Category Archives: Medicare

The Rime…

Posted on by
Ah! well a-day! what evil looks
Had I from old and young!
Instead of the cross, the Albatross
About my neck was hung.
— The Rime of the Ancient Mariner, Part II, Stanza 14.

Samuel Taylor Coleridge

Obama must be feeling as if he were that Ancient Mariner, who killed the Albatross and was condemned to wear its dead body around his neck. The difference is that Obama’s Albatross is Obamacare.

Some statistics were published today that is another weight, another burden, around Obama’s political agenda. Statistics, such as:

OBAMACARE POLL: THEY’VE TRIED IT AND THEY DON’T LIKE IT
Fifty percent of voters disapprove of ObamaCare, 43 percent strongly so, according to a poll out from the budget hawk group Public Notice. The survey, conducted by Tarrance Group, found that while 40 percent of respondents approved of the health law, a majority of key groups disapprove including women ages 18 to 44 (51 percent), employees of small businesses (57 percent), adults in households with children (56 percent) and voters who’ve tried to shop on ObamaCare Web sites (52 percent). The poll also showed that Members of Congress who voted for the president’s law are getting a negative reaction from voters, with 43 percent saying they less likely to re-elect those who voted for the health law versus 38 percent who are more likely to vote for their member if he or she voted for ObamaCare. — FOX Newsletter, 12-10-2013.

The critical issue is the age groups in the poll above. These groups are the demographic segment that Obama was planning on soaking to pay for his monstrosity. Now, they are opting out, refusing to play Obama’s game, a game he is losing badly.

But that isn’t the only damaging news about Obamacare. As we move closer to the implementation date, more failings of Obamacare are emerging. This time for prescription drugs—the list of covered drugs has been slashed. Many of us, forced onto Medicare, take maintenance drugs. Some are to control cholesterol, some to control blood pressure, plus many others. Now, with the list of covered drugs slashed, Obamacare and Medicare participants must pay for those drugs out of their pockets. Plus, for Obamacare enrollees, those out-of-pocket costs cannot be charged to your deductible.

OBAMACARE PAIN PILL
Dr. Scott Gottlieb, former senior policy adviser to the Centers for Medicare and Medicaid Services told Megyn Kelly that many prescriptions may not be covered under ObamaCare. “The list of drugs that the plans cover, in many cases, aren’t very long.  And if the drugs aren’t covered you’re on your own, you basically have to pay for it entirely out of pocket, and the money that you spend on those drugs doesn’t count against your out of pocket limit or against your deductible,” Gottlieb said. “This could cost patients who need special drugs a lot of money, literally tens of thousands of dollars a year.” — FOX Newsletter, 12-10-2013.

***

What a disappointment Paul Ryan has turned out to be. He ran in the last election, as a conservative, a tax conservative and a spending conservative. His current budget plan, with democrat Senator Patty Murray, exposes the lies he spoke during that campaign.

The Big Spenders Return

By: Erick Erickson (Diary)  |  December 10th, 2013 at 04:30 AM

If Paul Ryan were a Peanuts character, he’d be the guy who pulls the football out of the way just as he himself is about to kick it. Over the past number of years, Congressman Ryan has come up with a few reform proposals.

From his roadmap to this, he has made as his starting point for negotiations that which should be his ending point.

Now, with liberal Senator Patty Murray, Congressman Ryan wants to raise spending today on the promise that Congress will restrain itself ten years from now (or whenever the benchmark will be). It’s a return to pre-sequestration Washington — spending increases today in exchange for promises of spending cuts later.

I opposed sequestration at the time the GOP came up with it. I figured they’d do an end run around it. But they did not. Surprisingly, they stuck with it if only because they couldn’t figure out a way to undermine it without rocking the boat with their base.

Now it’s looking like they are prepared to rock that boat.

The Democrats have repeated painted doom and gloom scenarios about sequestration. They said it would undermine economic growth, but the latest economic figures dispute that. They said it would cause increased unemployment, but the latest employment numbers dispute that. They’ve said a great deal, all of which has been nonsensical hyperbole.

Based on what has been reported so far, the Ryan-Murray plan seems like outright capitulation to the big spending, big government agenda of both parties’ lobbyist class. In fact, the op-eds already coming out for it are being written by those who stand to profit from more spending.

Congress should start at sequestration spending levels and reduce spending from there — not raise revenue and not raise spending. After all, like Obamacare, sequestration is the law of the land too.

A sellout in any form, is still a sellout. Actions like this, Ryan’s betrayal of his Tea Party supporters, makes me wonder if there are ANY national politicians, Cruz, Lee and a handful of others excepted, who are not traitors to their constituents?

Here is a link to another report on the Paul Ryan-Patty Murray Tax and Spend bill. It’s very informative.

***

If you watch the news coming out of the Middle-east, you may have come across this article, the possible creation of strange allies, Saudi Arabia and…Israel! Neither country wants a nuclear Iran on their borders.

Saudis to Obama: We Will Not Tolerate a Nuclear Iran

By Karin McQuillan, December 10, 2013

Individuals who have even visited Israel, or who observe Judaism, or who carry a Bible are banned from Saudi Arabia.  Yet Saudi Arabia’s Israel-hating King Abdullah just flew in an Israeli scientist to have dinner with him, to enjoy some royal hospitality, accept a medal and the $200,000 “Arab Nobel Prize.”  It’s a not-so-subtle message to President Obama: the unthinkable can happen, so don’t assume the Saudis won’t join with Israel to bomb Iran.

Obama’s new Iran policy moves the Mid-East closer to war over oil and religion — Sunni Saudis versus Shia Iranians.  There is no more strategic commodity than Gulf oil to the entire world economy.  American national security stakes could not be higher.   Iran’s end game, some say more than an attack on Israel, is to seize the Saudi oil fields.  There is a Shiite majority in the oil province that the Saudi Princes fear could be turned by Iran.  The Saudis no longer see the U.S. as an ally in stabilizing the Middle East.  We have become a force for chaos. The UK Telegraph:

Chris Skrebowski, editor of Petroleum Review, said the great unknown is how Saudi Arabia will react to a move deemed treachery in Riyadh… The great question is whether they can live with this deal, or whether it is intolerable,” he said.

Mr Skrebowski said the Middle East is a tinder box, in the grip of a Sunni-Shia civil war comparable in ideological ferocity to the clash between Catholics and Protestants in early 17th Century Europe. Saudi Arabia has already shown how far it will go to protect its interests, helping to overthrow Egypt’s Muslim Brotherhood.

The Saudis are signaling that they will unleash a pre-emptive war in the Middle East in response to Obama’s nuclear capitulation to Iran.  These signals are an effort to change Obama’s decision to prop up the mullahs and green light their nuclear program.  Can the Saudi threats become real?  It’s a wild card our President is willing to play.

The column continues, here, at the American Spectator website.

The Obama administration, acting as if by design, is alienating our friends and allies. If Obama’s plan is to isolate the United States from our friends around the world, he is being extremely successful. That’s is Obama’s only agenda item that is working.

Facebook

Comparisons

Posted on by
Obamacare went to the Supreme Court last week.  Obama’s Solicitor General and his assistant were…well, let’s say they did not present their side very well. One description I read on the Internet said they were minor leaguers meeting major league All-Stars. In my opinion it was worse than that.

The conventional wisdom of the pundits and many others is that Obamacare is toast and that it will be declared unconstitutional in its entirety.  I’m not so sure, but the outcome of Obamacare isn’t my primary topic today.

Given the premise that Obamacare is unconstitutional, libs say they’ll just expand medicare to include everyone. Medicare has been in force since the 1960s. Everyone knows it’s constitutional and has no requirement for people to sign up. No Individual Mandate so they say.

Really?

I’m retired and started drawing Social Security in January of last year. I signed up for Medicare and it became effective for me on the 1st of March.  Much as I dislike Medicare, I didn’t have much choice.

I could have refused Medicare.  Yes, I had that right.  If I did, however, I’d also lose my Social Security.  As much as I hate to admit it, my Social Security income is a significant percentage of my fixed income. More than my other sources combined.

Given that, and I’m not alone, I really didn’t have a choice.  My circumstances, like that of most retired Americans, made choosing Medicare an Individual Mandate.

My preference would have been to continue with my health insurance provided by my former employer. Theoretically, I could if I ponied up payments for that insurance.  The monthly bill, however, was more by several hundred dollars than my pension check.

My former employer assumed I would be receiving medicare when I hit 65 and did not provide equal corporate health insurance to retirees once they reach Medicare age.

This year, my options became much more…limited.  I had a gap of several months when my employer healthcare ended and Medicare began.  My wife, also retired, was in the same boat.  We were able to find some month-to-month catastrophic insurance at a reasonable cost, around $400/mth for the two of us.  It was limited, no prescription plan, pay-as-you-go for office visits and office lab-work.

For some, this would be a viable alternative. For us, it was not optimum. We needed a drug plan for our expensive medications, and for blood work done every quarter. For us, as bad as it is, we’re back to Medicare.

I don’t know how long Medicare will be suitable.  If Obamacare remains in force, two current Medicare add-ons, the Advantage Plan, and Supplemental Insurance, will not be allowed.  I and my wife, in a last minute rush, chose an Advantage plan for this year.  Now that I’ve had a chance to do more investigation, we’ll choose a Supplemental plan next year—if we can.

Given existing Medicare law, do we have an Individual Mandate requiring us to choose Medicare?  For us, “Yes.”

Therefore, if retirees have no choice but to sign up for Medicare, that is an Individual Mandate.  If the Individual Mandate portion of Obamacare is not constitutional is not Medicare unconstitutional as well?

That is a very good question that I have no answer.  While it may require me to pay more out-of-pocket, I like Paul Ryan’s plan to move Medicare to a subsidized private health plan. With competition, and much less federal regulation, I’ll bet healthcare for retirees will become much, much better and much, much cheaper for all.

If conservatives win the White House and Congress next fall, let’s reform Medicare by dissolving it and all the existing regulations with it.  Changes are needed and Paul Ryan’s plan is, for me and my wife, a much better option than Medicare as it now exists.

Friday Follies for February 24, 2012

Posted on by

Gas Prices: A refinery fire in Washington state is the trigger, so says news sources, for the recent spike in retail gas prices. A fire last Friday at the BP Cherry Point site at Blaine, WA, is the trigger for the increases.  Gasbuddy.Com, a website that tracks gas prices across the country, says the fire halted production at the site.  The BP Cherry Point refinery produces 90% of the transport fuel for the west coast.

This weekend a major fire that started Friday at the BP Cherry Point Refinery in Blaine, Washington has left the refinery unable to take in its daily intake capacity (230,000 barrels per day), much of which arrives from Alaska. Approximately 90 percent of the crude oil refined there emerges as transport fuels making it the largest marketer of gasoline and jet fuel on the West Coast.
…

The refinery is on a massive sprawl of 3,300 acres and was built in 1971, making it one of the newer refineries in the U.S. Until this weekend, it was producing 3.5 million gallons of gasoline; 2.5 million gallons of jet fuel; and 2.2 million gallons of diesel per day. — GasBuddy.com

The suddenly cut in production was felt across the country.  West Virginia saw a $0.20-0.30 per gallon jump reports the West Virginia Gazette.

CHARLESTON, W.Va. — Gas prices in Charleston rose between 20 and 30 cents per gallon on Wednesday.

According to Gasbuddy.com, a company that tracks gas prices at more than 140,000 gas stations in the United States and Canada, gas prices at most stores in the area were between $3.49 and $3.58 early in the day and had risen to $3.79 and above by late afternoon.
Jan Vineyard, president of the West Virginia Oil Marketers and Grocers Association, said the cost from one of the area’s major suppliers went up 15 cents for gas stations, causing the higher prices. — WVGazette.

The West Virginia report also blames the crises with Iran and the transition to summer blends contributing to the increased prices.

Locally, here near KC, we could expect another ten to twenty cent increase in our gas prices before the weekend according to GassBuddy.  The price here has already risen twenty to thirty cents just this week.

***

My wife and I hit 65 this year.  Like it or not, we’re being forced to sign up for Medicare.  My former employer only provided health insurance until we reach 65. At that point we’re dropped and expected to join the Medicare crowd.  Frankly, I couldn’t afford to stay with my employer’s health plan, it was costing me $1400/mth.  Up to this point, the cost was covered by a savings fund created when I was working.  Contributions to that fund ended years ago with the merger of Sprint and Nextel.  Sprint had a pension plan, Nextel didn’t.  After the merger, Sprint didn’t have a pension plan either.

The survival and efficiency of Medicare is an interest for us. A vital interest you might say.  There have been several Medicare reform plans submitted recently.  One, the abomination called Obamacare, is now the law of the land if it isn’t repealed.  Obamacare will replace Medicare.  Oh, the name Medicare will continue but the fact is with Obamacare Medicare will cease as it currently exists.

Paul Ryan submitted a plan last year.  The left went into a frenzy over it.  It was a good plan but some better ones have emerged since.

Burr-Coburn: The Best Medicare Reform Proposal Yet

Many politicians (and many voters) duck the hard choices when it comes to Medicare reform. But what’s remarkable about the past year is that, in some ways, momentum appears to be building for real improvements to the program’s quality and sustainability. Based on a new proposal from Sens. Richard Burr (R., N.C.) and Tom Coburn (R., Okla.), the impossible seems within reach: the triumph of sound policy over interest-group politics.
…
If Wyden-Ryan and Lieberman-Coburn got together to do what many people did on Valentine’s Day, Burr-Coburn would be the result.
I’d previously called Wyden-Ryan a “game changer” for its utilization of two key reform principles, premium support and competitive bidding. Lieberman-Coburn hits the other key principles of reform, including cost-sharing and fraud prevention. As I wrote last June,

I have a lengthy essay in the Summer 2011 issue of National Affairs on Medicare reform, entitled “Saving Medicare from Itself.” In it, I discuss six core concepts for real Medicare reform: (1) preserving benefits for people aged 55 and older; (2) making sure that retirees share more of the costs of their care, and thereby a stake in prudent consumption; (3) means-testing; (4) indexing the Medicare retirement age to life expectancy; (5) aggressive fraud prevention; (6) allowing seniors to shop for value in insurance plans. The Lieberman-Coburn bill hits on many of these points in a way that well complements Paul Ryan’s premium support proposal.

Wyden-Ryan hits (1) and (6), while Lieberman-Coburn hits (2) through (5). Together, they comprise the most complete Medicare reform proposal, using bipartisan policy principles, that has yet been put together.
The plan includes these elements.
Premium support and competitive bidding
Burr-Coburn incorporates something quite similar to the Wyden-Ryan system of competitive bidding and premium support, in which retirees would be able to choose among private plans and a “public option” of traditional Medicare.
…
One key difference between Burr-Coburn and Wyden-Ryan in this regard is that Burr-Coburn implements competitive bidding and premium support in 2016, not in 2022. On the plus side, this six-year difference has a huge impact on the long-term cost savings of Burr-Coburn.
Increasing the retirement age
As with Lieberman-Coburn, Burr-Coburn gradually increases the Medicare eligibility age from 65 today to 67 in 2027. This will allow Medicare’s eligibility age to match that of Social Security.
Improving the Medicare benefit
One thing that most people don’t realize is that Medicare, designed in 1965, has significant gaps and flaws in the design of its insurance benefit. Medicare doesn’t cover catastrophic costs, forcing many seniors to buy supplemental Medigap plans for their own protection, and giving providers perverse incentives to favor expensive hospitalizations over more efficient outpatient care.
Burr-Coburn would combine Medicare Part A (hospitalization) and Part B (outpatient physician services) into a single deductible, with a unified deductible of $550, co-insurance of 20 percent of costs until a retiree had spent $5,500, co-insurance of 5 percent until he had spent $7,500, and full coverage above $7,500.
Means-testing
Burr-Coburn requires greater cost-sharing for people with higher incomes: a far superior solution to raising taxes to subsidize these individuals. Those with incomes above $85,000 as individuals or $170,000 as married couples would be subject to a higher cap on out-of-pocket costs: $12,500 instead of $7,500.  For those with incomes above $107,000 individual or $214,000 family, the cap would be higher ($17,500) and even higher ($22,500) with those making $160,000 as individuals or $320,000 as married couples.
In addition, the plan would charge lower Medicare premiums to lower-income seniors, and higher premiums to higher-income retirees.
Cost-sharing reform

One of the worst aspects of Medicare is the way it is almost intentionally designed to waste money. Medigap plans are a big part of this, by providing private-sector supplemental coverage that undermines Medicare’s ability to incentivize seniors to be mindful of wasteful medical spending.

Flattening the “doc fix”
One of the worst and most persistent problems with federal budgeting has been the Medicare Sustainable Growth Rate, a global cap on the growth of Medicare payments to doctors and hospitals.
Because the global cap doesn’t keep up with the rise in the cost of health care, and provides no incentive for doctors and hospitals to be more efficient in the way they provide care, Congress has had to routinely step in with “doc fix” legislation that jacks up Medicare spending.
Repeal IPAB, Obamacare’s Medicare rationing board
Obamacare’s vision of government-rationed health care was on full display with the enactment of its Medicare Independent Payment Advisory Board, a new bureaucracy that seeks ultimately to control which treatments seniors can receive, based on the board’s view of their cost-effectiveness.
There are several problems with this approach, despite its enduring appeal to central planners. First is that rationing has done nothing to control the growth of health spending, as Britain has shown. In addition, “cost-effectiveness” is subjective, and imposes a one-size-fits-all formula on a diverse country of 300 million people, who respond differently to different treatments. (For more on this topic, see my report on my appearance before Congress at an hearing on IPAB.)
Burr-Coburn repeals IPAB and replaces it with a system that allows seniors to voluntarily chose the benefits and plans that best suit their needs.
Is Burr-Coburn the best solution? No. It is significantly better than what we have and more so with what we’ll get with Obamacare.  What it is, is a good start.  I’ve heard many conservatives complain about the Bush Prescription Drug plan. What those conservatives fail to see is that it works.  In fact it is the only Medicare segment that uses market forces to control costs. It works.
My wife and I are in a gap at the moment. My retiree heath insurance ended in December. My Medicare won’t start until March, May for Mrs. Crucis. At the moment we’re paying our own insurance.  I’ve found that catastrophic insurance isn’t too bad, about $150 for the two of us each month. Our prescription drugs aren’t too high either due to the price pressure from the Bush Subscription plan. It does make us watch our medical expenses and plan what should be done, what must be done, and what we can skip.
All-in-all, that’s a good thing.  It makes me wonder how much medical costs would drop if we repealed Medicare all together?  It’s an idea to consider.

Bye, bye, Gingrich

Posted on by
I remember when Newt Gingrich was elected Speaker of the House.  He had fire and an agenda, the Contract with America. He made significant changes in the operation of the house.  He also helped kill Obamacare ver. 1, aka Hillarycare.  But in politics as with everything, it’s “what have you done lately?”  Gingrich’s recent performance was a surprise to many and revealed the statism in Gingrich that also infests so many of the ‘Pub national elite.

His attack against the Ryan plan is a page out of the liberal playbook. He could have presented a viable alternative, how he could work with Ryan and the Tea Party to make changes to better the plan.  Instead, Gingrich violated the Reagan Rule (never speak badly about a fellow Republican) and killed any chance of conservative support that wasn’t in league with the elites.

Gingrich had so much potential.  But he blew it last Sunday and revealed his true self—a Ruling Class wannbe. Many have spoken about Gingrich’s fiasco so I won’t continue,  However, perhaps this piece from the Investor’s Business Daily will provide better perspective on the Medicare reform debate.

Editorial: Gingrich On Wrong Side In Medicare Debate

 Posted 05/16/2011 06:48 PM ET
Politics: Democrats’ reckless Mediscare attack against Rep. Paul Ryan’s reform is bad enough. But for Republican presidential hopeful Newt Gingrich to feed them ammunition is unconscionable.
Ever since the Wisconsin Republican unveiled his Medicare reform plan, Democrats from President Obama on down have tried to cast it as radical. Indeed, “Ryan’s radical plan to destroy Medicare” is practically their mantra.
So it was disheartening, to say the least, to see Gingrich dropping the R word left and right on “Meet the Press” this past Sunday. “I don’t think imposing radical change from the right or the left is a very good way for a free society to operate,” he said, adding that “I would be against a conservative imposing radical change.”
Ryan was absolutely right when he said on Monday: “With allies like that, who needs the left?” The true shame is that Gingrich blew a golden opportunity explain why Ryan’s plan is, in fact, the opposite of radical.
First, he could have pointed out that Ryan wouldn’t change anything in Medicare for a decade, leaving all current retirees alone, and giving today’s workers plenty of time to get ready.
Then he could have explained that the reform idea at the core of Ryan’s plan has, in one form or another, been championed by sensible Democrats for many years.
Under Ryan’s plan, rather than creaky government-run insurance, future retirees could choose from a menu of private plans, with the feds picking up the bulk of the premium tab.
This “premium support” idea was first advocated more than 15 years ago by health experts at two liberal think tanks, and by a bipartisan Medicare commission that President Clinton put together in 1998. An earlier version of Ryan’s plan was drafted with the help of Clinton budget director Alice Rivlin.
And instead of casting it as scary “right-wing social engineering,” Gingrich could have noted that Ryan’s reformed Medicare would look very much like what most workers have today — a choice of private plans, with the bulk of the premiums paid by somebody else.
Finally, he could have reminded the public that what’s really radical is what Obama and his fellow Democrats are advocating — do nothing, hope to win some votes by scaring seniors and let Medicare bankrupt the country.
Instead, Gingrich shamelessly echoed Obama’s bogus claim that there isn’t anything wrong with Medicare that can’t be fixed by wringing out “waste, fraud and abuse” — the classic dodge for politicians unwilling to make any hard choices.
On Monday, Gingrich tried to walk back his comments, with his spokesman claiming that what he really meant by “radical” was simply that “politically you can’t get to what Ryan wants from where we are. It will be demagogued to death.”
Maybe that’s true. But we’ll never know as long as Gingrich is the one doing the demagoguing.

Sorry, Newt, you won’t get my vote.  When you start supporting the left and their agenda, you’re no longer part of my Republican party.  I’m not an elitist, nor a Ruling Class wannabe. I’m just a American citizen working to restore the greatness of this nation that’s been stolen by the democrats and their Marxist core.                      

Poorhouse or Deathhouse?

Posted on by
A 19th Century Poorhouse
County Poorhouses were common when I was growing up in southern Illinois.  There was one just on the outskirts of the Franklin County Seat, an old multi-storied house dating back to the Civil War.  It was rumored to have belonged to a slave-owner who went south to fight for the Confederacy and never returned.  I don’t know the truth of that but it’s a good story.

In the 1950s, these homes were more like today’s medicaid-funded nursing homes.  The social safety-net so beloved by FDR had shifted responsibility for caring for the indigent, poor and the terminally ill from kith ‘n kin and church to government.  Before FDR, even in the midst of the great depression, folks were cared for by their their families, local churches and, as last resort, the county government.  The families, churches and local governments took personal care of those needed assistance.  They were kith and kin.

By 1953, all that had changed.

My paternal grandfather was a cantankerous old coot.  He was a miner and had outlived many of his contemporaries and most of his enemies.  During the 1920s and 30s, he was a union organizer during the union/mine owner wars of Williamson and Franklin counties. Many folks around Benton, IL had long memories.  While no one was angered enough to “disappear” Grandpa, he wasn’t being cut any slack either.  Of his immediate family, Dad was about the only one who could put up with Grandpa for any length of time.

From time to time, one of Dad’s sisters would take Grandpa to live with them.  These “visits” didn’t last long and within a week or so, Dad would get a call to come and get Grandpa.
One winter not long after we’d moved out to the farm, Grandpa was living with one of my aunts, the mines were on strike—again, and Dad had gone to Chicago to find work until the strike was over.  Mom was teaching school and I stayed with my maternal Grandmother until I was picked up at the end of the day.  
My Aunt threw Grandpa out of their house and called Dad to come get Grandpa—but no one was home. (I’m not even sure we had a phone at that time.) With no one to take Grandpa, my Aunt called the Sheriff and told him to take Grandpa to the Poorhouse.  
The Poorhouse,at that time, was funded by the county and the county filed for Guardianship of those in the poorhouse. That allowed them to seize any assets the poorhouse residents may have, such as pension and social security checks and any property they owned.  The first inkling Mom had of what had happened was the arrival of the Sheriff at the farm with an eviction notice.  
When we lived in town, Mom and Dad lived in Grandpa’s house with Grandpa. Dad’s mother had died just before I was born and when I came along, Mom and Dad wanted a larger place. After a few years, Grandpa sold his house and the money used to help buy the farm along with money saved by Mom and Dad.  
My Aunt told the Sheriff that Grandpa owned the farm.  Not so. The farm was in Dad’s name, not Grandpa’s.  It took a bit of work for Dad’s lawyer (who was also the County State’s Attorney) to get things straightened out.  In the meantime, Grandpa was stuck in the poorhouse.

Nursing homes today, even the badly operated ones, are worlds better than the poorhouses of the 1950s.  Today, there is state and in some cases federal oversight.  Some nursing homes are excellent, some are marginal.  It was different in 1953.

Expense control was a prime consideration then as it is today.  Any surplus by the poorhouse was absorbed into various pockets.  Cost was controlled by limiting services and controlling resources.  (Sound familiar?) There were no nurses available to care for the sick residents. There were no dietitians overseeing the menus. There was no law nor regulations governing cleanliness and vermin control.

I was only four years old when we went to get Grandpa at the poorhouse. I still remember. 
He was in a room on the third floor with 15 to 20 other old men. The room, by today’s standards, would be small for a double room in any nursing home.  He was tied to the bed. He kept trying to escape, we were told, so they tied him up. If Grandpa got away, no more money for the County.

Grandpa, in his 80s at the time, was quite vigorous.  When we lived in town, he would take me to a local greasy-spoon, a walk of a couple of miles, where he’d spend an afternoon with some friends.  

Dad had to carry him down to the car.

He hadn’t eaten for a couple of days, nor was he allowed to go the outhouse.  There was no indoor bathroom. He’d laid in filth for several days.

Dad cleaned him up when we got to the farm. Mom’s mother came out to help take care of Grandpa for a couple of weeks but Grandpa Miller wasn’t in too good a shape either.  My sister was at college. She came home to help at the end of her term.  By summer, Grandpa was able to walk on his own, but he never fully recovered and died the following year.

While Grandpa had a number of enemies, including, I later discovered, the County Sheriff, he also had a number of friends.  The Sheriff lost his next election.  It was too late for Grandpa. He died before election time came around.  The Manager of the poorhouse departed that summer taking all the money in the poorhouse account and the county closed the place.  Not being cost-effective would be the term today.

I still remember Mom calling the poorhouse, the Death-house.  She wasn’t alone.  I remember hearing the term a decade later when I was in High School and the place was torn down. Whoever was there for any length of time, died.  Usually, it was someone who had no family nor friends.  Someone alone.  Care had to be managed and resources were limited.  Those sentiments have resurfaced again during this last year.  It’s now known as Obamacare.

I’m glad poorhouses no longer exist.  I hope to Heaven I’ll never have to go to a nursing home.  

Is today’s use of nursing homes better than being cares for by family and friends?  I don’t know.  I do know that anything would be better than resurrecting Death-houses.

Can Medicare survive?

Posted on by

This has personal interest for me and my wife.  We signed up for Social Security last week.  Neither of us is 65, we’ve a couple of year yet for eligibility. But our healthcare options are limited and growing smaller thanks to Obamacare.

This column published in the Washington Times is more optimistic about the survivability of Medicare.       

SAVING & GOODMAN: Obama murdered Medicare

But the market can bring her back to life

By Thomas R. Saving and John C. Goodman
–
The Washington Times
7:32 p.m., Friday, October 15, 2010
The health care reform law enacted in spring will have a devastating impact on elderly and disabled Medicare enrollees if its provisions are not substantially changed.
The law creates a new mechanism to reduce the rate of increase in Medicare payments to doctors and hospitals. As a result, Medicare payments will fall below Medicaid rates before the end of this decade, and they will fall increasingly behind the rates paid by all other payers in succeeding decades.
To appreciate what that means, consider that Medicare currently pays about 20 percent below what private insurance pays. At those rates, hospitals lose money on Medicare patients. Under the spending cuts called for in the Affordable Care Act (ACA), payments will get worse in the future.
According to estimates from the Office of the Medicare Actuary, Medicare will be paying just two-thirds of what private payers spend by the end of the decade and just one-half as much by midcentury. Moreover, as Medicare rates fall increasingly below Medicaid rates, the elderly and the disabled will be the last patients doctors will want to see – if they have time for them at all.
Compounding these problems is the fact that the ACA will create a huge rationing problem systemwide. Although the law is expected to create as many as 34 million newly insured people, all funds to create new health care providers were zeroed out of the bill. Subsequently, the administration has promised new funds to increase supply, but they will be nowhere near the increase in demand.
Additionally, Medicare spending cuts will create enormous financial stress for the nation’s hospitals. According to the actuary’s office, more than one in seven health care facilities will be unprofitable before the end of the decade. That number will climb to one in four by 2030 and to 40 percent by midcentury.
One way to think about these changes is to consider the reduction in spending on Medicare beneficiaries relative to the expected path prior to the legislation. Under the new health care law, the average senior on Medicare will receive $2,300 less in annual benefits within 10 years and $3,844 less after 20 years. (All numbers are measured at current prices.) By midcentury, average spending per beneficiary will be $9,413 less than it would have been.
…

Fortunately, there is a better alternative. Instead of encouraging draconian price controls that will drive doctors and hospitals out of the market and leave Medicare beneficiaries with less access to care, we should allow the market to respond to patient needs. 

During the Clinton administration, the majority of the members of the National Bipartisan Commission on the Future of Medicare favored a “premium support” approach. Medicare would be converted from a top-down pricing system to a bottom-up system, in which providers would compete for patients. Individuals could shop for health care plans and use their premium support amount as full or partial payment. Such a reform would bring to all parts of Medicare what competition already has done for participants in Medicare’s new Part D drug program.
If the premium support amount were adjusted upward with the growth in per-capita national income, the resulting cost growth would be very similar to the path the health overhaul bill has set us on.
But unlike the price controls imposed by the ACA, premium support would not cause any providers to go out of business. Significant changes would occur in health care delivery. With Medicare participants paying directly for some of their health care, there would be an increase in the variety of delivery systems as providers competed for patients based on price and quality. A reform structured in this way would free doctors and patients from the cost-increasing, quality-reducing constraints of the current system.

You can read the entire column here, courtesy of the Washington Times.

What the dems don’t say and don’t want known is that Obamacare will cut $600M from Medicare to help “pay” for Obamacare.  The result is the Medicare will be destroyed on the alter of the libs “single-payer” system like the Brit National Health Service—a service that is actively imposing death panels to choose who will live and die.

This nation is still a republic, not a socialist oligarchy—yet and won’t be if I can do anything about it.                

Rove: The electoral consequences of killing Medicare Advantage

Posted on by

I don’t know the demographics of those that read my posts. I am old enough for Medicare and Social Security. I have not subscribed because I’m still working. However, if I were to retire, Medicare Advantage is something I’d be interested in—it’s definitely worth a closer look.

Ed Morrissey writes that Obama is looking to curtail this program. Maybe by 20% it is reported. Here is Morrissey’s column from Hot Air.

Over the past few weeks, I’ve written about Barack Obama’s plan to kill Medicare Advantage, a successful public-private partnership that extends benefits and access for Medicare patients, in order to pay for the overhaul of the American health-care system. We have personal experience with Medicare before and after buying into the Advantage program (which requires monthly premiums above those of Medicare Part B and D) and understand its value. Karl Rove looks at the electoral consequences of killing the program, to which 20% of all Medicare recipients belong, and warns that it could cost as many as 23,000 votes per Congressional district:

Medicare Advantage was enacted in 2003 to allow seniors to use Medicare funds to buy private insurance plans that fit their needs and their budgets. They get better care and better value for their money.

Medicare Advantage also has built-in incentives to encourage insurers to offer lower costs and better benefits. It’s a program that puts patients in charge, not the government, which is why seniors like it and probably why the administration hates it.

Already, an estimated 10.2 million seniors—one out of five in America—have enrolled in Medicare Advantage. Mr. Obama is proposing to cut the program by nearly 20% and thus reduce the amount of money each will have to buy insurance. This will likely force most of them to lose the insurance they have now. Yet Mr. Obama promised in late July in New Hampshire that, “if you like your health-care plan, you can keep your health-care plan.”

There are roughly 23,400 seniors on average in a congressional district who have Medicare Advantage, but who face losing it if Mr. Obama has his way. That’s enough votes to tip most competitive House and Senate races.

Obama already has problems with seniors. His polling numbers have dropped dramatically among older voters, who see his targeting of Medicare and Medicare Advantage as dangerous to their health-care coverage. Continuing to press for its elimination will certainly motivate them to fight back at the voting booth in 2010.

The average difference between Democrats and Republicans in House races in 2008, by the way, was 22,979. Bear in mind that the Democrats had several strong winds at their backs, including an unpopular Republican administration against which to run, Barack Obama’s ability to turn out voters for his historic campaign, and a sense that the Democrats hadn’t had a chance to lay out their agenda. They managed to build a strong majority in the House with that average margin, which falls below Rove’s calculations of Medicare Advantage subscribers.

None of those strong winds will be at the backs of Democrats. Obama won’t be on the ballot, and the midterms will be a referendum on his policies rather than his personality. Nancy Pelosi and Harry Reid’s agenda has lost favor with the majority of Americans now that they’ve taken off the masks and laid it out for the nation to see. Democrats no longer have Bush to run against, although they’ll probably still try to use him as a bogeyman — and will get spanked for doing so. They can’t afford to lose 2,000 seniors in each district, let alone 23,400 — and seniors have the highest turnouts on Election Day.

This is as big a political loser as can be possibly imagined, and Blue Dogs should keep that in mind.

It is becoming more and more clear that the dem’s worse enemy is Barack Obama. I just hope the country can survive until the 2010 elections.

Facebook