies, clinical decision supports, and easier access to health information and data for doctors at the point of care
• Better functioning markets with the right incentives (particularly for quality and efficiency) and meaningful price signals
• Development and proliferation of evidence-based clinical practice guidelines, which are in relatively short supply at present
• More integrated service delivery, a form of reorganization to provide better care more cheaply
• Potentially, all-payer rates to eliminate the potential for cost shifting or dumping and mute the impact of provider market power and provider consolidation on prices

Most of these are overlapping and interconnected goals. And several of these are areas in which Medicare (real Medicare) is beginning to lead the way as a payer, potentially accounting for some its recent slowdown in growth.

You are aware that the Mayo in the Phoenix area stopped taking medicare patients some (under limited circumstances). Patients were told to show up with their checkbooks. So, you now pay for the Mayo if that is what you want. So just what was is that was guaranteed ?

This gets back the key point: Medicare is a health insurance plan. That means there is a set of benefits--covered services--associated with the plan. No provider is compelled to accept any health insurance plan, which is why plans are associated with provider networks in the first place. Medicare's guaranteed benefit refers to the fact that enrolling in Medicare guarantees that your insurance will pay for a certain list of services. It's a statement about what your health insurance plan looks like, it isn't a statement about a particular physician or provider facility.

 

[Listening]

This gets back the key point: Medicare is a health insurance plan. That means there is a set of benefits--covered services--associated with the plan. No provider is compelled to accept any health insurance plan, which is why plans are associated with provider networks in the first place. Medicare's guaranteed benefit refers to the fact that enrolling in Medicare guarantees that your insurance will pay for a certain list of services. It's a statement about what your health insurance plan looks like, it isn't a statement about a particular physician or provider facility.

And when no one is taking medicare ? What then ?

The articles I read indicated that several other clinics in the area were looking at the Mayo "experiment" rather closely.

I can only assume that if Mayo wasn't sued or forced to behave differently....other clinics might follow suit.

Seniors are going to sit by and let that happen ?

 

[Greenbeard]

And when no one is taking medicare ? What then ?

1) If you'll notice, in the bulleted list above I suggested the possibility of all-payer rates (similar to what Maryland has had in place for hospitals for the last thirty odd years), at least in some states, meaning that all payers--Medicare, Medicaid, and any private insurer--pay the same rate for a given service from a given institution. Thus no patient looks more or less attractive to a facility based on the reimbursement rates of his payer.

2) Depending on the metric you're looking at, seniors currently have comparable access or better access to care than the closest privately-covered control group one can come up with: older, pre-Medicare adults (aged 50-64) with private insurance. From MedPAC's March 2011 report:

To obtain the most current access measures possible, the Commission sponsors a telephone survey each year of a nationally representative, random sample of two groups of people: Medicare beneficiaries age 65 years or older and privately insured individuals age 50 to 64. The overall sample size is 4,000 in each group (totaling 8,000 completed interviews, including an oversample of minority respondents).2 By surveying both groups of people— privately insured individuals and Medicare beneficiaries— we can assess the extent to which access problems, such as delays in scheduling an appointment and difficulty finding a new physician, are unique to the Medicare population.

Results from our 2010 survey indicate that most beneficiaries have reliable access to physician services, with most reporting few or no access problems. Most beneficiaries are able to schedule timely medical appointments and find a new physician when needed, but some beneficiaries experience problems, particularly when they are looking for a primary care physician. Medicare beneficiaries reported similar or better access than privately insured individuals age 50 to 64.

On a national level, this survey does not find widespread physician access problems, but certain market areas may be experiencing more access problems than others due to factors unrelated to Medicare—or even private— payment rates, such as relatively rapid population growth. Moreover, although the share of beneficiaries reporting major problems finding a primary care physician is small, this issue is a serious concern not only to the beneficiaries who are personally affected but also—on a larger scale—for the functioning of our health care delivery system. The Patient Protection and Affordable Care Act of 2010 (PPACA) contains several provisions to enhance access to primary care, including increasing Medicare payments for primary care services provided by primary care practitioners. This policy marks an important step toward ensuring access, but more levers should be explored. Regulatory changes have also resulted in some payment increases for services that primary care providers frequently provide. The Commission will continue examining multiple approaches for improving Medicare’s payment policies to promote primary care.

Most beneficiaries report timely appointments
Because most Medicare beneficiaries have one or more doctor appointments in a given year, an important access indicator we examine is beneficiaries’ ability to schedule timely appointments. In the 2010 survey, among those seeking an appointment, most beneficiaries (75 percent) and most privately insured individuals (72 percent) reported “never” having to wait longer than they wanted for an appointment for routine care (Table 4-1). Another 17 percent of Medicare beneficiaries and 21 percent of privately insured individuals reported that they “sometimes” had to wait longer than they wanted for a routine appointment. The differences between the Medicare and privately insured populations in their “never” and “sometimes” response rates were statistically significant, suggesting that Medicare beneficiaries were more satisfied with the timeliness of their routine care appointments.

As expected, rates for getting timely illness- and injury- related appointments were better than rates for routine care appointments. Among those needing appointments, Medicare beneficiaries were more likely than privately insured individuals to report “never” having problems getting timely illness or injury appointments (83 percent of Medicare beneficiaries and 80 percent of privately insured individuals); 13 percent of Medicare beneficiaries and 15 percent of privately insured individuals reported “sometimes” having to wait longer than they wanted. These differences are statistically significant, suggesting that Medicare beneficiaries were slightly less likely than privately insured individuals to encounter delays for illness and injury appointments. [...]

Finding a primary care physician appeared to be more difficult for privately insured individuals than for Medicare beneficiaries. Specifically, among the small share of people (7 percent in each insurance group) who looked for a new primary care physician in the past year, 79 percent of Medicare beneficiaries and 69 percent of privately insured individuals reported that they had no problem finding one. This difference is statistically significant.

 

[The Rabbi]

IOW Greenbeard want the gov't to dictate to people whether to smoke, how much to drink, what to eat, etc etc. Because that is what "preventive care" turns into. The evidence is preventive tests cost far more than they save. So mandating lifestyle changes is the way to go, since a lot of health care money is spent cleaning up poor lifestyle choices.

 

[Greenbeard]

IOW Greenbeard want the gov't to dictate to people whether to smoke, how much to drink, what to eat, etc etc.

I say patient-centered medical home and you hear that? There's a big world out there--someday you should take off the ideological blinders and take a look at it.

 

[Listening]

And when no one is taking medicare ? What then ?

1) If you'll notice, in the bulleted list above I suggested the possibility of all-payer rates (similar to what Maryland has had in place for hospitals for the last thirty odd years), at least in some states, meaning that all payers--Medicare, Medicaid, and any private insurer--pay the same rate for a given service from a given institution. Thus no patient looks more or less attractive to a facility based on the reimbursement rates of his payer.

In other words, you will be regulating private insurers (forcing them to pay on par with medicare).

Is that what you are suggesting ?

 

[candycorn]

If only the loony left would do a little googling to remind themselves of facts before they tell the fish tales they tell.

You misspelled "looney".

Google it.

Dumb ass.

 

[bripat9643]

If only the loony left would do a little googling to remind themselves of facts before they tell the fish tales they tell.

The fact check here has proven the Republitards wrong, why are you avoiding this?

Most fact check sites are just leftwing propaganda sites. What makes them anymore credible than any other leftwing hack site?

 

[bripat9643]

Bogus claims that just keep getting repeated

"We are in a recovery."

"If you like the health care plan you have you can keep it"

 

[bripat9643]

Bogus claims that just keep getting repeated

"We are in a recovery."

"I do solemnly swear (or affirm) that I will faithfully execute the Office of President of the United States, and will to the best of my ability, preserve, protect and defend the Constitution of the United States."

 

[bripat9643]

Bogus claims that just keep getting repeated

"We are in a recovery."

"Cut Deficit in Half by end of first term"

 

[bripat9643]

Bogus claims that just keep getting repeated

"We are in a recovery."

"Unemployment rate will be 8.5% without stimulus."

 

[bripat9643]

Bogus claims that just keep getting repeated

"We are in a recovery."

"Guantanamo bay to be closed within a year"

 

[bripat9643]

Bogus claims that just keep getting repeated

"We are in a recovery."

"Won’t Raise taxes on those making less than 250,000 per year."

 

[Chris]

The Republicans have won PolitiFact's Lie of the Year award two years in a row.

I think they are trying for three.