Tucson Citizen.com
Medicare and More -

The Selling of Health Care Reform (Obamacare)

by on Dec. 03, 2011, under Health

On Wednesday of this week (November 30th) the Arizona  AARP held a town hall meeting in Tucson to talk about the Affordable Care Act. About 100 people heard a representative from the Department of Health and Human Services talk about a long list of things that are in the Affordable Care Act.

The attendees were overwhelmingly seniors who expected the meeting to be focused on Medicare, since the advertisement for the event  said it would be “a community conversation about new changes to your Medicare benefits”.  But Medicare and Part D drug coverage made up a small part of the presentation.

The speaker, Eric Alborg talked about health insurance exchanges that will be set up in each state so people can go on-line and sign up for coverage. But he did not make it clear that these exchanges do not apply to people on Medicare. They are for people under 65 or not on Medicare.  Medicare is a health insurance program.

Mr. Alborg did talk about the Part D donut hole (coverage gap) and how it is being phased out over the next several years.  He explained that anyone who goes into the donut hole in 2011 gets a 50% discount on their brand drugs.  This topic got the audience involved as many people wanted to talk about their own experience with their drug coverage and Medicare.

One lady said her expensive inhaler put her in the donut hole, and she is happy to get a discount on the full cost.  However, she said the retail cost of her inhaler had been raised by 50% in the last year, which meant her 50% discount wasn’t such a good deal.

A man said his prescription is being moved from tier 2 to tier 3  by his Part D plan in 2012. That will raise his co-pay from $45 this year to $95 next year.

The Health and Human Services representative was not prepared to talk about these kinds of details, and after the presentation it was clear that many of the seniors wanted to tell him about their problems with Medicare and Part D and were asking for some help. Mr. Alborg told a few of these folks that he would look into their issue, but he is a policy expert and not a problem-solver.

I was pleased to see a crowd of people exposed to the many good things I see in the Affordable Care Act (aka “Obamacare”) such as:

Insurance companies will have to accept everyone for coverage. Of course, this comes with the mandate that everyone get health insurance, if they don’t already have it through their employer. (begins in 2014)

Children up to age 26 can be kept on their parent’s employer health insurance. (already in effect)

Insurance companies must offer insurance to children with pre-existing conditions (in small group plans). (already in effect)

Insurance companies can no longer cancel an individual insurance policy when a person gets sick. (already in effect)

Lifetime benefits limits for health insurance plans are being phased out. (already in effect)

Insurance policies must cover preventive care. (already in effect for policies written after September 2010))

Companies with more than 50 employees must provide health insurance to their workers.  (2014)

Small companies will get tax credits for paying for some of their employees’ health insurance premiums. (already in effect)

Individuals who must buy their own health insurance will receive tax credits to help them pay their premiums.  (2014)

This entry was posted on Saturday, December 3rd, 2011 at 9:34 am and is filed under Health. Tags for this post: , , , , , , , . You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

RSS feed for this post (comments)
  • James

    So who’s payin for all this? Ohhh…I see…it will be the middle working class. This is not going to turn out at all like anyone thinks…wait until people are denied at hospitals.

    • medicareblogger

      You’re already paying for those 30 million people without health insurance. When they get sick and can’t pay the hospital bill, those of us with health insurance end up with higher premiums.  Or the state pays for their care which means we taxpayers are footing the bill.  If everyone is required to be in the system, the middle class will see their health insurance premiums go down.  There are plenty of studies to show that the Affordable Care Act it will save money in the long run.

  • JD

    You know the real irony here is medical care like food, a roof over ones head is a common need and necessity, with out good medical care one can die, without food one can die, without a roof over ones head one can become sick from exposure to the elements and die, what is so hard for the fake compassionate christians in the far right wing to see their attitude/love of money above all else will doom them to a eternity in a place they will not like to be!:-)

  • James

    Who said I was christian? I am pointing out the fact you are putting healthcare in the same hands of the people who wrecked the economy, steal tax payer money, and lie to you, and you really think this is going to be the difference?  Also, do you people not do math? Who is going to pay for this? Companies cannot afford healthcare for more then 50 employees, especially in this economy when NOBODY is buying. When it all comes crumbling down, you’ll see what I mean, till then, keep praying to your false ideals that make no sense.

    • medicareblogger

      Health care is being left to the insurance companies to earn billions of dollars and decide who gets what care. The only difference is that insurance companies will have standards to meet and limits on their profits. How is that bad?
       
      You assume that employers don’t want to offer health insurance, when they probably do – but it is too expensive now. Tax breaks will make health insurance more affordable – and if companies don’t provide the insurance, employees can go to the exchange and be part of a big pool.  How is that bad?
       
      You see the negative while others see the positive. Time will tell. Stop watching Fox News.

  • itfitzme

    The PPACA (Obama Care) doesn’t change the existing laws regarding denial of service at emergency rooms.  Emergency rooms still must accept people that are uninsured. 
    The cost of health care is fundamentally the result of shortages of supply.  The facts are that growth rate of health care insurance premiums have already come down.  
    A funny thing is that the increase to the total insurance premium to the employer in 2010 was less than every before.  But, employers increased the share paid by the employee.  So employees thought that premiums went up.
    It is often cheaper for employers to provide for health care insurance than it would be for them to give the money directly to the employee.  There are tax breaks.  Basically, the employer buys the insurance then sells it to the employee. 
    Health care prices are due to numerous factors.  The supply chain includes publishers, drug manufacturers, financial l0an companies, hospitals, doctors and other health care professionals, insurance companies, pharmacies, ambulance services and the employer.  It also includes stock holders.
    Prices are due to both supply shortages and consumers willingness to pay.  Prices are not just driven by costs.  They are cost plus profit.  And, costs include CEO salaries.  Profit is after costs and taxes, after all expenses.  Increased cost does not directly drive prices.  And, health care is not the perfectly competitive market.  Profit doesn’t exist in a perfectly competitive market.  The basic supply and demand model that most people use does not apply to health care.  There is very little consumer force to keep prices down.
    The PPACA does a number of general things, all of which improve the health care market.  It increases supply.  It reduces costs.  It reduces waste.  It caps profits so more of the money goes to health care than to stock holders. 
     

  • josegaudet72

    I think that health care reform is a great idea. I have type 1 diabetes and for me to get insurance, it was a nightmare until I found “Penny Medical” search for them online and you can get affordable health insurance instantly.

  • JD

    There is a solution for medical care in America, but it would be fought tooth & nail by medical community, insurance companies and any company or individual which profiteers off folks misfortunes of being the unlucky sick/ill in our society! Create a national medical care service, like our military with a minimum term of service, training to be paid for by government, medical care for free to any US citizen who needs it, nationalize all hospitals, ban medical insurance companies much as one would a mafia loan shark or criminal enterprize, nationalize all medical/drug company supplier’s, make the drugs at cost, continue paying medical scientist’s for research & discovery on a “commission basis of production/producing results”, make it illegal for private medical care to charge over a certain amount for any medical care in the medical care industry for the doctors & nurses who operate in private industry as family doctors, the rich elite doctors who don’t do medicine for humanistarian reasons will cry, whine bloody murder, leave the field, leaving the ones who do it for the hypocritical oath the medical profession is famous for, nurses will be unhappy at not getting them huge hourly wages, the status quo would be upset yes! Now one might say this is communism but it already exists today in the Veterans Medical care system, if a non-va doctor bills for a service the VA over see’s the billing, and allows what is deemed fair, and if a bill is deemed unfair the doctors bill is reduced to the fair amount, as a Veteran who gets this demonized nationalized medical care I can attest to it works quite well but the leeches of society who profiteer off the sick will do everything in their power via their lobbyist’s to ever allow such a thing as nationalized medical care!

  • JD

    We have idiot’s in our society who either are not sick yet, to young to worry about becoming sick and go through life thinking they will never get old, never get cancer or some physical infirmity! The great irony is if one lives long enough, ones body will start to break down like a old car/truck, and at some point the shade tree mechanic cannot fix it with a cover up repair! The ones whining about cost of medical care and those who demonize nationalizing medical care will never the two meet, one is to logical, to wise and too few and the other to young, to ignorant and  to many!:-)

  • JD

    And for those who think doctors would quit being doctors thats a funny one, will they become cab driver’s, sling burgers at mcdonalds/burger king if their huge fee’s were reduced to “fair amounts”, if one believes that one believes in the tooth fairy!:-) Fear mongering by those who swear doctors will not treat under socialized/nationalized medical care are just that fear mongering, there are those who would jump a free college education for a term of years at a nationalized medical service versus what we have today giving them huge student loans to pay off, which often burden them for many years more than a term of “government medical service would”! And for the rich 1% who want the private doctors/nurses once they realize their bills too would go down to “fair amounts” it would not be long before their greed would over come their fears!;-)

  • Carly EngageAmerica

    In 2014, when the major coverage expansions of the health law begin to take effect, national health spending is expected to grow 8.3%. By 2020 the number of Americans with employer-sponsored insurance is expected to drop to 168 million as a result of baby boomers joining Medicare and employers dropping health coverage for workers. The Congressional Budget Office estimates that, by the end of the decade, 3 million fewer people will get health insurance from their employer http://eng.am/nE0nnN).In order to curb this out-of-control growth, reforms in several areas can be implemented that, if adopted, would save $9.4 trillion by 2035 when compared with Congressional Budget Office (CBO) baselines. The government should implement cost caps (approximately $5,500) on catastrophic illness. This would reduce the use of secondary policies and decrease overutilization of medical resources. Also, the government needs to implement an additional premium on beneficiaries to cover deficits within the Hospitalization Insurance Program – it cannot receive funds from general government revenues to finance its deficits, and will be insolvent by 2020, according to the CBO. Furthermore, beneficiaries’ contribution toward Part B of Medicare should be increased gradually from 25% to 35% to reduce the fund’s reliance on general tax revenues. The same policy should be implemented for Part D of Medicare. Finally, benefits for the wealthiest recipients should gradually be phased out (http://eng.am/uO83aB).

«
»