Friday, September 7, 2012

The Great Medicare Battle

Now that the Republican and Democratic Conventions are over, it's clear that Medicare has become the issue that will determine the outcome of the 2012 presidential election. And the parties' proposals couldn't be more different.

President Obama's health care law will cut $716 billion from Medicare . Where does this number come from? The majority will come from reductions in payments to doctors and hospitals, and to Medicare Advantage plans. As this NCPA study shows, the cuts in Medicare provider fees are not sustainable if seniors are to have continued access to health care.

On the other hand, Mitt Romney and Paul Ryan offer a plan that gives seniors more control over their Medicare dollars and unleashes competitive forces to slow Medicare spending. This is the power of the free market at work.

Tuesday, September 4, 2012

If You Like Your Insurance...

Kathleen Sibelius, Secretary of HHS, spoke at the opening session of the Democratic National Convention in Charlotte, NC on September 4, 2012. Her main points were essentially all the same lies we've heard since early 2009. So many things to say but I will focus on only one falsehood.

Ms. Sibelius repeated the common lie of the Affordable Care Act; "If you like your insurance you can keep it."  This is patently untrue unless she is speaking to someone on another planet. I sell health insurance and have seen policies evolve to meet the incredible standards and regulations spawned by the ACA. There isn't one policy left in Washington State that resembles policies bought and paid for in 2008 or earlier. Nobody gets to keep the policy they like. Nobody.

Insurance companies are strangled by onerous regulations. They are hindered by, in Washington anyway, a commissioner of insurance that hates insurance companies and insurance agents. Always has, always will. His view: government - good, private business - bad.

Deductible and coinsurance have skyrocketed. Gone are the days of $100,$500 or even $1,000 deductibles. The majority of policies have deductibles starting at $1,800 and go up to $10,000. Most companies are no longer offering traditional drug coverage. Now they offer discount programs worth 18% to 20% off retail. After ACA it's no longer possible to keep the policy you like.

Preventive care is now the norm but you'd better be careful - the big print giveth and the small print taketh away. For example, preventive care offers cancer screenings including screenings for colon cancer. This may be a colonoscopy (if coded accurately by the provider) or a fecal occult blood test. You never know if you're going to end up paying $1,200 for a procedure or end up getting it for no charge. And guess who becomes the bad guy? The insurance company, of course.

No, Ms. Sibelius is flat out wrong. Nobody gets to keep the insurance they like. It isn't happening anywhere in the country and she gets the Pinocchio award for today.