Medicare celebrated its 45th birthday last week. There were parties around the country and, while I don't know if people brought presents, health care reform is kind of a gift for Medicare. The Medicare Trustees issued their annual report this week and said Medicare is on sounder financial footing -- by 12 years -- than it was a year ago. Seniors who fall in the prescription drug donut hole can now get rebates to help with the cost of their prescriptions; next year they'll get 50% discounts on those prescriptions. Also next year, preventive care like mammograms and physicals will be free for seniors.
President Obama used his weekly address to talk about Medicare and how health care reform has strengthened it.
And as reform ramps up in the coming years, we expect seniors to save an average of $200 per year in premiums and more than $200 each year in out of pocket costs, too.
... we are no longer accepting business as usual. We’re making tough decisions to meet the challenges of our time. And as a result, Medicare is stronger and more secure.
That's a good thing, and something you'll never hear from the Republicans who are more interested in talking down Medicare and Social Security than improving them.
Alabama Democrats shouldn't run against health care legislation. The DNC has a new ad and each bullet point hits yet another key demographic. Explanations after the jump:
Most of the focus has been on the advice Rep. Alan Grayson (D, FL) offered to Dick Cheney -- STFU -- and, hilariously, Matthews either didn't or pretended he didn't understand what that meant. That's the last part of this segment, but this video also captures the earlier, equally interesting if less entertaining portion.
The first thing I noticed is that Grayson seems generally pleased with the Senate proposal on health care reform and confident there will be a bill on the way to signature before Christmas. Finally! He makes a great point that the Medicare infrastructure could readily be used for everyone and we're wasting that provider network by making it available only to seniors. He also restated, "What I want is the Medicare provider network available for everybody. If we had medicare for everybody I'd be fine with that, but what I really want above all is health care for everybody.
I think that's what most of us really want, at bottom. Maybe we'll get there eventually. Now for the "what is a Progressive" bit:
Matthews: Are you a Progressive?
Grayson: Yes.
Matthews: OK, Progressive means getting there one step at a time, doesn't it?
Grayson: Well we're making progress, that's true.
Matthews: A Radical is somebody who wants everything the way they want it now. That's what a Radical is. A Progressive is somebody that moves along step by step so that everybody can get aboard so that we have a democratic process that get's aboard ... this new change we're getting into.
What do you think of those definitions of Progressive vs. Radical?
Republicans have never liked Medicare and would like nothing better than to dismantle it -- which is pretty ironic since their whole health care town hall campaign has been about firing up senior citizens to make sure they vote in 2010. Here's Jeff Sessions at a town hall last week weaseling on the question of whether he would introduce a bill to repeal Medicare.
Jonathan Alawine, a USA student, asked Sessions if he would introduce a bill to repeal Medicare as a way to reduce government spending on health care.
"It's a fair question," Sessions said, adding that senior citizens are getting the benefits they have already paid for. "Some people have planned their lives around Medicare. I don't think it's a smart thing for us to try to do."
The straightforward answer would have been "I oppose any attempt to repeal Medicare," but instead Sessions noted that the idea is not politically smart. That's because he'd be more than happy to repeal Medicare (and Social Security, too) if his party didn't desperately need senior's votes next year. Older Americans are the only voting demographic that might stave off Republican irrelevancy for a few years. How ironic that GOP success depends on senior citizens, the very group with the most to lose should Republicans succeed in dismantling the social safety net.
We are coming down to the home stretch on healthcare, and we have seen the results of the first couple of rounds of crazy that have been sent forth in an effort to stop the process.
In addition to the Town Halls, opponents are flooding the email inboxes of America's "low information" voters with no end of lies. Those emails are getting passed around and around and around, and by now some of them have probably appeared in your inbox.
But it's summer...and who has time to respond to this stuff?
Well, guess what, Gentle Reader: I've already done the hard work for you.
Today's story is an email response that you can send right back to your "inbox friends". It's a reminder of some of the frustrations that we all share in this country and some explanations of what's being proposed...and a few words about socialism, to boot.
So get out there and copy and paste and forward and reply, and let's see if we can't fight the madness, one email at a time.
That's Do Not Resuscitate, for those who don't do hospital speak. It's frequently ignored, but the health care reform we need is critical to the long term health of Medicare (and Medicaid) because out of control costs are driving that program into the red. [Update: I photographed this sign today in Madison, a bastion of knee-jerk conservatism. Reckon they mean NO Medicare, NO VA care, NO Medicaid, NO SCHIP and NO Tricare?] Here's Leo Gerard on the GOP Just Say No plan:
Immobility is exactly what Republicans want, however. "No change" is their slogan. They've offered zero substantive reform for health care. In the years when they controlled Congress and the White House under former President George W. Bush, they did nothing to repair financial problems with Medicare. In fact, they falsely minimized the price tag of the new prescription drug program, Medicare Part D, and drove up the cost by forbidding government negotiation for lower medicine prices. In addition, although they failed to accomplish it, they pressed to privatize that socialist program called Social Security -- just months before the stock market tanked.
This is philosophical warfare, and for the Republicans, Medicare is an appropriate casualty. The GOP has made it clear they believe the public option being proposed in health care reform is socialism - an evil that must be eradicated at all costs. Of course, Medicare, a government-sponsored health care program for all people over 65 actually is socialist.
It's a slippery slope. First Republicans kill the opportunity for all Americans under the age of 65 to choose their own private insurance or get government-sponsored health care under the public option. Then, by doing nothing, Republicans destroy the ability of those over 65 to retain their government-sponsored health care.
Kill Medicare, privatize Social Security -- that's the real Republican agenda. They're coy about how they say it, because they know the public likes these programs, but that's what they really want to do. Dismantle anything that looks like a social safety net.
LIMBAUGH: Get the government out of it. Get the government, their stupid regulations, get the government out of Medicare. Look it -- the only way that cost-price ratios make sense is based on the consumer's ability to pay.
Get the Government out of Medicare, Rush? Isn't that sort of like saying get the Government out of Congress? At least he's out in the open now. The de facto leader of the Republican Party, while railing against Health Insurance Reform, and scaring the old folks half out of their wits with false claims about "death panels", has REVEALED THE PLAN.
THE GOP HEALTH REFORM ACT: Just jerk it. All of it. Medicare, Medicaid - the lot. Think of the dollars saved. And just think of the massive savings to Social Security as well! Why, we could continue to pay it out to Bob Dole and Newt Gingrich forever! And really, these are the folks who deserve it. They have served the People well, have they not? A whole generation of useless, poverty-stricken oldsters would die off many years earlier than projected, and the country would be Back on the Right Track!
The only part I don't understand is the part where they moan and sniffle about 'pulling the plug on Granny'. Maybe it's just not fast enough? I don't get it. Seems to me the GOP wants to pull the plug on everyone who doesn't have Blue Cross.
You know, these ardent 'capitalists' don't seem to realize that our government has been subsidizing the Insurance Companies since 1965. How? By covering the old, the infirm, the poor, and anyone else who is, in their parlance, a "bad risk". Uncle Sam takes the lemons - Insurers get the lemonade.
Now Big Insurance is whining about competition. Boys, you haven't covered anyone but the young, healthy, and employed for a generation. Oh sure, you get the odd kid with leukemia, or the wife with breast cancer, and sometimes you just can't weasel out of the claim, but mostly you've had it pretty soft. All those amazing stock profits, and CEO bonuses, are coming out of the US Treasury, if you stop to think for a minute.
American taxpayers have gotten a rotten deal. We pay more and more for less and less. We want a better deal. We want *gasp* COVERAGE. And we aren't buying this twaddle, Rush. You seem to have confused 'Americans in general' with 'idiots who listen to your show'. There are a lot of us out there, Rush, NOT LISTENING. We don't respond to your polls because we don't HEAR THEM. But hey, RUSH HAS A PLAN - not to worry.
The caller also mentioned that he recently broke his wrist, and he couldn't afford the costs to treat it. LIMBAUGH: caller shouldn't have broken his wrist if he couldn't afford it.
I don’t know if you’ve been thinking about it, but the costs of long-term care have been on the mind of some friends of mine lately.
For reasons that we won’t go into here, they are in the process of pricing long-term care at care facilities…and yesterday afternoon, we had a chance to have a look at the “menu” of services (the facility's term) that can be purchased at this particular location.
If you are facing this issue in your own family, if you are a taxpayer thinking about how we plan to fund long-term care in the future…or if, one day, you expect to be old yourself…this conversation will surely matter.
I just read an excellent article in The New Yorker about cost drivers in health care. It's online - I highly recommend that every American go read it. The author is a surgeon, and the article is built around a simple fact: McAllen, Texas has the next-to-highest rate of per-capita health care spending in the country - only Miami is higher.
In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns.
Why? The article is the story of the author's quest for the answer. He went to McAllen and interviewed physicians, hospital administrators, and even random McAllen residents.
One by one, he eliminates explanations for McAllen's outlier status - an unusually unhealthy population, much better than average care, malpractice - by comparison with El Paso, just up the Rio Grande, or other facts (such as the near-zero rate of malpractice lawsuits since Texas capped pain-and-suffering payouts). El Paso, with similar demographics, population, and unemployment, has half the Medicare spending that McAllen does.
What's finally left is medical overutilization, driven by fragmentation of the medical system and perverse incentives.
As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients.
But this part really makes the whole article. And this article is worth the price of the annual subscription, as far as I'm concerned
Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.
That last point is key - we tend to fixate on insurance companies vs. public option vs. single payer as a silver bullet. But fixing who writes the check is only part of the problem. How the check is getting spent is the other.
Bill Moyers: How Can We Expect an Industry That Profits from Disease and Sickness to Police Itself?
A great article which includes the 20 year cycle of calls for health care reform (emphasis mine):
Way, way back in the 1970’s Americans were riled up over the rising costs of health care. As a presidential candidate, Jimmy Carter started talking about the government clamping down. When he got to the White House, drug makers, insurance companies, hospitals and doctors – the very people who only a decade earlier had done everything they could to strangle Medicare in the cradle – seemed uncharacteristically humble and cooperative. “You don’t have to make us cut costs,” they promised. “We’ll do it voluntarily.”
By the early ‘90s, the public was once again hurting in the pocketbook. Feeling our pain, Bill and Hillary Clinton tried again, coming up with a plan only slightly more complicated than the schematics for an F-18 fighter jet.
This time the health industry acted more like Tony Soprano than Mother Teresa. It bludgeoned the Clinton reforms with one of the most expensive and deceitful public relations and advertising campaigns ever conceived – paid for, of course, from the industry’s swollen profits.
So anyone with any memory left could be excused for raising their eyebrows at the health care industry’s latest promises. As if on cue, hardly had their pledge of volunteerism rung out across the land than Jay Gellert, chief executive of Health Net Inc. and chair of the lobbying group America’s Health Insurance Plans, assured his pals not to worry abut the voluntary reductions. “We believe that we can do it without undermining the viability of companies,” he said, “and in effect enhancing the payment to physicians and hospitals.” In other words, their so-called voluntary “reforms” will in no way interfere with maximizing profits.
Well, nothing comes from nothing, as they say. As long as we have profit-driven health care, someone has to provide that profit, and if it isn't 'the companies' I suppose we all know who will be taking it in the neck for a long time to come, if things go the corporate way.
Let the games begin...
The Washington Post’s health care reform blog reported Tuesday that Blue Cross Blue Shield of North Carolina has hired an outside PR firm to put together a video campaign assaulting Obama’s public plan. And this month alone, the group Conservatives for Patients’ Rights is spending more than a million dollars for attack ads. They’ve hired a public relations firm called CRC – Creative Response Concepts. You remember them – the same high-minded folks who brought you the Swift Boat Veterans for Truth, the gang who savaged John Kerry’s service record in Vietnam.
Bush has vetoed a bill which would have rescinded a 10.6% cut in physician reimbursements from Medicare. Now, it's not like doctors are making big bucks on Medicare patients - Medicare (like any large insurer) doesn't pay anything like full price. They may get a lot of visits from Medicare patients, but they don't make much on them. And this cut was going so close to the quick that even more doctors were going to quit taking new Medicare patients. The AMA was lobbying full throttle to get this cut "uncut".
I don't mean that in a bad way. It's great that Governor Riley can get together with the Alabama Association for Justice (formerly the Alabama Trial Lawyers Association) to help protect elderly Alabamians from Medicare fraud. This is good for Alabama. It's amazing what can be accomplished when we stop bickering and focus on real problems. Shall we try that more often?
T.H.E. Social Work Agency Adoption home studies & care management services in the North Alabama area.
Licensed, certified, caring social workers. blog advertising is good for you
That's 
