วันพฤหัสบดีที่ 12 เมษายน พ.ศ. 2555

Republicans Self-Destruct Over Medicare



Posted by: Linda Carbonell on March 18, 2012.
From left: Sens. Lindsey Graham, Rand Paul, Jim DeMint and Mike Lee announcing their plan to "save" Medicare

Okay, it’s not the whole party, though the proposal put forth by Senators Jim DeMint and Lindsey Graham of South Carolina, Mike Lee of Utah and Rand Paul of Kentucky is right in line with the party’s goal They want to end Medicare and fold all senior citizens into the Federal Employee’s Health Benefit Plan.



The FEHBP is erroneously held up as some kind of perfect private health insurance system. Republicans point at it and their followers insist that Federal employees and legislators have the best health care system in America. It involves a couple of nation-wide fee-for-service plans, Blue Cross-Blue Shield and Mailhandlers, and dozens of smaller plans available in individual locations. These can be anything from an HMO to a PPO to a fee-for-service plan to closed systems that are owned by a hospital or doctors’ group, with four levels of coverage, self-only-high and self-only-low, family-high and family-low. To really appreciate the Federal health insurance system, picture a phone book for a small city. That’s what you have to wade through to find the policy for you. It’s like picking a plan for Medicare drug coverage times ten.



I can think of over a million people who will object to this idea….federal employees and retirees. Been there, done that, cannot wait for Medicare.



I’m one of them. My husband is a Federal retiree. He retired before reaching 65, after thirty years in the government. We pay $460 a month for our health insurance premiums for two people, with a $600 deductible and 20% co-pays. One of my prescriptions must be name-brand. I have very bad reactions to the generics. Our insurance company has decided that my doctor made a mistake and I’m just screwing with the system, so I have to pay a 75% co-pay on that one scrip.



In eight months, my husband will go on Medicare. His premium will be $99.90 a month with a $140 deductible and 20% co-pay for Plan B. He will need a supplemental plan for prescription drug coverage. I will go on one of Vermont’s health insurance plans, for which the premiums and deductible are income-adjusted. In short, our health insurance costs will be cut in half.



Right now, half of my husband’s income from his part-time job goes to cover the amount the FEHBP takes out of his pension. He will be able to cut back his hours just because of Medicare.



Frankly, we’re both tired. We’ve been working since we were teenagers. We were barely middle class, never quite breaking the median-income ceiling. Medicare means we can finally retire. It means the same thing for a lot of people. It also means being able to afford health care. The premiums we pay now eat up so much money that the deductible is a deterrent to having tests done and seeing the doctor on a regular basis.



Medicare isn’t broken. It is one of the most successful programs in American history. There are a lot of ways it can be improved, starting with a better system for detecting and prosecuting fraud, and finally expanding Vermont’s landmark Choices for Care program for long-term care for the elderly into Medicare nation-wide. Like all health insurance programs, there needs to be more emphasis on preventive care, more rewards for over-all effectiveness and less attention to trying to cover one’s ass – ordering too many tests just to prevent malpractice suits. The Canadian national health system includes a board that determines where highly expensive equipment is needed and discouraging overlaps of services.



Medicare and Social Security, along with Medicaid and other programs to support the neediest among us, eat up as much of the Federal budget as the Defense Department. The Republicans want to protect every dime in the Defense budget and cut their promised billions of dollars out of the safety net. This proposal proves once again that keeping Americans alive and healthy is less important to the Republicans than America retaining a defense budget equal to the combined defense budgets of every other nation on the planet.



It is moments like this that make one realize that Senators and Congressmen don’t handle their own family budgets. They don’t write the checks for co-pays and deductibles if a family member gets sick. They don’t pick up their own prescriptions. Or maybe, at $174,000 a year, it doesn’t matter to them. But they should be able to do the same comparison that I did, of the premiums and costs. Maybe they did. Maybe they are so deeply indebted to the insurance industry that they simply don’t care how much harm they do

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