Sunday, April 10, 2011

Dispelling the Myths About Medicare

As the enormous fight over raising the debt ceiling is about to commence, and believe me it will be more ferocious than the budget shutdown showdown, many are still mystified over Medicare as an "entitlement" and Paul Ryan's plan to fix it by changing it to a plan based on "premium support". That is, taking away a (somewhat) defined government benefit and turning it into a voucher program (Ryan decided to use the 'premium support' euphemism after too many got wise to the vouchers). In that program each senior 67 or over (the beneficiary age moves up to 67) receives $15,000 per annum to choose the insurance plan needed. I will show this is bollocks, but first things first!

It may stun many people to know that Medicare is by no means a "free" entitlement. First, people have paid into it over a life time at the rate of 6.2% in FICA taxes per paycheck. This is what appears on your W-2 tax form as "Medicare wages". It is that amount deducted from your pay for Medicare. Thus, it is most certainly not "welfare" and I'd even argue that it can be called an "entitlement". Certainly, if one is going to use that word, one must apply it to any and all government benefits, including VA benefits! Otherwise one is playing games with the language (especially since many on VA benefits never saw a single minute of combat so it becomes arguable that a guy can say he "earned it by fighting for our freedom" when all he may have done is wash bottles, cook or put on a radio headphone!)

Second, Medicare is not free even when you begin receiving it! It is in fact, damned costly! Having just enrolled in a Medicare Part F plan (which covers what Medicare Part A, and the Supplement Plan B don't) I am now finding that out as I approach my 65th birthday. While Part A, which covers basic care and hospital stays, it only covers 80% of these. You still have to find a way to pay the rest. Outpatient and similar services are covered under Plan B, and that is usually deducted from your Social security check - or, if you haven't begun S.S. yet, it comes out of your own income or bank account. Currently, the Part B premium amounts to $115.40 per month, or $1385 a year. Then you need to select from a Plan "F", "G", "K", "L" or "M" for any and all ancillary services that may be needed. These will include covering Part B co-insurance (the 20% not paid by Part A), the Part A and Part B deductibles, and any medical emergencies covered during foreign travel. I selected one of the lowest cost plans I could find, for F, and this comes to $131 a month, or $1572 a year.

Lastly, one needs to enroll in a Medicare Prescription Drug Plan (Part D) and that is critical since you only get one shot. Even if you're not on any drugs per se, counselors assure you that the best bet is to at least sign into one, in case you have to rely on a prescription (say for blood pressure) later. I have signed on hoping to find the drug I need (aciphex) and this will likely come to at least $600 a year, probably more like $750.

Now adding all these ancillary extra costs up for a year, you get: $3,707 (and this doesn't even include my wife's which is separate!) That's about $309 a month. Not exactly chump change. Not factored into this at all are: dental expenses (you have to pay for those additionally or via a dental plan), and the inevitable increases in premiums (which come nearly ever year due to medical inflation, especially in drugs, since Medicare doesn't bargain for the lowest costs like the VA)and also the inevitable increases that arise from serious medical issues and which introduce much higher costs. Say having to get a hip replacement one year. This is why people now 65 are asked to have at least $225,000 on hand to cover costs up to the time they die for things Medicare won't. Thus, even a Tea Bagger can see Medicare is no "freebie".

Now, what about Paul Ryan's plan? What he offers is a basic voucher system which simply gives money to seniors but makes no claim on either government or the insurance companies to deliver the care! Thus, one can easily find that the $15,000 given will buy exactly......nothing! I mean, let's get real! Why would any halfway intelligent person assume it would, which would mean insurers wanting to compete for your health care allotted bucks? They wouldn't! They don't do it now! Even a healthy 62 year old can't beg, borrow or steal an insurance policy without enormous costs, and if he has any pre-existing conditions, or even basic old person ones, he's totally out of luck. Take it from this guy who wrote into The Denver Post yesterday (letters):

How will the elderly navigate the private insurance jungle? At 62, in sound body, mind and senses, I was overwhelmed by the task and set back by denials for minor conditions that put me in a pricey sick pool when I am not sick. This is the "free market" we already have. Insurers will not be competing for the elderly. With all the health issues befalling them how will the aged find a fair deal and buy enough coverage with their allowance?

He makes excellent points, and these are such that the Dems need to reiterate them when the Tea baggers predictably put pressure on the House Repukes to try to implement this Ryan bull pockey. No one tells people the truth that once it goes in, and you fall under it, you'll have the devil's own job even finding insurance at a cost you can afford. I got a glimpse of this while trying to buy private insurance three years ago. The lowest policy I could find (and this was for a healthy 62 year-old with no meds, no major issues) was at over $800 a month, or $9600 a year. The only other alternative was to select an AARP program at $250/mo. but with monstrous deductibles (around $5,000/yr.). But in this case, you'd likely pay more in deductibles each year than you would for actual medical care! THIS is what those who will fall under Ryan's misbegotten plan are in for, which is why economist Paul Krugman describes it as "heartless" and "unaffordable for the middle class". Nor is this "scare mongering" other than to uninformed Teepee idiots who probably can't read anyway.

But at least a number of formerly diehard Ryan voters in Wisconsin now have it on their radar, including one unemployed worker, Brian Krutsch from Janesville. Krutsch like most ordinary workers happily voted Ryan and Republican all the way so long as the issue remained theoretical about the usual Teabagging baloney of "deficts and high spending". But what changed is when it ceased to be so distant and ethereal and became personal, as he now recognizes not only HE will be affected by it, but his kids as well. In an Associated Press account in today's paper he blurted out
"Old people need help with medical bills. There's too many under-insured right now- especially people like myself right now, who don't have insurance"

And once again, I ask, as I did with the tea bagger Safeway worker I encountered: Then why the hell do you keep voting for people and agendas against your own welfare and interests? Don't you have the intelligence and insight to SEE what they're plans are going to do to you?

Not only Krutsch, but evidently many others in Janesville (formerly Republican voters) are now seeing it, according to the AP account. One 74-year old resident was quoted as saying:

"It bothers me that my kids and our grandchildren might be affected by whatever has to be done".

Again, bravo, but WHY didn't you see this earlier? Is it that hard to parse? Or was it your indefatigable American optimism that blinded you? This is the recurring question!

The sad fact is that both these former Ryan voters are correct, but it may be too late now, especially if the Rs grab all three branches of government next year (unlikely, but quite possible if Obama caves any more, especially in the upcoming debt ceiling fight, which may see many libs just opt out, like last November).

The other sad fact, which these Wisconsin voters are slowly waking up to, is that Ryan's so-called "Path to Prosperity" makes NO demands on the wealthiest 1% (why economist Krugman calls it more "voodoo economics" based on supply side hooey that cutting taxes lowers deficits) and no demands on defense - now sucking up nearly 58 cents of every dollar spent annually. In other words, this rascal full well knows in his black heart that he is piling all the financial burdens onto the backs of the elderly and most vulnerable poor (since he also wants to fob off Medicaid to the states, an obligation they don't want any more than health insurers want to compete for the elderly with Ryan's stupid vouchers).

So DO people realize, those who are ordinary workers but keep voting Repuke, how damned hard and onerous their lives will be if Ryan's plan is allowed to pass? Do they have any inkling of the financial pain, the enormous expense that will be facing them? Well, if they don't, look above to my figures just on regarding normal spending for Medicare's costs, then multiple that by about 2.5 and you will see what you'll have to pay (assuming you can even find an insurer who will take you!) Choose to go without? Fine, just don't find yourself in an accident or health crisis that demands hospitalization or prolonged care, or you will end up in the poor house.

Believe me, I don't relish writing about these painful facts, but because it appears so many in this country are sleepwalking (like the unemployed Wisconsin worker, Brian Krutsch, had been), somebody has to do it, and someone has to rouse them from their Tea Party spell. Remember again: the Tea Baggers are merely useful idiots for the rich, and the Koch brothers are funding them. Do you want to be a useful idiot? Then keep with them and see how much they will destroy your future while they happily play their 18 holes and receive new Lexuses each year, thanks to the tax breaks YOU gave them! While they employed useful idiots like Ryan to do their bidding in eviscerating any remaining government help for YOU!

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