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Let’s Privatize Medicare
Townhall.com ^ | August 23, 2014 | John C. Goodman

Posted on 08/23/2014 5:39:04 AM PDT by Kaslin

Paul Ryan proposed a private health insurance alternative to Medicare for future retirees, liberal critics pounced. It’s another scheme to undermine health care for the elderly by “privatizing” and “voucher-izing” the program, they said.

Yet, almost one third of seniors are already in private health insurance plans. They are called Medicare Part C, or Medicare Advantage, plans. And you would be hard pressed to find any Democratic office holder who wants to abolish them. The reason? Seniors choose to be in these plans because they like them better than traditional Medicare.

Not only do seniors like them, but they appear to provide better care for less money. That’s the conclusion of a new study by two Harvard University health economists, Joe Newhouse and Tom McGuire. These mainstream researchers -- neither of whom can be called a right-winger – conclude that Medicare Advantage plans not only lower the cost and raise the quality of care for their enrollees, there are also spillover effects. In markets where Medicare Advantage plans have a significant presence, cost goes down and quality goes up for other patients as well – including traditional Medicare patients.

Austin Frakt, another health economist (left of center politically, no less), points to some recent research that confirms the positive health benefits of private insurance for the elderly:

… according to a paper in Health Affairs by John Ayanian and colleagues, women enrolled in a Medicare Advantage H.M.O. are more likely to receive mammography screenings; those with diabetes are more likely to receive blood sugar testing and retinal exams; and those with diabetes or cardiovascular disease are more likely to receive cholesterol testing.

That Health Affairs paper also found that H.M.O. enrollees are more likely to receive flu and pneumonia vaccinations and about as likely to rate their personal doctor and specialists highly.

Frakt, who is left of center politically, wrote this at The New York Times economics blog. Alert readers will remember that that is the same newspaper where columnist Paul Krugman has assured us in editorial after editorial that traditional Medicare is superior to private health insurance. Of course unlike Frakt, Krugman’s opinions are often contradicted by facts and evidence.

Right now the federal government pays the Medicare Advantage plans about 6% more than it would have spent had the enrollees stayed in traditional Medicare. But the Harvard economists suggest that the extra payments might be worth it. They go on to suggest that it might be good public policy to encourage all seniors to be in private health plans.

One irony in all of this is that in the 2008 election campaign, Barack Obama promised to eliminate the extra subsidies for Medicare Advantage plans. He didn’t promise to abolish the plans. But he did propose no favorable treatment and he implied that they were not delivering elderly enrollees anything special.

Instead, the president promised, “We’re going to find out what works and then go do it.”

In pursuit of that objective, we have spent tens of millions of dollars on demonstration programs and pilot projects investigating coordinated care, integrated care, managed care, pay-for-performance medicine, electronic medical records systems, etc. The result? Three separate Congressional Budget office reports have concluded that none of this is working, or at least not working very well. (See here, here and here.)

Yet here is a second irony. As I have pointed out before (see here and here), many of the ideas that aren't working in the pilot programs both here and in other countries actually are working in some of our best Medicare Advantage plans — especially in ones that are contracting with doctor associations. IntegraNet of Houston, for example, routinely lowers costs by about 25%, while raising quality at the same time. Overall, the Medicare Advantage space is the only place in all of Medicare where the president’s health reform promises are being realized!

The most significant innovations in medical practice are usually produced by entrepreneurs and although they may be motivated by many factors, entrepreneurship tends to flourish where there is significant downside financial risk and significant upside potential for profit. That's why some of the most interesting things going on right now are in independent doctor associations, managed by entrepreneurs, in contrast to the activities of hospitals, insurance companies and government agencies.

Here is a third irony. The ill-advised (medical loss ratio) regulations which the Obama administration has foisted on the entire insurance industry are inadvertently facilitating these developments. They have spurred insurance companies to shift the management of care to doctor organizations and thus increased the sphere of opportunity for entrepreneurial medicine. See my explanation of this at Health Affairs.


TOPICS: Culture/Society; Editorial; Government
KEYWORDS: 0bama; 0bamacare; elderly; healthcare; medicare; paulryan; paulryanbudget; privateinustry; privatization; seniors

1 posted on 08/23/2014 5:39:05 AM PDT by Kaslin
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To: Kaslin

Any idea that Paul Ryan comes up with should be rejected. He is nothing but a stalking horse for Big Government socialism.


2 posted on 08/23/2014 5:42:04 AM PDT by ClearCase_guy ("Harvey Dent, can we trust him?" http://www.youtube.com/watch?v=HBsdV--kLoQ)
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To: Kaslin

Medicare advantage is close to privatization.

The other half of the problem is collecting the money. That will be very difficult in a privatized system


3 posted on 08/23/2014 5:45:06 AM PDT by bert ((K.E.; N.P.; GOPc.;+12 ..... Obama is public enemy #1)
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To: bert
The gummint takes a hunnert an' four bucks from my SS check for Medicare and I pay 40 bucks or somethin' for Advantra and Advantra is billed for my medical needs ... not Medicare.

That's all I know about the situation.

4 posted on 08/23/2014 5:49:34 AM PDT by knarf (I say things that are true .. I have no proof .. but they're true.)
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To: Kaslin

If it is privatized, what will happen to all the illegal aliens’ coverage...would private entities be required to provide free coverage on the backs of working Americans like our dubious government is now doing? Fully federally regulated private industries are a little to close to fascism, for my liking.


5 posted on 08/23/2014 5:55:38 AM PDT by jacknhoo (Luke 12:51. Think ye, that I am come to give peace on earth? I tell you, no; but separation.)
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To: bert
Medicare advantage is close to privatization.
Not that close - it takes in hundreds of millions every year from the gubmint.
6 posted on 08/23/2014 6:03:49 AM PDT by oh8eleven (RVN '67-'68)
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To: jacknhoo

You must mistake medicare with medicaid. Medicare is earned because you pay into it while working. Medicaid is not. And you have to be at least 65 of age and on Social security before you qualify for Medicare. Also you still pay for medicare, because the premium gets deducted from your social security check


7 posted on 08/23/2014 6:04:44 AM PDT by Kaslin (He needed the ignorant to reelect him, and he got them. Now we all have to pay the consequenses)
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To: bert
Medicare advantage is close to privatization.

See the second paragraph

8 posted on 08/23/2014 6:06:37 AM PDT by Kaslin (He needed the ignorant to reelect him, and he got them. Now we all have to pay the consequenses)
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To: oh8eleven

You are correct and I acknowledged that fact.

The payroll collections go to the government but the Medicare Advantage disbursements are privatized.

In my mid, Medicare Advantage is a hybrid government/private system that works pretty well and until the Obamadoncare disruption worked very well.


9 posted on 08/23/2014 6:09:34 AM PDT by bert ((K.E.; N.P.; GOPc.;+12 ..... Obama is public enemy #1)
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To: ClearCase_guy

And it’s the likes of Paul Ryan that made us Republicans no longer but in our state it’s D or R.......no I....dammit!!


10 posted on 08/23/2014 6:30:17 AM PDT by Dawgreg (Happiness is not having what you want, but wanting what you have.)
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To: ClearCase_guy
Totally agree.

We are in the TOTAL government controlled medical care system of Medicare A/B with Tricare Life (Ret. Military over 65) as secondary. No visual aids, hearing aids, or dental care. All that comes out of our pockets.

They control your meds, will over ride your doctors DAW script for a generic you are allergic to, or does not work, where you get them, and when what test are run, restrict certain procedures like back nerve blocks to 3 per year. And each year there are changes. PSA for men is every 2 yrs. Bone Density test even for those with full blown Osteoporosis is every 2 years. Both Mammograms and Bone Density base line test should be at 40 at the very least. Bone Density testing every 2 yrs until a woman is past Menopause or shows signs of OP. Then yearly just like a Mammogram. Those of us with full blown OP should be having Bone Density test yearly, not every 2 years, it leaves our doctors guessing if the treatment is working or not for 2 yrs.

And since all OP Drugs come with FDA warnings, It is important to have the testing.

The 2 big items Seniors rely on the most are eye glasses and hearing aids. And NEITHER plan pay a dime toward these very expensive items. Co-pay would be a welcome addition for them. I don't expect them free, but after all the money we have shelled out in Medicare taxes there should be some provision for these items with a Co-pay.

I just shelled out yesterday on top of my Medicare monthly payment, $3,400 for a pair of base line 6 channel wireless hearing aids, middle of the road product and pricing, they are a 30 day trial at least, and if they don't work right I can choose another model and start the process over. That takes a big bite out of our retirement. Hubby is next in line for them if he can get Service Disability eligible as his hearing loss is Jet engine caused. He does NOT QUALIFY for VA health care, 2 SS checks and a Navy pension puts you over the threshold of $38,000 VA allows.

Eye glasses must be replaced yearly, and they are always around $4-500 as I require higher end lenses than the box stores offer.

Isn't government run health care "wonderful"?

11 posted on 08/23/2014 6:33:19 AM PDT by GailA (IF you fail to keep your promises to the Military, you won't keep them to Citizens!)
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To: ClearCase_guy

Agree. He is the wrong messenger.


12 posted on 08/23/2014 6:47:49 AM PDT by Hostage (ARTICLE V)
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To: Kaslin

Feds Spent $26.2 Million On Medicare Advantage For Illegal Immigrants
http://dailycaller.com/2014/04/25/feds-spent-26-2-million-on-medicare-advantage-for-illegal-immigrants/

Half of all New Mexicans now on Medicaid and Medicare
http://209.157.64.200/focus/news/3196187/posts?page=19


13 posted on 08/24/2014 5:13:10 AM PDT by jacknhoo (Luke 12:51. Think ye, that I am come to give peace on earth? I tell you, no; but separation.)
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