Medicare Advantage: Giving the People What they Want

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Health insurance can be complicated, and many details of health care and health insurance are lost on the public. Who likes to read an insurance policy? No one!

When our representatives in congress fail to live up to their promises with health care and support programs that aren’t working, these are the things NOT lost on us. We want our representatives to tell us why or why not proposals are good or bad ideas and offer alternatives.

Overall, everyone wants the same thing: affordable health insurance and lower health care costs.

In 1995, health care in the United States was 13% of GDP. In 2014, it was 17% of GDP. We spend more than any other nation in the World on health care. This is “Big” business. President Trump recently got the Senators together at the White House told them (and us) that he expected the Senate bill to be, “a phenomenal Bill for the people of our Country.” He was hoping it would be a bill that is, “generous, kind and with heart.” President Trump said the Senate is going to, “come out with a, “Real bill – not Obamacare!” The Democrats continue to resist any changes to Obamacare. Fortunately for them, the actual Senate draft bill was an adjustment to ACA – Obamacare, and its later version that I call the “Obamacare Dark”.

We hope the Democrats will embrace the idea of promoting Medicare Part C – as the Medicare Buy-In program that Hillary Clinton has been promoting and come to a compromise that will give Republicans some tax relief on and greater control over future health care costs. Democrats can take credit for coming up with the Medicare Part C Plan, that will include competitive benefit plans to attract new members, adequate premium subsidies and tax credits, more affordable plans for the needy, protection for pre-existing conditions, more uninsured voters signing up for coverage and more influence over the programs design. T

Democrats need to step up for their party to protect the interests of the people they represent and insist on the elements of the plan that will appeal to their base and participate in this solution. Medicare Part C is a start! I have made it abundantly that the federal government knows how to successfully structure health insurance programs. They are supervising several of them and they cover tens of thousands of people. The Senators and Representatives are all very smart, many of them millionaires, many of them know how to fix problems like this, but they can’t fix this problem purely because of politics. If you are as frustrated as I am with this situation, we can truthfully lay the blame squarely on many of our Congressional Representatives of both parties in Washington, D.C. They are “NOT” acting like Statesmen and Stateswomen and they are “Not” acting in our BEST interest. T

Every member of Congress and the Trump Administration should be aware that the federal government is already doing a great job providing essentially the things that everybody wants. Ask the more than 55 million Americans covered by Medicare A and B or the 17 million Americans covered by Medicare Part C – Medicare Advantage Plans how they feel about their health plans? They will ALL tell you they are happy to have them. Without them, they would be worried about how they were going to pay their bills, if they get sick.

Want to help support Medicare Advantage for All? To support and join this movement, you can download our Medicare Advantage Membership Application and complete it with your contact information and send it to us with your financial support or just complete the Pay Pal Credit card authorization on the About and Become A Supporter Pages on our web site.

For more information on the Medicare-Advantage-For-All plan and the movement, visit our Medicare-Advantage-For-All plan page or our Medicare Advantage Facebook page, call us at 1-888-683-3719 or contact our email us at: contact@medicare-advantage-for-all.com.

 

The post Medicare Advantage: Giving the People What they Want appeared first on Medicare News Advocate.

How to Fix Health Care with Medicare Advantage

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As Americans, we need some form of health insurance, because it is too expensive for many of us to afford without help. The challenge for the American federal government is to curb the tremendous increases in the cost of health care and at the same time give those people, who are not insured, access to affordable health insurance – this is what Obamacare is and was supposed to do, but that is not what is happening.

Obamacare was successful in increasing the number of people signing up for Medicaid by 11 million. The way Affordable Care Act (ACA) did that was easy. The federal government agreed to pay the states 100% (gradually reducing to 90% in 2020) of the cost of raising the eligibility for qualified citizens to sign up for the program. It was like signing people up for a free lunch.

Our focus on health insurance may cause us to forget that the federal government does have other national priorities, including a crushing trillion-dollar national debt and a multiple billion-dollar annual budget deficit. We can’t keep throwing money at every problem we have, without having some rational plan to handle the risks. How do we fix ACA (Obamacare) so that this time we get it right, without having to pay for a government takeover of the entire health care system – a move that will certainly and severely damage our quality of health care?

We have approximately 43 million citizens that need help from the government. These people include the ACA enrollees (9 Million), the low-wage uninsured and unemployed workers (28 million), and segments of the Medicaid eligible population (5 million). In order to “fix” the problems, we must figure out an economical way to help about 10%  to 13% of our total population. The problem is manageable.

The FIRST thing that Congress needs to understand is that the ONLY way they can lower the cost of health insurance, without doing anything about the health of the population, is to use the power of leverage in a REAL insurance plan! President Trump told the Senators, he wants, “a REAL bill – NOT Obamacare.” Congress must stop throwing good money after bad and make it possible to use the power of leverage in a “REAL” actuarially underwritten insurance contract. The power of leverage in health insurance, is the ability for health insurance carriers and HMOs to charge a low premium rate (less than one would normally have to pay on their own) to a large number of people and when the little premiums are all added together, the total amounts to enough money to pay for the health care expenses of those few in the group that actually get sick.

The only other “real” actuarially underwritten federally sponsored health insurance program (besides FEHB) that covers “We the People” is our Medicare Part C – Medicare Advantage. The Medicare Part C operates under the principals of “REAL” insurance. Medicare Part C – Medicare Advantage programs cover approximately 17 million of our most vulnerable elderly citizens. The program’s popularity has increased due to ACA. For the participants in Medicare Part C, the federal government does an annual evaluation on the actuarial equivalency of cost for Original Medicare. This means that they determine how much the government would have to pay an insurance carrier if they were going to produce an insurance program that was actuarially equivalent to the traditional Medicare program in a particular county. Therefore, CMS annually determines what capitation fee the federal government is willing to pay for health insurance in each county in the United States. The health insurance carriers and health maintenance organizations take these rates and design health insurance benefits programs, with CMS approval, to cover the participants within the margin of the prospectively determined capitation (per person dollar amount) rate. The federal government agrees to pay that rate and the insurers (insurers and/or health care providers) take the risk and assume the responsibility of administering the programs. There is no confusion about how much the carriers are to be paid. There are certain requirements that the insurers must meet to satisfy the Centers for Medicare and Medicaid Services and these are met in strict but collaborative and rational interactions characteristic of this successful Public-Private Partnership. This is the way it should be done and is unlike the turmoil that ACA has created in some markets.

Like the sound of Medicare Advantage for All? Support it!

To support and join this movement, you can download our Medicare Advantage Membership Application and complete it with your contact information and send it to us with your financial support or just complete the Pay Pal Credit card authorization on the About and Become A Supporter Pages on our web site.

For more information on the Medicare-Advantage-For-All plan and the movement, visit our Medicare-Advantage-For-All plan page or our Medicare Advantage Facebook page, call us at 1-888-683-3719 or contact our email us at: contact@medicare-advantage-for-all.com.

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