I'm certain that you've heard that the Medicare Advantage Program is very controversial. If you are young and you are not caring for an elderly relative, the Medicare Advantage Program may mean nothing to you. But if you or a loved one is enrolled in one of the programs, you are likely very concerned about the debate raging in Congress today.
What is Medicare Advantage? Under today's Advantage programs private insurers like United Health Care or Humana take over the administration of Medicare including the interface with the United States Government. They standardize all fees and greatly reduce the paperwork and eliminate virtually all complications for seniors. They often pay more than Medicare for many services, saving seniors substantial amounts of money.
But, they do cost the government about 14% more per senior than standard Medicare enrollment. Many claim this just goes to fatten the bankroll of evil and greedy insurance company executives. And anecdotal horror stories, generally totally unsubstantiated, are flowing through the blogosphere about seniors being denied care. These are almost certainly false because the companies are highly regulated and must, by law, cover any expense Medicare itself would cover.
My mother is enrolled in an Advantage Program through United Health Care. It is stunningly excellent and has saved her a great deal of money and countless headaches. I cannot praise the program enough. So I am biased.
On the other hand, I have several close friends who are doctors and also get to hear their side of the story. While the bookkeepers like the amazing simplicity of Advantage Programs, the doctors and hospitals actually are paid less than they would receive under straight Medicare. You see, Insurance Companies actually negotiate lower prices from health care providers. And, doctors tell me, the payments are often much more logical under Advantage programs, fees are more in line with real world costs. Medicare vastly overpays for certain services.
It is important to note, before I continue, that Advantage programs are primarily used by the very poor who cannot afford traditional Medicare Supplemental Insurance programs. Advantage covers some expenses much more fully than traditional Medicare. And, as I've already mentioned, it's a lot easier to use.
Today's debate revolves around what Insurance Companies are allowed to communicate with their customers. The Obama Administration has DEMANDED that all insurance companies cease and desist all communication with customers about the impending elimination of the Advantage Program. Today, on a nearly straight party line vote, the Senate backed the Administration.
The claim by the Obama Administration was that some communication lied or attempted to frighten seniors. However, Congressional Budget Office Director Douglas Elmendorf seemed to back the insurance companies Tuesday testifying under oath that seniors in the private Medicare Advantage plans would likely see substantially reduced benefits under the Senate Finance Committee legislation now under debate.
President Obama and virtually all Congressional Democrats have all PROMISED that despite the massive reductions and other planned cuts to the Medicare program, seniors would not see their benefits reduced under the Obama Health Care Restructuring. That claim is the centerpiece of every Obama speech and his address to the joint session of Congress last week. The only thing is, as Congressional Budget Office Director Douglas Elmendorf testified, that simply isn't true!
In his attack on the insurance companies yesterday, Senator Max Baucus, Finance Committee Chairman, boldly declared, "It is wholly unacceptable to mislead seniors regarding any subject — particularly on a subject as important to them, and to the nation, as health care reform."
I agree completely. It's damned time Senator Baucus and his fellow Democrats STOPPED LYING TO SENIORS AS THEY ATTEMPT TO SECRETLY GUT A SUCCESSFUL AND IMPORTANT PROGRAM.