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April 27, 2015

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Letter to the editor:

Target the root of Medicare problem

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Some in Washington would rather cut Medicare benefits than solve the real issue driving the rising cost of Medicare, which is the skyrocketing cost of health care.

This is like a doctor only treating symptoms of an illness instead of the root cause. It is very troubling that some members of Congress would raise the eligibility age or propose other cuts in benefits rather than address the inflated costs, waste and lack of coordinated care in fee-for-service medicine.

Medicare is an earned benefit. We pay into it our entire working lives, and we continue to pay premiums, co-pays and deductibles toward our care.

If Congress took meaningful action to control systemwide health care costs and built on the savings gained through health care reform, the nation’s finances and Medicare stability could prevail.

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  1. I thought President Obama said that health care costs would go down under Obamacare? Did he lie? Or was he just wrong? Or both?


  2. The root of the Medicare cost problem is our health insurance system that requires us to pay $1 in premiums to get 80 cents worth of healthcare benefits. Every other industrialized country in the world has universal health care and spend much less, as a percentage of their GDP, than we do.

    A single payer plan is what we need, But no! We're Americans and we're much too clever for that. Maybe we need a cure for stubborness or stupidity before we can get a handle on health care costs.

  3. Yeah, we need more government intrusion into the market place. That's the answer, NOT! An entity that is spending itself into oblivion (and taking all of us along for the ride) is surely not one I'd trust to look to for answers on how to economize! Only the kooks on the left seem to be unable to put 2 & 2 together and come up with 4.

  4. Many of us dissatisfied with the ACA hoped to have a single payer "Medicare for All" as the basic health plan with the option of purchasing an Advantage or Supplemental plan as well. Instead we got the ACA, written and delivered by the insurance companies, their lobbyists and pet representatives. From every perspective, from cost to national security, universal coverage makes sense. What does not make sense is putting that in the hands of private industry.

  5. I can honestly say that in my own personal case, Medicare has been billed for well over $100,000 of total WASTE...unneeded meds and the last 5 years. There are many detailed examples but the cutest is one of the smallest rip offs in dollar terms. I have had sleep apnea for 25 years. Awhile ago the filter to my CPAP machine fell apart. It was plain sponge rubber about 1/4"x1/2"x1". Best price on-line...$17.50. But wait, it is not legal to buy medical equipment without a prescription, even if you offer to pay for it yourself. You can only get a prescription from a Doctor. Cost of visit, over $100. THEN they can ship and bill Medicare. I bought an 8"x10" sheet of sponge rubber at a frame shop for $3 and cut the new filter myself. I now have 159 more of them which I think I can sell on-line. I believe they will fetch close to $3000. lol.
    The point is clear...government can't figure out how to do ANYTHING efficiently, and American businesses WILL not do it cheaply if they can get away with 100,000% markup pricing. Democrats blame the greedy, Republicans blame government (mostly if there is a Dem. in the White House). How are we going to fix this mess with the 3 Stooges in charge...Incompetent Bureaucrats, Greedy Capitalists and Looney Voters who can only spout their party dogma.
    O.D. Nelson

  6. Too bad for profit health care is more interested in profits than health care Carmine.

  7. I'm sure the letter writer is correct about inflated costs being a problem with affordable health care.
    As a Canadian living in a country with a universal health care plan, I certainly believe that our system is immeasurably superior to yours.
    Having said that, the cost of medical care is surging in Canada as well, and with an aging population, it is inevitable that our wonderful system will continue to erode away. There are just too many senior citizens (I'm one of them) and the cost to keep them as healthy as possible, or at least alive, during the later years of their lives is a burden that under any capitalistic or socialistic system is impossible to bear.
    As time progresses only the rich in either of our countries will be able to obtain complete health care late in life. The rest of us will have to accept that expensive tests and operations are necessarily reserved for the young and the rich.
    Get used to it!

    Donald Desaulniers

  8. "Too bad for profit health care is more interested in profits than health care Carmine." @ Mark Schaffer

    Tell that to the Nevada Cancer Insitute:

    "Its fate soured when the institute -- struggling with raising money -- filed for Chapter 11 bankruptcy last year and was bought out by UC San Diego.

    In a letter statement sent out by UC San Diego -- it said it was trying to come up with ways to keep it open.

    UC San Diego's statement said it had been trying to partner with another cancer center in town to stay afloat but says it was instead blocked by its current buildings owners, leading to their decision.

    In addition to the 350 patients, 75 employees have been given notice and are being offered severance packages."


  9. So lets eliminate MEDICAID. Those who are constantly "in need" can rely upon their churches and communities. States and local governments already provide free clinics, vaccines; non-profits offer free mammagrams and such. We see endless news coverage of free dental care (paid for by paying patients). NO ONE is entitled to medicaid. Those truly "in need" generally qualify for SSI, SSDI (and get Medicare), comparable disability for government "the need" just should not be the enormous amounts we pay into medicaid.

  10. rusty57,

    You gave an example of a psychiatrist's visit to a patient in a nursing home.

    I would like to ask you to state who requested the visit and why?

    What were the questions?

    How do you know what the the amount of the bill?

    What were the detailed services charged for by the psychiatrist?

    These are all crucial questions to understanding what was taking place. Without this information, which is subject to the HIPPA regulations, nobody, including you, can know the facts related to the patient or visit.

    Your example is worth nothing as stated.

    However, I am not stating that excessive charges were not involved. This is one of the problems with allowing providers to charge what they want, without regulations to control costs.

  11. There are several Medicare problems. The one driving the debt crisis is that Medicare pays far more than it takes in both due to the baby boomer retirement problem and its inherent flawed design pricing. I concede that many and maybe most Americans want it to continue and ideas of raising the retirement or enrollment age won't fly. Step one to redesign Medicare should be to be honest and tell us at what taxation level it will be sustainable. Will 8% do it or 10%?, 15%, or what? Once that is established we all will have both the incentive to reduce costs to save ourselves money. Further cost trimming will be more politically acceptable. I agree with PISCES41 that we shouldn't be satisfied with 80 cents of healthcare for our dollar which is what any insurance offers at best. I also disagree with anyone touting the mythical "single payer system" as a cure-all. Our government at least federally is inept at management and we would soon want the 80 cents on the dollar plan back. Lastly, the ACA is a foolish plan as it guarantees an insurer mandated customers, all overhead paid out of premiums and a profit of 15%, not just on their investment which is minimal but on the total cash flow. Giving any agent 15% of our entire health care budget is ludicrous.

  12. I recently had a knee replacement operation, spent 10 days in the hospital, and when the bills came in, I was overwhelmed with the bills. Doctors I had never heard of billing me for visits that never happened. Thank God I had a Medicare Supplement plan. Just got a bill from Humana that my premium is going up to $240 a month from $180 a month. Pack of thieves, all of them. May they rot in Hell.

  13. Roslenda,

    Medicaid is needed for SSI/SSDI recipients waiting to qualify for Medicare (30 months). For those who don't qualify, and are still in need of healthcare assistance, Medicaid is the only option.

    Medicaid also is needed for emergency healthcare for those who don't qualify for any program and who have insufficient funds. To deny people healthcare is inhumane, plus it would make it impossible for hospitals to absorb the costs if they were transported to a hospital.

    The only solution that covers your statement is to change the laws and leave people to die where they fall, or are dropped off, if they have no insurance coverage. Their death could take some time, so the streets might be littered with moaning dying and ill people, vomit, blood and feces. The streets could become a source of spreading infections to the healthy. That would be a very good image of the US to present to the world.

    Our healthcare system does need reform, and the best solution is one that rolls all the various programs into one universal healthcare system, with the needed cost, quality care, and fraud controls.

    In all government contracts, providers need to live within the cost controls that should be established. It isn't just people in need who must live ethical lives, businesses need to do the same. Adjusting to ethical values may take some effort for some, but in time they will become the norm.

    I think the term "entitlements" is a convenient term that separates humane and humanity from the discussion. Any term that causes people to be disassociated from the thought process in consideration of issues could be considered inhumane and unjust.

  14. There are many examples from people across the Internet and here of how there were charges that they couldn't explain related to doctor visits, and more.

    This comes from a lack of knowledge of how the hospitals and doctors have contracts to provide services, and the doctors bill separately for their part of the professional services as opposed to the technical component that is the hospital part.

    One could go for a radiological study, and the contracting physician reads the x-rays, etc., and dictates the report, then bills the patient. The hospital bills for the technical component, which includes use of the equipment, and which is included in the hospital bill. This same thing occurs in some laboratory, and other diagnostic procedures.

    Sometimes, you will get a bill from an assistant surgeon whom you never saw when you were conscious, but is required for the surgery.

    Call the billing hospital or physician if you don't understand the bill. They can usually explain what the charges were for and when.

    The amount charged is a combination of what the doctor chooses to charge and any insurance or program controls that involve profiling the charges to establish the UCR payment. The initiator of it all is the provider who has no controls and often overcharges to establish a higher profile payment down the line. That is the terrible game.

  15. Single payer universal healthcare works better than what we have now.

    One example:

  16. Medicaid is NOT needed. Emergency care is available whether or not you can pay--just ask the illegals.

  17. Health Care in Israel is Universal and participation in a medical plan is mandatory. As a result, their medical costs are about 1/2 of those in America.

    One of the reasons that health care is so expensive here is because it is a profit based industry. CEOs of health plans have been able to afford Zoos in their backyards. This results in the loss of affordable medical care to millions.

    Romney thought Israel's health care system was a great success - but not the kind we need in America. Thanks to the for profit medical industry, Romney's business associates live a wonderful life off the pain and misery of so many others and in spite of this misery, he is able to receive forgiveness from on High because of tax deductible cash donations to his church. Hallelujah, the choir has risen.

  18. @Peacelilly (re post at 5:55pm 2/3)

    Thank you for that informed post. Again, Roselenda exhibits her lack of knowledge regarding Medicare and Medicaid. At some point, even SHE will need to be on Medicaid once her personal stash of money is exhausted if she is struck down with a debilitating illness.

    And re your 6:15pm post: EVERYONE should go over ANY bill they receive from the doctor, hospital, etc. IF you can't do it yourself, have someone help you with it. That is why it is always best to never go to appointments alone; at least there is another person there to see what is going on and to ask questions; and for hospital stays, again have someone BE THERE as much as possible to see what is happening, even if they have to check your chart to see what is going on and to ask questions.

  19. @Roselenda (re post at 8:06pm 2/3)

    Medicaid is MORE than just emergency care. Give up already while you are ahead - even if it is only a half a step ahead. But I see no possibility that you may actually understand someday what Medicaid is.

  20. Munch: The part of medicaid I dislike most or almost most is that some to many use "health care" to provide the nurturing they are not getting from relationships. I have a friend who's addicted to uppers--RX's been paid for my medicaid for years and years.

    Not sure what you're misreading, Munch, but OTHER people argue that providing more than emergency care results in less costs--but that's not how it's working. Doctors and seeing and reseeing people over and over again but not obtaining healthy results.

  21. CarmineD (Carmine DiFazio) writes "I thought President Obama said that health care costs would go down under Obamacare? Did he lie? Or was he just wrong? Or both?"

    Or neither, Carmine. After all the Affordable Care Act doesn't take full effect until next year. Probably best to wait until it's fully installed before using this type of gripe.

    Rusty57 writes "Death panels. Rationing. It's coming."

    Wrong, Rusty. It's been here for decades. Organized and run by your friendly local insurance company for the sole benefit of their bottom line. Have liver cancer? Sorry. Not covered. You failed to disclose that hangnail you had 25 years ago. Besides, even if you had disclosed, your limit now is just what it was 25 years ago - $5000. Of course your deductible, $250 then, has been adjusted for inflation and is now $7500.

    PISCES41 (Jim Weber)writes: "The root of the Medicare cost problem is our health insurance system that requires us to pay $1 in premiums to get 80 cents worth of healthcare benefits."

    Not quite, Jim. The requirement that insurance companies must spend at least 80% of their premium dollars on actual care was part of the Affordable Care Act and took effect just recently. Until that time the ground was the limit. Nothing forbade a company from spending only 5% - or even less - of our premium dollars on actual care. Those were the "good old days" when we'd pay $1 and might actually get a dime's worth of benefits.

    The "Good Ole Days!! They were AWFUL!

  22. "Or neither, Carmine. After all the Affordable Care Act doesn't take full effect until next year. Probably best to wait until it's fully installed before using this type of gripe." @ Robert Leavitt

    Generally, I would agree. BUT....ALL experts in the health care field, who are knowledgeable of costs, say with almost 100 percent certainty that Americans can expect health care costs, EVEN MEDICARE and MEDICAID, to rise precipitously with Obamacare. If you can quote comparable sources otherwise, please do. I'll be happy to reconsider.


  23. FYI Robert Leavitt:

    "Remember when the President promised that Obamacare would reduce the cost of health insurance? "Under [our] plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year," said Obama in 2008. The law, like Romneycare in Massachusetts, would magically eliminate the mythical "free-rider problem" by massively subsidizing health spending for the lower middle class.

    Well, the Office of the Actuary in the Centers for Medicare and Medicaid Services recently put out its annual projections of national health care spending. And, contrary to the President, the actuaries find that Obamacare will dramatically increase the near-term growth rate of health care costs. In 2014, the actuaries find that growth in the net cost of health insurance will increase by nearly 14 percent, compared to 3.5% if PPACA had never passed. The growth rate of private insurance premiums will rise to 9.4 percent, from 5.0 percent under prior law: an 88% increase."

    This article, by a recognized authority in the field, is one of hundreds like it. Feel free to research for yourself.