Monday, October 19, 2015

dateline: October 19th, 2015

Hey Congress and Candidates for Prez:   Medicare Gaps are Sending Retirees to the Poorhouse, or Worse: Home without Needed Medical Care!

   So we've all endured decades of debate about The Affordable Care Act and other federal plans to finally create "affordable, universal, quality medical care." So why is it Congress cannot count and then deliver on what most advanced societies have done for their residents?

   See: "Cost of Care: The U.S. health care system is bleeding...", at:

-where it is reported that:

..."We are getting a bad deal with American health care. And it’s unsustainable.
We spent $2.919 trillion for health care in 2013, or $9,255 per American. Sure, the spending increase from 2012 to 2013 — 3.6 percent — was the lowest since the government started counting up all this spending in 1960.

But is that good news? Well, the tab is wildly above what the citizens of every other developed nation pay. In tiny, expensive Switzerland, where a McDonald’s combo meal sells for $13.39, average health care spending was $6,080 per person in 2012. In Germany in 2013, it was $4,884.

In part, we spend more because our prices are so much higher — for hospitals, for drugs, for medical devices and for medical salaries.
For more than 30 years, medical spending grew faster than pay for the average American worker. Real wages (controlled for inflation) actually decreased 4 percent, while health care costs are almost six times higher, the White House Council of Economic Advisers said in 2009. That bumped up health insurance premiums and left less money for everything else..."

   Take an average 65-year old retiree in Connecticut whose income is only his Social Security - say $693.00 after $104.00 is automatically deducted from his monthly, directly deposited Soc Sec check for "Medicare Part B." Back in the day, Medicare Parts A and B was more than sufficient to pay for most medical care but since health care providers continue to demand more pay for worse care and since insurance companies insist on ever-increasing, double digit premiums in order to pay their CEOs and stockholders millions of dollars taken out of patients' premium revenues in the new medical world of "the marketplace" - without really "managing" anyone's care or medical costs - which they were supposed to do in order to reduce medical costs and prices, given all this, millions of patients now shoulder unaffordable medical bills and have had to seek protection in federal bankruptcy courts or instead decide NOT TO SEEK care that they cannot afford. A poor choice for too many Americans in 21st Century America.

   Of course, there are many other Americans who are not retired and who still cannot afford health care. This is because Congress and the President and the various states have refused to enable consumer-patients to organize to negotiate more affordable insurance rates or premiums and to eliminate copays, deductibles, co-insurance and facility and other fees and have refused - in this era of an algorithm-inspired "high tech" iPHONE culture - to provide ways to even compare costs of the same procedures from different medical care providers having the same or similar quality ratios, and then have the ability - that is, the insurance - to pay for the one chosen. In short, the introduction of merged medical providers along with merged insurance companies creating a new Medical Industrial Complex where consumer-patient-ratepayers have no say is an absolute farce.

   Of course, there are alternatives some are pursuing. Like seeking affordable care overseas. (Read:'
Jeffrey Singer: The Man Who Was Treated for $17,000 Less,' - "Bypassing his third-party payer, my patient avoided a high hospital 'list price.", at:  ) Or divorcing one's spouse in order to obtain support from Medicaid for Medicare and private medical insurance premiums, co-pays and deductibles and co-insurances and facility and other fees. (Not recommended but let's face it: saavy younger people are foregoing marriage altogether in order to have any access to some health care.) Or legally hiding one's assets to circumvent foreclosure on one's assets. (Talk to your lawyers and estate planners!)

   Think of a word and the Medical Industrial Complex - now sucking about $2-$3 trillions out of our pockets annually - will find a way to use it to make still more money without worrying about the quality or accessibility of health care.

   Getting back to that Medicare beneficiary in Connecticut. His current annual deductible with an "Aetna Medicare Advantage Plan" is over $6,000, which, after this is paid by the patient, Aetna agrees to start paying over that amount. However, the brilliant legislators in Hartford and inside the DC beltway have yet to explain how such a person can really pay 75% of his annual income for just the deductible his medical insurance company, Aetna, charges.

   Given this, we have to ask Congress, the President and all those well-dressed candidates for federal office and not a few state legislators this question: SO WHAT ARE YOU GOING TO DO ABOUT UNAFFORDABLE, INACCESSIBLE, INFERIOR HEALTH CARE IN CONNECTICUT AND HERE IN THE USA?


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