Will we ever have single payer health care in this country?

[Ambivalent1]

Tell me about it. Most people don't realize it's a feeding trough for the insurance industry, for example.

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?
.

Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?

None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.

MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.

I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.

 

[dblack]

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I don't. So, given you are so knowledgable about this, maybe you can explain what this is all about (you must have missed other three times I've posted it in this thread):

33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.

In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.

We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.

I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop, and in the money, while Congress pretended to appease progressives.

I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?

 

[Mac1958]

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?
.

Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?

None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.

MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.

I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.

I don't remember if the numbers are available online. You'd think they would be. I'll let you know if it comes to me.
.

 

[Ambivalent1]

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?
.

Tell me, (I should admit that I detest MAPD plans) what is the Gov funding level with these plans?

None for Supplements, which simply fill the many gaps in Medicare. For MA plans, it's a PM/PM (per member per month) stipend, around $1,000 a month last time I checked, on average. There are a few variables, including age and geography.

MA plans are great for lower-income people, Supplements with a PDP are definitely better if you want full coverage.
.

I am a consultant to an agents/brokers in the industry, I understand how the Supps and Part D plans work but I know damn well the private companies are no making any money on premiums (MA). I've never been able to find what levels the Feds help with costs f these plans.

I don't remember if the numbers are available online. You'd think they would be. I'll let you know if it comes to me.
.

Thanks.

 

[Harpy Eagle]

Why cant we just fix the ACA? its in place, both party's messed it up. that would save a lot of money, and no one has come up with a better plan.

The Republicans had nothing to do with the ACA.

They just voted to repeal it 62 times...till they got control of both sides of Congress and the White House and then all of a sudden no longer wanted to repeal it...

Millions of Americans want nothing to do with any type of socialized medicine

Yet they keep voting for parties that want it to be expanded. Why is that?

People need to realize there is no need for the nanny state

good luck with that.

 

[Mac1958]

Medicare Supplements are paid for by the owner of the policy.

Medicare and Medicare Advantage plans are paid for by taxpayers.

It's amazing how many people have absolutely no idea how our Medicare system works, but pretend that they do.
.

Tell me about it. Most people don't realize it's a feeding trough for the insurance industry, for example.

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I used to think it was as you say, but I did some research and found this:

Medicare Supplements are paid for by the owner of the policy.

Medicare and Medicare Advantage plans are paid for by taxpayers.

It's amazing how many people have absolutely no idea how our Medicare system works, but pretend that they do.
.

Tell me about it. Most people don't realize it's a feeding trough for the insurance industry, for example.

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I don't. So, given you are so knowledgable about this, maybe you can explain what this (you must have missed other three times I've posted it in this thread):

33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.

In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.

We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.

I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop and in the money while Congress pretended to appease progressives.

I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?

I don't see anything there that contradicts my point. The only private business participants in the core Medicare system are providers and their various suppliers.

If you want to supplement your Medicare coverage, that's where private insurers come in.

Those are the facts. Take 'em or leave 'em.
.

 

[Harpy Eagle]

Why cant we just fix the ACA? its in place, both party's messed it up. that would save a lot of money, and no one has come up with a better plan.

The Republicans had nothing to do with the ACA.

They just voted to repeal it 62 times...till they got control of both sides of Congress and the White House and then all of a sudden no longer wanted to repeal it...

Millions of Americans want nothing to do with any type of socialized medicine

Yet they keep voting for parties that want it to be expanded. Why is that?

Because they were lied to. Republicans ran on repealing it. You can fault voters for being gullible, but you can't say they voted for socialism. That's just not so.

so, can I blame them for being stupid and not paying attention to the last 50 or so years?

The Repubs have been pushing bigger government and more government programs just as much as the Dems.

We do not have a party (outside of the Libertarian party) that is fiscally conservative.

 

[Rustic]

The Republicans had nothing to do with the ACA.

They just voted to repeal it 62 times...till they got control of both sides of Congress and the White House and then all of a sudden no longer wanted to repeal it...

Millions of Americans want nothing to do with any type of socialized medicine

Yet they keep voting for parties that want it to be expanded. Why is that?

People need to realize there is no need for the nanny state

good luck with that.

No doubt...

 

[Ambivalent1]

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I don't. So, given you are so knowledgable about this, maybe you can explain what this (you must have missed other three times I've posted it in this thread):

33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.

In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.

We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.

I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop and in the money while Congress pretended to appease progressives.

I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?

I tend to be a bit cynical with any Gov involvement, there is ALWAYS shit they won't tell about whatever they are doing. On a base level they are correct in that you have two funding mechanisms at work, you have Original (Gov) and the private companies marketing plans to pick up what the Gov doesn't. Make no mistake though, CMS is about Gov strangle hold on care,the tension in the entire system has always been which monies will be used the most and by whom.

That's all that the Medicaid expansion was, a way to shift dollars from the Feds (expenditures) to the States.

 

[dblack]

Tell me about it. Most people don't realize it's a feeding trough for the insurance industry, for example.

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I used to think it was as you say, but I did some research and found this:

Tell me about it. Most people don't realize it's a feeding trough for the insurance industry, for example.

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I don't. So, given you are so knowledgable about this, maybe you can explain what this (you must have missed other three times I've posted it in this thread):

33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.

In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.

We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.

I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop and in the money while Congress pretended to appease progressives.

I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?

I don't see anything there that contradicts my point. The only private business participants in the core Medicare system are providers and their various suppliers.

??? Seriously? Wow - you know those threads you start slamming people for wearing partisan blinders? LOL - you go!

Here - read it slower this time: "Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date."

Again, I ask. Are they lying, or just wrong?

Sorry to say Mac, but I thought you were above this. I appreciate when you posts threads slamming blind partisans and their refusal to acknowledge the basic facts of an argument. But you don't seem to be able to take your own advice.

 

[Harpy Eagle]

They just voted to repeal it 62 times...till they got control of both sides of Congress and the White House and then all of a sudden no longer wanted to repeal it...

Millions of Americans want nothing to do with any type of socialized medicine

Yet they keep voting for parties that want it to be expanded. Why is that?

People need to realize there is no need for the nanny state

good luck with that.

No doubt...

As long as people keep voting for Repubs and Dems the nanny state will just keep growing.

 

[dblack]

On a base level they are correct in that you have two funding mechanisms at work, you have Original (Gov) and the private companies marketing plans to pick up what the Gov doesn't.

Are you referring to the article I posted? That's not what they're saying. Congress pays insurance companies to "administer" Medicare. This is not about the supplemental plans they sell.

 

[Rustic]

Millions of Americans want nothing to do with any type of socialized medicine

Yet they keep voting for parties that want it to be expanded. Why is that?

People need to realize there is no need for the nanny state

good luck with that.

No doubt...

As long as people keep voting for Repubs and Dems the nanny state will just keep growing.

Lol
Yep,
Political correctness make sure that generation snowflake Will be fully dependent on the nanny state

 

[Mac1958]

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I used to think it was as you say, but I did some research and found this:

I've gone over this many times, and I'm not inclined to type out an explanation of the whole system. If you have specific questions, let me know

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I don't. So, given you are so knowledgable about this, maybe you can explain what this (you must have missed other three times I've posted it in this thread):

33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.

In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.

We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.

I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop and in the money while Congress pretended to appease progressives.

I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?

I don't see anything there that contradicts my point. The only private business participants in the core Medicare system are providers and their various suppliers.

??? Seriously? Wow - you know those threads you start slamming people for wearing partisan blinders? LOL - you go!

Here - read it slower this time: "Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date."

Again, I ask. Are they lying, or just wrong?

Sorry to say Mac, but I thought you were above this. I appreciate when you posts threads slamming blind partisans and their refusal to acknowledge the basic facts of an argument. But you don't seem to be able to take your own advice.

Whatever you'd like.

And to your quote above, "the government pays insurance companies to administer Medicare" through Medicare Advantage plans, which take over for Medicare with participants, as we have discussed multiple times on this thread.

People who actually know how the full Medicare system works, know that.
.

 

[Mac1958]

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I used to think it was as you say, but I did some research and found this:

Are you deliberately lying here, Mac? That doesn't seem like you, but you know damned well I'm talking about core Medicare, not the supplemental shit. The basic setup was designed to preserve insurance companies profits. Why do you keep steering around that? What kind of blinders are preventing you from acknowledging the basic facts about what we're delaying with? How can we have an honest conversation as a nation when so many of you play the obfuscation games?

No, the core Medicare system does not go through private insurance companies. They get involved with Medicare Advantage plans and Medicare Supplements.

I'll say it again: I've done years of training on this system. For six years I was the financial guy in the room when one of the primary insurance providers put together the Medicare Advantage plans, piece by piece, benefit by benefit, cost by cost, for every last county in my state.

If you want to think I'm lying or playing games, great.

I have significant professional training and professional hands-on experience on this. Do you?

I don't. So, given you are so knowledgable about this, maybe you can explain what this (you must have missed other three times I've posted it in this thread):

33. Medicare is a Private–Public Partnership || Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.

In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.

We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.

I never realized this until I did some research, but it sounds like Congress. They cut a deal to preserve the profits of their buddies in the insurance industry - to keep them in the loop and in the money while Congress pretended to appease progressives.

I'm curious why you think this isn't true. I don't know much about the Center for Medicare Advocacy, but they don't seem like partisan shills, or "fake news". Do you think they're lying deliberately? Or are they just confused? If they are, then are the other sources out there equally confused. What gives?

I don't see anything there that contradicts my point. The only private business participants in the core Medicare system are providers and their various suppliers.

??? Seriously? Wow - you know those threads you start slamming people for wearing partisan blinders? LOL - you go!

Here - read it slower this time: "Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date."

Again, I ask. Are they lying, or just wrong?

Sorry to say Mac, but I thought you were above this. I appreciate when you posts threads slamming blind partisans and their refusal to acknowledge the basic facts of an argument. But you don't seem to be able to take your own advice.

Whatever you'd like.

And to your quote above, "the government pays insurance companies to administer Medicare" through Medicare Advantage plans, which take over for Medicare with participants, as we have discussed multiple times on this thread.

People who actually know how the full Medicare system works, know that.
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And one more thing, the NGS (to which a few private insurers are involved) is a claims administrator for Medicare, but that's on the back end only. The lion's share of Medicare revenues to private insurance companies, the part of this that many have issues with, come from running Medicare Advantage plans and Medicare Supplements.

I'm guessing that's what this is about.

I have no idea why we're discussing this, but I'll assume you do.
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[Markle]

Bullshit. This is why our mortality rate is inferior not because of healthcare. Don’t deviate.

That's pretty funny!

As far as I know, correct me if I'm wrong but I believe every countries mortality rate is 100%.

Please be bit more clear.

Please get your head out of your ass.

Share with us all where anyone gets out of here alive.

 

[Markle]

Medicare Supplements are paid for by the owner of the policy.

Medicare and Medicare Advantage plans are paid for by taxpayers.

It's amazing how many people have absolutely no idea how our Medicare system works, but pretend that they do.

That post does prove that you have no clue as to how Medicare works.

Yes, Medicare Supplemental insurance is paid or by the owner of the policy.

No, Medicare is paid for by withholding taxes.

Medicare Advantage is paid for by the person covered by Medicare. It is deducted from your monthly check.

 

[Markle]

medical insurance companies are not high profit corporations. Now, shall we discuss the profit rates of big pharma? Apple, google, FB?

Who pays the billions of dollars in research to develop new life saving, life-extending, and life-improving drugs.

What other nation has developed as many of those drugs has American companies and why?

 

[Mac1958]

Medicare Advantage is paid for by the person covered by Medicare. It is deducted from your monthly check.

No, it's not paid for only by the participant. Your premium is just a PIECE. There is MORE TO IT.

Again: Medicare Advantage is funded by a PM/PM (per member/per month) stipend paid by CMS to Medicare Advantage companies, who take over for Medicare with that participant and are allowed to charge a monthly premium depending on the benefit package of that particular plan.

Some Medicare Advantage plans have a zero dollar monthly premium. How the **** do you think their Medicare services are paid for when the premium is ZERO?

Holy shit, you people and your arrogant ignorance.
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[Mac1958]

Good gawd, this is like me telling a ******* mechanic how to rebuild a transmission.

Incredible.