Troubling, if true.

[finknottle]

The government ordered an investigation into Humana after the insurance provider sent a letter to its subscribers warning that Helath Care Reform legislation may lead to cuts in Humana's Medicaire Advantage program.

 

The story is from Fox, and obviously slanted.

http://www.foxnews.com/politics/2009/09/23...-care-provider/

 

Unfortunately, the rest of the media no longer reports on things embarrassing to the government until they have too - they ignore them. So there is no reporting of the administrations side, lest there be an aknowledgement of a problem. All I know is that the crux of the story is true, that McConnell made such charges.

[YellowLinesandArmadillos]

My question and possible justification for the investigation is Did they use Government Funds to send the letters and did they report it in their lobbying disclosure report. If not the investigation is justified and the slant on this information O'Connell's whining is disingenuous.

 

Otherswise, Humana, though the letter is disgusting and a bunch of chicken little tactics, is probably within it rights to send the letter.

[GG]

My question and possible justification for the investigation is Did they use Government Funds to send the letters and did they report it in their lobbying disclosure report. If not the investigation is justified and the slant on this information O'Connell's whining is disingenuous.

 

Otherswise, Humana, though the letter is disgusting and a bunch of chicken little tactics, is probably within it rights to send the letter.

 

So, you are more concerned about the money flow than the obstruction of free speech?

[Magox]

I actually wanted to talk about this yesterday, but I was sidetracked discussing what a "fact" is. This pisses me off to no freaking end, the Democrats are trying to shut everyone up that is against their plan. I've said this before, their motto is "If you can't beat'em, demonize'em"

 

Humana sends out a letter to their clients, telling them what they believe will happen (and will happen), which btw is supported by the Non partisan (left leaning) CBO http://www.libertysarmy.com/2009/09/23/hea...-health-reform/ , and now the government wants to investigate them and in essence trying to silence them since it does not fit their agenda.

 

This is a very disturbing trend, remember the flag@whitehouse.gov deal? Or BO's speech in front of congress and said "If you misrepresent what's in this plan, we will call you out." In other words, if people say something that they don't agree with they will call you out, perfect example, Humana.

 

But what really pisses me off is what transpired yesterday, the Democrats blocked an amendment to allow the CBO and the general public to do a full cost analysis on the bill http://washingtontimes.com/news/2009/sep/2...y-votes//print/

 

Democrats on the Senate Finance Committee on Wednesday turned back a Republican amendment to wait 72 hours and require a full cost estimate before the final committee vote on the health care reform bill.

 

It was the committee's first vote out of more than 500 amendments awaiting them, in what has already been a contentious mark-up session.

 

The amendment would have delayed a vote on the final bill for about two weeks to allow the Congressional Budget Office to complete its final analysis on the cost and implications of the legislation.

 

Chairman Max Baucus, Montana Democrat, promised committee members that they'd have a preliminary analysis of the bill before they vote.

 

Republicans said the full analysis, which details the cost and implications of the bill, is necessary to inform their vote.

 

"It's what [the public] expects us to do anyway -- read a bill before you vote on it," said Sen. Charles E. Grassley, ranking Republican on the panel.

 

Further complicating the process is the fact that the Finance Committee works on "conceptual language" -- plain English explanations that are later turned into legislative text.

 

The committee has always worked with conceptual language with the understanding that if a lawmaker finds a discrepancy later, the chairman can change the text to reflect what was intended.

 

Democrats argued that the conceptual language made it easier to understand what the committee is voting on, but Republicans said that the legislative details are significant.

 

Rushed floor votes on the stimulus bill and the cap-and-trade energy bill -- both of which totaled more than 1,000 pages -- have fueled calls from the public that lawmakers read bills before voting on them. The House resolution is supported by several public-interest groups, including the Sunlight Foundation, which point out that hasty votes can result in unintended consequences, such as the provision tucked into the stimulus bill that had the effect of authorizing executives of bailed-out insurance giant AIG to receive retroactive bonuses.

 

Earlier this summer, Mrs. Pelosi told a reporter she would allow a 48-hour waiting period prior to bringing health care legislation up for a vote.

 

This is the kind of **** that pisses people off. Why the hell not? it's only 2-3 more weeks, but of course these assclowns want to push it through now, absolutely sickening.

[Pine Barrens Mafia]

I think Medicare Advantage will end up phased out anyway, it's simply been an abject failure.

[kegtapr]

I think Medicare Advantage will end up phased out anyway, it's simply been an abject failure.

 

It's been anything but. Medicare Advantage is the only way most seniors get the care they actually need. Reimbursment rates are absurd and need to be fixed, but dropping MA plans will leave seniors paying for A LOT more of the care they receive and can't afford.

[GG]

It's been anything but. Medicare Advantage is the only way most seniors get the care they actually need. Reimbursment rates are absurd and need to be fixed, but dropping MA plans will leave seniors paying for A LOT more of the care they receive and can't afford.

 

I think Joe sells a competitive product.

[Pine Barrens Mafia]

I think Joe sells a competitive product.

 

MOST seniors would be far better suited with a Medicare Supplement and Medicare as primary than with a MA plan that can end up costing them thousands in out-of-pocket costs.

[kegtapr]

MOST seniors would be far better suited with a Medicare Supplement and Medicare as primary than with a MA plan that can end up costing them thousands in out-of-pocket costs.

 

Except that premiums for Medigap plans are generally more expensive and create a greater annual cost to seniors, especially if you have employer group MA plan retiree benefits. A healthy senior would be wasting money with a Medigap plan. MA plans provide a better balance by saving the seniors money but giving the safety net for catastrophic events.

 

Not to mention, they lose out on wellness benefits that often offset the premium for MA plans.

[Pine Barrens Mafia]

Except that premiums for Medigap plans are generally more expensive and create a greater annual cost to seniors

 

Until they get sick. Which they do in high percentages. Then, they ALL want a supplement. Then it's too late. Too bad for the unlucky senior who, say, is healthy but gets in a car wreck or has a heart attack. Then the low premiums seem to suck when they're stuck in a network, have co-pays out the wazoo and have to go through a gatekeeper to get tests they need.

 

Much better to know what your healthcare expense is going to be when you start the year, as you can do with an F or J plan supplement.

 

I know, I see it every day. Someone thinks they're smart being on an MA plan, then they get sick. Then the bills stack up. then they come to me all upset and all I can do is tell them they're SOL since they blew their federal open enrollment on an MA plan.

 

Let me guess... you work for Blue Cross/Humana/Advantra or one of those other MA firms?

[Chalkie Gerzowski]

This thread makes Kommandant Soetero sad...

[kegtapr]

Let me guess... you work for Blue Cross/Humana/Advantra or one of those other MA firms?

 

 

Close...........but better.

 

If a senior signs up for a cheap or no premium MA plan, then you are correct. They are going to incur a lot of OOP expenses. No premium MA plans offer no more coverage than traditional Medicare. There are many moderate cost MA plans out there where people won't incur the costs you speak of for a cheaper premium than Medigap, all while recouping some of the cost by the additional wellness benefits they receive. You can still incur OOP expenses with Medigap policies as well, especially if you pick the wrong one.

 

Stuck in network? Who cares. Most seniors have their doctors and don't stray from them. There are also PPO options available with a national network and no referrels, still chaper than Medigap.

 

I'm sure you do have experiences with people who picked the wrong coverage. But we wouldn't retain over 90% of our existing members year after year if that was the norm. It's far from the abject failure you say it is. I stand by the fact there is a lot that can be fixed, but face it, different options are better for different people.

 

Also, keep in mind you're looking at this from your perspective in PA. I'm in NY with what is basically the model plan that sets the national standard. We may both have valid points based on the offerings in our areas.

[Pine Barrens Mafia]

If a senior signs up for a cheap or no premium MA plan, then you are correct. They are going to incur a lot of OOP expenses.

 

Which most seniors do, since that's the whole point of MA.

 

Also, keep in mind you're looking at this from your perspective in PA. I'm in NY with what is basically the model plan that sets the national standard. We may both have valid points based on the offerings in our areas.

 

Actually, I'm now with a firm that has me licensed in 49 states. (Only unlicensed in Hawaii because you need to physically live in that state to sell/consult there. I agree, that different circumstances require different tools. If a senior is too unhealthy to qualify for or too poor to afford a medigap policy, then a MA plan would be okay. Not great, not the best, but better than nothing. But for any senior that has the means to pay for a supplemental policy (such as plans C, J, or F), it is the best health insurance that money can buy. Nothing like going to a hospital for a triple bypass and not paying a dime out of pocket. One health event like that makes up for the lifetime of premiums.

 

I'd be interested to hear who you're selling for, PM me if you want.

 

Oh, and BTW, is NY *not* a total pain in the ass to the insurance industry?

[kegtapr]

Which most seniors do, since that's the whole point of MA.

 

 

We don't even offer a no premium MA plan. That does suck for seniors that get roped into one thinking it's providing additional benefits. There are a lot of shady practices in the world of Medicare. I can't tell you how many times we have members disenrolled from our plan because they were tricked into signing something for another plan.

 

Oh, and BTW, is NY *not* a total pain in the ass to the insurance industry?

 

The recent tax on insurers is enough to answer that question. Nooooooo, of course we won't pass that along to our members. Idiots.

[YellowLinesandArmadillos]

It's been anything but. Medicare Advantage is the only way most seniors get the care they actually need. Reimbursment rates are absurd and need to be fixed, but dropping MA plans will leave seniors paying for A LOT more of the care they receive and can't afford.

Wrong, it gives no more benefits and costs the government an estimated 12% more per patient than medicare providing the same benefits... your tax dollars at work in the inefficient insurance sector. Why currently even the public option is more efficient sadly than anything the current make up or the insurance oligopoly is spewing.

[kegtapr]

Wrong, it gives no more benefits and costs the government an estimated 12% more per patient than medicare providing the same benefits... your tax dollars at work in the inefficient insurance sector. Why currently even the public option is more efficient sadly than anything the current make up or the insurance oligopoly is spewing.

 

Not wrong, try again. For a no premium MA plan you are correct. There are a lot of MA plans that provide more benefits.

 

And as I said, reimbursment rates need to be fixed. But don't forget that passing the administration off to private insurers takes it away from the government providing them with less administration. Give everything back and that 12% disappears pretty quickly. They'll no longer have the private plans to do their dirty work. Insurers are made responsible for many things that Medicare should be and it's a good thing. You think private insurers are inefficent? Ha. If you had to deal with Medicare on a daily basis, you'd see what inefficent could really be.

[Pine Barrens Mafia]

Not wrong, try again. For a no premium MA plan you are correct. There are a lot of MA plans that provide more benefits.

 

And as I said, reimbursment rates need to be fixed. But don't forget that passing the administration off to private insurers takes it away from the government providing them with less administration. Give everything back and that 12% disappears pretty quickly. They'll no longer have the private plans to do their dirty work. Insurers are made responsible for many things that Medicare should be and it's a good thing. You think private insurers are inefficent? Ha. If you had to deal with Medicare on a daily basis, you'd see what inefficent could really be.

 

Now this post I'll actually agree with. Medicare billing without crossover (which is how it worked at the first company I worked for) is a total nightmare.