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The Conservative Principles Inherent in the Medicare Reform Legislation
Various sources, including Sen. Bill Frist's site, Sen. Rep. Policy Comm., and the White House ^ | 2/6/04 | My2Cents, and various sources

Posted on 02/06/2004 10:08:46 AM PST by My2Cents

The Conservative Principles Inherent in the Medicare Reform Legislation

(This article was written from information gleaned from a variety of sources, including the White House, the Senate GOP Policy Committee, the Sen. Majority Leader's website, the Amer. Assoc. of Health Plans., and from the author's experience in the health care industry.)

There has been much murmuring among conservatives over President Bush’s domestic policies, stemming mainly from spending initiatives. “Spending like a drunken sailor” is pretty much the way it’s been characterized.

Central to the discontent has been the passage by Congress, at the urging of the President, of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Virtually all of the attention, and ire, of grassroots conservatives has been directed at the price tag of the bill – an estimated $395-500 billion over the next ten years. Yet hardly any attention has been given to the overall provisions of the bill, many of which are consistent with conservative principles, and which indeed were supported by many conservatives in Congress. Because many the provisions of the bill reflect conservative principles, it is very likely that the estimated price tag of the bill is overstated since a major goal of the reform legislation is to reduce the overall future costs of Medicare, and health care in general, as the provisions of the bill take hold.

While the prescription drug benefit for the fee-for-service side of Medicare has received virtually all the popular attention, other provisions of the reform legislation include:

-- enhancing the ability of Americans to pay for their own health needs through expanding the availability of Health Savings Accounts (HSAs);
-- new accounting measures which will enhance accuracy in monitoring the solvency of the overall Medicare program;
-- expanding lower-cost choices in medical coverage for senior Americans rather than placing all into the traditional (and more expensive) fee-for-service side of Medicare;
-- reducing the rising cost of prescription drugs across the board; and
-- cost-containment provisions including income thresholds for Medicare Part B premiums starting in 2007 (the higher the income of an individual or a couple, the less the federal subsidy, and the higher the premium paid for Medicare coverage), and an increase in the Medicare Part B deductible with future raises in the deductible indexed to inflation.

Prescription drug coverage -- Incorporating the efficiencies of the private sector

The provision of the Medicare reform bill attracting the most attention is the prescription drug benefit. The big reason for this is that the drug benefit is admittedly the most costly aspect of the bill. But it should be pointed out that even the large estimated cost associated with the drug benefit is simply that -- an estimate -- and an estimate that is based on, if you will, a "worst-case scenario." The actual cost of the drug benefit is not known, and may end up being much lower than the Congressional Budget Office has projected.

One aspect which could result in this benefit being not as expensive as anticipated is that it is not actually an entitlement in the traditional sense of government assistance programs. First, the drug benefit program is voluntary; while available to every Medicare beneficiary, not every beneficiary will accept the benefit. In actuality, it is not a traditional government-run program at all. The Medicare prescription drug benefit will be made available through private drug benefit insurance companies or health plans which will administer the benefit. The benefit will, literally, be run as a commercial benefit plan, not as a traditional government program.

Similar to any private sector benefit plan, the Medicare drug benefit will require a monthly premium paid by the beneficiary; it will requirement the payment of an annual deductible; and once the deductible is paid, the benefit program requires a "coinsurance" cost paid by the beneficiary -- a 25% cost-sharing up to $2,250 of drug expenses. Such cost-sharing provisions have proven effective in controlling the cost of health care coverage.

Because the drug benefit is voluntary, Medicare beneficiaries are not required to buy into it. Many Medicare beneficiaries already have some form of Medicare supplemental coverage which includes a drug benefit, so they will likely be disinclined to sign up for the new Medicare drug benefit. Also, an aspect of the Medicare reform bill is to introduce competition between the Medicare program and private sector plans. There may be drug coverage products in the commercial market which provide a better deal to Medicare beneficiaries than what the Medicare reform bill provides. Another aspect of the Medicare reform bill is the enhancement of the managed care side of Medicare. Many of the existing private health plan products offered as an alternative to the fee-for-service side of Medicare already contain a prescription drug benefit, hence, the cost of drugs is already being paid by Medicare for those enrolled in such plans, which means that for these beneficiaries there will be no increase experienced in paying for their drug coverage. And since these plans will be offering comprehensive or "full-service" medical benefits, including prescription drugs, the cost to the consumer of the health plan's drug benefit may actually be less than the cost of the benefit as designed by the Medicare reform bill.

Additionally, the very inclusion of a drug benefit to Medicare will reduce the cost of the program. For example, prior to this reform, Medicare paid for extended hospital stays for ulcer surgery at a cost of about $28,000 per patient. Yet Medicare would not pay for the drugs which eliminate the cause of most ulcers, drugs that cost about $500 a year. Now, drug coverage under Medicare will allow seniors to replace more expensive surgeries and hospitalizations with less expensive prescription medicine to treat their conditions.

In short, while the Medicare drug benefit is available to all beneficiaries (those in the fee-for-service side, as well as in the managed care side), and since the cost estimates are largely based on the assumption that most will take advantage of the new benefit, the price tag placed in the drug benefit may actually be on the high side since many beneficiaries already have a drug benefit, or commercial products may provide a better deal than what the bill's design provides.

Reducing the Cost of Drugs

The bill also contains provisions, unrelated to Medicare, which will lower the cost of all drugs -- benefiting not only Medicare beneficiaries and the program, but every consumer. The law injects competition into the Medicare marketplace, which will drive down the price of drugs. Private health plans have largely been successful in negotiating discounts with pharmaceutical manufacturers. Beneficiaries enrolled in a Medicare prescription drug program or a Medicare Advantage program will reap additional savings, since these plans will likely combine the attributes of a private insurance company and a pharmacy benefit manager (PBM). PBMs are designed, in part, to negotiate discounts with pharmacies and drug manufacturers on behalf of health plans.

In addition, to help American consumers of all ages, the new law provides incentives to encourage the use of generic name drugs, which are usually less expensive than brand-name drugs. The law also streamlines the bureaucratic process to bring generic drugs to the market faster.

Expanding Health Care Choices

One of the main cost-containment aspects of the Medicare reform bill is the creation of a new "Medicare Advantage" program to replace the "Medicare+Choice" program established by the Republican Congress in 1997.

"Medicare+Choice" (M+C) was the addition of a managed care side to the Medicare program, providing a cost-effective option to the more costly fee-for-service design of traditional Medicare. Medicare+Choice was intended to bring the efficiencies of the commercial managed care design into Medicare. However, the funding formula for M+C in relation to the traditional fee-for-service side established by the Clinton Administration never enabled M+C to prove its promise of cost containment. (Some have speculated that the Clinton Administration's disdain for the commercial managed care industry after it helped defeat "HillaryCare" in 1994 motivated it to choke the life out of M+C before it could prove it's worth; clearly, the Clinton Administration never intended to allow M+C to succeed.)

As a revamped managed care side of the program, Medicare Advantage will allow beneficiaries a wider range of health coverage products, including preferred provider organizations (PPO) and HMO options, opening up the Medicare program to commercial health coverage designs which have proven more cost-effective than traditional fee-for-service indemnity insurance products. These more cost-effective alternatives will enable both the beneficiary, and the government, to share in anticipated cost savings.

According to a recent survey conducted by the American Association of Health Plans of commercial plans intending to sell products to the Medicare market, Medicare-Advantage beneficiaries will see immediate improvement in their coverage over current Medicare coverage, at an overall cost savings to the Medicare program due to the managed care approach. For example:

-- Lower cost sharing: The management of coverage built into the Medicare Advantage program will allow plans to lower monthly premiums, in some cases dramatically. As an example, one health plan in New England will decrease its premiums by an average of 23% -- with beneficiaries saving as much as $67 per month compared to current out-of-pocket costs; there is also expected to be a reduction in the cost of co-pays and deductibles.
-- Enhanced benefits: In addition to prescription drugs, many plans will be able to provide benefits not found in the traditional Medicare design, such as preventive screenings (e.g., for prostate or breast cancer, diabetes, and cardiovascular disease) which will enable diseases to be found earlier enhancing the likelihood of cure and lowering the long-term costs of treatment, and disease management programs.
-- Increased enrollment: After five years of slow growth and declining availability of private plans available through the Medicare+Choice program, plans are now expecting to add -- not subtract -- beneficiaries in the program. That is a strong sign of confidence in the direction of Medicare reform, and will result in greater cost savings for the Medicare program overall as more beneficiaries opt for the Medicare Advantage program.
-- New Products: A number of companies which intend to market products through the Medicare Advantage program plan to also offer Health Savings Accounts, drug discount cards, and new Medigap packages in addition to the basic scope of benefits guaranteed to Medicare beneficiaries. The reform legislation passed by Congress enables modernization of the Medicare program through the joining of product innovations brought in by the private sector.
-- Coordination of benefits: An element of the commercial health care marketplace, this practice has resulted in slower increases in health coverage premiums than have been experienced in the standard indemnity market. It will not be an element of Medicare through the Medicare Advantage program.

Summary

The passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 will provide all Medicare beneficiaries with the option of a standardized prescription drug benefit, but the bill also contains provisions which move the Medicare program on a path of privatization, introducing competition into the system, and expanding the quality of benefits and care to beneficiaries while instituting new cost-containment methods. The estimated cost of the reforms -- primarily the drug benefit provision -- are admittedly hefty. But the conservative principles of competition, private sector administration of the drug benefit, innovation in administration of benefits, and cost-containment provisions, could very likely bring down the overall cost of the program, while bringing Medicare coverage up to the level and quality of private benefit plans, and into the 21st Century.

(This overview of the Medicare reform bill was produced, in part, from information from the following sources):

http://frist.senate.gov/index.cfm?FuseAction=Issues.Detail&Issue_id=27

http://rpc.senate.gov/_files/MedicareModernization011604DM2.pdf

http://www.whitehouse.gov/infocus/medicare/index.html


TOPICS: Government; News/Current Events
KEYWORDS: atrw; gop; healthcare; healthcarereform; medicare; medicarereform
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The cost estimates of the Medicare bill are of great concern, but are only part of the picture. What most people ingore are the built-in cost-containmnet aspects of the Medicare bill, elements which will greatly improve the efficiency of the program, and will likely put the entire program on a path toward privatization -- decidedly CONSERVATIVE principles. This is another one of those "Big Picture" perspectives that conservatives need to be taking in regard to President Bush and the Congressional Republicans.
1 posted on 02/06/2004 10:08:47 AM PST by My2Cents
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To: kitkat; ilovew; hoosiermama; texasflower; Maigrey; homemom; B-Bear; Wphile; SoCalPol; dolly; ...
***Pragmatic Conservatism Ping***
2 posted on 02/06/2004 10:12:18 AM PST by My2Cents ("Well...there you go again.")
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To: My2Cents; MeekOneGOP; onyx; JohnHuang2; Dog Gone; Dog; isthisnickcool; OKSooner; VOA; mhking; ...
That is the best article I have seen yet on the "Conservative" aspects of the Medicare bill. Thanks for gathering all this information together.

When my Senator Inhofe voted for the bill, I knew then that it contained "Conservative" parts or he would not have voted for the bill. This bill is going to keep rural hospitals in Oklahoma up and running!

If anyone wants on the Bush-Cheney '04 ping list, please freep mail me.

3 posted on 02/06/2004 10:14:58 AM PST by PhiKapMom (AOII Mom -- Support Bush-Cheney '04)
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To: PhiKapMom; Tamsey; onyx; doodlelady; afraidfortherepublic; Wolfstar; GraniteStateConservative; ...
Those who are concerned about the cost of the Medicare drug benefit are really expressing the position that the federal government shouldn't be providing any health care coverage to seniors at all. That's a fair position. But let's be honest: no responsible conservative politician or office holder is going to make that case. Medicare is a reality. The debate was lost 40 years ago. Now the question is how to institute real cost-containment measures into the program, and how to move more beneficiaries into the commercial health care coverage market. The Medicare reform bill includes steps in this direction.
4 posted on 02/06/2004 10:15:55 AM PST by My2Cents ("Well...there you go again.")
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To: My2Cents
The debate was lost 40 years ago.

Exactly. It is not going to go away so you get the best bill you can get to reform the program. This gives seniors a choice -- if they don't want a choice, they are free not to choose another plan. Never could figure out what seniors were so upset about having a choice since they could keep their old plan.

My Mom, who is a senior, thinks the reason seniors didn't like it is because they wanted it all for nothing.

5 posted on 02/06/2004 10:20:25 AM PST by PhiKapMom (AOII Mom -- Support Bush-Cheney '04)
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To: My2Cents
THANK YOU for pinging me to this.....this is great...here's one interesting excerpt:

"Additionally, the very inclusion of a drug benefit to Medicare will reduce the cost of the program. For example, prior to this reform, Medicare paid for extended hospital stays for ulcer surgery at a cost of about $28,000 per patient. Yet Medicare would not pay for the drugs which eliminate the cause of most ulcers, drugs that cost about $500 a year. Now, drug coverage under Medicare will allow seniors to replace more expensive surgeries and hospitalizations with less expensive prescription medicine to treat their conditions."

6 posted on 02/06/2004 10:22:54 AM PST by goodnesswins (If you're Voting Dem/Constitution Party/Libertarian/Not - I guess it's easier than using your brain.)
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To: My2Cents
Excellent! Thank you for taking the time to compile this info.
7 posted on 02/06/2004 10:23:04 AM PST by hobson
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To: PhiKapMom
Add me to your Ping list, please?

This is valuable information. I've copied it to my HD for future use, which will probably occur on this thread!

8 posted on 02/06/2004 10:23:05 AM PST by TruthNtegrity (I refuse to call candidates for President "Democratic" as they are NOT. They are Democrats.)
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To: My2Cents
Thank you so much for taking the time to do a detailed explanation of this program. Having dealt with Medicare for my parents, I am well aware of the costs to the government involved by the bureaucracy and paperwork, and also the way in whicih the government pays for certain things (like cataract surgery) but neglects paying for things like preventative screening.

Your articile is much appreciated. Thanks!

9 posted on 02/06/2004 10:29:39 AM PST by Miss Marple
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To: My2Cents
The cost estimates of the Medicare bill are of great concern..........

$500 Thousand Million over 10 years in NEW spending (wealth transfers)...........

For many, this is the only issue, new spending.

10 posted on 02/06/2004 10:30:02 AM PST by WhiteGuy (Congress shall make no law... abridging the freedom of speech, or of the press...)
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To: My2Cents
Outstanding research and analysis of an hugely important subject. Thanks for helping to inform us.

The following bona fide CONSERVATIVE aspects of Medicare reform cannot be emphasized enough:


11 posted on 02/06/2004 10:30:03 AM PST by Wolfstar (George W. Bush the 1st truly great world leader of the 21st Century)
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To: goodnesswins; My2Cents
Good point! Think the same may apply to diabetic care? Thanks for the ping 2c
12 posted on 02/06/2004 10:31:34 AM PST by hoosiermama (Ask Kerry to list the major pieces of enacted legislation he has authored in his career.)
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To: PhiKapMom
Here's the difference between Democrats and Republicans: Democrats talk about "health care reform," but never do anything because if they actually *solved* problems, they'd lose an issue they can bring up every two years. Republicans actually make the effort to institute real reforms. They are not going to sponsor a bill to eliminate Medicare. What they have done is passed a bill which includes reforms that are conservative in principle, including cost-containment measures, encouraging greater efficiencies, including more of the private sector into providing coverage for beneficiaries, and putting the program on a path toward privatization.

To simply argue that the price of the drug benefit is too high is, frankly, a lazy argument. The entire bill should be considered, and the provisions that are conservative in principle should be supported.

13 posted on 02/06/2004 10:34:04 AM PST by My2Cents ("Well...there you go again.")
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To: WhiteGuy
I've acknowledged the cost concern in the article. But I'm also appealing to people to show some integrity and consider other aspects of the bill which will begin to reign-in the overall costs of the program.

To bang on the price tag and say "this is the only issue that matters" is short-sighted. The price tag is a concern, but consider the other issues which may mitigate that price tag.

14 posted on 02/06/2004 10:37:12 AM PST by My2Cents ("Well...there you go again.")
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To: hoosiermama
Think the same may apply to diabetic care?

To reiterate from the post:

"Enhanced benefits: In addition to prescription drugs, many plans will be able to provide benefits not found in the traditional Medicare design, such as preventive screenings (e.g., for prostate or breast cancer, diabetes, and cardiovascular disease) which will enable diseases to be found earlier enhancing the likelihood of cure and lowering the long-term costs of treatment, and disease management programs."

15 posted on 02/06/2004 10:40:15 AM PST by My2Cents ("Well...there you go again.")
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To: My2Cents
This is excellent. You will never hear me complaining about George Bush's Medicare Bill. As an employer, I was hit with the excessive cost for insurance coverage for employees over 50. It is really easy to see why older workers are let go -- their health premiums raise the cost of the whole pool. I know that it is illegal to let people go because of their age, but in reality it happens all of the time.

Because of the recession, I made the choice to kick my husband and myself off of our own company insurance and move to Medicare. We each purchased a Medicare supplement, so we are 100% covered. Since even a minor illness with one or two days treatment as an outpatient can cost $12,000 and up these days, this was an absolute necessity.

The only problem is that we cannot purchase drug coverage. Since both of us are on Lipitor and blood pressure meds (as are all of our friends our age) we are finding the cost expensive. The idea of ever needing any additional medicine is truly frightening as our income declines. Blood pressure meds and meds to lower cholesterol are truly helping the aging population. Use of these drugs is preventative and saves the Government money in the long run because they prevent strokes, etc, that would cost a whole lot more money to treat. It is foolish to risk the more expensive treatment by not helping with the less expensive solution.

16 posted on 02/06/2004 10:40:25 AM PST by afraidfortherepublic (Re-elect Dubya)
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To: My2Cents
Add me to the Pragmatic Conservatism ping list, please.
17 posted on 02/06/2004 10:42:43 AM PST by hchutch ("I never get involved with my own life. It's too much trouble." - Michael Garibaldi)
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To: My2Cents
I appreciate your position.

Do you REALLY believe in your heart that the federal government will ever reduce the amount spent on MEDICARE?

I don't. Now not only will medicare spending continue to increase every year, the entitlement has been augmented.

All of those items you mentioned are terrific, could they have been done without adding a bunch more spending?

I suspect that it's very possible.

My apologies for swiping your screen name but,

That's my 2 cents......
18 posted on 02/06/2004 10:45:08 AM PST by WhiteGuy (Congress shall make no law... abridging the freedom of speech, or of the press...)
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To: My2Cents; Howlin; Mo1; Tamsey; onyx; LisaFab
I applaud you for going through the tireless work of putting this all together, backed with your keen awareness of this issue!

For that, I am going to retrieve my pinger/paperweight from my computer desk and ping fellow FReepers toward this thread!

*ping*

19 posted on 02/06/2004 10:46:05 AM PST by BigSkyFreeper (All Our Base Are Belong To Dubya)
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To: My2Cents
The bill also contains provisions, unrelated to Medicare, which will lower the cost of all drugs -- benefiting not only Medicare beneficiaries and the program, but every consumer. The law injects competition into the Medicare marketplace, which will drive down the price of drugs. Private health plans have largely been successful in negotiating discounts with pharmaceutical manufacturers. Beneficiaries enrolled in a Medicare prescription drug program or a Medicare Advantage program will reap additional savings, since these plans will likely combine the attributes of a private insurance company and a pharmacy benefit manager (PBM).

The only thing that will drive down the cost of healthcare, including prescription drugs, will if the consumer directly pays for more of the services or products directly.

Having the government pay for the cost of prescription drugs is the surest way to increase the cost of prescription drugs. A third-party paying for products and services is the problen, a problem that gets worse thanks to this socialist plan.

If there was a true interest in reducing the cost of prescription drugs, seniors would be given greater access to buy drugs on the free market from countries like Canada and Mexico.

20 posted on 02/06/2004 10:59:48 AM PST by Ol' Sparky
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To: WhiteGuy; PhiKapMom
Well, I appreciate your position, too, Guy.

Do I really believe the feds will reduce Medicare spending? Realistically, no. But it has to be recognized that this bill wasn't just a new spending initiative, but the first substantive attempt since Medicare was established to institute cost-containment elements to the program, and to institute practices which the private sector uses to hold down costs. If these elements take hold as planned, they will reduce the cost of Medicare. That's a big "if," but the Republican Congress and the President are making a serious effort.

Actually, this bill wasn't the first attempt to put cost-controls into Medicare. That attempt was in 1997 with amendments to the budget act which established the original "Medicare+Choice" program. But as I pointed out, the Clinton Administration was so committed to keeping seniors tied to the federal government for their health needs, that it eviscerated the private health plan component of the '97 Medicare reforms. This bill reestablishes and strengthens those reforms.

So herein is a major difference between the two parties: With the Democrats you will get nothing but further enslavement to federal entitlements. With the Republicans you get real reforms intended to enable people to break free of those entitlements. Will the reforms work? Time will tell, but the effort is being made.

I should also point out something I found which I didn't include in the post: While the drug benefit may cost (emphasis on "may" because as I suggest, what we're hearing now may be an estimate on the high side) $500 billion over the next decade, the things the Senate Democrats wanted to put into the bill would have cost $2 trillion over the same period of time. And if they had their way, they would have obligated taxpayers to a $2 trillion price tag, and wouldn't have made the attempts at cost-containment which the Republicans placed into the bill.....Everyone needs to remember this when they go to the voting booth and are tempted to "send a message" by voting for some insured loser rather than voting for the Republican candidate for U.S. Senate.

21 posted on 02/06/2004 11:00:21 AM PST by My2Cents ("Well...there you go again.")
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To: PhiKapMom

22 posted on 02/06/2004 11:03:38 AM PST by MeekOneGOP (Check out this HILARIOUS story !! haha!: http://www.freerepublic.com/focus/f-news/1060580/posts)
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To: My2Cents; PhiKapMom
Thanks for the excellent, excellent article! And thanks to PhiKapMom for the wonderful pings!

For my husband and I, the preventive care coverage (which will reduce the overall cost in the future) and HSA's alone are what makes this truly a good step in the conservative direction. Democrats would still be sitting around b*tching about how the evil Republicans are killing off seniors.
23 posted on 02/06/2004 11:04:21 AM PST by alwaysconservative (We're rooting for you, President Bush!)
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To: Ol' Sparky
The only thing that will drive down the cost of healthcare, including prescription drugs, will if the consumer directly pays for more of the services or products directly.

That is part of the drug provision. Monthly premiums, co-pays, deductibles, and coinsurance once the deductibles are reached. The commercial market knows that a patient out-of-pocket share in paying for services will inhibit over- and often unnecessary ultilization of benefits. Frankly, I think the deductible for the drug benefit is rather high. Most people will never blow past it.

24 posted on 02/06/2004 11:05:51 AM PST by My2Cents ("Well...there you go again.")
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To: My2Cents
In the 1990's the health care specialty of home helath care really came into it's own. Patients were being sent home "sicker and quicker" and big changes to what home care had traditionally offered were quickly needed.

Procedures that had usually been only done in hospital were now extended to the home. Home intravenous therapy was one example, frequently for the administration of long term antibiotic therapy.

Insurance companies, HMO's jumped all over this. Pharmacies marketed their home infusion programs, coordinators were set up etc. Home care agencies scrambled to hire staff to cope with the extra case load.

Then, inexplicably, Medicare announced that it would not cover IV's unless they were administered in a hospital or skilled nursing facility which was the old standard that Medicare had used for decades. Although the private sector continued to fund the home IV administration procedures, if you happened to require 3 or 6 weeks of IV's and were on Medicare you had to go to a skilled nursing facility for the duration your therapy. Even if you were well enough and safe enough to be at your own home. So Medicare paid for not only the treatment, but the associated costs of placing the patient in the facility for that time period.

I raise this because it illustrates I believe, some of the severely entrenched thinking that Medicare has been administered under. There have been surface changes to plans, coverage issues, funding etc. for many many years and are often touted as platform issues in political campaigns. There have been new program names. But not much changed has occured to the substance of the program and what it covers and how it pays for it. Old Medicare seems a lot like Old Europe.

What you post about the speculation of the Clintons purposely killing the effectiveness of any recent changes, out of spite, is compelling as well. The time period, at least in my example, fits.

Thank you My2Cents, for putting this information together. Hopefully the effect of having competition to help keep costs down, expanded choices for the consumer, enhanced and coordinated benefits will also translate into a more modern and progressive Medicare. I have good faith in a captialistic market-driven system. Barring any other shenanigans from duplicitous politicians (for example), I believe the principles of a free market should apply here.

Prairie
25 posted on 02/06/2004 11:06:41 AM PST by prairiebreeze (WMD's in Iraq -- The absence of evidence isn't evidence of absence.)
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To: alwaysconservative; PhiKapMom
There are two groups of people who strenuously opposed these reforms -- 1) the usual naysayers who can only see issues from the perspective of cost, and whose answer to everything is "Get your hand out of my pocket!", and 2) the Congressional Democrats. Why do you think the Democrats were so opposed to this reform bill? Answer: If successful, it will actually start moving people out of Medicare and back into private commercial insurance products for some, most, or even all of their health care needs. Less dependence on government.

The naysayers in their kneejerk opposition to the President's goals here should take a good look at who they are allied with on this issue

26 posted on 02/06/2004 11:10:39 AM PST by My2Cents ("Well...there you go again.")
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To: alwaysconservative; afraidfortherepublic
My husband and I were very pleased to finally have HSA's included. As a self-employed contractor, he does all his own withhloding, and we have been buying our own health insurance - which now equals about 9% of his gross salary, since 1998.
An HSA will be our own investment in our future health care, and is a much better option than pouring money into our insurance company.

HSAs are to Medicare what IRAs are to Social Security!
27 posted on 02/06/2004 11:11:02 AM PST by EllaMinnow (If you want to send a message, call Western Union.)
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To: My2Cents
Hey, I know you are concentrating on the positives. That is a grand policy and something we should all try to do.

What we must strive for, in my opinion, is avoidance of the left's faulty belief that good intentions are just as worthwhile as real results.

If the left wingers had gotten their way, the new entitlement would have cost an additional 2 trillion over ten years, instead we have a new entitlement that costs only $500 billion.

Even you, whom I believe to be genuine and sincere, cannot bet the farm on this law's "reforms" reducing the neverending annual expansion of medicare.

"Do I really believe the feds will reduce Medicare spending? Realistically, no."


I wish this new law started reducing the medicare expense every year and completely got the government out of the business, I really do, I'd even meet you somewhere, let you scream "I TOLD YOU SO" in may face, and kick my ass.

But none of that is going to happen.
28 posted on 02/06/2004 11:14:50 AM PST by WhiteGuy (Congress shall make no law... abridging the freedom of speech, or of the press...)
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To: prairiebreeze
inexplicably, Medicare announced that it would not cover IV's unless they were administered in a hospital or skilled nursing facility which was the old standard that Medicare had used for decades.

Breezy, thanks for pointing this out. The Medicare system is a dinosaur, desparately in need of reform, and in need of catching up with the health care innovations of the past four decades. Simply hauling its fat carcass into the 21st Century will result in wiser use of funds, greater efficiencies, more effective care, and in the long run, lower costs, I believe. What true conservative could oppose that?! You raised excellent points.

29 posted on 02/06/2004 11:15:01 AM PST by My2Cents ("Well...there you go again.")
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To: BigSkyFreeper
retrieve my pinger/paperweight from my computer desk

Ummmmm.... BigSky? Any chance I could talk you into a pinger/paperCLIP instead???

/rubbing noggin...

30 posted on 02/06/2004 11:18:41 AM PST by Tamzee (W '04..... America may not survive a Democrat at this point in our history....)
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To: Tamsey
Any chance I could talk you into a pinger/paperCLIP instead???

I could use one of those too! *shuffling papers* ;)

31 posted on 02/06/2004 11:22:00 AM PST by BigSkyFreeper (All Our Base Are Belong To Dubya)
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To: My2Cents

I knew this was a good thing from what Newt stated way back in the Wall Street Journal, "Newt Gingrich: Conservatives Should Vote 'Yes' on Medicare"...


"Every conservative member of Congress should vote for this Medicare bill. It is the most important reorganization of our nation's health-care system since the original Medicare Bill of 1965 and the largest and most positive change in direction for the health system in 60 years for people over 65."

and this...

"If you are a fiscal conservative who cares about balancing the federal budget, there may be no more important vote in your career than one in support of this bill. Since health expenditures comprise almost 14% of the U.S. GDP, a shifting away from the failed bureaucratic third-party payer model and back to a market-mediated binary payer model, where the customer controls his own first health dollars, is the single most significant reform that can be made in saving the country from skyrocketing health costs and steadily increasing calls for taxpayers to finance more and more of the health-care system through higher taxes."

http://www.freerepublic.com/focus/f-news/1025610/posts
32 posted on 02/06/2004 11:26:06 AM PST by Tamzee (W '04..... America may not survive a Democrat at this point in our history....)
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To: WhiteGuy; PhiKapMom; All
No, I wouldn't bet the farm on the eventual success of the reforms, but the reforms are well-intended and based upon the experience of similar reforms in the private market, they are proven cost-savers. We'll see. I think it was worth the effort, even the drug benefit, because, as has been pointed out, there are drugs which control symptoms and even treatment at a much lower cost than surgery or hospital-based alternative treatments. We shell-out $500 billion over the next ten years in prescription drugs, it could result in an actual savings of a trillion or so dollars in unnecessary hospitalizations, which the old Medicare system would have necessitated.

I should also point out that Congressional Republicans are committed to further reforms of Medicare. While they supported the cost-containment measures in this bill, they believe that more cost-containment measures are needed. If the Dems take back one of the houses of Congress, and/or the Presidency, these further cost-control methods will never see the light of day. The Medicare bill was a step in modernizing and reigning-in the cost of the program. More needs to be done, as you suggest. And the first step in achieving these further goals is to re-elect Pres. Bush, and to put more Republicans in Congress this year.

33 posted on 02/06/2004 11:27:30 AM PST by My2Cents ("Well...there you go again.")
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To: Tamsey
Good find, Tamsey. In all honesty, I had not seen Newt's earlier comments on the Medicare bill.
34 posted on 02/06/2004 11:29:48 AM PST by My2Cents ("Well...there you go again.")
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To: My2Cents
It should also be noted that the Democrats were saying in the last debate last fall, the Republicans were/are trying to do away with Medicare entirely, essentially starving/killing off every single senior citzen and disabled American, which is not true. Reform isn't "doing away", it's just basically streamlining, updating, fixing, what have you, what already exists. If anyone is scaring seniors, it's the Democrats. All those folks who tore up their AARP membership obviously were misinformed. I live with my grandmother and she receives the AARP Newsletter, and I couldn't agree with them more. It should also be noted, that I've never been a big fan of the AARP.
35 posted on 02/06/2004 11:35:15 AM PST by BigSkyFreeper (All Our Base Are Belong To Dubya)
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To: BigSkyFreeper
So THAT is the problem, you're out of paperclips and just grabbed what was handy.... I guess I'm lucky you don't have a cat sleeping on your desk like I do ;-)

You can borrow some of mine 'till you get more...


36 posted on 02/06/2004 11:36:34 AM PST by Tamzee (W '04..... America may not survive a Democrat at this point in our history....)
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To: Tamsey
Hey! Nice! Colored paperclips! I'll put those in my GOP mug. :)
37 posted on 02/06/2004 11:39:40 AM PST by BigSkyFreeper (All Our Base Are Belong To Dubya)
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To: My2Cents
I'm not surprised you didn't see Newt's editorial :-(

It didn't get much attention here and most it DID get was terrible... lots of smearing mentioning adultery, treason, neo-con, etc.

I didn't find it until much later myself and just bookmarked it, but I should have thought to ping folks, sorry.
38 posted on 02/06/2004 11:42:01 AM PST by Tamzee (W '04..... America may not survive a Democrat at this point in our history....)
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To: redlipstick
We are also self-employed and I intend to be speaking to our accountant and our insurance agent about HSA's very soon!

Prairie
39 posted on 02/06/2004 11:42:19 AM PST by prairiebreeze (WMD's in Iraq -- The absence of evidence isn't evidence of absence.)
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To: BigSkyFreeper
Speaking of color, it wasn't just Newt who proved to me this was a good bill...

A Greenie I know turned purple with rage... a simple but very telling clue ;-)
40 posted on 02/06/2004 11:49:09 AM PST by Tamzee (W '04..... America may not survive a Democrat at this point in our history....)
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To: My2Cents; PhiKapMom; Mo1; Tamsey; onyx
This is another example of President Bush taking an issue away from the DemocRATS. He's working for true change in the system and not just empty grandstanding which is what the RATS do with these types of issues.

Prairie
41 posted on 02/06/2004 11:52:37 AM PST by prairiebreeze (WMD's in Iraq -- The absence of evidence isn't evidence of absence.)
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To: prairiebreeze
That's a very good post, prairie, and I will have to think through some of the issues. You may change my mind about this bill.

Although opposed to one or two of the president's proposals, I strongly support President Bush. Former conservatives who advocate staying home because they don't agree 100% with the president's proposals are, IMO, placing too little value on the judicial appointments coming up in coming years.

For those who oppose various bills or proposals, I believe the correct and most effective course of action would be to phone and write representatives to vent concerns regarding a specific piece of legislation or spending in general.
42 posted on 02/06/2004 11:58:24 AM PST by Peach (The Clintons have pardoned more terrorists than they ever captured or killed.)
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To: My2Cents
The one thing that makes me thing this article is right is that Ted Kennedy hates this bill.
43 posted on 02/06/2004 11:59:17 AM PST by Tribune7 (Vote Toomey April 27)
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To: prairiebreeze
I agree that this is a "do-something" President, who takes bold steps because he wants to keep moving on the issues. It is nothing like the paralysis we've seen before, even with Republicans. This is one courageous President!
44 posted on 02/06/2004 12:03:54 PM PST by alwaysconservative (We're rooting for you, President Bush!)
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To: Tribune7
The one thing that makes me thing this article is right is that Ted Kennedy hates this bill.

What's good for Democrats, is bad for America.

45 posted on 02/06/2004 12:04:59 PM PST by BigSkyFreeper (All Our Base Are Belong To Dubya)
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To: Tribune7
The one think that makes me thing this article is right is that Ted Kennedy hates this bill.

That says it all. Thanks.

46 posted on 02/06/2004 12:13:31 PM PST by My2Cents ("Well...there you go again.")
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To: BigSkyFreeper
AARP is a big fan of ME, apparently, because they keep sending me membership cards!
47 posted on 02/06/2004 12:17:14 PM PST by My2Cents ("Well...there you go again.")
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To: My2Cents; *ATRW
Excellent work in researching and presenting this material. Will be sending it around..

Ping to ATRW...fyi

Thankyou M2C!
48 posted on 02/06/2004 12:19:56 PM PST by DollyCali (2004: Opportunity for love, growth, giving, doing..... It is our choice.)
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To: prairiebreeze
Bush was also willing, in 2001, to sign an HMO reform bill ("Patients Bill of Rights). The bill was sent to conference, but never emerged. The reasons nothing ever came out was that Bush was willing to accept everything the Democrats wanted, except unlimited personal damage awards through litigation. The Dems, thinking more of their trial lawyer constituency than actual patients, balked. Also, the Dems really don't want to settle on a bill, because they don't want to lose HMO-hatred as an issue they can manipulte voters with.

Let all of this be a lesson -- The Democrats really don't want to address problems. They only want to allow problems to fester so they can manipulate voters' frustration every two years. The GOP puts forward real reforms, backed by conservative principles.

49 posted on 02/06/2004 12:24:48 PM PST by My2Cents ("Well...there you go again.")
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To: Peach
Former conservatives who advocate staying home because they don't agree 100% with the president's proposals are, IMO, placing too little value on the judicial appointments coming up in coming years.

Anyone ignoring the value of judicial appointments coming up in the next few years, and the impact of this election on those appointments, isn't a real conservative.

50 posted on 02/06/2004 12:26:29 PM PST by My2Cents ("Well...there you go again.")
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