The Widdershins


Posted on: August 20, 2012

Except he didn’t.

The number that he “stole” changes from talking head to talking head.

Note Widdershins:  I am not fond of the Affordable Care Act or Obamacare.  I’d much rather have had single payer or Medicare for All.  However, I dislike scare tactics and lies even more and the Republicans are becoming bullshit artists when it comes to Medicare and Obamacare.

Now to listen to Romney, Ryan, and their minions it was downright thievery!  He just took that money and he plopped it into his Obamacare plan.  Except he didn’t.  What he did do was to cut payments to Medicare Advantage Plans.  The Advantage plans are sort of like an HMO or PPO organization.  Here’s a brief description of the plans from the Medicare government site.

Can you get your health care from any doctor, other health care provider, or hospital?

In HMO Plans, you can’t get your health care from any doctor, other health care provider, or hospital. You generally must get your care and services from doctors, other health care providers, or hospitals in the plan’s network (except emergency care, out-of-area urgent care, or out-of-area dialysis). In some plans, you may be able to go out-of-network for certain services, usually for a higher cost. This is called an HMO with a point-of-service (POS) option.

Also, you have to choose a primary doctor and you’ll have to get a referral from your primary doctor to see a specialist.

Here is some info on the Medicare PPO Plans:

A Medicare PPO Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. In a PPO Plan, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You pay more if you use doctors, hospitals, and providers outside of the network.

Can you get your health care from any doctor, other health care provider, or hospital?

In most cases, you can get your health care from any doctor, other health care provider, or hospital in PPO Plans. PPO Plans have network doctors, other health care providers, and hospitals.

Each plan gives you flexibility to go to doctors, specialists, or hospitals that aren’t on the plan’s list, but it will usually cost more.

Here’s a little bit of history on Medicare Advantage Plans from wiki:

 With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original  Medicare plan (Parts A and B). These programs were known as “Medicare+Choice” or “Part C” plans. Pursuant to the Medicare Modernization Act of 2003, “Medicare+Choice” plans were made more attractive to Medicare beneficiaries by the addition of prescription drug coverage and became known as “Medicare Advantage” (MA) plans. Medicare Advantage plans are offered through private companies known as Medicare Advantage Organizations (MAO)

I recall seeing some plans that advertised there was no premium required other than your normal medicare premium that was deducted from your Social Security check.  And they had perks too!  You could get, say, a gym membership included when you joined, or “free” vision care or discounts.  A lot of folks thought that was a pretty good deal.  No extra premium and you just had a small co-pay when you went to your (in network) doctor.  However, there are some “catches” to the Advantage plans:

Medicare Advantage plans are required to offer coverage that meets or exceeds the standards set by the original Medicare program, but they do not have to cover every benefit in the same way. If a plan chooses to pay less than Medicare for some benefits, like skilled nursing facility care, the savings may be passed along to consumers by offering lower co-payments for doctor visits.

I knew a woman whose mother was in the hospital after a fall and upon discharge, the docs decided she needed some skilled nursing care for a month.  She had a Medicare Advantage plan and that plan would only cover 14 days worth of skilled nursing care.  In addition, it had stricter limits on in-home physical therapy care.  They had little choice at the time but to go along with what would be paid but at the earliest time she could, this lady changed back to traditional medicare with a supplement that covers the deductibles.  Now talk about “rationed” care!!

So why is Obama going after Medicare Advantage Plans?  Because like Willie Sutton said “that’s where the money is”, or at least some of it.  No, it’s because the payment formulas that were created in 2003 overpaid the M.A. plans by an average of 12 percent over traditional MedicareThese formulas change in the PPA law that was enacted in 2010.

The health reform law of 2010 revised the methodology for paying plans and reduced the benchmarks. For 2011,benchmarks were frozen at 2010 levels. Beginning in 2012, reductions in benchmarks will be phased-in over 3 to 6 years. The benchmarks will range from 95% of Medicare fee-for-service costs in the top quartile of counties with relatively high percapita Medicare costs (e.g., Miami-Dade), to 115% of fee-for-service costs in the bottom quartile of counties with relatively low Medicare costs (e.g., Boise). Plans with higher quality ratings will begin to receive bonus payments added to their benchmarks in 2012, based on provisions in the health reform law and a CMS demonstration. Rebates will be reduced for all plans, but plans with higher quality ratings will keep a larger share of the rebate than plans with lower quality ratings.

So where is all of this money coming from that Obama is is supposed to have stolen?

Well, for the most part it comes in savings in Medicare.

The law calls for $555 billion in cuts in future growth of the program – over 10 years. The total projected cost of Medicare over that time, according to the nonpartisan Congressional Budget Office, is $7.1 trillion, even with the cuts.

CBO predicts that federal outlays for Medicare in fiscal year 2020 will be $929 billion, compared with projected spending of $519 billion this year. So the program isn’t being cut below existing levels, or even stopped in its tracks. It will simply grow slightly less than it would have otherwise – about 7 percent less.

It’s important to note that in the 2010 health care bill it specifically states:

the law specifically protects seniors’ benefits. Section 3601 says that nothing in the statute “shall result in a reduction of guaranteed benefits under title XVIII of the Social Security Act” (that’s the part of the U.S. Code that establishes the Medicare program). It’s true that about one-quarter of Medicare recipients could lose some or all of the additional benefits that they receive through what are called Medicare Advantage plans, but that’s not the same as getting lower quality care. And the vast majority of seniors will see benefits increase.

How will these billions of dollars in savings be obtained?

Most of the savings are supposed to come from the Independent Payment Advisory Board, a yet-to-be-staffed agency charged with finding waste. That’s the “death panel” that Sarah Palin, et al, have warned about, sort of, but in the law it’s spelled out that the cuts “shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums.

Well, good luck with that, but it’s hardly the “theft” of billions from Medicare, nor will it be the “death panels” that have been  talked about.

Overall, I think I’d prefer Obama’s plan compared to Paul Ryan’s “voucher” program (see link in “activism” on the right).


Some of the links used in this post:

This is an open thread.



Here is the rub” It;s hard to control costs in a for-profit system.

These statements are nothing but “dog whisltes” to the morons who watch Fox News and believe they come away informed.

“Obama is a Kenyan” appeals to those who prefer to accept anything the GOP fashions as a meme to attract low information voters who eagerly buy into this stuff.

The “Fast and Furious” episode is another whopper that predicts Obama is about to confiscate every gun in the US, they know there are those who will accept this stuff without question. The same applies to this lie regarding Medicare funding.

The lies are getting bigger and the electorate is getting stupider IMHO.

And I agree 100% with chat: until they can control the costs of healthcare premiums we aren’t moving one inch off the problem.

You’re 100% right, Fredster. But here’s the problem. The Democrats couldn’t find it in them to deal with the real problem, the insurance companies, and pass Medicare for All. They controlled both Houses and the Presidency and they could have done it with both hands tied behind their backs.

They didn’t want to. Instead we got that bolus of verbiage which is ACA. Nobody can say what’s in it without sounding like a tax information booklet. Even your good and clear post, my eyes were glazing over by about paragraph 5. (And I’m a bio PH. D. and I do my own long form taxes….)

So, anyway, what I’m trying to say is that I think the Repubs may be quite successful with their lies. They’re simple. They tap into people’s sense of being cheated, so they sound about right. And all the Democrats have in response is a tax booklet.

It would be pathetic if it wasn’t so horrible.

Great post Fredster! You explain this difficult stuff very well.

The drivel coming from Romney and Ryan over this issue is shameful and that the press is letting them get away with it is worse. Where to start — this issue is like trying to decide how to shake hands with an octopus — so many options.

Here are a few questions that Romney and Ryan never seems to answer:

1. Since they are pledged to repeal the ACA from day one, how can you “voucherize” an elderly population where almost everyone has a pre-existing condition?

2. Since they are going to reinstate the institutionalized “over-payments” under the Medicare Advantage Plans, they have in essence accelerated the demise of Medicare by 8 years. The Romney/Ryan plan doesn’t go into effect until 2023 so there’s a window of perhaps as much as five years where there’s a hole of several trillions blown in the budget.

3. Here’s the big one — everyone, D and Rs alike, admit that costs must be contained, not just for seniors, but the average insurance consumer as well. Reducing the Medicare population is reducing the bargaining leverage the government has in attempting to bend the cost curve. Even someone who believes in the wacked-out economic principles of Hayek and the Austrian gaggle of goat farming economists admit this — so what is the R/R answer to controlling cost — it can’t be “let the market” do it because they have no faith in the market since they are advocating a hybrid system of government and free market. The answer must be: Let things continue as they are — the insurance companies become more profitable, no requirement to spend 80/85% of every dollar on healthcare, just let the good times roll — an insurance company shareholder enrichment act — talk about picking winners and losers.

One last thing that no one is willing to talk about — under both Romney and Ryan’s plans — Medicaid is being turned into a state block grant program with cuts of about $80 billion a year. So what happens when more and more “voucherized” seniors run out of money — where is their care? State Medicaid programs are at their limits — new admissions to Medicaid long-term beds are going to be capped — what are the alternatives R/R advocate? It’s Darwinian — they won’t admit it, but it is. Their bumper sticker should read, “How dare you get old before you got rich!”

quixote: Sorry for causing the eye-glazing. 😉
And you may be right in that the repubs have a simple, one sentence statement they use: He stole the money.

Now, like all things government, I have my doubts about “waste, fraud and abuse” and I sincerely doubt they will find “billions” that can be labeled as abuse, so cuts or controls are going to be placed on spending somewhere along the way.

Oh and congrats! You didn’t go into spammy! 😆

socal@5: Well I just hate hearing the lies and not fessing up about what “their” plan is. When I found some “linky goodness” with some Kaiser pubs, I especially wanted to include those. I have found that thier publications and analyses are pretty honest, no tilt to either side.

Prolix re the medicaid: Yep, that’s the one the states are having a conniption fit about. Of course it gives the states a lot of discretion as a block grant, but then Obamacare also throws so many of the working poor into that.

The states will cut back on the reimbursement rate to nursing homes for medicaid and folks won’t have to be worried so much about rodents and bugs at Granny’s nursing home, but rather that the rodents and bugs part of granny’s meals!

Just hear this:

R.I.P. Phylls Diller 😦

@9 — Fredster, what I’m reading is that Granny’s not going to make it to long-term care — Medicaid admissions will have to be frozen within a few years if Romney and Ryan were to get their way. Granny will be somewhere other than a nursing facility — where, no one offers a clue.

Prolix@11: if they do that (freeze admissions) all hell will break loose. It will be a contest as to how those medicaid $$$s will be spent.

I have come to a conclusion, I live in Florida I remember 2001 when Ralph Nader with 70,000 votes sent Shrub to the White House. I remember being angry at the Nader voters who really have the blood of 15,000 american lives that have died in the Endless War.

I will not be responsible for sending Mitt Romney and Paul Ryan to Washington. I am voting for Barak Obama because 2% less evil is 2% less evil. In the case of Ryan I believe its actually more than 50% less evil. Todd Akin sealed it for me. and the below:

I just had a woman on the phone today she was having to move again because her home was invaded by an attacker who assaulted her for two hours, she was lucky she lived, he has been arrested, but under the Ryan-Akin’s Rape bill it might not have been considered a crime because she knew here attacker. Violence against women must stop now.

That is not 2% anymore they are pure evil I am sorry. Violence against women must stop now and if Mittens/Ruin get within a mile of the Oval it will be all out war on women.

I hope my Widdershins friends understand.

Fuzzy: Every one of us has to do what they feel is the right thing in this election. That’s just a horrible story. 👿

The Repubs are pulling their ads en masse for Todd Akins of MO.
Talking about substituting…wait for it…John Ashcroft! 😆 He of cover up the breasts on the statues!! 😆 😆

Fredster, I’m sure you know, but the fault behind the eye-glazing was in my brain, not your writing. I’m just saying I have a somewhere-above-average brain for that kind of thing, and I think people with even fewer holding places in their minds will be ripe for Repub lies.

John Ashcroft? Holy Mother of Dog. Isn’t he older than dirt by now?

About the Todd Akins drivel, I’m wondering if that isn’t a downstream consequence of modern media. They’re so atomized, it’s easy for all of us to hear nothing but echoes of our own world views. He seems to think that what he said was quite normal. But if he got out more, he’d know, being a good little politician, that he needed to lie.

I wonder if that means the Roves of the current campaigns are going to assign reading lists (in addition to vocabulary lists) to the foot soldiers.

quixote@16: Oh I understand where you’re coming from, but it isn’t the most exciting of topics is it? Still, I thought it should be brought out about the, let’s say, inconsistencies in the Repub position.

Quixote, anyone who sez this *needs* to suffer the consequences of it:

It seems to be, first of all, from what I understand from doctors, it’s really rare. If it’s a legitimate rape, the female body has ways to try to shut the whole thing down.”

If you are totally clueless, what’s wrong with just saying so or saying “I don’t have enough information or expertise to comment on that.”

Lordy knows I’m not happy with Claire “my kids tell me how to vote” McCaskill, but she would be better than this guy.

@13: I wrote over at Sky Dancing months ago that I planned to vote for Obama. I made my decision after watching the GOP debates leading up to the Romney nomination. The debates convinced me that Romney was not the “moderate Republican” “nice-guy” former governor from MA many people seemed to think he was.

Revelations about Romney’s years at Bain and his refusal to release more than 2 years of tax returns further solidified my views about him. Now with Romney’s selection of Ryan as his running mate, I feel I must fully support Obama since I live in a possible swing state. The Ryan budget ( which Romney said he supports – except when he doesn’t ) and Ryan’s radical anti-choice position make me sick to my stomach. Romney choose this man over many other possible running mates who are far less extreme! He cannot run away from that decision. It is his first major decision since winning the GOP nomination and is extremely telling.

Romney-Ryan are radically anti-women, anti-middle class, anti-working class, and they care nothing about the disabled, the elderly, and the poor. It will be devasting for this country if Romney is elected. Romney-Ryan will set us back at least 50 years in so many ways. Just think who Romney is likely to choose for the Supreme Court!

I can’t even bring myself to write about the effects of Romney-Ryan Medicaid cuts on nursing home patients. It is too upsetting and too close to home.

Fuzzy, your story about the woman who was attacked is heartbreaking. I hope she will be able to eventually find some healing and peace. She certainly will not find it from politicians like Akin and Ryan. Evil bastards!

My stomach is in a knot.

Beata said: Evil bastards! No Evil rat-bastards!!

Beata: Your state is in play as is Fl. For me, either Al or La, it won’t matter as they will go red. So, I feel I have the luxury (?) of voting for Jill Stein.

(edited for typos) I need to stop watching football when I type. 😆

Fredster, this was a very good post. Excellent research. I’m glad you are continuing to write about health care issues. They are indeed complicated but so important to us all.

@20: Fredster, go ahead and vote for Stein. I understand. I’m never going to be rah-rah Obama. I think you all know that. But Romney scares the hell out of me, especially now that he has chosen Ryan as his VP.

Beata: Thanks, I appreciate that. 🙂 I like it when I’m able to find some good, non-partisan (imo) info from a place like Kaiser. I think they are fairly neutral in this debate.

I just got a bee in my bonnet over the lies Romney and Ryan are telling. Of course Paul Ryan went to The Villages in Fl. Probably everyone there is already on medicare or they are at least 55 so nothing he plans will affect them (or me). But where are the questions from someone younger than 55? They will be the ones affected the most by this plan. That’s not to say that Obama won’t make changes either. I just don’t think his will be as drastic as what the two clowns are proposing.

Beata@22: In ’08 I voted for McCain and it was priimarily as a protest against Obama and for Hillary. This time, HRC isn’t involved so I can still register my dislike of Obama by voting for Stein and also knowing that in the state totals it’s not going to make a big difference. Romney will carry both Al and La with no problem.

You know, I have universal health care, and no it’s not free despite the silliness of your politicians. My taxes are much higher than yours and that is because my taxes fund stuff like – oh I don’t know – Universal Health care. I know I’ve bored you all silly before about my health care, so I won’t bother iterating again, but I cannot believe that you folks don’t have it – after all, your country is much richer than mine. Mind you, the “conservative” mindset it taking hold here too, which means that the corporations are on the move trying to take over other countries. I don’t think it will take here – at least I hope it won’t, but you never know. Those Global corporations have very deep pockets, and it appears that everyone who goes into politics wants lots of money. I’m sure they are not all corrupt, but I suspect that the ones who are not corrupt are in the minority.

Beata, I’m concerned about you. Are you okay? REmember, I have spare bedrooms – I keep saying that to you folks. I have spare bedrooms!

P.S. this is the only place that I’ve ever offered that – the spare bedroom part.

HT, I’m not okay to tell you the truth. I’m under a lot of stress and close to the breaking point. I need to stay strong right now for my mother’s sake. Beyond that, I don’t know. A long vacation in a state hospital for the situationally-bonkers sounds nice, but I think Raygun closed them down years ago. Darn.

Thank you for your concern.

Beata, this blog has my e-mail address. I give them approval to release it to you, if you need someone to exchange concerns with. I thought when my parents died 26 years ago, but 13 days apart, I would end up in an asylum. I suspect I almost did. When my little brother died in February, I kept it together for his kids for 5 months. The sumbitch died intestate – didn’t leave a will. And he had just moved in with his second ex-wife who was claiming that she was common law, so had a right to his estate. What fun. I didn’t have time to grieve, but two weeks ago, while talking with a government agency, I broke down – totally tears all the way. I felt badly after, because I had given that poor govenment agent a problem. Next I called his bank, and broke down again. then I called another agency, and once again broke down. Not to belabor a point, but sometimes, being strong sometimes comes back to bite you in the behind because you’re trying to be strong, and not paying attention to your own health. I’m still learning. Today I can talk to people without breaking down….until I hang up the phone. And trust me, just to admit this is huge for me. I was always the strong one. Now I’ve found that strong doesn’t mean what I thought it meant.
All this to say, take care of yourself. I know how difficult it is when someone you love so much is in danger. Just take care of yourself.

Beata: We’re here for you if there’s anything we can do. Also, I can provide you HT’s email address if you wish and vice versa.

HT: If something were to happen to me right now, I don’t have a will drawn up. Don’t know how much of a mess it would be. I guess at the least I should let someone know what I want done with my body. (find a convenient way to get rid of it!) I guess I could write up something informal, myself and then get a couple of people to witness it. (shrug)

Fredster, I don’t know how much of a problem it is in your country, but in dealing with my my brother’s mess (and honestly I think he did have a will, but his second x-wife probably destroyed it), when consulting a lawyer, I asked him the same question – that being do I need to go to a lawyer. IN my case, my will was very simple – I had written it up and had it witnessed by two neighbours – my two children were chosen as executers, and both were the only beneficiaries. this lawyer asked if there was anyone else who could challenge it – my response was no. When I asked if I should actually get something more formal – I.E. going through a lawyer he told me not to waste my money (what little I had) – meaning I had a thoroughly legal document. After going through the problem with my brother I am going to go the lawyer route, just to ensure that my two kids never have the same issues I am encountering with my brother’s estate. Worse still, by dying intestate, I cannot afford to put through trying to become the administrator of his estate because I would then have to give surety in the amount of twice what his estate is worth. and I do not have that kind of money. I’m on a pension for goodness sake. I guess my point is that you should have a will – not just a will but a living will that outlines what is to happen should you be incapacitated and they want to put you on machines to keep you alive. I don’t want that myself, so I’m pursuing a living will, as well as power of attorney. I know most people do not want to discuss this, shy away from it, however I do not want my children to go through what I’m experiencing with my brother’s death.

HT: I *think* for myself, a document that was properly witnessed would be sufficient since I have no immediate living kin.

I do have a living will/advanced directive done. And, I scanned it and then put it in the docs on my cell phone! LOL!!

Good for you Fredster. I’ve told my twosome what I want – as a matter of fact I told them that if I attained the ripe old age of 80, they should shoot me, because I’ve quite honestly lived a full life by then, and term insurance ends when you hit 81, meaning that 180K that I’ve paid for over the last 50 years just disappears into the hole that insurance companies build in to maximize profity. I also do not want a funeral, and have actively sought out contributing my body to science (if they will take it). It’s different for everyone, I agree. However, when I’m dead, I’m ded. I don’t want either of my children to go through what I’m attempting to unravel for my brother’s children – my nieces and nephew. It’s not right to put them through this crap. I know I am a very intelligent person, but when dealing with the machieavellian laws surrounding this situation, I’m at a loss, and unfortunately I can not pursue it any further. What is most ridiculous, I have already resolved most of the issues. And for crying out loud, his estate is only worth around 3K. All I want to do is resolve the final issues, most of them caused by the woman who refused to give me his papers right after he died.
I miss my brother – very much. And it hurts me every time I have to deal with one more issue. that’s why I’m going with a lawyer for my children. You do not have anyone, although I think that you have lots of people – maybe not by blood, but you have a lot of people that you care for, and who care for you. You are just that kind of person.
Sorry for burdening you with this crap. I had a bad day and needed to unload on someone. Forgive me.

Well I have told everyone that I wish to be cremated. Even that in the states can be expensive! Take a look at this:

I had told the f.h. director that did mom’s services what I wanted and he said it would be around $2000+. That’s the direct thing where the family/friends/loved ones can get a brief “look” to say “yep that’s him”. You’re placed on a gurney with a sheet up to your chin. The f.h. just “sets” the face and the mourners get around 10-20 mins with you. Then it’s off to the fire. I see now that *this* f.h. above has jacked their prices up since the last time I looked. Oy!

Sorry for burdening you with this crap. I had a bad day and needed to unload on someone. Forgive me.

No problem at all HT. We all need to vent sometime.

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