Sunday, October 31, 2010

The Government PAYS the Healthcare Providers to Manage the Plans!

Being new to what my friend Dee calls "The Blogosphere," I feel like such a novice. However, getting past that, there is so much I want to share with readers of my blog. There is so much happening in the Health Care industry that is impacting all of us, especially those of us who are getting older, approaching the age of 65.

At 65, we in the U.S. are eligible for Medicare. Back in 1965, when Congress passed the Social Security Act, they passed Part A for Hospital coverage and Part B for Doctors/Medical coverage. Many seniors felt this coverage was not sufficient. Many who could afford it bought supplements to fill the gaps Medicare didn't cover. Then, in 1997, Congress passed the Balanced Budget Act (sponsored by a Republican) which allowed Medicare beneficiaries the option to receive their Medicare benefits through private Health Insurance companies. They sell "Medicare Advantage (MA) Plans." Then in 2003 (sponsored by a Republican), with the "Medicare Prescription Drug, Improvement and Modernization Act," Medicare benificiaries could now purchase prescription drug plans (PDP) and Medicare Advantage with Prescription Drugs (MAPD) through private Health Insurers. These two acts (1997 and 2003 -- bills sponsored by Republicans) opened the door for private health companies (Big Business) to virtually take over Medicare. It is a gold mine for them and for Pharmaceutical companies. How? Healthcare providers make these MAPD plans so attractive to seniors that they are are now addicted to them. These plans weave together Hospitalization, Doctor/Medical benefits and Prescription Drug Plans for a Premium of $0. Yes. Zero Dollars.  These plans are so attractive, they are a signficant improvement vs government offered Medicare. These plans charge less for hospitalization, very low co-pay for doctor visits ($10 - $20), flexibility to go in and out of network, very low co-pay for generic drugs and significantly lower co-pay for Branded and higher Tier drugs. Additionally many plans include membership to fitness clubs, low cost dental, vision and hearing coverage as well as Wellness programs, all for $0 Premiums.
Many people ask, "How can Health Care providers offer these plans at $0 premiums? Where do you make your money?" The answer is, the government. The government pays the Healthcare providers to manage the plans.

Now, to the issue:
1. How can Healthcare providers provide such LOW Cost plans (which include PDP)?

(Because these Big Business Providers receive so much profit!)
2. Who sponsored these bills? (As my friend Dee would say: Republicans! More to come)
3. Democrats in Congress are wise to this and have protested, however the MESSAGE has not filtered down to every day American.
Note: So much more to come! More revelations with each Blog Post!
Note 2: Here is an article about the Dems in Congress addressing this issue in 2007!

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