THIS WILL END HEALTH CARE PUBLIC POLICY FOR NOW------
I hear from Democratic voters all the time ----give Affordable Care Act time---it is a platform for single-payer and I understand ---there is another Democratic voter misled by a Clinton neo-liberal pol or outlet.
THE ONLY SINGLE-PAYER PLATFORM BEING BUILT IS A THIRD WORLD PREVENTATIVE CARE FOR ALL.
So, while Democratic voters tied to Clinton neo-liberals wait with held breathe for this platform----the Clinton/Obama neo-liberals are outsourcing all of Medicare and Medicaid to global corporations having no intent of oversight and accountability to US Constitutional and FEderal and state laws regarding public health.
Maryland dismantled it oversight decades ago---there is no state or local public health agency that monitors for Rule of Law Constitutional right and Federal and state law adherence. We simply have global corporations producing health data that says everything they are doing is giving good results. No stats on complaints----bad health outcomes----or lose of access.
All of this happens because of the President embracing that Federalism Act saying to states---GO AHEAD--DO WHAT YOU WANT ---- WE ARE NOT LOOKING.
There is nothing more Republican than the Federalism Act---and social democrats would not dismantle all oversight and accountability just to maximize corporate profits -----open the door to systemic corporate fraud -----and elimination of all US legal protections for citizens regarding health care.
Office of Inspector General
Report (OEI-09-12-00530)
04-11-2014
Offshore Outsourcing of Administrative Functions by State Medicaid AgenciesComplete Report
SummaryWHY WE DID THIS STUDY
Outsourcing occurs when State Medicaid agencies enter into agreements with contractors to perform administrative functions. Outsourcing can occur inside the United States (domestic outsourcing) or outside (offshore outsourcing) and can be direct (when a Medicaid agency contracts with an offshore contractor) or indirect (when a Medicaid agency's contractor subcontracts to an offshore contractor). There are no Federal regulations that prohibit the offshore outsourcing of Medicaid administrative functions. However, the Health Insurance Portability and Accountability Act (HIPAA) requires covered entities to have business associate agreements (BAAs) to protect personal health information (PHI).
HOW WE DID THIS STUDY
We conducted a survey of 56 Medicaid agencies, including those of the District of Columbia and the U.S. territories. We asked Medicaid agencies (1) whether they had any policies, Executive Orders, State laws, or contract requirements (collectively, "requirements") addressing the outsourcing of administrative functions offshore and (2) whether they directly or indirectly outsourced administrative functions offshore. For Medicaid agencies with outsourcing requirements, we asked whether these requirements address PHI and whether the Medicaid agencies monitor contractors' compliance with the requirements. We reviewed the Medicaid agencies' requirements and BAAs. For the Medicaid agencies that outsource offshore, we asked what types of administrative functions are outsourced offshore.
WHAT WE FOUND
Only 15 of 56 Medicaid agencies have some form of State-specific requirement that addresses the outsourcing of administrative functions offshore. The remaining 41 Medicaid agencies reported no offshore outsourcing requirements and do not outsource administrative functions offshore. Among the 15 Medicaid agencies with requirements, 4 Medicaid agencies prohibit the outsourcing of administrative functions offshore and 11 Medicaid agencies allow it. The 11 Medicaid agencies that allow offshore outsourcing of administrative functions each maintain BAAs with contractors, which is a requirement under HIPAA. Among other things, BAAs are intended to safeguard PHI. These 11 Medicaid agencies do not have additional State requirements that specifically address safeguarding PHI. Seven of the eleven Medicaid agencies reported outsourcing offshore through subcontractors, but none reported sending PHI offshore. If Medicaid agencies engage in offshore outsourcing of administrative functions that involve PHI, it could present potential vulnerabilities. For example, Medicaid agencies or domestic contractors that send PHI offshore may have limited means of enforcing provisions of BAAs that are intended to safeguard PHI. Although some countries may have privacy protections greater than those in the United States, other countries may have limited or no privacy protections.
This report does not contain recommendations.
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Clinton/Obama neo-liberals are laughing all the way to the bank as all the Federal structures for Medicare and Medicaid are dismantled----outsourced globally----with no intent of enforcing US Rule of Law for American citizens.
The only thought for global corporate pols is how to move all Federal funding for these Federal programs and Trusts to global corporations and which ones get to loot this revenue.
THAT IS ALL THAT GLOBAL POLS ARE THINKING REGARDING AFFORDABLE CARE ACT.
It's gone way beyond technology outsourcing----they are building all these technology connections to health care for the express action of outsourcing it overseas. There will be no ability of the public to monitor what is happening in these administrative systems......it will become just like global corporate customer service where you wait forever to get no information and the service was not good and the product defective.....ONLY THIS TIME IT IS YOUR HEALTH CARE.
As all corporate health care policies are eliminated and brought to this preventative care only-------even labor unions members with the best of health policies will fall into this same outsourced and predatory health care system.
The federal outsourcing boom and why it’s failing Americans
By Steven Pearlstein Columnist January 31, 2014 Washington Post
Two of the biggest news events of the past year have been the leaks about top-secret snooping by the NSA and the disastrous rollout of Obamacare. But in an important way, they are both manifestations of a story that has been unfolding for decades — that of a federal government that has outsourced too much of what it does to private contractors while allowing the quality of its own workforce to atrophy.
Lots of Americans were disturbed to learn from Edward Snowden that the government is keeping track of their every phone call and text message. But they might have also wondered why a 30-year-old government contractor in Honolulu, with security clearance that was approved by another private contractor, had routine access to some of the government’s most sensitive secrets. Even worse, two years after Pfc. Bradley Manning did the same thing, Snowden managed to download millions of pages of documents from a computer system designed and managed by private contractors without setting off a single alarm. The whole affair was an embarrassment to Washington’s government contracting sector.
Steven Pearlstein is a business and economics columnist who writes about local, national and international topics. View ArchiveSo, too, the fiasco with HealthCare.gov, which despite the bleating of Republicans has almost nothing to do with the wisdom of the new health-care law and everything to do with the way the government and its outside contractors set about implementing it. While several of the contractors failed to perform as promised, in hindsight it appears the government also made a crucial mistake in deciding to rely on the IT staff at the Centers for Medicare and Medicaid Services to manage the contractors and oversee the final integration of the new system. Free-market ideologues will reflexively see in this failure further evidence of the inherent inferiority of public-sector workers. In truth, it is evidence of how outdated civil service rules and ill-conceived caps on the size and pay of the federal workforce have eroded the government’s ability to perform even essential government tasks.
The federal government has long relied on outside contractors to provide it with weapons systems and other goods. But starting with the Reagan administration, there has been a determined shift of work from government employees to private contractors, on the theory that they could do it better and cheaper. For a time, that was true. Much of the early outsourcing was for lower-skilled clerical and maintenance functions for which government workers received pay and benefits well above the market rate. Or it was for the design and operation of new computer systems that automated the work of government and had never existed before.
But in recent years, much of the outsourcing has been driven by politics and ideology.
ADVERTISING
To demonstrate their commitment to “shrinking” the size of the federal government, both Republican and Democratic politicians set about shrinking the federal workforce and then capping it at 2 million workers, despite continued growth in the economy, the size of the federal budget and demand for government services.
“This obsession with small government is a sham,” declares Daniel Gordon, who headed the Office of Procurement Policy in the first Obama term before joining the law faculty at George Washington University.
Not only are there caps on the number of government workers, but there are also caps on government pay that ignore the realities of the marketplace — and that, too, has driven the outsourcing trend. It may be politically popular in a country where median household income is $51,000 to require that no federal employee should be paid more than the $174,000 earned by a member of Congress, but it makes it pretty hard for the government to recruit and retain the lawyers and economists and biochemists and software engineers it needs when they can make double and triple that in the private sector. So it’s no surprise that the only way that government managers can fulfill their mission is to outsource its brains, shifting high-level work to private firms that have the flexibility to pay their workers market rates.
In the end, taxpayers are not only indirectly paying the higher salaries they refuse to pay directly to government employees — they also wind up paying for the contractors’ profit and the costs of winning and managing contracts.
Government employees, however, must also shoulder some of the blame for the outsourcing boom.
If you give federal managers the choice of filling vacancies from the candidates who emerge from the government’s arcane recruitment and promotion system (and who, once chosen, will be virtually impossible to fire if they don’t work out), or you gave them the choice of handpicking whomever they want and hiring them under an open-ended “umbrella” contract with a private firm (with the power to fire them at a moment’s notice), nine in 10 would hire the contractor. And that’s exactly why you now find so many contract employees in government offices working side by side with government employees.
The system the government uses to recruit, hire, evaluate and incentivize its employees is seriously broken. And yet every attempt to reform it is bitterly opposed by federal employee unions, who take it as their mission to prevent good employees from being rewarded and bad employees from being fired. The result is that the unions are protecting ever-fewer employees with ever-lower pay.
Those open-ended IDIQ (for “indefinite delivery, indefinite quantity”) contracts, by the way, now account for anywhere between one quarter and one half of all federal service contracting, according to Gordon. Originally, they were designed to allow agencies buy smaller quantity of standardized supplies, or respond to the occasional surge in workload, without having to go through the long and cumbersome process of letting a new contract. But now they are routinely used by agencies for orders worth hundreds of millions of dollars that involve no competition, little transparency and dubious savings.
These clever work-arounds to the government’s personnel and contracting systems have driven the rapid growth in government contracting, much of it here in the Washington region. Federal contracting grew from about $200 billion in 2000 to about $550 billion in 2011 before falling back to $450 billion last year. Sixty percent of that was for services. By some estimates, there are twice as many people doing government work under contract than there are government workers.
Against that backdrop, hardly anyone considered it remarkable that the government would have outsourced the day-to-day operation of its most secretive computer system to Booz Allen Hamilton, the agency’s leading contractor. Nor, during the homeland security push after 9/11, did anyone question why a company such as USIS, which was originally spun off from the government to do simple background checks for new employees at departments such as Agriculture and Education, should be doing investigations for top security clearances normally done by the FBI. After the Snowden affair, the government sued USIS, accusing the firm of pushing through clearances without sufficient investigation in order to qualify for performance bonuses.
And long before the botched rollout of Obamacare, even the Professional Services Council, the leading trade association for federal contractors, was complaining publicly that too many agencies lacked skilled workforce to manage the contracting process — in particular, contracts for complex new computer systems. Numerous agencies had turned to outside contractors to manage its outside contractors before Gordon issued an order in 2011 declaring contract management to be an “inherently government function” that should be done only by government employees.
What Snowden and HealthCare.gov have made clear is there is a limit to how much outsourcing can be used as a work-around to the problems of dysfunctional government. It’s time — actually, it’s way past time — to fix the underlying problems.
Up to now, the Obama White House has made the calculation that it’s not worth the political capital to take on the public employee unions over civil service reform, and its not worth the political risk of challenging the tea party Republicans to push for an increase in the size of the federal workforce. Given what’s happened, maybe it’s time to recalculate.
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“Medicare is a highly effective key part of Australia’s great public health system, yet this government is determined to dismantle it and sell the profitable bits to its big business mates,” Ms Flood said “It is absolutely shocking.” SAME THING HAPPENING IN US----DO YOU HEAR ABOUT THIS?
In dismantling all of the public health structures at Federal, state, and local levels there goes more of the public sector and with it the public sector unions.
Who supports Clinton/Obama neo-liberals every election? National labor union leaders supporting union-busters.
All of these jobs lost are leaving the nation as with all private sector downsizing----they are doing the same NAFTA overseas expansion of private corporations now with our government sector -----all controlled by global corporations. When Wall Street shouts----CORPORATIONS ARE NOW IN CHARGE OF AMERICA---THIS IS WHAT THEY MEAN.
Social Democrats want to not only rebuild public health oversight and accountability and public hospitals and clinics----it wants to expand Medicare ----meaning no 20% deductible -----everyone in for all health care and no one out. This has nothing to do with the Affordable Care Act hand-off of our entire health system to global corporations led by global health insurance corporations deciding how to bring corporate profits higher by predatory structures and denying access to 90% of Americans to most ordinary health care.
Below you see an article by Australian public sector unions that you see little of in the US and the same thing is happening.
Medicare outsourcing could cost 20,000 jobs: CPSU
By Julian Bajkowski on August 11, 2014
The Community and Public Sector Union has taken a flamethrower to plans to scope-out the potential for outsourcing Medicare claims and payments processing, warning that tens of thousands of jobs are at risk.
As industrial tensions continue mount across the wider public service, the sector’s main union has branded the market testing exercise an attempt to “sell off” jobs and “outsource Medicare payments to big business.”
Although it is more likely the Abbott government is trying to eliminate APS jobs rather than go through the more expensive and less appealing option of trying to sell them, Health Minister Peter Dutton’s attempt to update and get Medicare’s technology infrastructure in order is ringing big alarm bells.
“This outrageous move could cut up to 20,000 public service jobs, most in regional and suburban Australia where jobs have already been hit hard,” National Secretary Nadine Flood said, adding the majority of Medicare’s staff “are women on an average salary of $63,000 a year and based mainly in suburban and regional areas.”
“These are not highly-paid fat cats, they are mostly mums and dads on average wages who will struggle to find alternative jobs in areas where jobs are scarce, particularly the thousands of them working in regional Australia.”
Health Minister Peter Dutton has made assurances that Medicare’s counter services are not in the frame for outsourcing under the EOI, however the paucity of detail has continued to feed into fears the present round of 16,500 APS job cuts could be the tip of the iceberg.
“Medicare is a highly effective key part of Australia’s great public health system, yet this government is determined to dismantle it and sell the profitable bits to its big business mates,” Ms Flood said “It is absolutely shocking.”
She accused the government of using stealth tactics to pursue a privatisation agenda without telling the community of public servants.
“They’re doing it without a word to the community or to thousands of Medicare workers whose jobs are in the firing line. The first we hear of this is a tender to sell off Medicare. This is a nasty, sneaky move by the Abbott Government,” Ms Flood said.
“Australians are wary about privatisation because so often they pay more and get less. The last place we want that to happen is with something as important as Medicare.”
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Remember, the Affordable CAre Act is a Republican policy written to deregulate and privatize all of Federal public health and Trusts like Medicare and Medicaid. THESE POLICIES WERE WRITTEN IN REPUBLICAN THINK TANKS.
So, Obama as a Clinton neo-liberal does not care if ACA is given the name ObamaCare because neo-liberals are Republicans wanting to kill the Democratic Party and want Democrats to think their party is doing this----NOT REPUBLICANS.
No matter how you slice the data-----almost $1 trillion dollars was cut from Medicare and Medicaid since 2010. The only changes from below came when the supposed cuts from private, corporate Medicare Advantage disappeared. All cuts for public Medicare installed------cuts for private corporate Medicare removed. This happens all along the Affordable CAre Act passage......every policy shouted as making corporations pay their fair share vanishes as ACA is rolled out.
Absolutely no discussion has happened yet in the US over these policies. Federal Congressional neo-liberals simply tell their state assembly pols to pass all the privatization policies by state and then the same told to local city halls and THEY JUST DO IT----NO QUESTIONS ASKED.
We have statewide elections in which health care is never mentioned---all candidates do is shout the same ----WE ARE FOR THE COMMUNITIES.
Most candidates at local level do not know public policy---they depend on a mayor or state assembly person to tell them what to do. In Maryland, neo-conservative Johns Hopkins writes all health policy adopted with no discussion at all levels of government.
How ObamaCare Guts Medicare
The president's pledge that 'If you like your health plan, you will be able to keep it' clearly does not apply to America's seniors.
By
Peter Ferrara And Larry Hunter
Updated Sept. 9, 2010 12:01 a.m. ET The Democratic Senatorial Campaign Committee has attacked Senate Republican candidates for wanting "to end Medicare as we know it." And in Nevada's hotly contested Senate race, Majority Leader Harry Reid is attacking Republican Sharron Angle, saying she wants to "gut" Medicare. But Mr. Reid has already gutted it. He and his colleagues did so by passing ObamaCare.
Senior Editorial Writer Joseph Rago explains the increase in insurance premiums. Columnist Mary Anastasia O'Grady and John Fund, an OpinionJournal.com columnist, critique the President's plan.In his analysis accompanying the recently released Annual Report of the Medicare Board of Trustees, Richard Foster, Medicare's chief actuary, noted that Medicare payment rates for doctors and hospitals serving seniors will be cut by 30% over the next three years. Under the policies of the Patient Protection and Affordable Care Act, by 2019 Medicare payment rates will be lower than under Medicaid. Mr. Foster notes that by the end of the 75-year projection period in the Annual Medicare Trustees Report, Medicare payment rates will be one-third of what will be paid by private insurance, and only half of what is paid by Medicaid.
Altogether, ObamaCare cuts $818 billion from Medicare Part A (hospital insurance) from 2014-2023, the first 10 years of its full implementation, and $3.2 trillion over the first 20 years, 2014-2033. Adding in ObamaCare cuts for Medicare Part B (physicians fees and other services) brings the total cut to $1.05 trillion over the first 10 years and $4.95 trillion over the first 20 years.
These draconian cuts in Medicare payments to doctors, hospitals and other health-care providers that serve America's seniors were the basis for the Congressional Budget Office's official "score"—repeatedly cited by the president—that the health-reform legislation would actually reduce the federal deficit. But Mr. Obama never disclosed how that deficit reduction would actually be achieved.
There will be additional cuts under ObamaCare to Medicare Advantage, the private option to Medicare that close to one-fourth of all seniors have chosen for their coverage under the program because it gives them a better deal. Mr. Foster estimates that 50% of all seniors with Medicare Advantage will lose their plan because of these cuts. Mr. Obama's pledge that "If you like your health plan, you will be able to keep it" clearly does not apply to America's seniors.
Moreover, there will be additional cuts to Medicare adopted by bureaucrats at the Medicare Independent Payment Advisory Board. ObamaCare empowers this board to close Medicare financing gaps by adopting further Medicare cuts that would become effective without any congressional action. Mr. Foster reports that "The Secretary of HHS is required to implement the Board's recommendations unless the statutory process is overridden by new legislation."
The drastic reductions in Medicare reimbursements under ObamaCare will create havoc and chaos in health care for seniors. Many doctors, surgeons and specialists providing critical care to the elderly—such as surgery for hip and knee replacements, sophisticated diagnostics through MRIs and CT scans, and even treatment for cancer and heart disease—will cease serving Medicare patients. If the government is not going to pay, then seniors are not going to get the health services, treatment and care they expect.
Mr. Foster reports that two-thirds of hospitals already lose money on Medicare patients. Under ObamaCare it will get much worse. Hospitals also will shut down or stop serving Medicare patients.
The president's concept of spreading the wealth includes sacking the Medicare system, on which America's seniors have come to rely for medical care, in favor of others the president's progressive vision deems more worthy.
Everyone should know by now that Medicare suffers dramatic long-term deficits and unfunded liabilities, and is in need of fundamental, structural reforms. But effectively refusing to pay the doctors and hospitals that provide the medical care the program promises to seniors is no way to solve that problem.
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As I said earlier-----Kaiser of California has a long history as an HMO now ACO and with that a long history of serious consumer complaints. It is the ACO model that simply went national with Affordable Care Act. In Baltimore, TV advertisements are pounding people with ads to drive seniors to these private Medicare plans with all kinds of private corporate structures that we now have to go to to know which in several listings of Medicare choices are best for us.
Medicare is one Federal program that every senior gets the same coverage and access according to Federal and Constitutional law. It is simple----you hit an age and you sign up for Medicare and you get good health care. IT WORKED FINE FOR DECADES EXCEPT FOR THE CORPORATE FRAUD AND PROFITEERING.
We know that when corporations outsource Medicare and Medicaid it will be corporations like Kaiser that does this. At the same time it is Kaiser that gives us all the data saying how good these HMO/ACOs are for saving money and giving INDIVIDUALIZED care.
IT IS ONE GREAT BIG SCAM JUST LIKE THE WALL STREET COMPLEX FINANCIAL INSTRUMENTS WITH THE SAME GOAL OF MOVING MONEY WHILE BEING PREDATORY AND CORRUPT.
This is the partnership we have in Maryland and especially Baltimore as neo-conservative Johns Hopkins joins this national HMO/ACO and goes global. What happens when Federal Medicare ends under Clinton neo-liberals? Seniors simply are pooled into these ACOs and given whatever access to care that ACO wants----regardless of what Federal Medicare and Constitutional rights to health care are.
Note below where this article states------just because a monthly premium is $0----does not mean it is not equivalent with Federal Medicare. THIS IS KAISER'S BIG SELL IN IT MEDICARE ADVANTAGE PLANS----$0 DEDUCTIBLES THAT ARE REALLY NO DIFFERENT THAN FEDERAL MEDICARE.
There is absolutely no one defending Federal Medicare or educating that these global pols and ACA policies seek to end our Federal public health.
Kaiser Permanente Medicare Advantage Plus Prescription Drug Plans
The following Kaiser Permanente plans offer Medicare Advantage and Part D coverage to California residents. Medicare Advantage plans, also known as Medicare Part C, are alternatives to original Medicare. These plans help cover the costs of services provided by hospitals, doctors, lab tests and some preventive screenings. These plans' Part D component helps cover prescription drugs. Even if a plan's monthly premium is $0, you would still pay the equivalent of the original Medicare premium. Not all plans shown here will be available to you; enter your zip code to see plans in your area.
You can read about whether Medicare Advantage is right for you. If you only want plans with drug coverage, browse Prescription Drug (Part D) Plans.
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Below you see the insanity that is simply global corporate pols working together to end public subsidy in health care. The idea that we need so many kinds of Medicare-----so many kinds of Medigap is what deregulates what Federal and Constitutional Medicare is.
As this concerned citizen is relating------it appears Obama and neo-liberals are creating conditions for those having Medigap from continuing to get it-----and to end access to all American citizens.
THIS WILL BE THE END OF ACCESS TO MEDICARE FOR MOST AMERICANS AS PEOPLE CANNOT AFFORD 20% OF MEDICARE DEDUCTIBLES AND CO-PAYS SO WILL NOT BE ABLE TO ACCESS MEDICARE.
Again, even the upper-middle class who are now being made to think they will be able to access Medicare are watching as health care prices soar-----and you know what? THERE WILL BE NO MEDICARE OR MEDICAID----ONLY A GUTTED OF FUNDING MEDICAID OR ALL.
'H.R. 1470 that was replaced by H.R. 2 – Medicare Access and CHIP Reauthorization Act of 2015 has passed the Senate and is on the way to the President’s desk where it is expected to be signed in to law. The law will be touted as fixing the doctor reimbursement problem in the media. However, this law will effectively end Medigap Plans F & C beginning for newly eligible Medicare beneficiaries on Jan 1st 2020'.
Will I lose my Medigap Plan F?March 31, 2015Will I lose my Medigap Plan F?
Since Congress Standardized Medigap plans in 2010, which increased the benefit for Excess Charges and added a Hospice benefit to Medicare Supplement Plan G, a common debate over whether Plan F is better than Plan G ensued. The only real difference is who would pay the $147 Part B deductible for the Medicare recipient. Plan G doesn’t cover the Part B deductible, allowing for the individual to pay the first $147 in medical expenses each year. Plan F on the other hand, provides “first dollar coverage” and pays the Part B deductible. Plan G has grown in popularity as more carriers have begun to offer it, and many at a discount compared to the Medicare Supplement Plan F they offered. Also, Plan G does not accept Guaranteed Issue enrollees allowing premiums to stabilize by keeping the less healthy individuals off of the plan. However, Plan F must accept all Guaranteed Issue enrollees without any underwriting.
In the debate to control Medicare costs, “first dollar coverage” has been blamed for higher utilization rates of the healthcare system. Plan F has been in the crosshairs of congress more than once due to the ACA (Affordable Care Act) and if not for the NAIC (National Association of Insurance Commissioners) may have already been on the chopping block. The belief that “first dollar coverage” leads to unnecessary medical care and providers to order unnecessary tests is wrong-minded. Multiple studies of Medicare cost-sharing have shown that imposing an increased cost-share would result in seniors reducing needed medical care at the onset of a medical problem leading to higher costs long term.
After cutting through the legal and political jargon, what is left is a bill in the US House of Representatives HR 1470 which proposes “first dollar coverage” be eliminated by prohibiting plans from covering the Part B deductible. This proposed change is only for retirees starting in 2020. However, as with other plans that have been eliminated, Medigap enrollees can expect their premiums to rise significantly if younger and healthier seniors are prevented from enrolling into their plan. This does not mean that a solution to the problem can’t be found, but if it is left up to Congress to solve I am not hopeful.
In closing, if you currently have a Plan F Medigap policy you should be able to keep your policy because it is guaranteed renewable. However, it may become so unattractive due to high premiums that you will wish you didn’t have a Plan F.
*note- Plan C Medigap is a “first dollar coverage” plan and would be affected too.
**UPDATE**
H.R. 1470 that was replaced by H.R. 2 – Medicare Access and CHIP Reauthorization Act of 2015 has passed the Senate and is on the way to the President’s desk where it is expected to be signed in to law. The law will be touted as fixing the doctor reimbursement problem in the media. However, this law will effectively end Medigap Plans F & C beginning for newly eligible Medicare beneficiaries on Jan 1st 2020. Existing Medigap Plan F & C owners will be allowed to retain their current coverage that will most likely be accompanied by substantial rate increases beginning in 2020. There will be time for this provision to be reversed. Prior attempts at passing similar legislation were unanimously opposed by all fifty State Insurance Commissioners regardless of political affiliation. Hopefully another update will be forthcoming.
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When Baltimore touts a life span in underserved communities 20-30 years shorter than in affluent it becomes the bellweather for what Affordable Care Act will be-----as Johns Hopkins and Maryland has excluded people from health care access by income for decades disregarding US Constitutional and Federal guidelines not allowing this.
The US has since Reagan/Clinton neo-liberalism been second world in its health care access and outcomes because of dismantled oversight and accountability and systemic corporate fraud and corruption in our health system that will now get worse with Affordable CAre Act.
'The U.S. ranking reflects poor scores on measures of healthy lives — "mortality amenable to medical care," infant mortality and healthy life expectancy at age 60'.
Health survey ranks U.S. last among rich peers
Michael Winter, USA TODAY 8:36 a.m. EDT June 17, 2014(Photo: M. Spencer Green, AP)
For the fifth time in a decade, the United States is the sick man of the rich world.
That's according to the latest Commonwealth Fund survey of 11 nations, which ranked the world's most expensive health care system dead last on measures of "efficiency, equity, and outcomes." So too in 2010, 2007, 2006 and 2004.
The United Kingdom got the golden apple for 2014, with Switzerland a close second.
The U.S. ranking reflects poor scores on measures of healthy lives — "mortality amenable to medical care," infant mortality and healthy life expectancy at age 60.
The highest U.S. score was a 3, for "effective care." The USA also outranked its peers on preventive care and on speedy access to specialists.
But the nation fares poorly on "access to needed services" and on getting prompt attention from primary care physicians.
The other eight countries surveyed were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway and Sweden.
What do the healthier cousins have that the United States does not? Universal health care, the Commonwealth Fund points out. Nonetheless, Canada limped just ahead of its southern neighbor in the survey.
"Other nations ensure the accessibility of care through universal health systems and through better ties between patients and the physician practices that serve as their medical homes," the fund writes in its summary.
Though the Affordable Care Act "is increasing the number of Americans with coverage and improving access to care," the latest survey relied on data from before the law was implemented fully. Still, the ACA "will further encourage the efficient organization and delivery of health care, as well as investment in important preventive and population health measures."
Some highlights:
U.S. physicians face particular difficulties receiving timely information, coordinating care, and dealing with administrative hassles. Other countries have led in the adoption of modern health information systems, but U.S. physicians and hospitals are catching up as they respond to significant financial incentives to adopt and make meaningful use of health information technology systems. ...
Disparities in access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home. ... Meanwhile, the U.S. has significantly accelerated the adoption of health information technology following the enactment of the American Recovery and Reinvestment Act, and is beginning to close the gap with other countries that have led on adoption of health information technology. ...
Many U.S. hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, but the U.S. can also learn from innovations in other countries—including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions. Based on these patient and physician reports, and with the enactment of health reform, the United States should be able to make significant strides in improving the delivery, coordination, and equity of the health care system in coming years. ...
The survey included questionnaires from patients and doctors, along with data from the World Health Organization and the Organization for Economic Cooperation and Development. It also contains results from recent Commonwealth Fund surveys of patients and primary care doctors and how they view their countries' health systems
I hear from Democratic voters all the time ----give Affordable Care Act time---it is a platform for single-payer and I understand ---there is another Democratic voter misled by a Clinton neo-liberal pol or outlet.
THE ONLY SINGLE-PAYER PLATFORM BEING BUILT IS A THIRD WORLD PREVENTATIVE CARE FOR ALL.
So, while Democratic voters tied to Clinton neo-liberals wait with held breathe for this platform----the Clinton/Obama neo-liberals are outsourcing all of Medicare and Medicaid to global corporations having no intent of oversight and accountability to US Constitutional and FEderal and state laws regarding public health.
Maryland dismantled it oversight decades ago---there is no state or local public health agency that monitors for Rule of Law Constitutional right and Federal and state law adherence. We simply have global corporations producing health data that says everything they are doing is giving good results. No stats on complaints----bad health outcomes----or lose of access.
All of this happens because of the President embracing that Federalism Act saying to states---GO AHEAD--DO WHAT YOU WANT ---- WE ARE NOT LOOKING.
There is nothing more Republican than the Federalism Act---and social democrats would not dismantle all oversight and accountability just to maximize corporate profits -----open the door to systemic corporate fraud -----and elimination of all US legal protections for citizens regarding health care.
Office of Inspector General
Report (OEI-09-12-00530)
04-11-2014
Offshore Outsourcing of Administrative Functions by State Medicaid AgenciesComplete Report
SummaryWHY WE DID THIS STUDY
Outsourcing occurs when State Medicaid agencies enter into agreements with contractors to perform administrative functions. Outsourcing can occur inside the United States (domestic outsourcing) or outside (offshore outsourcing) and can be direct (when a Medicaid agency contracts with an offshore contractor) or indirect (when a Medicaid agency's contractor subcontracts to an offshore contractor). There are no Federal regulations that prohibit the offshore outsourcing of Medicaid administrative functions. However, the Health Insurance Portability and Accountability Act (HIPAA) requires covered entities to have business associate agreements (BAAs) to protect personal health information (PHI).
HOW WE DID THIS STUDY
We conducted a survey of 56 Medicaid agencies, including those of the District of Columbia and the U.S. territories. We asked Medicaid agencies (1) whether they had any policies, Executive Orders, State laws, or contract requirements (collectively, "requirements") addressing the outsourcing of administrative functions offshore and (2) whether they directly or indirectly outsourced administrative functions offshore. For Medicaid agencies with outsourcing requirements, we asked whether these requirements address PHI and whether the Medicaid agencies monitor contractors' compliance with the requirements. We reviewed the Medicaid agencies' requirements and BAAs. For the Medicaid agencies that outsource offshore, we asked what types of administrative functions are outsourced offshore.
WHAT WE FOUND
Only 15 of 56 Medicaid agencies have some form of State-specific requirement that addresses the outsourcing of administrative functions offshore. The remaining 41 Medicaid agencies reported no offshore outsourcing requirements and do not outsource administrative functions offshore. Among the 15 Medicaid agencies with requirements, 4 Medicaid agencies prohibit the outsourcing of administrative functions offshore and 11 Medicaid agencies allow it. The 11 Medicaid agencies that allow offshore outsourcing of administrative functions each maintain BAAs with contractors, which is a requirement under HIPAA. Among other things, BAAs are intended to safeguard PHI. These 11 Medicaid agencies do not have additional State requirements that specifically address safeguarding PHI. Seven of the eleven Medicaid agencies reported outsourcing offshore through subcontractors, but none reported sending PHI offshore. If Medicaid agencies engage in offshore outsourcing of administrative functions that involve PHI, it could present potential vulnerabilities. For example, Medicaid agencies or domestic contractors that send PHI offshore may have limited means of enforcing provisions of BAAs that are intended to safeguard PHI. Although some countries may have privacy protections greater than those in the United States, other countries may have limited or no privacy protections.
This report does not contain recommendations.
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Clinton/Obama neo-liberals are laughing all the way to the bank as all the Federal structures for Medicare and Medicaid are dismantled----outsourced globally----with no intent of enforcing US Rule of Law for American citizens.
The only thought for global corporate pols is how to move all Federal funding for these Federal programs and Trusts to global corporations and which ones get to loot this revenue.
THAT IS ALL THAT GLOBAL POLS ARE THINKING REGARDING AFFORDABLE CARE ACT.
It's gone way beyond technology outsourcing----they are building all these technology connections to health care for the express action of outsourcing it overseas. There will be no ability of the public to monitor what is happening in these administrative systems......it will become just like global corporate customer service where you wait forever to get no information and the service was not good and the product defective.....ONLY THIS TIME IT IS YOUR HEALTH CARE.
As all corporate health care policies are eliminated and brought to this preventative care only-------even labor unions members with the best of health policies will fall into this same outsourced and predatory health care system.
The federal outsourcing boom and why it’s failing Americans
By Steven Pearlstein Columnist January 31, 2014 Washington Post
Two of the biggest news events of the past year have been the leaks about top-secret snooping by the NSA and the disastrous rollout of Obamacare. But in an important way, they are both manifestations of a story that has been unfolding for decades — that of a federal government that has outsourced too much of what it does to private contractors while allowing the quality of its own workforce to atrophy.
Lots of Americans were disturbed to learn from Edward Snowden that the government is keeping track of their every phone call and text message. But they might have also wondered why a 30-year-old government contractor in Honolulu, with security clearance that was approved by another private contractor, had routine access to some of the government’s most sensitive secrets. Even worse, two years after Pfc. Bradley Manning did the same thing, Snowden managed to download millions of pages of documents from a computer system designed and managed by private contractors without setting off a single alarm. The whole affair was an embarrassment to Washington’s government contracting sector.
Steven Pearlstein is a business and economics columnist who writes about local, national and international topics. View ArchiveSo, too, the fiasco with HealthCare.gov, which despite the bleating of Republicans has almost nothing to do with the wisdom of the new health-care law and everything to do with the way the government and its outside contractors set about implementing it. While several of the contractors failed to perform as promised, in hindsight it appears the government also made a crucial mistake in deciding to rely on the IT staff at the Centers for Medicare and Medicaid Services to manage the contractors and oversee the final integration of the new system. Free-market ideologues will reflexively see in this failure further evidence of the inherent inferiority of public-sector workers. In truth, it is evidence of how outdated civil service rules and ill-conceived caps on the size and pay of the federal workforce have eroded the government’s ability to perform even essential government tasks.
The federal government has long relied on outside contractors to provide it with weapons systems and other goods. But starting with the Reagan administration, there has been a determined shift of work from government employees to private contractors, on the theory that they could do it better and cheaper. For a time, that was true. Much of the early outsourcing was for lower-skilled clerical and maintenance functions for which government workers received pay and benefits well above the market rate. Or it was for the design and operation of new computer systems that automated the work of government and had never existed before.
But in recent years, much of the outsourcing has been driven by politics and ideology.
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To demonstrate their commitment to “shrinking” the size of the federal government, both Republican and Democratic politicians set about shrinking the federal workforce and then capping it at 2 million workers, despite continued growth in the economy, the size of the federal budget and demand for government services.
“This obsession with small government is a sham,” declares Daniel Gordon, who headed the Office of Procurement Policy in the first Obama term before joining the law faculty at George Washington University.
Not only are there caps on the number of government workers, but there are also caps on government pay that ignore the realities of the marketplace — and that, too, has driven the outsourcing trend. It may be politically popular in a country where median household income is $51,000 to require that no federal employee should be paid more than the $174,000 earned by a member of Congress, but it makes it pretty hard for the government to recruit and retain the lawyers and economists and biochemists and software engineers it needs when they can make double and triple that in the private sector. So it’s no surprise that the only way that government managers can fulfill their mission is to outsource its brains, shifting high-level work to private firms that have the flexibility to pay their workers market rates.
In the end, taxpayers are not only indirectly paying the higher salaries they refuse to pay directly to government employees — they also wind up paying for the contractors’ profit and the costs of winning and managing contracts.
Government employees, however, must also shoulder some of the blame for the outsourcing boom.
If you give federal managers the choice of filling vacancies from the candidates who emerge from the government’s arcane recruitment and promotion system (and who, once chosen, will be virtually impossible to fire if they don’t work out), or you gave them the choice of handpicking whomever they want and hiring them under an open-ended “umbrella” contract with a private firm (with the power to fire them at a moment’s notice), nine in 10 would hire the contractor. And that’s exactly why you now find so many contract employees in government offices working side by side with government employees.
The system the government uses to recruit, hire, evaluate and incentivize its employees is seriously broken. And yet every attempt to reform it is bitterly opposed by federal employee unions, who take it as their mission to prevent good employees from being rewarded and bad employees from being fired. The result is that the unions are protecting ever-fewer employees with ever-lower pay.
Those open-ended IDIQ (for “indefinite delivery, indefinite quantity”) contracts, by the way, now account for anywhere between one quarter and one half of all federal service contracting, according to Gordon. Originally, they were designed to allow agencies buy smaller quantity of standardized supplies, or respond to the occasional surge in workload, without having to go through the long and cumbersome process of letting a new contract. But now they are routinely used by agencies for orders worth hundreds of millions of dollars that involve no competition, little transparency and dubious savings.
These clever work-arounds to the government’s personnel and contracting systems have driven the rapid growth in government contracting, much of it here in the Washington region. Federal contracting grew from about $200 billion in 2000 to about $550 billion in 2011 before falling back to $450 billion last year. Sixty percent of that was for services. By some estimates, there are twice as many people doing government work under contract than there are government workers.
Against that backdrop, hardly anyone considered it remarkable that the government would have outsourced the day-to-day operation of its most secretive computer system to Booz Allen Hamilton, the agency’s leading contractor. Nor, during the homeland security push after 9/11, did anyone question why a company such as USIS, which was originally spun off from the government to do simple background checks for new employees at departments such as Agriculture and Education, should be doing investigations for top security clearances normally done by the FBI. After the Snowden affair, the government sued USIS, accusing the firm of pushing through clearances without sufficient investigation in order to qualify for performance bonuses.
And long before the botched rollout of Obamacare, even the Professional Services Council, the leading trade association for federal contractors, was complaining publicly that too many agencies lacked skilled workforce to manage the contracting process — in particular, contracts for complex new computer systems. Numerous agencies had turned to outside contractors to manage its outside contractors before Gordon issued an order in 2011 declaring contract management to be an “inherently government function” that should be done only by government employees.
What Snowden and HealthCare.gov have made clear is there is a limit to how much outsourcing can be used as a work-around to the problems of dysfunctional government. It’s time — actually, it’s way past time — to fix the underlying problems.
Up to now, the Obama White House has made the calculation that it’s not worth the political capital to take on the public employee unions over civil service reform, and its not worth the political risk of challenging the tea party Republicans to push for an increase in the size of the federal workforce. Given what’s happened, maybe it’s time to recalculate.
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“Medicare is a highly effective key part of Australia’s great public health system, yet this government is determined to dismantle it and sell the profitable bits to its big business mates,” Ms Flood said “It is absolutely shocking.” SAME THING HAPPENING IN US----DO YOU HEAR ABOUT THIS?
In dismantling all of the public health structures at Federal, state, and local levels there goes more of the public sector and with it the public sector unions.
Who supports Clinton/Obama neo-liberals every election? National labor union leaders supporting union-busters.
All of these jobs lost are leaving the nation as with all private sector downsizing----they are doing the same NAFTA overseas expansion of private corporations now with our government sector -----all controlled by global corporations. When Wall Street shouts----CORPORATIONS ARE NOW IN CHARGE OF AMERICA---THIS IS WHAT THEY MEAN.
Social Democrats want to not only rebuild public health oversight and accountability and public hospitals and clinics----it wants to expand Medicare ----meaning no 20% deductible -----everyone in for all health care and no one out. This has nothing to do with the Affordable Care Act hand-off of our entire health system to global corporations led by global health insurance corporations deciding how to bring corporate profits higher by predatory structures and denying access to 90% of Americans to most ordinary health care.
Below you see an article by Australian public sector unions that you see little of in the US and the same thing is happening.
Medicare outsourcing could cost 20,000 jobs: CPSU
By Julian Bajkowski on August 11, 2014
The Community and Public Sector Union has taken a flamethrower to plans to scope-out the potential for outsourcing Medicare claims and payments processing, warning that tens of thousands of jobs are at risk.
As industrial tensions continue mount across the wider public service, the sector’s main union has branded the market testing exercise an attempt to “sell off” jobs and “outsource Medicare payments to big business.”
Although it is more likely the Abbott government is trying to eliminate APS jobs rather than go through the more expensive and less appealing option of trying to sell them, Health Minister Peter Dutton’s attempt to update and get Medicare’s technology infrastructure in order is ringing big alarm bells.
“This outrageous move could cut up to 20,000 public service jobs, most in regional and suburban Australia where jobs have already been hit hard,” National Secretary Nadine Flood said, adding the majority of Medicare’s staff “are women on an average salary of $63,000 a year and based mainly in suburban and regional areas.”
“These are not highly-paid fat cats, they are mostly mums and dads on average wages who will struggle to find alternative jobs in areas where jobs are scarce, particularly the thousands of them working in regional Australia.”
Health Minister Peter Dutton has made assurances that Medicare’s counter services are not in the frame for outsourcing under the EOI, however the paucity of detail has continued to feed into fears the present round of 16,500 APS job cuts could be the tip of the iceberg.
“Medicare is a highly effective key part of Australia’s great public health system, yet this government is determined to dismantle it and sell the profitable bits to its big business mates,” Ms Flood said “It is absolutely shocking.”
She accused the government of using stealth tactics to pursue a privatisation agenda without telling the community of public servants.
“They’re doing it without a word to the community or to thousands of Medicare workers whose jobs are in the firing line. The first we hear of this is a tender to sell off Medicare. This is a nasty, sneaky move by the Abbott Government,” Ms Flood said.
“Australians are wary about privatisation because so often they pay more and get less. The last place we want that to happen is with something as important as Medicare.”
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Remember, the Affordable CAre Act is a Republican policy written to deregulate and privatize all of Federal public health and Trusts like Medicare and Medicaid. THESE POLICIES WERE WRITTEN IN REPUBLICAN THINK TANKS.
So, Obama as a Clinton neo-liberal does not care if ACA is given the name ObamaCare because neo-liberals are Republicans wanting to kill the Democratic Party and want Democrats to think their party is doing this----NOT REPUBLICANS.
No matter how you slice the data-----almost $1 trillion dollars was cut from Medicare and Medicaid since 2010. The only changes from below came when the supposed cuts from private, corporate Medicare Advantage disappeared. All cuts for public Medicare installed------cuts for private corporate Medicare removed. This happens all along the Affordable CAre Act passage......every policy shouted as making corporations pay their fair share vanishes as ACA is rolled out.
Absolutely no discussion has happened yet in the US over these policies. Federal Congressional neo-liberals simply tell their state assembly pols to pass all the privatization policies by state and then the same told to local city halls and THEY JUST DO IT----NO QUESTIONS ASKED.
We have statewide elections in which health care is never mentioned---all candidates do is shout the same ----WE ARE FOR THE COMMUNITIES.
Most candidates at local level do not know public policy---they depend on a mayor or state assembly person to tell them what to do. In Maryland, neo-conservative Johns Hopkins writes all health policy adopted with no discussion at all levels of government.
How ObamaCare Guts Medicare
The president's pledge that 'If you like your health plan, you will be able to keep it' clearly does not apply to America's seniors.
By
Peter Ferrara And Larry Hunter
Updated Sept. 9, 2010 12:01 a.m. ET The Democratic Senatorial Campaign Committee has attacked Senate Republican candidates for wanting "to end Medicare as we know it." And in Nevada's hotly contested Senate race, Majority Leader Harry Reid is attacking Republican Sharron Angle, saying she wants to "gut" Medicare. But Mr. Reid has already gutted it. He and his colleagues did so by passing ObamaCare.
Senior Editorial Writer Joseph Rago explains the increase in insurance premiums. Columnist Mary Anastasia O'Grady and John Fund, an OpinionJournal.com columnist, critique the President's plan.In his analysis accompanying the recently released Annual Report of the Medicare Board of Trustees, Richard Foster, Medicare's chief actuary, noted that Medicare payment rates for doctors and hospitals serving seniors will be cut by 30% over the next three years. Under the policies of the Patient Protection and Affordable Care Act, by 2019 Medicare payment rates will be lower than under Medicaid. Mr. Foster notes that by the end of the 75-year projection period in the Annual Medicare Trustees Report, Medicare payment rates will be one-third of what will be paid by private insurance, and only half of what is paid by Medicaid.
Altogether, ObamaCare cuts $818 billion from Medicare Part A (hospital insurance) from 2014-2023, the first 10 years of its full implementation, and $3.2 trillion over the first 20 years, 2014-2033. Adding in ObamaCare cuts for Medicare Part B (physicians fees and other services) brings the total cut to $1.05 trillion over the first 10 years and $4.95 trillion over the first 20 years.
These draconian cuts in Medicare payments to doctors, hospitals and other health-care providers that serve America's seniors were the basis for the Congressional Budget Office's official "score"—repeatedly cited by the president—that the health-reform legislation would actually reduce the federal deficit. But Mr. Obama never disclosed how that deficit reduction would actually be achieved.
There will be additional cuts under ObamaCare to Medicare Advantage, the private option to Medicare that close to one-fourth of all seniors have chosen for their coverage under the program because it gives them a better deal. Mr. Foster estimates that 50% of all seniors with Medicare Advantage will lose their plan because of these cuts. Mr. Obama's pledge that "If you like your health plan, you will be able to keep it" clearly does not apply to America's seniors.
Moreover, there will be additional cuts to Medicare adopted by bureaucrats at the Medicare Independent Payment Advisory Board. ObamaCare empowers this board to close Medicare financing gaps by adopting further Medicare cuts that would become effective without any congressional action. Mr. Foster reports that "The Secretary of HHS is required to implement the Board's recommendations unless the statutory process is overridden by new legislation."
The drastic reductions in Medicare reimbursements under ObamaCare will create havoc and chaos in health care for seniors. Many doctors, surgeons and specialists providing critical care to the elderly—such as surgery for hip and knee replacements, sophisticated diagnostics through MRIs and CT scans, and even treatment for cancer and heart disease—will cease serving Medicare patients. If the government is not going to pay, then seniors are not going to get the health services, treatment and care they expect.
Mr. Foster reports that two-thirds of hospitals already lose money on Medicare patients. Under ObamaCare it will get much worse. Hospitals also will shut down or stop serving Medicare patients.
The president's concept of spreading the wealth includes sacking the Medicare system, on which America's seniors have come to rely for medical care, in favor of others the president's progressive vision deems more worthy.
Everyone should know by now that Medicare suffers dramatic long-term deficits and unfunded liabilities, and is in need of fundamental, structural reforms. But effectively refusing to pay the doctors and hospitals that provide the medical care the program promises to seniors is no way to solve that problem.
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As I said earlier-----Kaiser of California has a long history as an HMO now ACO and with that a long history of serious consumer complaints. It is the ACO model that simply went national with Affordable Care Act. In Baltimore, TV advertisements are pounding people with ads to drive seniors to these private Medicare plans with all kinds of private corporate structures that we now have to go to to know which in several listings of Medicare choices are best for us.
Medicare is one Federal program that every senior gets the same coverage and access according to Federal and Constitutional law. It is simple----you hit an age and you sign up for Medicare and you get good health care. IT WORKED FINE FOR DECADES EXCEPT FOR THE CORPORATE FRAUD AND PROFITEERING.
We know that when corporations outsource Medicare and Medicaid it will be corporations like Kaiser that does this. At the same time it is Kaiser that gives us all the data saying how good these HMO/ACOs are for saving money and giving INDIVIDUALIZED care.
IT IS ONE GREAT BIG SCAM JUST LIKE THE WALL STREET COMPLEX FINANCIAL INSTRUMENTS WITH THE SAME GOAL OF MOVING MONEY WHILE BEING PREDATORY AND CORRUPT.
This is the partnership we have in Maryland and especially Baltimore as neo-conservative Johns Hopkins joins this national HMO/ACO and goes global. What happens when Federal Medicare ends under Clinton neo-liberals? Seniors simply are pooled into these ACOs and given whatever access to care that ACO wants----regardless of what Federal Medicare and Constitutional rights to health care are.
Note below where this article states------just because a monthly premium is $0----does not mean it is not equivalent with Federal Medicare. THIS IS KAISER'S BIG SELL IN IT MEDICARE ADVANTAGE PLANS----$0 DEDUCTIBLES THAT ARE REALLY NO DIFFERENT THAN FEDERAL MEDICARE.
There is absolutely no one defending Federal Medicare or educating that these global pols and ACA policies seek to end our Federal public health.
Kaiser Permanente Medicare Advantage Plus Prescription Drug Plans
The following Kaiser Permanente plans offer Medicare Advantage and Part D coverage to California residents. Medicare Advantage plans, also known as Medicare Part C, are alternatives to original Medicare. These plans help cover the costs of services provided by hospitals, doctors, lab tests and some preventive screenings. These plans' Part D component helps cover prescription drugs. Even if a plan's monthly premium is $0, you would still pay the equivalent of the original Medicare premium. Not all plans shown here will be available to you; enter your zip code to see plans in your area.
You can read about whether Medicare Advantage is right for you. If you only want plans with drug coverage, browse Prescription Drug (Part D) Plans.
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Below you see the insanity that is simply global corporate pols working together to end public subsidy in health care. The idea that we need so many kinds of Medicare-----so many kinds of Medigap is what deregulates what Federal and Constitutional Medicare is.
As this concerned citizen is relating------it appears Obama and neo-liberals are creating conditions for those having Medigap from continuing to get it-----and to end access to all American citizens.
THIS WILL BE THE END OF ACCESS TO MEDICARE FOR MOST AMERICANS AS PEOPLE CANNOT AFFORD 20% OF MEDICARE DEDUCTIBLES AND CO-PAYS SO WILL NOT BE ABLE TO ACCESS MEDICARE.
Again, even the upper-middle class who are now being made to think they will be able to access Medicare are watching as health care prices soar-----and you know what? THERE WILL BE NO MEDICARE OR MEDICAID----ONLY A GUTTED OF FUNDING MEDICAID OR ALL.
'H.R. 1470 that was replaced by H.R. 2 – Medicare Access and CHIP Reauthorization Act of 2015 has passed the Senate and is on the way to the President’s desk where it is expected to be signed in to law. The law will be touted as fixing the doctor reimbursement problem in the media. However, this law will effectively end Medigap Plans F & C beginning for newly eligible Medicare beneficiaries on Jan 1st 2020'.
Will I lose my Medigap Plan F?March 31, 2015Will I lose my Medigap Plan F?
Since Congress Standardized Medigap plans in 2010, which increased the benefit for Excess Charges and added a Hospice benefit to Medicare Supplement Plan G, a common debate over whether Plan F is better than Plan G ensued. The only real difference is who would pay the $147 Part B deductible for the Medicare recipient. Plan G doesn’t cover the Part B deductible, allowing for the individual to pay the first $147 in medical expenses each year. Plan F on the other hand, provides “first dollar coverage” and pays the Part B deductible. Plan G has grown in popularity as more carriers have begun to offer it, and many at a discount compared to the Medicare Supplement Plan F they offered. Also, Plan G does not accept Guaranteed Issue enrollees allowing premiums to stabilize by keeping the less healthy individuals off of the plan. However, Plan F must accept all Guaranteed Issue enrollees without any underwriting.
In the debate to control Medicare costs, “first dollar coverage” has been blamed for higher utilization rates of the healthcare system. Plan F has been in the crosshairs of congress more than once due to the ACA (Affordable Care Act) and if not for the NAIC (National Association of Insurance Commissioners) may have already been on the chopping block. The belief that “first dollar coverage” leads to unnecessary medical care and providers to order unnecessary tests is wrong-minded. Multiple studies of Medicare cost-sharing have shown that imposing an increased cost-share would result in seniors reducing needed medical care at the onset of a medical problem leading to higher costs long term.
After cutting through the legal and political jargon, what is left is a bill in the US House of Representatives HR 1470 which proposes “first dollar coverage” be eliminated by prohibiting plans from covering the Part B deductible. This proposed change is only for retirees starting in 2020. However, as with other plans that have been eliminated, Medigap enrollees can expect their premiums to rise significantly if younger and healthier seniors are prevented from enrolling into their plan. This does not mean that a solution to the problem can’t be found, but if it is left up to Congress to solve I am not hopeful.
In closing, if you currently have a Plan F Medigap policy you should be able to keep your policy because it is guaranteed renewable. However, it may become so unattractive due to high premiums that you will wish you didn’t have a Plan F.
*note- Plan C Medigap is a “first dollar coverage” plan and would be affected too.
**UPDATE**
H.R. 1470 that was replaced by H.R. 2 – Medicare Access and CHIP Reauthorization Act of 2015 has passed the Senate and is on the way to the President’s desk where it is expected to be signed in to law. The law will be touted as fixing the doctor reimbursement problem in the media. However, this law will effectively end Medigap Plans F & C beginning for newly eligible Medicare beneficiaries on Jan 1st 2020. Existing Medigap Plan F & C owners will be allowed to retain their current coverage that will most likely be accompanied by substantial rate increases beginning in 2020. There will be time for this provision to be reversed. Prior attempts at passing similar legislation were unanimously opposed by all fifty State Insurance Commissioners regardless of political affiliation. Hopefully another update will be forthcoming.
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When Baltimore touts a life span in underserved communities 20-30 years shorter than in affluent it becomes the bellweather for what Affordable Care Act will be-----as Johns Hopkins and Maryland has excluded people from health care access by income for decades disregarding US Constitutional and Federal guidelines not allowing this.
The US has since Reagan/Clinton neo-liberalism been second world in its health care access and outcomes because of dismantled oversight and accountability and systemic corporate fraud and corruption in our health system that will now get worse with Affordable CAre Act.
'The U.S. ranking reflects poor scores on measures of healthy lives — "mortality amenable to medical care," infant mortality and healthy life expectancy at age 60'.
Health survey ranks U.S. last among rich peers
Michael Winter, USA TODAY 8:36 a.m. EDT June 17, 2014(Photo: M. Spencer Green, AP)
For the fifth time in a decade, the United States is the sick man of the rich world.
That's according to the latest Commonwealth Fund survey of 11 nations, which ranked the world's most expensive health care system dead last on measures of "efficiency, equity, and outcomes." So too in 2010, 2007, 2006 and 2004.
The United Kingdom got the golden apple for 2014, with Switzerland a close second.
The U.S. ranking reflects poor scores on measures of healthy lives — "mortality amenable to medical care," infant mortality and healthy life expectancy at age 60.
The highest U.S. score was a 3, for "effective care." The USA also outranked its peers on preventive care and on speedy access to specialists.
But the nation fares poorly on "access to needed services" and on getting prompt attention from primary care physicians.
The other eight countries surveyed were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway and Sweden.
What do the healthier cousins have that the United States does not? Universal health care, the Commonwealth Fund points out. Nonetheless, Canada limped just ahead of its southern neighbor in the survey.
"Other nations ensure the accessibility of care through universal health systems and through better ties between patients and the physician practices that serve as their medical homes," the fund writes in its summary.
Though the Affordable Care Act "is increasing the number of Americans with coverage and improving access to care," the latest survey relied on data from before the law was implemented fully. Still, the ACA "will further encourage the efficient organization and delivery of health care, as well as investment in important preventive and population health measures."
Some highlights:
U.S. physicians face particular difficulties receiving timely information, coordinating care, and dealing with administrative hassles. Other countries have led in the adoption of modern health information systems, but U.S. physicians and hospitals are catching up as they respond to significant financial incentives to adopt and make meaningful use of health information technology systems. ...
Disparities in access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home. ... Meanwhile, the U.S. has significantly accelerated the adoption of health information technology following the enactment of the American Recovery and Reinvestment Act, and is beginning to close the gap with other countries that have led on adoption of health information technology. ...
Many U.S. hospitals and health systems are dedicated to improving the process of care to achieve better safety and quality, but the U.S. can also learn from innovations in other countries—including public reporting of quality data, payment systems that reward high-quality care, and a team approach to management of chronic conditions. Based on these patient and physician reports, and with the enactment of health reform, the United States should be able to make significant strides in improving the delivery, coordination, and equity of the health care system in coming years. ...
The survey included questionnaires from patients and doctors, along with data from the World Health Organization and the Organization for Economic Cooperation and Development. It also contains results from recent Commonwealth Fund surveys of patients and primary care doctors and how they view their countries' health systems
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