Medicare’s Too Costly Private Plans

[groovedaddy]

Private health insurance plans were supposed to bring better care and lower costs to elderly patients covered by Medicare. Instead they have increased the cost and complexity of the program without improving care, according to new analyses published by the respected journal Health Affairs. Congress clearly has more work to do to remove unjustified subsidies that prop up many of the most inefficient private plans.

Back in the 1980s, private plans — known as health maintenance organizations — were seen as a savior for Medicare. They could provide the same or better services as traditional fee-for-service Medicare, but because of managed care they could do it at a lower cost. Over the years Congress brought other, less managed private plans into Medicare, and in 2003 the Republican-dominated Congress substantially increased government payments to private plans.

Medicare currently pays the private plans — now called the Medicare Advantage program — 13 percent more on average than the same services would cost in the traditional fee-for-service program. Some of the added payments are used to provide extra benefits for enrollees, like reduced cost-sharing or reduced premiums for such extra benefits as vision and dental care.

The added value averages more than $1,100 a year per patient. Not surprisingly, that makes them attractive to individuals and employers seeking coverage for retirees. It has fueled an explosive growth in enrollments. Almost a quarter of all Medicare beneficiaries, more than 10 million people, are enrolled in private plans.

http://www.nytimes.com/2008/11/29/opinion/29sat1.html?th&emc=th

[BrklynLiberal]

1. But they sure as hell are making money for the insurance companies...and that is all

that prez shit-for-brains and his minions ever wanted.

[fmlymninral]

2. these Medicare advantage plans

help the low income individuals who can not afford Medicare supplement plans. medicare alone leaves the senior exposed to the possibility of having thousands of dollars in medical expenses which mandates the necessity of medicare supplement plans. However they start at $126 dollars per month per individual. Medicare also does not pay for any preventive health care which the Advantage plans do pay for and some advantage plans pay for vision and dental care. So in reality the true cost is less than the combination of a medicare and a supplemental plan.

[dflprincess]

3. Which begs the question

why should anyone need a Medicare supplement plan? Medicare should cover everything the supplements do - especially preventative care.

[fmlymninral]

4. unfortunately they do not

medicare part A covers hospital minus a 1024 dollar deductible which can be applied every time you go into the hospital if the events are 60 days apart. Part B only pays 80% of of the doctor bill. no preventive at all. no long term care either.

[dflprincess]

5. I know it doesn't - but it should

The healthcare system in this country is a disgrace. Not that I'm telling you anything you don't already know.

[grasswire]

6. why would anyone buy an advantage plan when there's medigap?

The Medigap plans are standardized by law. A plan F from BCBS has the same benefits and exclusions as a plan F from Kaiser Permanente. There are no surprises and no high-pressure sales jobs.

The advantage plans I studied are nearly worthless compared to the medigap.

[xchrom]

7. recommend