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Huge News: New legislation to make prescription drugs available to people under traditional Medicare without the privatized companies:

Asclepios
Your Weekly Medicare Consumer Advocacy Update

At Last, a Solution

October 25, 2007 • Volume 7, Issue 42

Congress wrote the Part D law with the profits of insurance companies and drug manufacturers in mind, not with the interests of people with Medicare at heart. Insurance companies like random reassignment because it gives each of them an equal shot at the government subsidies that come with every person enrolled in their Part D plan.

Drug makers like parceling out people with Medicare among multiple Part D plans because it diminishes what little power insurance companies have to negotiate lower drug prices. Best of all, drug companies like the privatized delivery of Medicare drug coverage because it prevents the federal government from using the buying power of 43 million people with Medicare to negotiate lower drug prices.

FORTUNATELY, SOME KEY LAWMAKERS HAVE A PLAN TO REDRESS THIS INEQUITY. This week, Representative Jan Schakowsky, Democrat of Illinois, Representative Marion Berry, Democrat of Arkansas, and Senator Richard Durbin, Democrat of Illinois, introduced legislation to give people with Medicare the option to obtain drug coverage directly through Original Medicare.

Under a Medicare-administered drug benefit, the government would use the best available medical evidence to decide which drugs should be covered and would negotiate the lowest prices possible, just like the Department of Veterans Affairs does for our veterans. People with Medicare would receive a stable, guaranteed benefit, not a plan that changes what drugs are covered each year. Low-income people with Medicare would have a permanent home for their drug coverage instead of being dealt out to insurance companies on an annual basis.

It will be an uphill battle to overcome the opposition of the drug companies and the insurance industry and make this bill law. We have to start now. Please write and urge your senators and representative to co-sponsor the Medicare Prescription Drug Savings and Choice Act of 2007.

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Medicare Part D Appeals Help for Advocates Is Here!

MRC’s new Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.

* * * *

Medicare Private Health Plan Monitoring Project

The Medicare Rights Center (MRC) would like to hear about your experience, or that of someone you know, enrolled in a private health plan. With information about what the issues are with Medicare Advantage plans, we will be able to demand that those problems be fixed.

Submit your story at www.medicarerights.org/maplanstories.html.

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MEDICARE FOR ALL would be like sunshine and a beautiful sky, a grassy field, people relaxing and children playing... To think that we can have guaranteed healthcare - quality healthcare - for every single person in this country - would be free for everyone to enjoy, like a sunny day…

MEDICARE FOR ALL would cost an estimated $47 billion less than we are now spending. Even though millions of us have no health coverage at all, we spend almost twice as much as the other countries that cover every one. We waste hundreds of billions on insurance companies which do not provide any healthcare. In fact, one third of that money is wasted on insurance company salaries, stock holder profits, and marketing. The only way to pay for all of us is to remove the useless waste and profits of the insurance companies.

MEDICARE FOR ALL would provide much better benefits for all of us including both the uninsured and the insecurely insured -- that's all of us.

Get more information here FAQ

WHAT YOU CAN DO --

Sign the Petition and Tell Congress What to Do.

Join Healthcare-NOW

MEDICARE FOR ALL

No Co-Pays No Deductibles No Premiums No Supplemental Policies No privatized healthcare No Medicare Advantage Ripoffs No Subsidies to Pharmaceutical Drug Companies NO Insurance Companies No Marketers and TV Ads No Lobbying Costs No Stockholder profits No Out of Pocket Costs No Bills in the Mail No Healthcare Bankruptcies	Yes, Choice of Doctors and Care Yes, Preventive Care for All Yes, All Long-Term Care Yes, Dental Care Yes, Optical and Hearing Care Yes, All Necessary Surgery Yes, All Nurses and Doctors Yes, All Hospitals Yes, All Mental HealthCARE Yes, All Prescriptions Yes, All Durable Medical Equipment Yes, Drug and Alcohol Treatment Yes, Rehabilitation Yes, All Lab Costs Yes, Home Healthcare
JUST HEALTHCARE	Everybodyin in; Nobody Out!

Employer Health Benefits 2006 Annual Survey

“The following statistics from the respected Kaiser Family Foundation shows that health insurance companies have raised thier premiums costs almost 100% since 1988 whereas the cost of health care itself has risen only about 4 1/2% per year. It is not the cost of healthcare itself that we are challenging. It is the cost of continuing to support insurance company profits.” The more care they give, the less profits they make. We want more care, less profits.

Percentage Increase in Health Insurance Premiums, by Plan Type, 1988-2006

Exhibit 1.2: Percentage Increase in Health Insurance Premiums, by Plan Type, 1988-2006

	1988	1993	1996	1999	2000	2001	2002	2003	2004	2005	2006
Conventional	12.4%	9.1%	1.9%	6.0%	9.5%*	11.3%	13.8%*	14.3%	11.1%	5.0%*	8.4%
HMO	8.4	7.7	-0.2	5.6	7.6*	10.4	13.5*	15.2	12.0*	9.4*	8.6
PPO	20.3	7.2	1.0	5.4	8.5*	11.6	12.7*	13.7	10.9*	9.4*	7.3*
POS	^	5.2	1.1	4.6	7.8*	9.9	12.2*	13.2	11.3	9.1	8.4
HDHP/SO	^	^	^	^	^	^	^	^	^	^	4.8
ALL PLANS	12.0%	8.5%	0.8%	5.3%*	8.2%*	10.9%*	12.9%*	13.9%	11.2*	9.2%*	7.7%*

*Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2006; KPMG Survey of Employer-Sponsored Health Benefits, 1993, 1996; The Health Insurance Association of America (HIAA), 1988.

How we can win a system of Medicare for All – an enhanced and improved Medicare for All -- here in the United States. See H.R. 676, the United States National Health Insurance Act REMEMBER, it must be nonprofit. Any plan that includes the current unnecessary waste and profits of insurance companies will be unsustainable and unable to cover all of us.

What do we mean by enhanced and improved Medicare for All?
Everything covered with No additional costs!

Everyone would have a card like this and everyone would get healthcare.

But how can we pay for it? SEE the financing plan for the United States National Health Insurance Act, HR 676. (Medicare for All)

MEDICARE IS UNDER ATTACK by the Bush Administration and the corporate privatizers. We can save it and make it available to all, but we must act fast. Here are the Facts from Rekindling Reform.

Important Articles about Medicare:

David Sirota, author of HOSTILE TAKEOVER, How Big Money and Corruption Conquered Our Government and How We Take It Back. This book has the clearest explanation of how the insurance companies and drug companies are keeping us from having a national single payer healthcare system – “Medicare for All.” And how we can change that. Now available in paperback. Below are some excerpts:

" Extend Traditional Medicare to all Citizens:

Fact: Thousands of Americans suffer and die each year because they can’t afford adequate healthcare. Fact: Even if you don’t care about these people, the for-profit healthcare system is hurting our country by forcing us to spend billions of dollars on an inherently wasteful system, thus creating a huge drag on the economy that affects everyone. One solution is a universal healthcare system where government is the single payer. A shorter name for that is “Medicare for Everybody.”

As economist, Paul Krugman says, ‘The great advantage of universal government-provided is lower costs. Medicare,’ Krugman notes,’ has much lower administrative costs than private insurance.’ In all he points out, ‘the savings from a single payer system would probably exceed $200 billion a year, far more than the cost of covering all of those now uninsured.’

Medicare is one of the most popular programs in American history. The only reason we don’t have Medicare for everybody is that the private insurance companies know such a system would be the end of their legalized profiteering and they have thus spent millions of dollars on lobbying and campaign contributions to prevent such a reform.

How many more people have to die before Congress acts? How many more billions of dollars does our country have to waste before we do what we obviously need to do?”

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From Alternet:

Michael Moore speaks with Bill Maher about "Sicko" [VIDEO]

Click here to see the interview, May 27th

Post by Joshua Holland

Video: First live interview in more than two years. More »

POWER POINT COMPARISON OF PROGRAMS BEING PROPOSED IN CONGRESS AND BY PRESIDENTIAL CANDIDATES:

A Power Point by Professor Len Rodberg, Research Director of the NY Metro Chapter of PNHP. Rodberg presented this comparison at a forum held by the NY Metro Chapter of PNHP and co-sponsored by the NY Chapter of Healthcare-Now. He describes the many "hybrid" healthcare plans that have been introduced by Members of Congress all of which leave billions in profits for the insurance companies;

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CONTRAST the devastation of lives under the Current System against what a Guaranteed Medicare for All (H.R. 676) plan would provide:

There is good news on the horizon and it has to do with getting quality, guaranteed healthcare for every person in the United States - from womb to tomb.

Michael Moore’s new film SICKO will dramatize the problem of healthcare in America – graphically demonstrating why our country is ranked #37 in the provision of healthcare for our people, just one notch above the country of Slovenia.

Why do we need quality guaranteed healthcare for everybody? Is there anyone out there who is not yet convinced?

See the film. Tell the following stories from the people in our country struggling to survive with insecure and unjust healthcare coverage. And be sure to tell people that there is a solution if we all work for it! MEDICARE FOR ALL, HR 676.

Remember the life of Deamonte Driver. Portions of his story are excerpted here as posted by Mary Otto of the Washington Post.

Twelve-year-old Deamonte Driver died of a toothache in February. A routine, $80 tooth extraction might have saved him.

Response from Healthcare-NOW: If the United States National Health Insurance Act had been in place, Deamonte Driver would be alive today. Under H.R. 676, every child (and every adult) is entitled to quality dental care. Deamonte might have had a brilliant future as a poet, a Congressperson, a farmer, a carpenter, a dentist himself. His mother might be looking forward to grandchildren instead of being grief-stricken and broken-hearted.

If we had a guaranteed national single payer healthcare system, that is.

If his mother had been insured. If his family had not lost its Medicaid. If Medicaid dentists weren't so hard to find. If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth. Read More >>

To find out what you can do - Take Action with Healthcare-Now.org

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Preventing Waste and Abuse in MEDICARE FROM ASCLEPIOS

(Bush Part D drug program and manipulation of people into so-called "Medicare Advantage" costs the taxpayers additional money in subsidized profits to insurance companies.)

May 31, 2007 • Volume 7, Issue 22

Health care is expensive, but it is an investment well worth making. A people unwilling to ensure the health of its children, of individuals disabled by disease or accident and of older adults needs to re-examine its priorities.

Still, compassion is not incompatible with common sense.

Medicare cost taxpayers over $408 billion in 2006. People with Medicare paid over $42.9 billion in Part B premiums.

It will cost the federal government about $50 billion to extend the State Children’s Health Insurance Program to uninsured children who need coverage.

With sums like these, we need to examine whether every dollar is well spent.

That is why Congress appointed the Medicare Payment Advisory Commission (MedPAC), a nonpartisan, independent panel of experts tasked with finding out whether Medicare is paying enough, or too much, to the doctors, hospitals and other providers who care for people with Medicare.

For the last three years, MedPAC has been warning that Medicare is paying too much to private Medicare Advantage plans. For the last three years, Congress has failed to act and the overpayments have ballooned. This year, it will cost taxpayers and people with Medicare an extra $1,000 for every enrollee in a private Medicare plan than it costs to provide health care under Original Medicare for the same person.

Over the next five years, that adds up to $65 billion for the insurance companies, money that cannot be spent on children’s health insurance or on helping low-income people with Medicare with their drug and medical expenses.

It will take courage for senators to stand up to the insurance industry and their lobbyists and rein in these overpayments. The Senate’s performance this year is not encouraging. It caved to the pharmaceutical industry and refused to give Medicare the ability to negotiate lower prescription drug prices, something supported by three-quarters of the electorate.

A number of senators have begun to take a hard look at the Medicare Advantage program. For example, Senator Barack Obama, Democrat of Illinois, is calling for a stop to this “waste and abuse.” Senator Obama wants to pay the private Medicare plans the same amount it costs for providing care under Original Medicare. We hope that kind of common sense catches on.

Medical Record

“I am a volunteer SHIP counselor. I have been assisting a 92-year-old woman with her Medicare Advantage plan. She lives about 7 miles out of town and relies on neighbors to drive her to town to take care of business. She arrived in my office with a box full of correspondence and said she had been enrolled in a plan against her wishes. She said an agent had come to her door and she let him in and he tried to sell her something. She said she was happy with her supplemental and drug plans and never agreed to switch to an MA plan. She never signed anything. I called the agent, and he said the application was done on his computer and signed with an electronic signature. I then asked my client if she had given him permission to sign her name and if he had had a computer with him in her home. She said no to both” (Story submitted to the Medicare Private Health Plan Monitoring Project, Medicare Rights Center, May 18, 2007).

“Preventing waste and abuse in Medicare: Medicare’s private plan alternative, called Medicare Advantage, was established to increase competition and reduce costs. But independent reports show that on average the government pays 12 percent more than it costs to treat comparable beneficiaries through traditional Medicare. These excessive subsidies cost the government billions of dollars every year and create an incentive structure that has led to fraudulent abuses of seniors” (“Plan for a Healthy America,” Barack Obama).

“To pay MA plans appropriately, the Commission recommends that benchmarks—the basis of plan payments in MA—should be set at 100 percent of Medicare FFS expenditures. The Commission first made this financial neutrality recommendation in March 2001. For the past several years, we have analyzed payments to private plans compared to FFS and have found consistently that plan payments exceed FFS expenditure levels” (Testimony of Glenn M. Hackbarth, J.D., Medicare Payment Advisory Commission chairman, before the Senate Finance Committee, April 11, 2007).

PRESIDENT PROPOSES END OF MEDICARE (from Economist Dean Baker -- published on February 7, 2007)

President Bush Proposes Phase Out of Medicare, Media Pay no Attention
In fact, President Bush does propose phasing out Medicare in his new budget, if the NYT got its facts right. According to this article, President Bush proposes to change the rules on the means-testing of Medicare benefits, so that the income current cutoffs of $80,000 for individuals and $160,000 for couples are not indexed.

This means that over time, more and more of the senior population would have to pay premiums that largely cover the cost of their Medicare. In other words, Medicare will no longer be government provided health care for most of the elderly population.

How fast will the benefits phase out? Well in roughly twenty years, the means-testing would be hitting singles who are the same point in the income distribution as someone earning $40,000 a year today, and couples earning $80,000. In forty years, the point at which Social Security is first projected to face a shortfall, the means-testing would be hitting singles who are at the same point in the income distribution as someone earning $20,000 a year today, and couples earning $40,000. In other words, under President Bush's proposal many middle income elderly people would face the loss of their Medicare subsidy before Social Security faces any funding shortfall. A bit further out, and only the poor would still recieve any subsidy through the Medicare program.

After Social Security, Medicare is the country's largest social program. When a president proposes phasing it out, it should be big news. Why aren't the reporters covering it?

Books & Articles

Medicare must be restored, protected and strengthened. Here’s How

Reclaiming Medicare
Asclepios: Your Weekly Medicare Consumer Advocacy Update

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