Another reason Health Care-for-All is the solution to problems below...

The stories about health care on spinning out fast and furious, so it's hard to cover every nightmarish situation that screams for universal health care, now.

Trump's Junk Insurance Plan Wastes Money, Doesn't Pay for Health Care: Here's one thing almost everyone said would happen...except Trump and his drooling mod of deplorable's:

BREAKING: Trump’s junk insurance plans are spending an average of 39% of your premium on actual medical care. ACA requires 75% minimum. Short-term health plans spend little on medical care.

No, really? This is what happened before the ACA became law, and why the ACA was so desperately needed.

Uninsured Rise, Again: Excluding Trump and his panting cult, almost everyone predicted an increase in the uninsured rate thanks to Trump's attack on Obama's one big political and social success:

ModernHealthcare: The Obamacare exchanges last year lost 1.2 million of its unsubsidized enrollment last year, the CMS found in a report released Monday.

From 2016 to 2018, 2.5 million people who were paying their entire Affordable Care Act premiums dropped out of the individual market.

The Trump administration's latest enrollment snapshot doesn't bring many surprises given the high price tag for premiums, but the numbers are stark. The exchanges saw a 40% drop in unsubsidized enrollment from 2016 to 2018, and the declines hit almost every state.

Check out this down-the-rabbit-hole perspective:

In a statement, CMS Administrator Seema Verma characterized the report as another sign that the ACA isn't working. "The ongoing exodus of the unsubsidized population from the market proves that Obamacare's sky-high premiums are unaffordable."

Uh, that "unaffordable" and "unsubsidized" market Verma is talking about is...the existing insurance market without government subsidies, which is what Republicans call the free market and want to return to. Doh?

The high premiums (are) attributed to "sabotage" by the Trump administration and GOP lawmakers in Congress.

Medicare-for-All includes all coverage, all doctors, and all hospitals!!! Democrats continue to repeat absolute nonsensical talking points pushed by Republicans:

Joe Biden and other moderate Democratic candidates opposed to “Medicare for All” have cast the plan as anti-labor, arguing that it would leave union members worse off by stripping them of the health care benefits they painstakingly negotiated. But not all labor unions agree. Many others unions remain undecided. 

Some of the biggest labor groups in the country have embraced the plan. Those supporting Medicare for All say health care increasingly dominates contract battles, consuming bargaining power that could instead be directed toward raising wages and improving working conditions.

Sara Nelson, president of the Association of Flight Attendants: “When we’re able to hang on to the health plan we have, that’s considered a massive win. But it’s a huge drag on our bargaining. So our message is: Get it off the table.”

It's true that union workers are wary of giving up hard-won benefits, even when promised a plan that covers more services for less money.

Eliminate International Medical Vacations: Lower Hospital Costs Dramatically, Pay Doctors Well Instead in Medicare-for-All: Bet you didn't know a major Wisconsin manufacturer is saving huge amounts of medical payouts with this in foreign countries: 

Donna Ferguson awoke in the resort city of Cancun. She walked down a short hallway from her Sheraton hotel and into Galenia Hospital. A surgeon, Dr. Thomas Parisi, who had flown in from Wisconsin the day before, stood by Ferguson’s hospital bed and used a black marker to note which knee needed repair. For this surgery, she would not only receive free care but would receive a check when she got home.

The hospital costs of the American medical system are so high that it made financial sense for both a highly trained orthopedist from Milwaukee and a patient from Mississippi to leave the country and meet at an upscale private Mexican hospital for the surgery.

Ferguson gets her health coverage through her husband’s employer, Ashley Furniture Industries. The cost to Ashley was less than half of what a knee replacement in the United States would have been. That’s why its employees and dependents who use this option have no out-of-pocket copayments or deductibles for the procedure; in fact, they receive a $5,000 payment from the company, and all their travel costs are covered. Parisi, who spent less than 24 hours in Cancun, was paid $2,700, or three times what he would get from Medicare, the largest single payer of hospital costs in the United States. Private health plans and hospitals often negotiate payment schedules using the Medicare reimbursement rate as a floor.

The high prices charged at American hospitals make it relatively easy to offer surgical bargains in Mexico: In the United States, knee replacement surgery costs an average of about $30,000 — sometimes double or triple that — but at Galenia, it is only $12,000, said Dr. Gabriela Flores Teón, medical director of the facility.

The standard charge for a night in the hospital is $300 at Galenia, Flores said, compared with $2,000 on average at hospitals in the United States. The other big savings is the cost of the medical device — made by a subsidiary of the New Jersey-based Johnson & Johnson — used in Ferguson’s knee replacement surgery. The very same implant she would have received at home costs $3,500 at Galenia, compared with nearly $8,000 in the United States, Flores said.

Medicare Needs Major Changes Too: Here's a story I personally experienced with own mom that ended up costing our family a lot of needless out-of-pocket spending.

NOTE: Every bad thing in the blog post would not be an issue with universal health care. Think about that: 

Medicare paid for Betty Gordon’s knee replacement surgery in March, but the 72-year-old former high school teacher needed a nursing home stay and care at home to recover.

Yet Medicare wouldn’t pay for that. So Gordon is stuck with a $7,000 bill she can’t afford — and, as if that were not bad enough, she can’t appeal. The reasons Medicare won’t pay have frustrated the Rhode Island woman and many others trapped in the maze of regulations surrounding something called “observation care.”

Patients, like Gordon, receive observation care in the hospital when their doctors think they are too sick to go home but not sick enough to be admitted. They stay overnight or longer, usually in regular hospital rooms, getting some of the same services and treatment (often for the same problems) as an admitted patient — intravenous fluids, medications and other treatment, diagnostic tests and round-the-clock care they can get only in a hospital.

But observation care is considered an outpatient service under Medicare rules, like a doctor’s appointment or a lab test. Observation patients may have to pay a larger share of the hospital bill than if they were officially admitted to the hospital. Plus, they have to pick up the tab for any nursing home care. Medicare’s nursing home benefit is available only to those admitted to the hospital for three consecutive days. Gordon spent three days in the hospital after her surgery, but because she was getting observation care, that time didn’t count.

There’s another twist: Patients might want to file an appeal, as they can with many other Medicare decisions. But that is not allowed if the dispute involves observation care.

Monday, a trial begins in federal court in Hartford, Conn., where patients who were denied Medicare’s nursing home benefit are hoping to force the government to eliminate that exception. A victory would clear the way for appeals from hundreds of thousands of people. The class-action lawsuit was filed in 2011 by seven Medicare observation patients and their families against the Department of Health and Human Services. Seven more plaintiffs later joined the case.

“This is about whether the government can take away health care coverage you may be entitled to and leave you no opportunity to fight for it,” said Alice Bers, litigation director at the Center for Medicare Advocacy, one of the groups representing the plaintiffs. If they win, people with traditional Medicare who received observation care services for three days or longer since Jan. 1, 2009, could file appeals seeking reimbursement for bills Medicare would have paid had they been admitted to the hospital. More than 1.3 million observation claims meet these criteria for the 10-year period through 2017, according to the most recently available government data.

Ways we know Trump Republicans Wheels falling Off!!!

This is only Monday...

This is so far removed from any basic understanding of the Constitution that it defies explanation. The last time I looked, conservative media made up 92 percent of the public airways, but that was okay because that kind of programming sells. And isn't that what freedoms all about, profit?

ObamaCare Unconstitutional? Leave it to conservative columnist Jennifer Rubin to clearly make the case, Trump Republicans can no longer hide their lies, like the one about those "activist judges" "legislating from the bench." Was Republican Sen. Roy Blunt on something when he said, "that doesn't mean that legislators can act like judges..." What the...?

CHUCK TODD: But didn’t this federal judge act like a legislator? And he decided, on his own, what the law is going to be? Isn’t this a form of judicial activism? He said, “Well, I’ve decided that Congress said this is a zero tax. I’ve decided it’s no longer a tax.” That’s the definition of a judge writing legislation, is it not?

BLUNT: That doesn’t mean, that doesn’t mean that legislators can act like judges, just because, just because judges sometimes act like legislators.

TODD: So you acknowledge, in this case...

BLUNT: No...

Will Medicare Go Away? Yes, because now everyone will have health care!!! The media is driving me crazy letting Republicans frame "Medicare-for-all" as the horrifying end of Medicare? No, we won't need Medicare or Medicaid because surprise, now everyone has health care! Seriously, is it that difficult? Will someone please stop this idiotic talking point before it starts making sense to the drooling Trump base.

BLUNT: You know, the one thing I think we would be able to unite on is Medicare-for-all would wind up meaning Medicare for none. If Democrats want to take that view to the American people, and seniors, particularly, people who are now covered by Medicare, understand the ramifications of that. There is no way that will happen. And there’s no way voters will let it happen.

Chuck Todd did not correct this lunacy. What is wrong with media reporters who hear this and then don't think right away that it doesn't make any sense? 

Health Insurance Companies think we're Stupid, and maybe they're right?

Medicare sign up time is now, and so I attended a seminar by one of the big insurers.

What was clear? Our U.S. health care system is really really bad, because it's designed by for-profit insurance companies and hospitals. I learned this at that recent "seminar." The insurance company representative stood in front of us describing a Rube Goldberg process of different copays and deductibles, procedures and limits, that no one in their right mind could begin to understand, and he knew it. That's why we needed their companies to help.

Even though I wasn't buying the sales pitch, the crowd of Medicare insurance buyers surprisingly just assumed this was all normal. Really?

I interrupted and pointed out that what he just described was the best argument yet for universal health care, where every doctor and hospital is your doctor and hospital with no copays or deductibles or surprise bills in the mail months later.

The crowd turned on me. Yes, believe it or not.

Arguing for Bad complicated Insurance? You bet: The current bad system has been around so long that everyone thinks what we have now is normal. In the end, one person asked why I was complaining, when Medicare itself was the ultimate government-run system? A good but ridiculous question.

I said Medicare is designed to force people to buy private "supplemental" insurance or Medicare Advantage policies run by private insurers, requiring another "extra premium" taken out of our shrinking Social Security check every month. That's after having already paid into Medicare all our lives. Crazy?

Takeaway? We like a complicated health care insurance system because we're used to it, and it gives us a sense of control, that we're making decisions and that it's our fault if things don't work out.

We've never had the discussion about wiping the slate clean. Imagining a society where employer-based insurance, individual market insurance, group-based insurance coops, Medicare, Medicaid, and self-insurance would just...disappear. No bills, no surprises, no medical bankruptcies, and no networks. Just lots of time to live our lives to their fullest and concentrating on what really matters, our families, whether children or aging parents.

The Challenge: Everybody gets mailers inviting them to insurance presentations and even a free meal. Go sometime and watch in stunned amazement how convoluted and insane their rules and regulations are, policies they say we need. You'll quickly understand how corporate numbers crunchers and ghoulish CEO's have covered every inch of greed and profit from the sick or dying. The question you have to ask yourself; do you have the stomach for it?

Social Security and Medicare the target, and Republicans won't fix it.

Besides the recent GOP tax cuts that lowered our payroll taxes, stagnant wages and fewer workers supporting seniors on Social Security and Medicare in the future will have a lasting negative impact. So is it any surprise the programs may have looming funding problems?



The Democrats warned voters about Paul Ryan's not so hidden agenda behind the tax cuts (besides letting people who have tons of money to keep even more it); he wanted to cut our major self-funded insurance programs via lies about their solvency, retain the current cap on income, and ignore the declining worker support for the programs.

A new report on Social Security and Medicare finds that the system is now paying out more than it brought in, forcing the system to dip into its $3 trillion pool of reserves — for the first time since 1982.

Ryan set this up and is now retiring with a smile on his face, because he knows his dream cuts are inevitable:

Overall, it suggests that taxes to fund systems for retired or disabled Americans either have to go up, or benefits have to eventually be cut. Today, there are 62 million people in the Social Security System, a number that'll jump to 90 million by 2040. And by then, there will be fewer workers supporting those beneficiaries.

Trickle Down Voodoo will Save us All? You were waiting for this one, weren't you?

Treasury Secretary Steven Mnuchin said "the administration’s economic agenda — tax cuts, regulatory reform, and improved trade agreements — will generate the long-term growth needed to help secure these programs and lead them to a more stable path."

As for Ryan, it's not the unfunded tax cut spending, it's those working-class Americans retiring and the disabled to blame...:

And Sen. Tammy Baldwin said this:

If Social Security, Medicare, Medicaid, and the countries infrastructure cost so much and is running out of money, why are we cutting taxes that fund what we need?

And finally, more and more Americans aren't buying into that old "Democrats are just being partisan" argument anymore. From MSNBC's Steve Benen:

As we discussed a few weeks ago, Critics of the Republican tax plan made several key predictions during the abbreviated debate over the proposal: (1) the corporate windfall would go toward stock buybacks, not capital investments; (2) the package was filled with sloppy errors that would need to be fixed; (3) the plan would be used as a pretext to go after Social Security and Medicare; (4) the tax breaks would wreak havoc on the nation’s finances; and (5) the American mainstream would reject the regressive plan and Republicans couldn’t use the tax breaks as some kind of electoral life preserver. (6) the “pass-through” provision would principally benefit the wealthy, not small businesses. Republicans, at least publicly, made the case this wouldn’t happen. The evidence now points in the opposite direction.

Ryan, the wonk genius, spews stupid again....Deficits + "Baby boomers retiring was going to do that" = ?

There's no excuse for the following comment...none. It's a lie and another show of ideological obedience. MSNBC:

Speaker Paul Ryan (R-Wis.) says that trillion-dollar deficits could not have been avoided by the GOP-controlled Congress, responding to critics within his party who say that leaders have behaved irresponsibly.

“That was going to happen. The baby boomers retiring was going to do that,” Ryan said on NBC’s “Meet the Press” of projections that the country will start running trillion-dollar deficits as soon as 2020.

Here's what FactCheck.org wrote about Wisconsin's embarrassment, Paul Ryan. What he said...:

Ryan: "That was going to happen. The baby boomers’ retiring was going to do that. These deficit trillion-dollar projections have been out there for a long, long time. Why? Because of mandatory spending, which we call entitlements. Discretionary spending under the CBO baseline is going up about $300 billion over the next 10 years. Tax revenues are still rising. Income tax revenues are still rising. Corporate income tax revenues. Corporate rate got dropped 40 percent, still rising."

Which means...he's lying again. At a time when baby boomers were retiring, he's made it almost impossible to save them from certain economic disaster:

Overall, CBO says the new tax law “increases the total projected deficit over the 2018–2028 period by about $1.9 trillion,” mostly because of a reduction in individual income tax revenue and an increase in debt service.

Ryan declares cuts Medicare, Medicaid and Social Security, the real reason we have deficits?

Even before they increase the deficit with their tax cut bill, Republicans are still blaming spending and our social safety nets for the higher US debt. Check out what Bruce Bartlett and Jess McIntosh had to say about cutting "entitlements..."

There's really not much I can add to this jaw-dropping ballsy anti-American voter agenda. They really believe this stuff. WashingtonPost:

House Speaker Paul D. Ryan (R-Wis.) said Wednesday that congressional Republicans will aim next year to reduce spending on both federal health care and anti-poverty programs, citing the need to reduce America's deficit.

“We're going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit. Frankly, it's the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that's really where the problem lies, fiscally speaking.” -Paul Ryan

Ryan: “I think the president is understanding that choice and competition works everywhere in health care, especially in Medicare ... This has been my big thing for many, many years. I think it's the biggest entitlement we've got to reform. What it is we really need to convert our health care system to a patient-centered system, so we have more choices and more competition. Choice and competition brings down prices and improves quality; government-run health care is the opposite of that. So I think these reforms that we've been talking about, that we're still going to keep pushing, that will help not just make Medicaid less expensive ... but it will help Medicare as well. We have a welfare system that's trapping people in poverty and effectively paying people not to work. We've got to work on that.”

Top Republicans aim to cut government spending next year. Republicans are close to passing a tax bill nonpartisan analysts say would increase the deficit by at least $1 trillion over a decade. Senate Republicans have cited the need to reduce the national deficit while growing the economy.“You also have to bring spending under control. And not discretionary spending. That isn't the driver of our debt. The driver of our debt is the structure of Social Security and Medicare for future beneficiaries,” Sen. Marco Rubio (R-Fla.) said last week.

While whipping votes for the tax bill, Senate Finance Committee Chairman Orrin G. Hatch (R-Utah) attacked “liberal programs” for the poor and said Congress needed to stop wasting Americans' money. “We're spending ourselves into bankruptcy. Now, let's just be honest about it: We're in trouble. This country is in deep debt. You don't help the poor by not solving the problems of debt, and you don't help the poor by continually pushing more and more liberal programs through.”

Liberals have alleged that the GOP will use higher deficits — in part caused by their tax bill — as a pretext to accomplish the long-held conservative policy objective of cutting government health-care and social-service spending, which the left believes would hit the poor the hardest.

“What’s coming next is all too predictable: The deficit hawks will come flying back after this bill becomes law,” said Sen. Ron Wyden (D-Ore.), the ranking Democrat on the finance committee, during a speech on the tax debate. “Republicans are already saying 'entitlement reform' and 'welfare reform' are next up on the docket. But nobody should be fooled — that’s just code for attacks on Medicaid, on Medicare, on Social Security, on anti-hunger programs.”

Senate GOP "Search and Destroy" Repeal Bill Dead. Why does "Trimming health care spending" make sense to Republicans?

Medicaid, Medicare and veteran health care covers 36 percent of the U.S. population. 32 percent in Wisconsin. That's a huge percentage of government health care. Why not go all the way with a national health care plan? And yet, Republicans continue to attack any government involvement. 

But there's a reason these major safety net programs were created; the marketplace did not provide or did not adequately cover any of these health care services. 

In order to destroy these public services, Republicans continue to push the fantasy that Democrats came up these safety net programs because they love big government, that "government is the answer to everything," and because Democrats love to spend, spend spend. 

Monumental Distraction: Consider the real reason, as explained by James Madison in the book "The Debate on the Constitution" ... "forgetting that the public good, the real welfare of the great body of the people is the supreme object to be pursued; and that no other form of government whatever, has any other value, than as it may be fitted for the attainment of this object."

Senate "Search and Destroy" Health Care Bill Dead: Only a few Republicans realized how bad their own legislation was, and backed away. But it never should have gotten that far.

The report from NPR below highlights the doctors side of the debate, just one of many professions never consulted by our all-knowing anti-government/but big government Republicans. Is "it's time to trim health care spending" a sane argument to begin with? Here's the audio:

"Where in this bill is the protection for children," asks Dr. Jonathan Davis, the chief of newborn medicine at Tufts Medical Center, as he stands in the hospital's NICU among babies who weigh as little as 1 pound. Roughly 60 percent of babies in the Tufts NICU are covered by Medicaid. it's unclear whether Tufts could provide this care for free if the baby or her mom didn't qualify for Medicaid. Davis says they also need good insurance after they leave the hospital.

"Because if those children don't go home to get great primary care, follow-up, early intervention and support, all those gains that could potentially have been made are going to be lost."

Ryan to Plunder Seniors life savings Shopping in Medicare "Marketplace."

Even after debating the ins and outs of the Affordable Care Act for six years, reporters have done little to bone up on the subject. They still aren't asking the right questions of our politically motivated free market reformers.

Turning Medicare into a Shopping Experience? There's an odd dynamic here; while Rep. Paul Ryan has called the health care marketplace a disaster, he wants to turn Medicare into a health care marketplace...with subsidies.

Even worse, Ryan actually thinks seniors should be shoppers, ignoring cognitive aging, age-related financial vulnerability, dementia and Alzheimer disease.

I truly believe Ryan isn't just fully aware of the problem, but is purposely targeting seniors hard earned money and possessions for insurer plundering in the marketplace.

ALERT: What about Cognitive Aging and Age-Associated Financial Vulnerability, or AAFV?

Cognitive Aging: Part of the aging process is cognitive aging as it relates to driving safety and financial decision-making, (which the latter) would be problematic shopping for health care. As a person ages there is a gradual, but marked change in these cognitive functions, which is referred to as "cognitive aging." Cognitive aging is not a disease or a level of impairment—it is a lifelong process that affects everyone.

But the bigger problem comes with Age-Associated Financial Vulnerability (AAFV), something reporters should be asking guys like Paul Ryan about, especially when they blissfully talk about seniors shopping for insurance every year.

Age-Associated Financial Vulnerability: Managing money can be difficult at any age. For older adults, changes in physical condition and life circumstances can lead to changes for the worse in financial behavior, putting their well-being in danger. It's a pattern of financial behavior that places an older adult at substantial risk for a considerable loss of resources such that dramatic changes in quality of life would result ... a condition different from dementia, which already is recognized as putting older adults at risk of causing themselves financial harm.

1. Other potential contributing factors may include cognitive changes, such as a lessened ability to discern a person's trustworthiness, and psychosocial problems, including loneliness or depression.

2. In addition, the finance industry has identified older adults as an untapped market, which can lead to them being overwhelmed by the "dizzying array of financial products and services," according to Han and co-author Mark Lachs, MD, MPH, professor of medicine and co-chief of geriatrics and gerontology at Weill Medical College in New York.

"In my discussions with Dr. Lachs about our experiences with the heart-breaking effects of financial vulnerability among our older patients, we decided that naming the problem may be a useful first step to addressing the issue."- Duke Han, PhD, co-author of the study.

Americans like Medicare the way it is, but that won't stop Paul Ryan from killing it.

We can’t talk about Paul Ryan’s Medicare reform plans without first pointing out how he brought up “saving” the program; with a lie. That should be a serious warning. Ryan’s plan must be pretty bad if he has to manufacture an even worse scenario to sell it:  

Ryan said he wanted to address Medicare’s “serious problems” … argued that Medicare’s financial problems were caused by the healthcare reform law—though actually the ACA extended the projected solvency of Medicare’s Part A Hospital trust fund.

That lie is so big even the media is bringing it up all the time.

Premium-Support: It’s important to know that regular old Medicare pays a fixed amount, and that amount determines what the GOP’s more privatized alternative, Medicare Advantage charges. Without that fixed price, Medicare Advantage would be open to dramatic price increases by doctors and hospitals, where skies the limit.

    

Republicans have already hit one road block, but like everything they do, they’ll plow through that too:

Modern Health Care: A Health Affairs study last year found that Medicare Advantage plans keep their provider payment rates down by pegging them to traditional Medicare rates … plans benefit from Medicare’s rule that out-of-network providers cannot charge more than Medicare rates. “The only way Medicare Advantage plans are competitive with traditional Medicare is that there is a public option and there is price regulation that limits balance billing by non-network providers,” said Dr. Robert Berenson, a co-author of the Health Affairs study and former member of the Medicare Payment Advisory Commission.

Remember how Republicans blew a gasket over the Democrats supposedly ramming ObamaCare down our throats in just one year, and without a Republican vote? Well, I think they changed their minds on that…

Dr. Tom Price—a top contender to become HHS secretary—said that congressional Republicans will push ahead with a Medicare overhaul within the first six to eight months of 2017, and that the Senate will pass it through an expedited budget reconciliation process that avoids a likely Democratic filibuster.  

Authoritarian know-it-alls: Sure the public is against fundamentally doing away with Medicare, but as we’ve seen in Wisconsin, ideology and arrogant power “Trumps” what the public actually wants:

According to a mid-2015 Kaiser Family Foundation survey, 70% of Americans support keeping Medicare as it is today, with only 26% supporting a shift to premium support. Those percentages were similar among Democrats and Republicans. Just 18% of seniors supported turning Medicare into a premium-support program.

While some observers expressed surprise that Republicans want to leap into the perilous politics of Medicare reform after Trump’s narrow election victory, Tom Scully, who served as CMS administrator under President George W. Bush, was enthusiastic. “If they’re going to reform the ACA and Medicaid, absolutely they’ll do premium support, and they should, it’s the right thing to do,” he said. “They might get killed, but I don’t think they’re going to find it that politically difficult.”

NOTE: I'm still waiting for the first reporter to ask Paul Ryan how he expects seniors with diminishing mental capacity to shop for insurance and navigate new policies yearly. It happens to all of us, and for Ryan to ignore that flaw is irresponsible.

Republicans make raising retirement age for Medicare and SS Worse; Wealth Gap/Shorter Life Spans

Republicans are big on raising the retirement age for both Social Security and Medicare. It makes privatizing them with a one size fits all subsidy seem like a good idea. It isn't.

And now their plan, based on people living longer, is taking a hit because of their own draconian policies. Republicans have again hitched their wagon to a shifting standard that no longer supports their talking point, thanks to the wealth gap:

From 2000 to 2009, American death rates improved at 1.93 percent for men and 1.46 percent for women annually. From 2010 to 2014, that plunged to 0.6 percent for men and 0.42 percent. This is bad news for almost everyone but pension fund managers.

The latest, best guesses for U.S. lifespans come from a study (PDF) released this month by the Society of Actuaries: The average 65-year-old American man should die a few months short of his 86th birthday, while the average 65-year-old woman gets an additional two years, barely missing age 88.

Over the past several years, the health of Americans has deteriorated—particularly that of middle-aged non-Hispanic whites. Among the culprits are drug overdoses, suicide, alcohol poisoning, and liver disease, according to a Princeton University study issued in December. The Society of Actuaries’ website offers a longevity calculator that takes both your age and health into account.

Still, the bottom line is that longevity’s rise has slowed way down. If you’re trying to figure out how long you’re likely to live, estimates of “average” life expectancy may not be that helpful. That’s getting worse in an age of rising inequality. 

And for those who can afford the best health care the U.S. has to offer?

Great medical care and good fortune may add decades to the lives of the wealthy and educated, while much of the rest of America is left behind.Take a 40-year-old man in the top 1 percent. He can expect to live, on average, to 87. His counterpart in the bottom 1 percent would be expected to perish, on average, before his 73rd birthday. For women, who live longer on average, the gap was narrower, but still substantial. Life expectancy for the richest women is almost 89, about 10 years longer than the poorest.

NOTE: I'm not sure if the following was included the statistics above, but medical errors may have played a part in life expectancy rates. The Republican idea that we need to ignore and lessen the penalties for medical errors to bring down the cost of health care is not just upside down and illogical, but it'll just make the problem worse:

Medical errors rank behind heart disease and cancer as the third leading cause of death in the U.S., Johns Hopkins researchers say. ... Based on an analysis of prior research, the Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors. Based on an analysis of prior research, the Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors. - May 3, 2016

Health Care Ripoff part 3: ObamaCare premiums increase, thanks to Insurance industry Greed!!!

Ouch, health care insurers are increasing premiums on ObamaCare exchanges by double digits. I guess that would mean the smaller single digit increases weren’t as bad as Republicans said they were.

As I been saying here for years, insurers would eventually find a way to game the marketplaces and poison reform. Paul Ryan knew this when he said ObamaCare would collapse.

In the bad old days before the ACA, premiums increase every year between 20 and 50%. Oh, surprised? A short recap:

In August 2008, about six months before debate began in Washington on what would become the Affordable Care Act, 82 percent of Americans were so dissatisfied with the U.S. health care system they wanted it overhauled.

The main reason so many of us were uninsured in 2010 was that health insurance had simply become a budget-buster for many American families. The cost of employer-sponsored family coverage reached $13,375 in 2009, an increase of 131 percent in ten years, according to the Kaiser Family Foundation.
 
And almost 18 percent of our GDP is consumed by health care expenses, compared to 11.7 percent in France and 11.3 percent in Germany.  
Under Bush, the average family premiums (including both what employers and employees pay) went up $4,677 in his last six years in office, from 2002 to 2008, an increase of 58 percent. Bush’s first six years that increase was 72 percent.

Note: think what would happen in a GOP free market system replaced the ACA, with no plan requirements and no marketplace to compare prices. Do you think prices would increase dramatically even with supposed “affordable,” “buy what you can afford” junk policies? God would they.

Insurance companies want more Money....and are in a full court press to pressure the government to give them more money to boost profits. It worked before, with Medicare Advantage, why not ObamaCare. Briefly, let’s go back 16 years, with former insurance exec. Wendell Potter:

HISTORY (OF HEALTH CARRIER GREED) REPEATS ITSELF-Profit-Minded

 

Health Insurers Will Likely Return to Obamacare Fold in 2017: 16 years and five months ago, after the close of trading at the New York Stock Exchange, my staff and I at Cigna disseminated a press release we knew would lead to a lot of angst in Washington, on Wall Street and around the country. Cigna to Curb Medicare-HMO Risk; This was the headline in the company’s hometown newspaper, the Philadelphia Inquirer: Cigna to Exit 13 Medicare Markets … 104,000 of Cigna’s senior-citizen subscribers were being dumped because the company wasn’t happy with how much the government was paying it to provide access to medical care for those folks.

Guess who instigated the Cigna scheme? The Republican inspired Balanced Budget Act in 1997:

Insurers had been unhappy with their pay from Uncle Sam since the passage of the Balanced Budget Act of 1997, when Republicans were in charge of both the House and Senate. The GOP wanted to rein in spending on “entitlement” programs ... It reduced Medicare spending by more than $100 billion between 1998 and 2002 … capped annual reimbursement increases 2 percent on average...(but) medical inflation was averaging 8 percent annually. The companies clearly were not managing medical costs nearly as much as they had told lawmakers and their customers they would be able to do. So Cigna, at least, had decided to cut bait.

Fast forward to August 15, 2016 and the era of Obamacare. That was the day Bloomberg ran this angst-producing headline: Aetna to Quit Most Obamacare Markets, Joining Major Insurers. Why? Because, once again, the big insurers were not only not making the profit margins they felt they should be making, they were losing money on this particular book of business. So, just like they did a decade and a half ago, they decided to cut those enrollees loose.

And they were spectacularly successful back in the early 2000s. In short order, there was a reversal in fortune — in the insurers’ favor. So if the past is prologue, we can expect the insurance industry’s lobbyists to be hard at work to make sure history repeats itself. 

Keep in mind that the insurers’ Medicare + Choice losses were an unintended consequence of the Balanced Budget Act of 1997. Republicans in particular were alarmed when the insurers began abandoning the Medicare HMO market because it has long been a tenet of faith among many of them that private insurers could operate more efficiently than the traditional Medicare (TM) program, and consequently reduce overall spending on Medicare.

As you can see, this isn't an easy industry scam to explain. Here's more....

Congress Showed Health Carriers the Money: So halfway into the George W. Bush administration, with Republicans still in charge of both the House and Senate, the Medicare Prescription Drug, Improvement and Modernization Act of 2003 became law. The insurance industry’s lobbyists scored two big victories ... the prescription drug benefit (known as Part D) made it necessary for Medicare beneficiaries to buy their drug coverage through private insurers. And second, the Medicare + Choice program was overhauled to the industry’s liking (and renamed Medicare Advantage).

The government began paying private insurers more to cover the cost of sicker Medicare enrollees, so the companies that had bailed came rushing back in. There were also other provisions of the 2003 law that boosted the government’s pay to insurers. As a consequence, by the time Obamacare became law in 2010, the government was actually paying Medicare Advantage plans 14 percent more per beneficiary ($1,100 on average) than it would cost to cover those beneficiaries in traditional Medicare. Between 2004 and 2008, the overpayments totaled almost $44 billion.

One of the aims of Obamacare was to reduce those overpayments, and they have been reduced, but most insurers are still finding their Medicare Advantage business to be very profitable. You certainly don’t hear about insurers threatening to jump ship now.

You can also expect the insurers to lobby for more “flexibility” in designing their policies. They’d love to be able to go back to the days when they could sell junk insurance — policies with such meager benefits they rarely had to pay out much in claims.

Paul Ryan blames ObamaCare for private sector's Waste, Fraud and Abuse to boost profits.

The Paul Ryan quote making the rounds now tells us how little he knows about the private health care system we finally left behind.

I'm blogging about this again, hoping Democrats use any one of these points as ammunition against Republicans. I haven't had any luck yet.

It’s almost dangerous to be this out-of-touch: Ryan didn’t know premiums were out of control before the ACA, that Republicans were the ones pushing high deductible plans to discourage health care “over use,” and the maze of tangled insurance restrictions, co-pays, exemptions, dropped coverage's and premium increases make government regulation pale in comparison. And his weird shot at “waste, fraud, and abuse?” Ah, that’s the private sector scamming the government Paul. So that’s what makes going private so counter-intuitive and ideologically driven.

Finally, Ryan’s plan will actually force tens of millions of people off “the plans they like.” Never fear, ObamaCare made Republicans do it:  

“OBAMACARE IS MAKING THINGS WORSE BY THE DAY. IT DRIVES UP PREMIUMS AND DEDUCTIBLE COSTS FOR INDIVIDUALS, FAMILIES, AND BUSINESSES. IT FORCES PEOPLE OFF THE PLANS THEY LIKE. IT FUELS WASTE, FRAUD, AND ABUSE. AND IT CANNOT BE FIXED. ITS KNOT OF REGULATIONS, TAXES, AND MANDATES CANNOT BE UNTANGLED. OBAMACARE MUST BE FULLY REPEALED SO WE CAN START OVER AND TAKE A NEW APPROACH."  Ryan

The article below dissects Ryan’s plan in a common sense, very simple way. You'll notice everything is profit driven, just the opposite of every other civilized industrial country in the world repulsed by the idea:

For starters, it contains the often popular Republican idea of tort reform. In short, this would limit how much compensation one could receive if a doctor makes a mistake and ends up hurting them or a family member during a procedure. Since doctors and other medical personnel have insurance for this sort of thing, tort reform would end up benefiting insurance companies more than the average person. You’ll notice that’s a theme with this new healthcare plan.

Another popular Republican proposal that has made its way into this plan is allowing people to buy insurance across state lines. This sounds like a good idea in theory, as it would give people more choices. But there is one major flaw that the Republicans haven’t addressed, which is the race to the bottom. Since each state has its own rules and regulations regarding health insurance, it’s very likely that insurance companies would simply set up shop in the state that had the least amount of regulation, resulting in less protection for consumers.

Of course, it wouldn’t be a Republican healthcare plan without an attempt to attack Medicare. So let’s look at the latest Republican attack on one of the most popular programs in America. For starters, Ryan intends to raise the eligibility age to 67. Republicans also intend to phase out the current system and replace it with a “fully competitive market-based model—known as premium support.”

As I've mentioned before, aging diminishes our mental capacity to deal with complicated things like insurance policy small print and changes. To be unaware of this is to be horribly cruel.

I also stumbled across this tidy summary at the Business Insider:

1. Eliminate Obamacare. Kill it dead.

2. Allow Americans to purchase health insurance across state lines, so they can find cheap, catastrophic plans in states that allow companies to sell coverage with limited benefits.
3. Give Americans who don't get insurance through their employers, Medicaid, or Medicare a refundable tax credit-which is to say, a monthly subsidy-to help them purchase said catastrophic coverage.

4. Expand tax-exempt health savings accounts so that people with cheaper insurance can (maybe) afford to pay out of pocket for routine care, like check-ups.

5. Create special, state-subsidized "high-risk" pools to cover people with pre-existing conditions.

Which begs the question...

Last year, the average Obamacare insurance subsidy was $268 per month. If the ACA's subsidies are supposedly an unaffordable expense for the federal government, as Republicans generally seem to feel, it is difficult to imagine that they really plan to give people enough money to buy a "typical" pre-reform plan. What they actually intend is left to our imaginations.

The Republican health care plan, as it has been for years now, is to give Americans a small amount of money capable of helping them purchase cheap, not very comprehensive insurance.

Trump, Carson do away with Medicare!!! Opt for High Deductible Health Savings Accounts.

Republicans don't know anything about health care, and that ignorance is going to kill a lot of people.

The cavalier attitude we're seeing from Republicans who have off handedly said they'll get rid of Medicare is shocking stuff.

Imagine seniors trying to navigate the private health care system, getting surprise medical bills in the mail, or are expected to read the small print of exclusions. I'm wondering if Republican politicians have ever seen or talked to seniors in independent or assisted living facilities. Many don't quite have the mental agility they once had.

My own mother, 95 and a former real estate company owner, is no longer able to understand or take the time to go through the maze of choices. She wasn't even able to do it 10 years ago, and made some uncharacteristically bad choices, but I never knew. This is the world Republicans want seniors to wonder in helplessly.

And so it is with Donald Trump and Ben Carson. Neither of them understand deductibles or health savings accounts. Basically, here's the scoop:

Health Savings Accounts (HSAs) were created in 2003 so that individuals covered by high-deductible health plans could receive tax-preferred treatment of money saved for medical expenses.

The only real benefit is that the accounts money is tax deductible, but it will never cover the full cost of high deductibles insurance policies. Even worse, it was made to work in concert with HIGH DEDUCTIBLE plans, the very problem Republicans say they hate. So high deductible policies aren't going away.

Which means, they're not just talking out of their ass, they're going to pass something that will cost you a whole lot of money.

It's astonishing that Carson, a doctor, doesn't know this.

Here's Donald Trumps clueless answer on ABC's This Sunday:

Dumb as Bricks??? House Republicans do away with Medicare panel trying to save money, and kill disease prevention program.

The party of “fiscal conservatives” keep proving day by day how big a lie that is. Their ruthless mean spirited attacks on people seeking healthier lives is sick too.  

The Republican House hates the Affordable Care Act so much that they're willing to throw away $7 billion eliminating a panel that never had a chance to existed in the first place:

AP: The House voted Tuesday to kill a federal panel that is supposed to find ways to curb Medicare spending … Members of the Independent Payment Advisory Board have never been appointed, and the panel has never recommended savings from Medicare. Republicans have long targeted the board anyway, saying it would ration care … Sarah Palin said the law would create "death panels" that could decide the care seniors would receive.

And just as bad, they did away with the actual prevention program designed to save even more lives and money:

Democratic support for repealing the board evaporated when Republicans decided to pay the $7 billion, 10-year cost of eliminating it by cutting $8 billion from the health care law's prevention and public health fund, which the GOP says wastes money. Democrats call the prevention program a valuable part of that law.

A waste of money, preventing the pain and suffering that comes from untreated illnesses, not to mention the sadness and devastation of losing a loved one due to a preventable death.  

I don’t know why they're trying to make life even more difficult than it already is, any guesses?

Evil "ObamaCare" breaking up Network of Medicare Crooks, saving taxpayers billions.

Republicans have almost always taken the wrong side of everything. The Affordable Care Act is the latest example.

The ACA has slowed the growth of insurance premiums, forced the system to change how care is paid for, created a marketplace and competition between private businesses, paid for itself while providing subsidies to lower premiums based on income. It would be a whole lot better if insurers were taken out of the equation completely, but we’ll just have to wait for that.

One more thing; it appears “ObamaCare” also built a much better way to catch Medicare fraud. But I’m sure Republicans don’t care about that either, right?

How record Medicare fraud bust could give a boost to Obamacare: More than 240 people have been arrested in a nationwide sweep for allegedly submitting $712 million in false billings.

The Justice Department’s Medicare Fraud Strike Force has now charged more than 2,300 people with falsely billing more than $7 billion to Medicare since 2007, according to Reuters.
 
A provision of the Affordable Care Act is to provide an additional $340 million in anti-fraud funding over 10 years, according to NPR. Health officials view the extra money as an investment in health-care reform. With increased resources from the Affordable Care Act, HHS is investing in new tools to stop fraud before it happens, including a capacity to screen out questionable providers or suppliers. 

Sorry Republicans, the fraudsters weren't those vilified poor seniors showing off their AARP cards everywhere, they were medical professionals ripping the system off to stuff their pockets:

HHS Sec. Sylvia Burwell

Around the country, the schemes have morphed ... Now, officials say, the schemes involve a sophisticated network of doctors, clinic owners, patients and patient recruiters. Violent criminals and mobsters are also tapping into the scams ... agents bugged a medical center in Brooklyn, N.Y., where eight people are charged with running a $50 million scam that submitted bogus claims for physical therapy. Clinic owners paid patients, including undercover agents, in exchange for using their Medicare numbers and a bonus fee for recruiting new patients. Recording devices captured hundreds of kickback payments in a private room where a man sat at a table and did nothing but pay patients all day, authorities said.

In Dallas, six owners of a physician house-call company face charges for allegedly submitting nearly $43 million in billings under the name of a single doctor ... Several doctors and nurses were among those arrested in Miami, New York City, Detroit, Houston and Baton Rouge, La., accused of billing Medicare for unnecessary equipment and treatments that patients typically never received.

Civilian scammers came out of the woodwork too. 

In a separate Brooklyn case, authorities indicted six patients who shopped their Medicare numbers to various clinics. More than 3,744 claims were submitted on behalf of one woman in the past six years. The patients did not receive the services billed to Medicare, authorities said.

Republican presidential hopefuls now forced to argue saving Medicare $400 million in two years was a disaster?

A reminder that Obama's Medicare reform plan, part of the Affordable Care Act, did not cut the program as republicans warned. More than that, it's saved money and ushered in a better, less costly way to provide health care. The Hill: 

ObamaCare program saves Medicare $400 million.

An independent report released by the Department of Health and Human Services on

Going broke or starting to save half billion?

Monday finds that the pilot program saved Medicare more than $384 million across 2012 and 2013.

The pilot program, called Pioneer Accountable Care Organizations, is part of an effort to shift Medicare to paying for quality instead of quantity of care. Under the program, groups of doctors agree to accept lump payments under Medicare instead of individual payments for each service they provide, as in the traditional Medicare payment system.

The idea is to discourage unnecessary tests and procedures and better coordinate care. If the groups of doctors, known as Accountable Care Organizations (ACOs), end up keeping costs below the target, they get to keep some of the leftover money, providing an incentive to keep costs down.

Huckabee rips Ryan and other Republicans for trying to break the trust between government and the people, defends Social Security and Medicare

Mike Huckabee has certainly changed his tune since August of 2012. 

But I don't care what got him to change his opinion about Medicare and Social Security, as long as his message gets out to other republican voters who normally march in lockstep to the party edicts. 

And Democrats, take a hint at how Huckabee frames his defense of our social safety nets, because it kicks ass. Take it, quote him and get the message out. The Weekly Standard:

All it took was a kiss...?

Former Arkansas governor Mike Huckabee is making a big break with the Republican party on the issue of entitlement reform. "I don't know why Republicans want to insult Americans by pretending they don't understand what their Social Security program and Medicare program is," Huckabee said in response to a question about Christie's proposal to gradually raise the retirement age and implement a means test. 

Huckabee said: "Not just no, it's you-know-what no ... what we are really embracing at that point is we are embracing a government that lied to its people--that took money from its people under one pretense and then took it away at the time when they started wanting to actually get what they have paid for all these years."

Huckabee also said he wouldn't sign congressman Paul Ryan's plan to reform Medicare for Americans who are 55 years old and younger ... "that I'd be paying in and suddenly you're telling me they're going to be changing the rules for you here."

Paul Ryan and other advocates of Medicare reform have argued government will ratchet up medical rationing of care for Medicare recipients, but Huckabee dismissed such concerns, saying that "all medical care is rationed."

Huckabee said Republican proposals to reform entitlements are "disastrous, not only politically but I think they be disastrous in terms of further breaking the trust between the government and its people."

Huckabee said this morning that the only entitlement reforms he would support would be giving retirees the option to take a lump-sum cash payment upon retirement and changing the existing programs for people who are just now entering the workforce. 

Ryan rips Seniors, says they don't understand high cost of health insurance...after 50 years of paying into it?

This will be my second post on Paul Ryan's not-so-original reform plan for Medicare. This is from an article he wrote for the Kenosha News.

First, Ryan insists on pounding the idea of privatization with his cutesy “patient-centered” lie, a meaningless term where patients are still handed over to insurance companies. Yea, but the patient is at the center, or something like that right?

“Our plan would start to move us to a patient-centered system.”

Ryan's next revelation is already a part of Medicare and the Affordable Care Act. Ryan is embarrassing himself and showing everyone how little he knows about ObamaCare. It’s obvious he’s never looked into the current system; it's already transitioning doctors and hospitals into managed care plans. What he's describing accurately below, is the Obama plan, not his.  

“Doctor payments would depend more and more on results. Our plan would set up one streamlined program that would reward doctors who met performance goals and improved seniors’ health. Over time, Medicare would reward quality over quantity, and seniors would get better care because of it.”

While Obamacare critics complain about deductibles, Ryan wants to create a whole new one for seniors. Because Medicare has co-pays and deductibles, they require everyone to have “supplemental” insurance (Medigap). Seniors on a fixed Social Security income will have to pay about $147 a month extra to insurers just to cover co-pays and deductibles (add to that the $105 monthly fee for Part B).

Ryan apparently doesn't think the price of supplemental insurance, $147 a month, is painful enough for seniors seeking care in our already costly U.S. health care system. He wants seniors to pay another fee of $147 per year so they shop more wisely. Ryan incorrectly assumes health care is a consumer product we shop for (and insurance isn't health care):

Our plan would discourage unnecessary doctor visits and give seniors an incentive to seek the most effective care. Many seniors have “Medigap” insurance — that is, a private plan that helps pay for costs Medicare doesn’t cover, like co-payments and deductibles. These plans insulate people from costs and, experts believe, encourage the overuse of healthcare. Beginning in 2020, this agreement would prohibit Medigap plans from covering the first $147 of out-of-pocket spending, so cost is once again a consideration in healthcare decisions.

That's right, seniors who've paid insurers for nearly 50 years don't understand the cost of insurance. Condescending comments like this should piss off every American. He's also not that smart either.

Paul Ryan takes ObamaCare innovation and makes it his own? Not so fast.

I couldn't believe what I was reading. 

Paul Ryan’s not very original, and by my own estimates, not to smart either. In his recent editorial describing how he would privatize Medicare, he outright stole an ObamaCare feature. A feature he’s been trying to kill for years. Ryan even stole the failed marketplace idea and tax credits. And you thought Republicans hated ObamaCare?

And no one is calling him out on his hypocrisy, because politicians and the media don’t understand the Affordable Care Act. Ryan might have gotten away with it, but I’m here to expose this ghoulish phony. 

Ryan is taking credit for “managed care,” a reform idea that's now an integral part of ObamaCare, the marketplace, and Medicaid expansion. Yes, he's really trying to steal it, without ever saying "managed care:"

"Our plan would strengthen Medicare by encouraging better care and rewarding doctors for better results. Right now, Medicare pays doctors for every single treatment they perform … It rewards quantity, not quality, of care. We would … depend more and more on results. Our plan would … reward doctors who met performance goals and improved seniors' health. Over time, Medicare would reward quality over quantity, and seniors would get better care because of it … our plan would discourage unnecessary doctor visits and give seniors an incentive to seek the most effective care."

1. Wow, what an idea!!! If only the states tried doing this…

States are increasingly turning to Medicaid managed care as a key .... in many states under the Affordable Care Act. 

2. If only insurers began to adapt to all the changes in managed care... 

It’s important to understand that today, just about all health coverage plans are some type of “managed care” plan. Gone are the days of traditional “fee for service” … Under managed care plans pay doctors or hospitals directly … physicians may be paid a fixed annual per-member (“capitation”) rate, regardless of how many times the covered individual visits the physician. The health plan goal is to take away financial incentives to prescribe too much care.

3. If it sounds exactly like the Affordable Care Act...Ryan just loves to talk about "patient-centered health care," a tricky way to usher in privatization, and to say "you're on your own suckers," with no way for Americans to pay for their care. But the term means something completely different in the ACA:

TheAffordable Care Act is expected to impact access to care, change the way accountable care organizations are used. An ACO seeks to provide patient-centered treatment programs and manage the continuum of care across the healthcare delivery system, which includes everything from wellness to chronic disease.

Paul Ryan Medicare Plan a Copy of ObamaCare!!! A Train Wreck for 50 Million Seniors?

Going through my old "before the election" video archive, I discovered the most amazing...really AMAZING analysis of Paul Ryan's Medicare reform plan. You can thank MSNBC's Chris Hayes for this one.

Paul Ryan plans to put seniors in Medicare exchanges, just like the Affordable Care Act's exchanges. That would mean switching over 50 million plus seniors into a subsidized marketplace of insurers, with detailed policies so convoluted they're sure to stump and frustrate the elderly. I don't even understand my own policy.

This is a report that everyone should watch and shove in the face of those lying hypocrites in the Republican Party. Trolls won't know what to Tweet. Democrats should run on it in 2016. Crap, even John Boehner came right out and said it was very similar to the presidents health care bill. You can't make this stuff up:



Boehner continued to bash ObamaCare the other day, promising to try and repeal that horrible law: