For those insiting on Medicare for all, please take a look at the following:

[newtothegame]

If we're going to get the public option we all want, we have to stop providing the Repug's ammunition by pretending Medicare is the greatest thing since sliced bread. A recent study showed that Medicare had the highest denial rate of any major insurer, and was actually significantly higher than all other insurers except Aetna. Higher than Cigna. Higher than Humana. Actually, the evil United Health Care has the LOWEST denial rate of any major insurer. So if we keep pushing this "evil health insurance companies and their denials" meme in the same breath as our calls for "Medicare for all," what happens when Repukes come back to us with this? In addition, realistically, if Medicare does indeed have a problem paying for its current clients, or has some motivation to try not to, what happens when we all get on it?

http://www.ama-assn.org/ama1/pub/upload/mm/368/reportcard.pdf

We need to get the facts right so we don't have Repukes throwing stuff back in our face.

ed for sp

[Laelth]

1. Big difference. We can vote out the party running Medicare. We can't vote out the board of United.

I don't care who runs the system, so long as "We the People" can control it. We can control Medicare or a single-payer system. We can not control private insurers.

:dem:

-Laelth

[librechik]

2. the new bill will cut denial rates by far, whether for pre-existing conditions or whatever

the point is, citizens can work to fix Medicare. We can't touch private company's abuses nearly as easily.

[kestrel91316]

3. HAHAHAHAHA, still carrying water for the corporations, I see!!

[theoldman]

4. I have been on medicare for 10 years without ever having a problem.

The problem with Medicare is not denial of insurance due to an illness. The problem with medicare is that it does not pay enough to the doctors who love being rich. I will agree that the premiums for Medicare are too low and they must be increased. You can double the premiums and still be cheaper than regular insurance.

[newtothegame]

8. But then how can we nail private insurance for denials if we say it's no big deal for Medicare? n/t

[napi21]

11. Granted I;ve only been on Medicare for a little over 1 year, byt I've not had any denials either.

They state exactly what they pay for & what is not covered right on their web site. There may be a lot of things that AREN'T covered, but it's never a surprise if you read your info.

[Cleita]

16. And you won't unless the Republicans are allowed to tamper with it again.

I have had it for four years, had several surgeries and other treatments too. My husband had it for 13 years including seven years of dialysis. Neither of us ever had a denial.

[liberalhistorian]

22. She didn't say it was "no big deal." She said

that denial of care wasn't a problem she'd experienced with Medicare, but that their payment rates were. And the main problem with the payment rates is that doctors didn't think they were high enough. Not that they are NOT high enough, but that doctors didn't THINK they were, there's a huge difference.

And, as others have pointed out on here, we can control Medicare and Medicaid. We CANNOT control private insurance companies.

[virgogal]

5. Thanks for a most informative link----I'm on Medicare and was

unaware of the high rate of denials.

Scary stuff.

[MarjorieG]

6. Can't access it, but Medicare recent upgrade to private? We need to fix Medicare, which is cheaper

and in the long run more efficient. Calling public option a form of Medicare is a good selling point, and if provide a temporary form immediately, even better.

But then we have the Ben Nelsons, who want it so watered down and non-competitive that anything seems impossible.

[SteppingRazor]

7. Kind of a bullshit statistic.

You're pointing out Metric 12 without looking into Metric 13 -- reasons for denied coverage. Note that Medicare's reasons are generally not found in the other lists. In particular, note that reasons 26 and 27 appear nowhere in Medicare, but in almost every other insurer -- indeed, they are number 1 in many. These cover preexisting conditions and conditions that develop after coverage is dropped.

Also, note the sheer numbers involved in coverage -- Medicare covers six times as many as the next highest number in the study.

[newtothegame]

10. "Medicare covers six times as many as the next highest number in the study"

Which should help it keep it's numbers low even with outliers. But that isn't happening. Again, I'm not arguing against a public option by any means, but the calls of "Medicare for All" is just pure ammo for the other side.

[SteppingRazor]

23. Could you address my other point as well? Because I think it covers your concerns.

You worry that "Medicare for All" will be responded to with "But Medicare denies even more people than private health care." The response to that, in turn, is that Medicare denies people for legitimate reasons, not the preexisting condition, cancel your policy reasons of private insurance. Indeed, the vast majority of Medicare denials were for reason 16, which simply means that the insurer (Medicare) requires more information. Many of these are then approved following the providing of further info. And without this large percentage of denials, by my reckoning, Medicare would be among the lowest of all denials.

[napi21]

9. I agree with you, Medicare is not what a lot of people think it is.

There are THOUSANDS OF DOLLARS in out of pocket expenses if you're really sick, and even quite a bit OP if all you do is go to the DR. once in a while. Although I have to also add that somebody is paying those multi-million $ compensation packages and the gov't is NOT!

I just received the NEW book stating the new rates for my supplemental coverage in the mail today. EVERYTHING is UP! For some things the copay is only up $5.00, but others are up as much as $275 and that's up from 2009!! I have to take another look at the best plan for us!!!

[newtothegame]

12. Sorry to hear about that, hopefully we'll get some changes fighting the good fight! n/t

[Cleita]

14. Whatever problems Medicare has, they can be fixed. Those problems like

privatizing a lot of it with Medicare advantage programs and other holes Republicans have shot into it, have weakened it. Congress and the Obama administration are trying to address this. Medicare is not the problem with your supplemental going up. The insurance companies are. HR 676, the Medicare for all bill, gives more comprehensive coverage making supplementals pretty much unnecessary. Congress needs to look into this too. The insurance companies have been allowed to gouge seniors with these programs.

[theoldman]

18. My copays also went up.

They went up because the doctors and hospitals are charging more. Maybe some of the added cost is in anticipation of the new health care policy due in three years. Costs will go up if you cannot turn down a person with a serious illness.

[Cassandra]

13. Why should I believe what the AMA says about anything.

They've been against Medicare since before it existed and they would lie through their teeth on the subject.

[newtothegame]

15. Because these docs are the ones that are treating you. And your family. n/t

[Cleita]

17. My employer, a doctor, doesn't belong to the AMA because he says they are

too conservative and behind the times. I might add that they also serve up propaganda that the health care industry feeds them.

[liberalhistorian]

24. Actually, less than half of doctors are AMA members.

And many of those who ARE members are older. I've had many docs who not only weren't members, but they refused to become members because they disagreed with its me-me-me-me money-money-and-more-money anything-that's-good-for-the-people-but-doesn't-directly-benefit-us-or-mean-more-money philosophy was a major turnoff. It does NOT represent the vast majority of practicing physicians.

The AMA has been against any proposed policies that help the majority of Americans for over seventy years. It was even against the implementation of social security disability payments and lobbied hard against it, delaying it for years. The only reason they finally dropped their opposition to Medicare/Medicaid in the mid-60's was because they realized that too many people wanted it and it'd be bad publicity for them to continue denying it and they also realized that a lot more people would be able to see a doctor which would mean more money in their pockets.

[liberalhistorian]

19. I'm sorry, but I have a great deal of trouble believing

this and question its veracity. I've worked with both Medicare and Medicaid, both for work and on behalf of friends and family members, as well as private insurers; my parents are currently dealing with both Medicare (my mom) and Medicaid (which pays for my stepdad's nursing home care). There is NO comparison. Yes, there are problems with M/M. No, they are not perfect. But as compared to private insurers, there is NO COMPARISON. They are far easier to work with and their denials are far less. Much less. And they aren't run by inhuman greed-mongers whose only concern is profit, profit and more profit, off the backs of those who pay them for care and who get nothing in return for it.

So tell us, just how heavy IS that bucket of water you've been carrying for insurers and corporations and their well-heeled lobbyists?

[ddeclue]

20. They'll accept it when they are told they have to by law.

It's real simple - if you want to practice medicine you do it by OUR rules. If you want to take your ball and go home FINE -we'll train new doctors and you can go pump gas, same thing Reagan told the air traffic controllers.

[roakes10190]

21. Medicare

I have Medicare, have had for five years, and I have never been denied any service, procedure, or medication prescribed by my doctor, whom I was allowed to choose freely. Back when we were on the state employees insurance plan, Blue Cross, I was denied several services prescribed by my doctor, a doctor I had to choose from a booklet sent to us. Many procedures required prior approval by the insurance company and medications prescribed by the doctor were sometimes denied. I'm tired of people who don't have Medicare talking about how bad it is. It is not bad; it is wonderful.

[Lucy Goosey]

25. I'm not sure the metrics are fair.

Do the numbers for insurance company denial rates include everyone with a pre-existing condition who was denied coverage in the first place? Or who had their coverage revoked or not renewed when they got sick? Not to mention people who don't even apply to get private coverage, because they can't afford it. If not, I don't see how the comparison can be valid.

Not to defend the Medicare denial rates - I'm surprised they're so high. Medicare can be done better, though: see Canada, Europe, etc.

[Lint Head]

26. Aetna, Cigna, Humana and the evil United Health Care

all have Medicare contracts and are the ones doing the denying. The so-called evil health insurance companies are one of the main reasons claims are denied for medicare.
CIGNA has one of the biggest Medicare Durable Medical Equipment contracts in the country. Florida, where most of the Medicare fraud takes place, is contracted to CIGNA.