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.

Hard Working Americans, your Retirement Nest Eggs next Republican Target of Medicare Reform.

As we've discussed before, Republicans want to repeal the Affordable Care Act because it eliminates its funding source; a tax on the wealthy. Bingo! In other words, another tax cut for the rich. 

You're about to discover another trick for redistributing wealth upward. I know, who can keep up with all of them.  

Now it may sound cruel, but that's what it is; Republicans now have their eye on wiping out every Americans retirement nest egg. Trump's pick to oversee HHS and Medicare is Rep. Tom Price, who wants to bring "balance billing" to Medicare reform. Right now it's forbidden, and for good reason:

The most monstrous thing about the American medical system is predatory billing. A great many medical providers adjust their prices based on how defenseless the patient is, and bleed the weakest ones for every last red cent…this practice is something called "balance billing."

It's the practice of billing the patient for the difference between the sticker price and what insurance will pay. So if a hospital visit costs $1,000, but your insurance will only cover $300, some providers will "balance bill" you for $700. For unscrupulous providers (they’ll) take a rough estimate of the absolute maximum the patient can pay, and jack up the price so the "balance" hits it.

Price wants to allow it — thus allowing doctors and hospitals to devour the nest eggs of thousands of American seniors.

Balance billing will be waiting to snatch away your lifetime savings:

Out-of-network care — increasingly common as insurance networks get narrower and narrower — can still be balance billed even if it is for an emergency. People being blindsided by immense out-of-network bills — going to an in-network hospital that employs an out-of-network surgeon they conveniently failed to tell you about, for example — is an increasingly common experience.

Permanently obliterating the financial security of helpless families with no or bad insurance as a loved one dies slowly and painfully of a chronic illness is a nice little profit center for providers. But it pales in comparison to the gravy train they might get if they can bring balance billing to Medicare.

Physicians would still have to set up contracts beforehand setting an agreed price...(but) vastly higher than what Medicare pays now. It will be akin to seeing an out-of-network provider on private insurance now, something that causes thousands of bankruptcies today.

But allowing balance billing in Medicare is a straight-up evil policy. Republicans will attempt to camouflage it as allowing "free contracts" between patients and doctors or similar nonsense. Don't believe a word of it, seniors. They want your retirement money.

ObamaCare saving $2.6 Trillion through 2020 while Republicans roll out "new"detail free plan to increase insurer profits.

It's a good news/bad news kind of week for the Republicans; the bad news, at least for them, was the $2.6 trillion projected reduction in health care spending due to the Affordable Care Act. 

Projections of U.S. healthcare spending growth have come sharply down since Obamacare’s enactment in 2010 ... $2.6 trillion lower than the original post-ACA baseline forecast through 2020, a reduction in projected spending of almost 13%. This is known as “bending the cost curve”: Americans will be spending more in 2020 than they are now, but the rate of increase looks to be significantly slower than anyone expected. The study attributes much of the change, albeit an indeterminate portion, to the ACA. 

It’s true that growth in overall healthcare spending ticked up during 2014, reaching 6.2%  ... officials say that by the last quarter of 2015, spending growth had dipped back below 5%. If that’s so, the Urban Institute report says, “spending projections will continue to fall and it will become harder not to attribute at least some of the sustained cost containment to the ACA.”

As bad as that news was for Republicans, they did have some good news; Americans will finally get to see their long awaited "patient centered/free market" health care replacement plan for ObamaCare, something I’ve reviewed here in a previous post. In summary:

A series of familiar conservative healthcare ideas … The 37-page plan was originally billed as part of a comprehensive governing blueprint…

...Paul Ryan’s latest “comprehensive...blueprint" of the same old reform con, again, prevents the CBO from grading it:

…missing key details and legislative language that would allow independent analysts such as the Congressional Budget Office to assess its cost and impact.

Ignoring the natural aging process and diminished mental capabilities of seniors, Ryan wants them to shop till they literally drop:

…replace the current government-run Medicare benefit with a system of vouchers,“premium support," that seniors could use to offset at least part of the cost of premiums for private health plans.” 

Ryan's supposed "free market" plan oddly takes all the risk out of that marketplace with state high-risk pools, so insurers can make a profit from just healthy Americans:

Ryan himself has advocated turning over coverage for preexisting conditions to state-sponsored high-risk pools. As we’ve reported, this is a scam: high-risk pools have been tried before, and they almost always become ruinously expensive and doomed to fail.

Ryan also wants to allow states to cut health services, adding hoops and blockades for those who truly need care:

…eliminate federal rules that establish who should be covered, such as poor children and pregnant women, and which benefits should be offered. Each state would be allowed to decide who would get coverage.

Just one last chart supporting the ACA reforms:

Paul Ryan & Dumb Ron Johnson push Vouchers for Medicare so Seniors can finally shop, compare health care prices, read the small print, negotiate, and catch every change.

Either Republicans don't have parents, or they don't give a damn about em anymore.

Anyone who has seen their aging parents mental capacity diminish over time have got to wonder what in gods name are Dumb Ron Johnson and Paul Ryan thinking? It's a difficult part of aging that many of us rarely notice because we're not right there to see it happen to our parents.

The latest check by PolitiFact confirms that Dumb Ron Johnson likes free market vouchers for seniors on Medicare.

But just as important to note is how this plan was hatched and fine tuned by Paul Ryan, who's looking to pad insurer bottom lines over caring for aging seniors.

On the record, Johnson and Ryan own this outrageously bad idea:

Our rating

The state Democratic Party says Johnson voted to turn Medicare "into a voucher program."

To some health policy experts, there are technical differences between voucher and premium supports -- the latter term being preferred by Johnson and other Republicans when it comes to Medicare changes.

But under Ryan’s proposals, Medicare would no longer pay fees to health care providers -- instead, Medicare beneficiaries would get a fixed subsidy to use toward their health care.

We rate the statement Mostly True.

Okay, let's say vouchers become another complicated part of Medicare, and many of the same rules apply in the new free market version. Imagine navigating the following maze of existing rules that has been wiping out senior savings for decades, along with their adult children. I know, I just went through this. You've got to wonder why this has not been talked about:

In just two months, a federal law kicks in requiring hospitals to tell their Medicare patients if they have not been formally admitted and why. The law was a response to complaints from Medicare patients who were surprised to learn that although they had spent a few days in the hospital, they were there for observation and were not admitted. They may pay higher charges than admitted patients and do not qualify for Medicare's nursing home coverage.

The requires that starting Aug. 6, Medicare patients receive a form written in "plain language" after 24 hours of observation care … The information must also be provided verbally and a doctor or hospital staff must be available to answer questions.

But the form does not meet the expectations of Rep. Lloyd Doggett, D-Texas, who co-sponsored the law. The notice also does not sufficiently explain why observation patients are ineligible for Medicare's nursing home coverage, which under law requires at least three consecutive days as an admitted patient. If Medicare auditors find that hospitals erred by admitting patients who should have been in observation, Medicare pays nothing for their care. The number of Medicare observation patients rose to almost 2 million in 2014, 5% more than 2013, according to government statistics.

The notice’s information on drug coverage has also raised concerns. It reads, "Generally, prescription and over-the-counter drugs, including 'self-administered drugs,' given to you by the hospital in an outpatient setting (like an emergency department) aren't covered by Part B." Those "self-administered drugs," usually taken at home for chronic health conditions like high cholesterol, are generally covered by the patient's separate Medicare Part D drug plan but the coverage often doesn’t apply inside the hospital. Most hospital pharmacies do not participate as in-network pharmacies with Part D plans.

Ryan Medicare reform says Seniors living on $1000 a month must pay more for health care, "so the cost is once again a consideration."

After extensive research into the workings of Medicare, I came away wondering why most people aren't just as outrage as I am. Here's what I posted a few weeks ago:

Seniors slipping into poverty: Seniors on Social Security average $1,305 a month; minus $105 a month fee just to have Medicare; minus $140 to $200 a month for supplemental insurance (Medigap) that pays for co-pays and deductibles charged seniors.

Many people don't know there are co-pays and deductibles in the Medicare program, or that they are forced to buy "optional" supplemental insurance to pay for all of the out-of-pocket costs.

That leaves most seniors with the below poverty level income of just $1,000 a month. 

Bad, but that's not horrific enough for Paul Ryan!!!

Ryan's concerned that many of these low income seniors have been "insulated" from the true cost of health care due to their costly supplemental insurance plans that prevent them from losing it all.

The following is so sick, so unmistakably cruel, that any criticism pales in comparison to the sinking feeling you'll have after reading his twisted logic:

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. It would give seniors the security they deserve. And above all, it would be a firm step toward a patient-centered healthcare system."

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.