From Kaiser Health News:  A debt reduction task force that was created by the Bipartisan Policy Center recently made recommendations for reducing government spending. The task force, made up of Republicans and Democrats, targets Medicare as too generous a program for seniors.  I’ve posted excerpts from the article below.

Offering the latest tough-love strategy to reduce the nation’s debt, a panel of high-profile Republicans and Democrats on Wednesday recommended that Medicare beneficiaries pick up far more of their health care costs and the government substantially curb the amount both Medicare and Medicaid programs can grow in future years.

…The debt reduction task force was created by the Bipartisan Policy Center, established by former congressional leaders of both parties. Its recommendations come a week after the chairmen of President Barack Obama’s commission on controlling the national debt proposed increasing the age at which people qualify for Social Security to 68 by 2050.

…Right now, premiums account for 25 percent of the cost of Part B, or the physician component of the program, with the government paying the balance. The task force would increase beneficiaries’ share to 35 percent. [This means a much higher Part B premium from the current $96.40/month or $110.50/month.]

In addition, starting in 2018, traditional Medicare would be turned into a “premium support” program that would limit the rate of increase of federal spending per beneficiary to one percent above the growth rate of the economy. Under such a plan, beneficiaries likely would pay more to stay in traditional fee-for-service Medicare though they could save money by getting coverage though private health plans that would compete against each other for business.

“I think the premium support is a feasible way of controlling costs,” Rivlin said Wednesday at a press briefing.

…AARP Executive Vice President John Rother said his group would oppose premium support. Of the overall task force report, he said it “raises lots of questions because of how it shifts more costs to individuals.”

You can read the full article here.

On Friday I participated in a conference call with the Head of CMS (Centers for Medicare and Medicaid) and I got to ask a question as well as offer some advice about the Medicare.gov Plan Finder.

First, I pointed out to the top administrator of Medicare, Dr. Don Berwick, and his assistants on the call that Medicare.gov Plan Finder is not working properly.  I told them the largest Medicare Advantage plans in Pima and Maricopa counties are not showing up on the Plan Finder list.  One of the assistants said they’d look into that problem – and I will be watching to see if they indeed put some techie on this project as quickly as possible.

Second, I informed Dr. Berwick and his assistants that they were using the wrong terminology for the period of November 15 to December 31.  They kept calling this period the “Open Enrollment Period”.  This label was even used in their press release announcing the conference call.  I informed them that the proper term for November 15 – December 31 is the “Annual Election Period” and that the “Open Enrollment Period” (OEP) referred to January through March. I pointed out that the  OEP has been terminated and does not exist for 2012.

I asked Dr. Berwick and his assistants about the cancellation of OEP and what will happen when a person decides on February 1st that he doesn’t like his Medicare Advantage plan.  His only choice will be to dis-enroll from the Advantage plan and go back to Medicare. He can enroll in a stand-alone Part D.  But I asked the question, “Can that person get a Medicare Supplement with guaranteed issue?”  Well, I have a feeling these bureaucrats had no idea what I was talking about.  One of the assistants said, “Of course a person can get a Medicare Supplement”.  So I clarified, “But what if that 75-year old has health issues that might cause him to be refused/declined by the Medicare Supplement company?” The assistant mumbled a bit and said he’d get back to me on that.

Part of the assistant’s answer about the cancellation of OEP (January – March) was that “consumer advocates”  pushed for this change because of what they saw as “unnecessary marketing” by Advantage plans to seniors. The “consumer advocates” think seniors need only 45 days (with two holidays in this period) to choose their Medicare coverage for the entire next year.

I was fortunate to talk to the top administrator of Medicare and his assistants as they only took about ten questions at the end of the conference call. The Denver Post and Wall Street Journal were on the call and their questions were more about politics than process.  I will be  watching and waiting to see if the Plan Finder gets fixed and if I hear back on my question about seniors getting Medicare Supplements during OEP-D (disenroll).

Follow-up:

I did hear back about my Medicare Supplement guaranteed issue question. As I thought would be the case, a person who drops their Medicare Advantage plan in February is not guaranteed a Medicare Supplement.  If a person answers “yes” to any questions on a Medicare Supplement application he will be turned down.  So before anybody thinks about dis-enrolling from their Medicare Advantage, plan they need to be sure they can get  Medicare Supplement.

As of today, Tuesday, the Plan Finder was still broken.

Republicans say they will repeal or refuse to fund the Affordable Care Act (“Obamacare”). The very large bill involved many areas of health care reform, from Medicare pilot programs to limiting the profits of health insurance companies to allowing everyone to get insurance, even if they have pre-existing conditions.  Maggie Mahar writes about this in her Health Beat Blog and I’ve provided some of what she wrote here:

Maggie Mahar’s Health Beat Blog, November 5, 2010

It is unclear just how much of the reform legislation’s financing turns on Congressional approval. Reportedly, only about $100 million of the funding needed for the $1 trillion bill is subject to the Congressional appropriations process. (See below) Moreover, as John Gever points out on MedPage Today: “The items in the ACA that require significant appropriations are either popular — like bringing insurance to the uninsured –or don’t matter much to the electorate, like electronic health records. Killing these won’t score points with the voters Republicans will need in 2012 to defeat Obama, and could actually hurt them.”

Medicare is not going to bankrupt the country. To the contrary, Medicare’s trustees have told us that the ACA puts Medicare on the road to financial health, giving it an extra twelve years before the hospital fund even begins to fall short. As a result, Medicare has plenty of time to turn successful pilot projects into Medicare policy nationwide, changing how we pay for care, and how care is delivered.  Contrary to what you may have read elsewhere,  in the past, many pilots succeeded in reducing costs while lifting the quality of care, but were blocked by lobbyists representing those who feed at the trough filled with Medicare waste. The ACA changes the rules of the game by giving the Secretary of Health and Human Services the power to roll out a pilot project nationwide, without needing Congressional approval.

Under reform, the amount that any family pays out of pocket will be capped; insurers will not be able to hike premiums without justifying their increases to government regulators, and generous subsidies will make insurance affordable for the middle-class.

If private insurers are not able to offer care that meets the law’s standards at a price that individuals and employers can afford, insurance companies realize that in 2013 or 2014, Congress is likely to reconsider the public option. History suggests that over time, health care reform legislation, like other controversial social legislation (Social Security, for example, or the Civil Rights Act of 1964) is more likely to expand than to contract.  (Originally, Social Security did not include farm workers and domestic workers, excluding many African-Americans. After the Civil Rights Act was passed in 1964, subsequent legislation expanded the role of the Equal Employment Opportunity Commission. )

Reform already is underway: Insurers are no longer denying coverage to children suffering from pre-existing conditions. In 2011 Medicare Advantage premiums will be lower, and the sky-high co-pays that some Advantage insurers have asked seniors to pay for expensive prescriptions will disappear.  In just a few months, seniors who reach the “donut hole” will enjoy a 50 percent discount on prescription drugs; primary care doctors providing preventive care to Medicare patients will receive a 10% bonus, and both Medicare and new private sector insurance plans will no longer charge co-pays for preventive care.  Meanwhile, the Wall Street Journal reports that small employer eligible for tax credits already are beginning to purchase insurance for their employees.   In the months ahead, as more and more of the public becomes acquainted with the benefits of reform,  conservatives won’t be able to stop a moving train.