Senate Dems May Open Up Medicare To Pacify Progressives

[seafan]

From Sam Stein at the HuffPo:

December 7, 2009

Senate Democrats are discussing the idea of expanding Medicare by lowering the age at which the elderly could enter the government-run insurance program, Democratic sources on the Hill tell the Huffington Post.

The proposal would lower the age of eligibility for Medicare from 65 to 55, though an age limit of 60 has also been suggested. Crucial details -- such as the timing of the implementation of such a reform -- were not provided due to the sensitivity and ongoing nature of the deliberations. A high-ranking Democratic source off the Hill confirmed that such discussions are taking place.

Lowering the floor for Medicare is one of several ideas being discussed as a way to pacify progressives upset over the potential elimination of a public option for insurance coverage, one of the sources added. Senate Democrats held discussions this past weekend about replacing Senate Majority Leader Harry Reid's version of a public plan with one that would be non-profit-based. The alternative proposal would be offered in state exchanges, run by private insurers but monitored by the Office of Personnel Management.

.....

Expanding Medicare would likely prove to be a tempting olive branch to progressives in the Senate. Former DNC Chairman Howard Dean, in addition to championing such a proposal during the 2004 presidential campaign, has long discussed framing the public plan as an extension of Medicare, one of the most popular government-run programs in the country.

But there are potential complications with the compromise proposal. Medicare already is on an increasingly expensive financial track, though efforts to cut some of the budgetary waste from the system have met with forceful pushback from moderates and Republicans in the Senate. In addition, the Senate weakened a proposed Medicare Commission, which would have been granted autonomy to suggest or pursue money-saving proposals.
.....

Those *moderates* who are worried about escalating costs of Medicare might find this newsworthy:


December 7, 2009

MIAMI (AP) -- Miami-Dade County received about half a billion dollars from Medicare in home health care payments intended for the sickest patients in 2008, which is more than the rest of the country combined, according to a report released Monday.

The county accounted for a little more than half the country's claims even though only 2 percent of those patients receiving home health care live here, according to a report by the Department of Health and Human Services Office of Inspector General.
Authorities say it's just another example of Medicare fraud from the county that accounts for more than $3 billion a year in false claims. In some cases, agencies have billed Medicare for home health services for homeless people. In other cases, home health aides visited patients multiple times a day and did little more than house cleaning.

.....

In many cases, authorities say Medicare is billed for services that are never provided. Patients are paid between $700 and $1,400 a month in cash as part of the scam. In one government-subsidized apartment building in Miami, many people billing for home health care services had large plasma-screen TVs - believed to be payment for their participation.
In one Medicare scam, prosecutors charged eight Miami suspects with bilking $22 million from the system. They were accused of recruiting patients for services that were unnecessary, and even faking medical tests to prove they were entitled to the payments.

Authorities say Miami scammers have tapped into "outlier payments" reserved for extremely sick patients. When a health care provider bills for more services like occupational therapy and mental health services, it is granted outlier status and can almost double the amount of Medicare reimbursements it receives.

.....

Almost 90 percent of U.S. patients receiving more than $100,000 for home health care live in Miami-Dade County.
"What's going on that you're going to get that many services in your home?" said Dwayne Grant, a regional inspector for the HHS inspector general.
Cleaning up the $60 billion-a-year fraud in places like Miami-Dade County - an epicenter for scams involving medical equipment and HIV drugs - will be key to President Barack Obama's proposed health care overhaul.

Seems that South Florida is the biggest single cesspool of Medicare fraud in the country. It is a small place geographically. Ya think while the feds are investigating, arresting and prosecuting the mass of people involved in Scott Rothstein's ponzi schemes, we can get a few more feds to investigate Medicare fraud in South Florida?

I'm sure the rest of the country will appreciate it.



Let's get on the stick.




(bold type added)

[emulatorloo]

1. THAT WOULD BE GREAT!

[no limit]

11. Not if it means scrapping the public option

[derby378]

2. Not good enough

Either everyone has access to a strong public option, or no deal.

[berni_mccoy]

18. all or nothing?

Or nothing at all?

[derby378]

40. This current plan IS nothing

There is a difference between compromise and apostasy.

[BrklynLiberal]

3. THAT would be a great start!!!!!!!!

:thumbsup:

Altho I am not too keen on 55-year-olds being called "elderly".


:rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl:

[gateley]

4. They SHOULD be worrying about pacifying progressives -- they've

mostly alienated us thus far.

[laughingliberal]

8. To say the least nt

[Phoebe Loosinhouse]

5. Please oh please let this be true!

I personally think they should open it up to anyone without insurance, but 55 and older is a start.

[laughingliberal]

6. Oh, please let this go through. My only chance of coverage for the next

12 years. You know if this goes through that as the insurance companies keep raising rates, they will start bringing the age down.

Interestingly, one site early on that allowed us to compare different aspects of the proposals in the various committees, Senate Finance had this as one of the ideas. Never made it to the bill but it was an early idea.

[Hell Hath No Fury]

7. Well that does CRAP --

if you are under 55. Talk to me about opening Medicare to any American who wants to join and then I will be interested in listening.

[Cleita]

9. Why don't they lower the age to 0

or at least let those under 55 buy into it as an insurance choice?

[BrklynLiberal]

10. I would be willing to wager $20 that if the limit on FICA is raised...to include

even the very high wage levels, we would not have to worry about funding any of this...and that would inlcude expanding coverage to everyone.

I am not even talking about raising the percentage..just the cutoff level. Let there be no cutoff level..or it should be $1,000,000.

[glitch]

15. Remove the limit altogether, we've been coddling them too long anyway.

Welfare aristocrats.

And I would not take that bet. :hi:

[BrklynLiberal]

21. Welfare Aristocrats Love it!!!

[glitch]

12. It's a start, but since quite a lot of the newly unemployed are in their 50s I say lower it to 50

That could actually make them more rehireable.

[PHIMG]

13. A ten year drop is NEEDED.

These are the people who find it hardest to find jobs with benefits (because they are old and expensive to insure) and they are the most expensive to insure in the individual market.

This is better than the public option because it sets the precedent for expanding medicare.

Another thing that needs to happen is that anyone with Medicaid should be put into Medicare. This would relieve the burden on states and it would give those on Medicare more options in terms of providers.

EXPAND MEDICARE TO EVERYONE.

If we can only expand it to 55 and up right now. Then I can live with that.

But handing over hundreds of billions to BIG INSURANCE with nothing in return is insanity.

I never understood why S-CHIP was created instead of just allowing for a Medicare buy in. It's like conservadems just love creating new programs and new expensive bureaucracy rather then just expanding successful, efficient, popular programs like Medicare. What's up with that?

[laughingliberal]

24. This might actually give me a shot at getting a job again some day

It would help more to lower it to 50 but I'm about to be 55 and there is really little hope of my age group getting a decent job again as long as employers have to worry about covering their over 50's. This would help. It would also leave the private insurance cartels with less justification for jacking up their rates. If they aren't covering anyone over 54, they can't claim they're taking as much risk.

[PHIMG]

27. I'll cross my fingers and goodluck to you!

:hug:

[laughingliberal]

30. Thank you nt

[Sebastian Doyle]

14. Since the DLC is already trying to kill Medicare and Social Security

I don't really see this as a solution.

These goddamn stupid corporatist shills can't see the obvious. If EVERYBODY paid into Medicare, and NOT into Stephen Hemsley's 12th mansion, then there wouldn't be any goddamn Medicare funding problem.

[glitch]

16. And public education and public highways... wait for it. nt

[Nikki Stone1]

22. + 1, Sebastian Doyle

It goes against the grain and the plan. Corporations on the public plan, individual citizens off. I think they are floating this to see what happens. In the end, I believe that Medicare will be moved to this exchange anyway (as a special class of subsidized customers) and the bulk of health CARE funding will be off the books.

[leftstreet]

28. +1

[emulatorloo]

37. Has the DLC killed Medicare and Social Security? Wake me up when they "succeed"

Bush tried to privatize Social Security that went nowhere.

Lots of people "try to kill things" but they aren't able to.

[csziggy]

17. A plus to cleaning up Medicare fraud in South Florida is Jeb Bush could be involved

While they did not manage to pin him with any charges when he was connected to fraud years ago, he was definitely tied to the perpetrators:

Bush Family Value$: The Bush clan's family business

— By Stephen Pizzo
Mon Aug. 31, 1992 11:00 PM PDT

<SNIP>

Jeb and Miguel Recarey
With Miami awash in empty office space in 1986, it was no small event when bagged International Medical Centers as a key tenant for Padreda's HUD-financed building. IMC, which leased nearly all the space in Padreda's vacant building, was at the time one of the nation's fastest-growing health-maintenance organizations (HMO) and had become the largest recipient of federal Medicare funds. IMC was run by Cuban-American Miguel Recarey, a character with a host of idiosyncrasies. He carried a 9-mm Heckler & Koch semiautomatic pistol under his suit coat and kept a small arsenal of AR-15 and Uzi assault rifles at his Miami estate, where his bedroom was protected by bullet-proof windows and a steel door. It apparently wasn't his enemies Recarey feared so much as his friends. He had a long-standing relationship with Miami Mafia godfather Santo Trafficante, Jr., and had participated in the illfated, CIA-inspired mob assassination plot against Fidel Castro in the early 1960s. (Associates of Recarey add that Trafficante was the money behind Recarey's business ventures.) Recarey's brother, Jorge, also had ties to the CIA. So it was no surprise that IMC crawled with former spooks. Employee résumés were studded with references to the CIA, the Defense Intelligence Agency, and the Cuban Intelligence agency; there was even a fellow who claimed to have been a KGB agent, An agent with the U.S. Office of Labor Racketeering in Miami would later describe IMC as a company in which "a criminal enterprise interfaced with intelligence operations."

Recarey also surrounded himself with those who could influence the political system. He hired Jeb Bush as IMC's "real-estate consultant." Though Jeb would never close a single real-estate deal, his contract called for him to earn up to $250,000 (he actually received $75,000). Jeb's real value to Recarey was not in real estate but in his help in facilitating the largest HMO Medicare fraud in U.S. history. Jeb phoned top Health and Human Services officials in Washington in 1985 to lobby for a special exemption from HHS rules for IMC. This highly unusual waiver was critical to Recarey's scam. Without it, the company would have been limited to a Medicare patient load of 50 percent. The balance of IMC's patients would have had to be private -- that is, paying -- customers. Recarey preferred the steady flow of federal Medicare money to the thought of actually running a real HMO. Former HHS chief of staff McClain Haddow (who later became a paid consultant to IMC) testified in 1987 Jeb that directly phoned then-HHS secretary Margaret Heckler and that it was that call that swung the decision to approve IMCs waiver.

Jeb admits lobbying HHS for the waiver, but denies talking to Secretary Heckler -- and denies as well the charge that his call won the HHS exemption. "I just asked that IMC get a fair hearing," said later. After the IMC scandal broke in 1987, Heckler left the country, having been appointed U.S. ambassador to Ireland, a post she held until 1989. (Heckler is now a private citizen living in Virginia. We left a detailed message with her secretary, outlining our questions, but she declined to respond.)

Much, much more: http://motherjones.com/politics/1992/09/bush-family-value

[seafan]

36. Jeb Bush is a director of Tenet HealthCare (Settled lawsuit for Medicare fraud)

Oh yes, indeed, Jeb Bush certainly knows about Medicare fraud. (scroll down for story)


Hat tip to DU'er csziggy for that trip down memory lane.




Jeb Bush Joins the Tenet Gravy Train (To be paid ~ $37,000 a day), May 9, 2007

.....

Jeb Bush, the president's brother and former governor of Florida, is up for election Thursday as a director of troubled hospital chain Tenet Healthcare (THC Quote). Assuming he's waved through, his pay in his first year would come to nearly $37,000 a day.

.....

The U.S. attorneys announcing the settlement accused the company of "fraud" and trying to "manipulate and cheat the system."
Mike Leavitt, the Health and Human Services Secretary appointed by Jeb's brother George, said the company had "fraudulently abused the Medicare program."
It's also the same Tenet that just paid $80 million to the IRS after an audit found it owed back taxes going back as far as 1995.

.....

Tenet's recent public filings read like a police blotter. One of its clinics in South Carolina performed 436 open heart operations without certification. The company is being sued in California by staff claiming they were systematically short-changed on pay and overtime, in breach of the state's labor code. Three former Tenet staff members, at a New Orleans hospital it owned, are under investigation for allegedly euthanizing four patients following Hurricane Katrina.

.....

This will be Jeb Bush's first job since leaving the governor's office in Tallahassee four months ago.

.....

Sure, the Tenet job may look pretty tacky for someone of your standing, but the pay isn't bad.
It's lucky the media aren't paying too much attention. Anyone reading the public filings would have discovered that in your first year, you'll earn $474,500 -- for 13 days' work.
That's $36,500 a day. And the "work" consists of sitting in a board room, so it's not exactly heavy lifting. ..... Not bad for a guy who could manage only a B.A. in Latin American Studies from the University of Texas. Many of Tenet's 65,000 personnel are qualified medical staff with years of experience. Yet according to public filings, their average salary and benefits last year came to around $69,000 for full-time work.

.....

I'm sure your family lawyer has already explained the details, Jeb, but just to recap the terms: As a nonemployee director you'll get an immediate golden handshake of $260,000 in "restricted stock units." Nothing says "welcome aboard" quite like a quarter-million. Plus you'll get another $130,000 in restricted stock units each year. That's on top of your retainer of $65,000 a year.

And all that is before you turn up for a single board meeting. For each one you attend, you get another $1,500. There's another $1,200 every time you show up at a committee meeting

A word of advice: Avoid the audit and compliance committees. There's too much work and there's always the risk something will go wrong. For an easy life, join the compensation committee. It meets only seven times a year and you don't have to do anything. Just hire some consultants to review executive pay, and agree to whatever they suggest. The executives will be grateful, and that can pay real dividends down the road. See it as using shareholder money to stock up the favor bank.

Hhmmm. Might this be another reason Jeb Bush despises Charlie Crist?



Tenet settles with Florida AG Charlie Crist

February 21, 2006

Tenet Healthcare Corp. says it has reached a broad agreement with Florida Attorney General Charlie Crist to resolve litigation and ongoing investigations.

The matters include a civil lawsuit regarding Medicare outlier payments that was filed by the attorney general's office in March on behalf of 13 county hospital districts, health care systems and nonprofit corporations in Florida.

The government alleged Tenet's charges, which it said were improper, raised the threshold of cost covered for all hospitals, reducing compensation for public hospitals. The government uses the outlier pool to reimburse hospitals for the costs of treating severely ill Medicare patients that far exceed the standard cost of Medicare patient treatment.

The suit accused Tenet (NYSE: THC) of improperly inflating charges to a Medicare fund by more than $1 billion. Crist accused the nation's second-largest for-profit hospital chain of violating the Racketeer Influenced Corrupt Organizations (RICO) Acts.

None of Tenet's 15 South Florida hospitals were named as individual defendants in that lawsuit.

The settlement also ends an investigation begun in mid-2003 by the Florida Medicaid Fraud Control Unit of certain Medicaid payments and a separate investigation begun in early 2005 by that unit of certain Medicaid psychiatric billings at a Tenet hospital in South Florida, Tenet said in a statement. In the settlement agreement the company did not admit, and specifically denied all of the allegations made in the suit.

Yeah, Jeb Bush knows about the workings of Medicare fraud using the "outlier pool".



Or the "liar out by the pool"....

[csziggy]

43. Thank you - I missed those stories! More to add to my file on the Bush Family Evil Empire

Recovering from knee surgery during that period made me miss a lot.

If you or I were involved in anything like the things the Bush Crime Family engages in, we'd be in prison for life. Why don't prosecutors go after them? It is infuriating!

[Mass]

19. I hope it is true and works. It would be an important advance in making insurance affordable.

[Oregone]

20. Oh yeah? Does this opening get paired with the withdrawal from Afghanistan?

Its hard to take anything said anymore seriously

[CTyankee]

23. Just from a purely political perspective, this would be be an enormously popular move

on the part of the Dems. I cannot tell you how many people I have known over the past several years who have yearned to have the Medicare option but couldn't because they were "only" in the 50s. So many of them felt they just couldn't hold out until 65 and were desperate. Now it is even worse with so many older Americans losing their jobs.

The Dems would be buying themselves support from a whole other wedge of American voters. The Dem party will be seen as having given something precious to these people and those in their early 50s who would have more hope in their ability to last until Medicare kicks in.

Overall, it's an A plus for the Dems...voters will be eternally grateful.

[laughingliberal]

25. It could save the midterm elections for them

Not only would it take the disincentive for hiring older workers off the table for employers, it would also allow a lot of people who could, otherwise, retire to do so. This would open up the job market for a lot of younger workers. It could have far reaching effects on the economy.

[CTyankee]

26. Plus, as mentioned earlier in the thread, it sets a precedent for Medicare expansion.

The pukes will have their heads, if not their nether regions, handed to them if they try to block this. I can see the TV ads in 2010 already...

[laughingliberal]

29. It does set that precedent. I'm not a fan of incrementalism but this does put something in there

can be expanded and built on. Without something like this, there's not much there to expand and build on.

[CTyankee]

31. It makes me wonder why they haven't done this already. It's pretty late in the process but

we didn't hear much if anything at all about it during the debates in the House.

Can you tell me why?

[laughingliberal]

33. I can't. I saw it as an early proposal under Senate Finance but never saw or heard anything about it

once the gang of six thugs took over the process. My guess is it had no chance of getting any Republican support and that was in the days when they were still blowing the Republicans hoping they could cover their butts with that 'bipartisan' horse manure. Forgive me if I'm too blunt, here.

No idea why the House hasn't considered it. I know it would, likely, raise costs for Medicare but I have no problem with the premium being a little higher until we reach 65. The premium for COBRA for my husband and me was $1200 per month. We finally had to drop it and I've seen nothing in the current bills which would lower it very much for us.

[tonysam]

42. I think it would cut some of the age discrimination because of

increasing health care premiums.

[NightWatcher]

32. Dems, lower the medicare age to -9 months and you'll win OVERWHELMINGLY in 2010 and 12

If lowering it ten years is a good idea, why the hell not lower it ALL THE WAY DOWN? That'd be a GREAT IDEA.

[spanone]

34. k & r .....

[LaPera]

35. Not good enough, we demand a STRONG public option.

[emulatorloo]

38. We don't know ANY details about Rockefeller's proposal. How do we know it is "not good enough"?

I need to hear what's actually going on before I can make that sort of judgement.

[seafan]

39. Now reported in Politico and NYT: Senate Dems Seek Expansion of Medicare, Medicaid

Senate Dems Seek Expansion of Medicare, Medicaid


December 7, 2009
6:42 p.m. ET

WASHINGTON (AP) -- Senate Democratic liberals are seeking expansion of two large federal programs, Medicare and Medicaid, in exchange for dropping a government-sold insurance option from health care legislation sought by President Barack Obama, several lawmakers said Monday.

Under the potential trade-off with party moderates, near-retirees beginning at age 55 or 60 who lack affordable insurance would be permitted to purchase coverage under Medicare, which generally provides medical care beginning at 65. Medicaid, the federal-state health care program for the poor, would be open to all comers under 300 percent of poverty, or slightly over $66,000 for a family of four.

.....

Officials: Medicare buy-in on table, Politico, December 7, 2009



We'll see.

[tonysam]

41. Make it 55 ASAP n/t