My current Congressman is a conservative Republican… not so conservative that he falls into the wingnut category, but close. I’m what someone called a faint blue light in a sea of red. So I make a point to communicate with him fairly regularly, if only to remind him that he also represents people with views that don’t conform to his own. And if I get any response, it’s a blanket canned one repeating all the GOP talking points. It’s as if he doesn’t have an original thought in his head but simply responds out of obligation, using the same pre-recorded message to everyone.
My most recent communication was on health care. I use the term recent rather loosely, because I had forgotten what I said. After reading through the tirade on how we must protect the insurance industry from the inevitable collapse that would result from “government-run” health care — at least he’s gotten off the death panel bit — my blood pressure was rising, so I fired off a response.
I pointed out to him that when he first ran at least 5 terms ago, he promised to serve only 2 terms. So much for that promise. I also pointed out to him that he was already receiving government run health care as he is eligible for Medicare. Whether he also uses one of the health insurance plans available to Congress and all other federal employees, he is automatically enrolled in Medicare Part A. I challenged him to give up his government-funded, government-run health care programs. Will he? Certainly not! So I asked how he figured he could in good conscience participate in something that he obviously didn’t think his constituents were worthy of.
I’ve probably had a wider range of experiences in the health care system than he has. I benefited from the federal health care system for a number of years, thanks to my former husband’s employment as a civil servant. I’ve had employer-provided health insurance (and paid my portion of the premiums). I’ve been in the private insurance market, with its high-cost-low-benefit policies, been denied coverage, had coverage canceled after filing a claim, and been uninsured. I have experienced first hand the limitations of “managed care” with its gatekeepers, limited choice of providers and the like. And next year, my husband’s company has eliminated choice of plans altogether — there is one insurance plan for all employees. In contrast to my own experiences, this summer I’ve seen how Medicare with a private supplemental policy works, thanks to my mother-in-law’s health crisis.
If I had a vote on health care reform, it would be Medicare Part E (for everyone). It is a system that has been in operation for over a generation — i.e., no new bureaucracy and a proven track record. Participants pay a monthly premium of about $100 and most supplement that with a secondary, private plan. By bringing millions of additional people, many of them healthier than the senior population, into the system, per capita costs would automatically go down. Everyone would be covered. And the insurance companies would be able to sell those supplement policies to a huge pool of people. Just as they do with the current Medicare supplements, insurance companies would compete with each other in that secondary market.
Medicare cannot refuse people because of a pre-existing condition — nor can the insurance companies who provide Medicare supplements. And they cannot cancel your coverage when the bills start coming in. Everyone 65 or older is included now. Why not simply remove the age restrictions?
It is true that reimbursement rates for Medicare are lower than for other insurance plans. But doctors would be able to streamline their administrative activities. The bills would automatically go to CMS for payment. Currently, doctors must maintain a billing department whose function is to deal with insurance companies — getting prior approval for treatment and fighting for payment afterward. That cost of doing business would go away, more than making up for the reduced reimbursement rates.
Younger people argue that they are paying for the care of the elderly because their own medical costs are low. True, UNLESS you get into an accident or contract an illness. And if they do have a medical catastrophe, those who are uninsured can still get treatment. If they can pay, they are generally bankrupted. If not, the providers absorb the costs. And those of us who are insured pay for the care of the uninsured — to the tune of about $1000 each per year in increased premium costs. Every rational person admits that the current system isn’t working. The challenge becomes how to have a real discussion — looking at what is best for the American people, rather than how to preserve campaign contributions.
I just wanted to point out that insurance carriers can deny an individual a medicare supplement plan if they are outside of their open enrollment period. Many states have different regulations as well as many carriers. If an individual decides that they want a supplement when they are 66 and they haven’t had credible coverage since they became Medicare-eligible then chances are they could be penalized with underwriting questions.
Some carriers like Blue Cross Blue Shield in Illinois offer guaranteed issue at any time without underwriting or pre-existing conditions.
The key for Medicare-eligible individuals is to take the time during their open enrollment period to educate themselves about Medicare and the Supplements to ensure that they are making the right decision. A very informative site out there is http://www.over65insure.com. It is easy to navigate with easy to read content, plus people can cost compare carriers and their premiums.
All Supplement Plans are standardized by the government – so people need to understand that carriers charge different premiums for the same coverage!