WH suggests : "Requiring $100 co-payments for home health care visits"

[madfloridian]

The White House suggests that might be one way of saving on Medicare and Medicaid.

Line up and defend that, please.

But the cuts that are most likely to spark the loudest cries are those targeting future Medicare beneficiaries.

The White House insists none of the changes will affect people already in the program, and will largely kick in during 2017.

Among the hikes under consideration are:

Increasing the deductible for doctors' services (part B of Medicare) by $25 in 2017, 2019 and 2021,

Requiring $100 co-payments for home health care visits,

Charging an extra 15 percent premium on people who have especially generous Medi-gap plans,

Hiking the premiums by 15 percent for Medicare recipients who earn from $85,000 to about $210,000, to raise about $20 billion.

http://www.huffingtonpost.com/2011/09/19/president-obama-targets-p_n_969991.html

$100 co-pay for home health care visits?

From the pdf link it appears to be for each series of home visits, so that could be several a year for many people on Medicare. A very painful thing for so many...many who are very ill and can least afford it.

For the White House to suggest such is beyond reality.

[dennis4868]

1. I will discuss this when I hear it from Obama...

I also saw articles and DUers saying that Obama is going to cut SS in his deficit reduction plan he laid out today...I DO NOT PRACTICE HYPERSPECULATION...

[madfloridian]

9. HYPERSPECULATION...

I don't either.

[Whisp]

29. I will wait as well.

been bamboozled here too many times by the same people. hyperventilation, followed by a large silent pause when the misinformation is proven to be not exactly as hoped by the author.

then round 40, starting the same shit all over, with the same misinformation.

[bvar22]

60. OTOH,

Many times, that information has been 100% correct,
"followed by a large silent pause" from those who tried their best to discredit the information.


You will know them by their WORKS,
not by their excuses.

Solidarity!
--------------------------------------------------------------------------------------------------------------------------------

[madfloridian]

2. Thanks to DUer tpsbman for this info.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=439x1967142

[leftstreet]

3. But with Obama's Jobs Plan & Taxes on the Rich, we'll all be doing really well soon!

or not

:grr:


K&R

[bluestateguy]

4. What is the current co-pay?

nt

[madfloridian]

7. Depends on the type of Medicare plan.

Most have no copay until after a certain time.

This is out of line.

[Vinca]

5. The $100 for home health care is nuts.

If a person can't afford that they may decide not to stay in their home and opt for whatever facility a combination of Medicare and Medicaid will pay for and, in the end, will cost the government much more.

[nashville_brook]

36. esp when you consider that many patients need to be seen more than once a week.

[Mojorabbit]

41. I used to do home health nursing as a visiting nurse

This is outrageous if true.

[nashville_brook]

48. just seeing a nurse twice a week would take every cent of SS for most seniors

[newspeak]

51. I hope it's not true

every year our credit union has a x-mas tree with names on the branches--many senior citizens. Most ask for a gift card to the store or drug store. That tells you that many of our seniors are not in the best financial shape--how could they afford a co-pay of 100 dollars? For some, that's food for a month.

[MadHound]

6. Gee, once again Obama is considering a proposition that will negatively impact my life

In a major, major way.

My mother gets home health care visits at least four times a week. She has a couple of major conditions, and home health care is the one thing that allows her to live at home, and improves her quality of life considerably. It would quickly bankrupt her if she had to pay four hundred a week, and being that I don't want to see her in a nursing home, it would put a huge strain on my finances as well.

This kind of shit is not what I voted for. Leave Medicare and Medicaid alone. If you want to cut discretionary spending, start with the goddamn military. But oh no, we can't do that, it would piss off Obama's corporate backers.

[Name removed]

8. Deleted message

Sub-thread removed by moderator. Click here to review the message board rules.

[enlightenment]

10. I am so glad that my father will not live to see these

potential changes - and that my mother was able to benefit from what Medicare was designed for before she died.

For me, it was obvious quite a while ago that I will work until I drop; I can't afford extras like health care now and I sure as hell won't be able to when (if) I reach Medicare eligible age.

The language of these potential changes is very troubling - 'deductible', 'premium', 'plans' - all those words suggest a further shift from the care model that MediCARE was supposed to provide to the insurance model that has already destroyed out health care system.

Very, very sad.

[madfloridian]

11. I agree.

My parents paid for a good medigap policy, and we knew they were able to get good care without other copays. They would be stunned to see this happen with a Democratic administration.

[kath]

39. You forgot to put "Democratic" in quotation marks.

My disgust with this Trojan Horse just grows, and grows, and grows, and...

[SammyWinstonJack]

55. That would be a DINO Administration. nt

[ProSense]

12. Again

...these are high income-related increases, PDF

<...>

Increase income-related premiums under Medicare Parts B and D. Under Medicare Parts B and D, certain beneficiaries pay higher premiums as a result of their higher levels of income. Beginning in 2017, the Administration proposes to increase income-related premiums under Medicare Parts B and D by 15 percent and maintain the income thresholds associated with income-related premiums until 25 percent of beneficiaries under Parts B and D are subject to these premiums. This will help improve the financial stability of the Medicare program by reducing the Federal subsidy of Medicare costs for those beneficiaries who can most afford them. This proposal will save approximately $20 billion over 10 years.

<...>

Introduce a Part B premium surcharge for new beneficiaries that purchase near first-dollar Medigap coverage. Medigap policies sold by private insurance companies provide beneficiaries additional support for covering healthcare costs by covering most or all of the cost sharing Medicare requires. This protection, however, gives individuals less incentive to consider the costs of health care services and thus raises Medicare costs and Part B premiums. Of particular concern are Medigap plans that cover substantially all Medicare copayments, including even the modest co-payments for routine care that most beneficiaries can afford to pay out of pocket. To encourage more efficient health care choices, the Administration proposes a
Part B premium surcharge equivalent to about 15 percent of the average Medigap premium (or about 30 percent of the Part B premium) for new beneficiaries that purchase Medigap policies with particularly low cost-sharing requirements, starting in 2017. Current beneficiaries and near-retirees would not be subject to the surcharge. Other Medigap plans would be exempt from this requirement while still providing beneficiaries options for protection against high out-of-pocket costs. This proposal will save approximately $2.5 billion over 10 years.

<....>

On one hand, people complain the Medicare recipients are having trouble paying their premiums, and on the other they reject measures to bring down cost.

Medigap is a supplemental plan.

[madfloridian]

13. These are not measures to bring down cost for seniors.

These are measures meant to make insurance companies happy. It will do nothing for seniors.

I once took a stand that a certain politician could do no wrong. I now have the courage to admit I was wrong, and he was playing us for fools...using us to get votes.

Some here refuse to learn.

[ProSense]

14. Hmmm?

"These are measures meant to make insurance companies happy. It will do nothing for seniors."

How exactly is this going to make insurance companies happy when the point is to take advantage of Medicare's actual services?

The administration already eliminated co-pays on preventive care for all seniors.

[Horse with no Name]

24. That gave me intense respect for you too Mad

we tangled a lot during the primaries, but I was very glad to see that you went in eyes wide open instead of the doe-eyes that I still see.:hug:

[Mojorabbit]

42. I don't believe having good insurance

makes most people abuse the system. It just lets them go to the doc when they need to instead of worrying about whether they can afford to go or not. I am looking for a good medigap plan right now. I can guarantee you that I will not see the doctor unless I really need to. It is not one of my favorite places to go. Not like a trip to the park.
This is a stupid place to cut money out of the program.

[madfloridian]

15. There are the goals of a Democratic administration?? More from Huff Post

"WASHINGTON -- President Obama wants to extract $320 billion in savings from the health care system in his push to trim the deficit, starting with cutting payments to Medicare and Medicaid providers and ending with making beneficiaries pay more.

The biggest savings -- $135 billion over 10 years -- would come from letting Medicare pay for drugs at the same rates as Medicaid, which enjoys much greater rebates on generic and brand-name drugs.

The next largest source of savings -- $42 billion -- would come from nursing homes, rehab centers and long-term care facilities, which the administration thinks can be encouraged to be much more efficient in providing care right after people get out of hospitals."

http://www.huffingtonpost.com/2011/09/19/president-obama-targets-p_n_969991.html


These centers are already laying off workers, cutting services as we speak. Doctors' offices are cutting back services and blaming it on Medicare cuts by CMS.

[Horse with no Name]

28. I read a stat the other day about the best jobs in 2011

Healthcare jobs were NOT mentioned in the Top 5.

Think about that. It has been YEARS since I have seen that.

For the majority of hospitals, Medicare reimbursement is about 60% of their business (I can't link it--it was at a seminar I had to go to).

When these cuts start coming in, it will also negatively impact the jobs of nurses, physical and occupational therapists, speech therapists, CNA's, providers, paid caregivers, Social Workers...and through the gamut.

[madfloridian]

40. Hospitals in our area are laying off personnel, including nurses.

It's so bad now that a 12 hour wait in the ER is nothing anymore...even when taken in by ambulance.

I am disgusted.

[Broderick]

16. Is that a 100 dollar co-pay for the year?

or each individual visit?

[madfloridian]

17. I followed the pdf link.....it appears to be for each series?? I think.

And I know some people who would really have trouble with this. Some are in hospital and nursing homes a couple of times a year or more. I don't think it is annual.

[Broderick]

22. Okay, each series could be each "prescription" so to speak

If you require home health care for 3 weeks, 100 bucks. If it is required for 6 months, 100 bucks. Lifetime home healthcare, 100 bucks.

medicare and medicaid is different I suppose.

Just speculating. I really don't have a freaking clue.


It would take a lifetime of reading just to read each and every word in the US tax code. It is a farce. The language benefits benefactors at every turn and they know where their "portion" is to avoid taxes.

Just ask GE.

[Moosepoop]

27. It's for each home health care "episode"

that consists of at least 5 home visits that were not preceded by a hospital or nursing home stay.

Introduce home health co-payments for new beneficiaries.

Medicare beneficiaries currently do not make co-payments for Medicare home health services.
This proposal would create a home health copayment of $100 per home health episode, applicable
for episodes with five or more visits not preceded by a hospital or other inpatient post-acute care stay. This would apply to new beneficiaries beginning in 2017. This proposal is consistent with a MedPAC
recommendation to establish a per episode copayment. MedPAC noted that “beneficiaries without a prior hospitalization account for a rising share of episodes” and that “adding beneficiary cost sharing for home health care could be an additional measure to encourage appropriate use of home health services.”
This proposal will save approximately $400 million over 10 years.

[madfloridian]

30. How does one get home health care w/o a hospital stay?

Did that change since my parents passed on? I don't think you get home health care without a hospital stay of at least 2 or 3 days.??

Correct me if wrong.

[Moosepoop]

34. There are criteria that have to be met, but a hospital stay is not necessary.

https://questions.medicare.gov/app/answers/detail/a_id/1347/~/who-can-get-medicare-covered-home-health-care,-and-what-services-does-medicare

Who can get Medicare-covered home health care, and what services does Medicare cover?

If you have Medicare, home health care services are covered if you meet all the following conditions:

Your doctor must decide that you need medical care at home, and make a plan for your care at home.

You must need intermittent skilled nursing care, physical therapy, speech-language therapy, or to continue occupational therapy.

The home health agency caring for you must be approved by the Medicare program (Medicare-certified).

You must be homebound, or normally unable to leave home without help. To be homebound means that leaving home takes considerable and taxing effort. You can be homebound and still leave home for medical treatment or short, infrequent absences for non-medical reasons, such as trips to a barber or church. A need for adult day care doesn't keep you from getting home health care.

[Horse with no Name]

35. A physician can order Home Health if there is a DOCUMENTED need

Such as patients that are diabetic, patients that are on certain medications that require monitoring of levels, etc...in other words, there HAS to be a skill involved.

Certain diagnoses are automatically eligible.

They have to be considered homebound--meaning that they cannot get out and about without considerable inconvenience because of their disability.

Each and every visit the NECESSITY of it is certified by the RN that the care continues to be necessary.

It isn't, as suggested, just given without thought, consideration, or guidelines. Please also note that the fraud and waste associated in Medicare fraud have almost ALWAYS been perpetrated by republican campaign donors.

[FloriTexan]

57. Doctor prescribed...

That's how we got my MIL on it. Medically necessary and it was covered 100%. If we would have had to begin paying a copay neither she nor we could have afforded it.

[coalition_unwilling]

46. Instead of cutting the defense budget and soaking the rich, they're

proposing to charge seniors $100 for each episode? This country is just fucking insane. That's all there is to it.

This is what you get when the Appeaser in Chief takes single payer and public option off the table.

Oh well, the 2008 campaign was great entertainment.

[madfloridian]

53. It would take 10 yrs to save 400 million...yet it could do great harm to very ill seniors.

Is that worth the cost?

[SoapBox]

18. "Charging an extra 15 percent premium on people who have especially generous Medi-gap plans"

WELL, hopefully that does not include my 90 year old Mom, who now lives with me...since
we many times have to jump through hops for care.

The only time we don't have a problem is when we go to the PCP office, where we ONLY ever
see a nurse practitioner. We've never even seen the doctor in 2 years.

I'm super glad for Medicare...but sometimes...

SO Prez O, how's about fixing the problems instead of only yakking about stuff that the VAST majority
of Americans never get.

[Missy Vixen]

19. Does the President know that the reason why people and doctors USE home

health care is two-fold?

1. Keeps those with treatable illness/injury out of hospitals, where it's possible to contract MRSA and worse.

2. Home health care is CHEAPER and MORE EFFECTIVE than hospitalization!

Good God Almighty, who's advising him?

BTW, maybe we should write to the White House and apprise him of the following: Our ninety-pound dog jumped on my husband's foot a month ago. We went to our regular doctor, who advised us to go to the hospital for an immediate x-ray. Husband had crushing injury, cellulosis, and staph. He got IV antibiotics, more antibiotics by mouth, and was sent home. Two emergency room visits later, he was admitted to the hospital, had surgery, and spent four days there.

We have a $200 copay for each emergency room visit. I can't even imagine what the bills will be. We attempted to get a handle on the situation without going to the hospital - i.e., saw the doctor, did what he was told, etcetera.

WE HAVE INSURANCE. The bill from the first emergency room visit came: $900 after insurance payment. We're going to have to make payments on the rest.

People on Medicaid/Medicare can't afford a freaking several-hundred-dollar co-pay a week for treatment.

[madfloridian]

20. "Good God Almighty, who's advising him?"

Well-said. It's beyond belief this is happening.

[WinkyDink]

49. (Wrong spot.)

[Horse with no Name]

21. It WILL save the government money AND be a stimulus to several industries...

like casket makers, funeral homes, etc. because it will make Home Health unattainable to ALMOST everyone--except the wealthy.

Home Health was initially meant to be the safety net to catch the sick folks that were sent home from the hospital too soon because of the treat and turf mentality of the hospitals.

Now, I don't expect the insurance companies to all of the sudden reconsider and let people stay until they are well, so, the ONLY conclusion that we take from this is that your sick parents/family members will be coming home to YOU to take care of the best that you can and if you are unwilling or unable to do so--and for those folks without family--you will be sent home to die.

The culture of life, my ass.

[madfloridian]

23. Yes, home health care has been a safety net. It works. It's good for people.

So now they decide to screw with it.

[benld74]

25. Huffington Post? Really? More proof froma reliable source please

[madfloridian]

31. It is very good source. It is just maligned here. Just like Firedoglake.

They are both made light of here because they often critique Obama.

They both have many good writers, and it is out of control here now about criticism.

The president is walking on some sacred ground now, and it is shocking to many of us.

Sometimes it is best to stop pretending and just face reality.

[Bluebear]

32. Do tell what sources you approve before the poster searches k?

[nashville_brook]

37. actually, you can refer to the WH press release on this one...they just did the math

[Bluebear]

47. Crickets

[boston bean]

26. If home health care is too expensive, think about the cost of a nursing home!

This is assbackwards. They should be trying to keep as many people out of nursing homes as possible. The cost for care in a nursing home, is astronomical.

[Raine]

33. That's INSANE!!! nt

[mrmpa]

38. Home health care visits usually occur when one is....

discharged from the hospital. Decades ago, one was not released from the hospital until they were well. Now you are discharged from the hospital when your insurance deems it to be, and you can have home visits because they are cheaper. So wanting to charge for home health visits is insanity.

[kestrel91316]

43. That will dovetail nicely with the $1000/mo Social Security payment I will be living on

IF IT STILL EXISTS.

[WCGreen]

44. Well, the last time I was released from the hospital, I was required

to have daily home visits for 10 days. That would have cost me an extra 1,000 because they didn't want to keep me in the hospital for three more days...

Yep that's gonna make it easy for people on fixed incomes which is most of us because really, when was the last time you got a significant wage increase...

[tblue37]

45. If that was a single "series," I imagine it would have cost $100 total. nt

[WinkyDink]

50. The Admin's motif/theme has been loud and clear from the git-go: BOOMERS MUST GO.

[ecstatic]

52. For high income/wealthy medicare recipients... read people! nt

[FSogol]

54. More fear-mongering from Huff Post.

:facepalm:

[chill_wind]

56. Here's the White House's 80 page plan for Deficit Reduction for the Super Committee

for those who keep denouncing everything being discussed anywhere as hyperspeculation and saying they're waiting to hear whatever from the WH.

http://www.whitehouse.gov/sites/default/files/omb/budget/fy2012/assets/jointcommitteereport.pdf

-----------------------------------------

and here's the language on the home health co-payments- page 39

Introduce home health co-payments for new beneficiaries. Medicare beneficiaries currently do not make co-payments for Medicare home health services.. This proposal would create a home health copayment of $100 per home health episode, applicable for episodes with five or more visits not preceded by a hospital or other inpatient post-acute care stay.. This would apply to new beneficiaries beginning in 2017.. This proposal is consistent with a MedPAC recommendation to establish a per episode copayment.. MedPAC noted that “beneficiaries without a prior hospitalization account for a rising share of episodes” and that “adding beneficiary cost sharing for home health care could be an additional measure to encourage appropriate use of home health services..” This proposal will save approximately $400 million over 10 years..

[librechik]

58. twice a week for a month? $800 OOP on Social Security? Get real!

[bvar22]

59. So whats the problem?

Rich Folks can easily afford that.
We should be happy for them.
"We can't begrudge them their wealth."



You will know them by their WORKS,
not by their excuses.

Solidarity!
--------------------------------------------------------------------------------------------------------------------------------

[mdmc]

61. ..

[hobbit709]

62. Is anyone at the WH living on what most people on SS and Medicare live on?

I guess it's hard to relate to what most retired Americans live on when you're making way over the median income level.

[Name removed]

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