Friday, April 24, 2015

IBM Medicare OneExchange - A Medicare Tutorial by Kaiser Foundation

The Kaiser Foundation is a great resource for information about Medicare.  The foundation regularly issues reports and statements about Medicare ranging from its history, how it works, who uses it and how much it costs.  They also regularly issue position papers to Congress to try to guide legislators to make informed decisions about Medicare.
For example, legislators have embedded in a recent law, H.R. 2 aka the "Doc Fix" law, a provision to eliminate Medicare Supplemental plans that are "first dollar payer" plans.  Congressional representatives decided people who have such plans "go to the doctor more" and thereby cost Medicare more money.  While it is probably true a small percentage of people who have such plans go to the doctor more, the root cause is likely because they are sicker.  Maybe that's why they buy those plans which are substantially more expensive.  But no one in Congress is doing root cause analysis nor reading position papers to find out if their hypothesis is correct.  Our legislators just decided those plans cater to people who are hypochondriacs.  There probably are some.  But the notion that people buy "first dollar pay" plans to be able to frivolously use doctor services is not true.  Who wants to go to the doctor?  As a sample of one, I sure don't.  Kaiser Foundation did advise Congress it was not true.  Congress chose to ignore them.  Amazing.
Anyway, the following report, issued in March 2015, by Kaiser is very comprehensive.  It covers the history of Medicare, an analysis of the users of Medicare and the impact of the Affordable Care Act.  It is a long report but I urge you to read it and become educated about Medicare because there is so much misinformation in the media.  This report will help you separate fact from fiction and maybe even be inspired to push your Congressional representatives to act on real information instead of hypothesis:
I also urge you to pay close attention to what legislators do to Medicare because the changes are subtle and buried in bills like H.R. 2.  Remember, if a representative stays in office for five years they get federal health insurance coverage for life and don't use Medicare.  They have no vested interest in keeping Medicare robust. My hypothesis is majority legislators are taking a back door approach to privatizing Medicare. This "first dollar pay" legislative change did not apply to Medicare Advantage plans.  If it is bad then it should be bad for any insurance plan.  Why not restrict Medicare Advantage plans from doing it?   Do they want to push people to Medicare Advantage plans?  As more people use Medicare Advantage plans, the original Medicare insurance pool will shrink until it becomes unaffordable for the federal government to maintain as an option.  Is there is a slow drum beat to reduce Medicare insurance coverage by pushing seniors into private "managed care" insurance coverage? 

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