Healthcare

How to Reduce Medicare Spending Without Cutting Benefits | Committee for a Responsible Federal Budget — another policy joke😜

Here is the crux of the matter; do you and do you believe other people spend more on health care simply because their out-of-pocket costs are minimal or none? Members of Congress and policy makers do. 

Do you believe that engaging health care services will change measurably if the patient pays the Medicare 20% coinsurance? 

For that to be true don’t you also have to believe that patients welcome, maybe seek unnecessary health care, that only because the may not be liable for a $10.00 co-pay they run to the doctor when otherwise they would not?

My employer-provided Medicare supplemental coverage has a $750 deductible and pays nothing of my coinsurance until total charges for the year reach $5,000. In other words, I must pay the first $1,750 each year. While I may not be typical, I can assure you that when my wife needed health care, none of that was a factor, going to the recommended, highly rated surgeon was. 

There is no question that unnecessary health care is a problem, but is it patient driven or patient controlled?

 Restrict Supplemental Coverage – $50 billion to $125 billion. 

Medigap plans tend to be a bad deal for both beneficiaries and the federal government, resulting in higher Medicare spending and greater out-of-pocket costs for most seniors. Policymakers could reduce excess utilization by further limiting the ability of Medigap plans to provide first-dollar coverage. Doing so would reduce net out-of-pocket costs for Medicare beneficiaries because it would lower the high premiums they currently pay for Medigap plans. Policymakers could also apply this principle to employer-sponsored retiree health benefits by allowing employees to “cash out” of their employer-provided plan in exchange for a premium subsidy and restricting TRICARE-for-Life supplemental coverage from covering first-dollar costs as well.

Source: How to Reduce Medicare Spending Without Cutting Benefits | Committee for a Responsible Federal Budget

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7 replies »

  1. As my deductible is $4,000, I do accelerate and defer elective treatment. I am sure this is what the bureaucrats see and misinterpret.

    I know at least 10 older relatives who either delayed or accelerated needed treatment based on whether they had met their deductible, expense maximum that year.

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  2. It’s funny that everybody thinks patients demand unnecessary medical treatments. I think the real issue is that patients don’t what treatments are necessary but listen to their doctors. Yes, there is a percentage who run to the ER with runny noses and you will always have that. Then there are the people who refuse to go to the doctor and as a result end up in the ER when it is too late. But in general, I think most people already hate going to the doctor and it doesn’t matter if it is free or cost 100%. I know I just love going to the lab, kind’a hoping that I have a bad result so that I don’t feel like I waste my time and money.

    The Internet, the TV doctors on various news outlets, and the various drug commercials would have you talking to your doctor daily if you could. I want to know which ache and pain is normal for getting older and which will result in death if left untreated? Am I correctly self-diagnosing the pain in my left arm as a strain or is it a heart attack?

    I hate taking my meds. I hate going to the doctor. I hate going for tests. But if I trust my doctor then I should listen to her otherwise find a new doctor. I would really like to know which test is the result of lawsuits and which are the result of the AMA and good medical practice? Are they testing for something that only effects 1 out million or 1 out 10 patients? Is it a test the drug companies are pushing with no benefits to the average patients? There must be a new computer program because if I don’t fall within a certain percentage of the bell curve, I am out for this test or that test.

    A co-worker (non-smoker) had a sore throat and was going to get it looked at his next annual visit but his wife made him go to the doctor. He had cancer which would have killed him if he waited until his next visit. He is now fully recovered. I would have waited because I hate going to the doctor. Raise the copayments and that would have only made me wait longer to be sure that my sore throat didn’t clear up in another month or so. $150 buys a lot of cough drops. Waiting another month may bring certain death.

    Do you know which is the right choice? Neither do I. The medical community says do not wait. The insurers say we over use. How am I supposed to know? Raise the copayments high enough until people don’t go to the doctor but end up in the ER instead? Where is the right balance?

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  3. We have the high deductible F plan. Our monthly cost is about $44 and it has hardly gone up in 5 years. Most years we only pay a few hundred for medical expenses each – note that on the normal GP visit, for example, the bill is $150, medicare marks it down to $100 and we have to pay $20. So as long as not in the hospital the costs are nominal and we save several hundred per month. When we have had hospitalization it is about a wash to full F as the max dollar out of pocket is about $2100 and the insurance premiums we save are just a bit less than that. So, overall we are financially ahead by a significant amount with the high ded F. I think most people do not know of it (only a subset of companies offer it and not the AARP) and when mentioned to them they are scared of deductibles so they over pay for the no deductible F. The other way you win on this is that the premium increases are negligible. Over 5 years they have been a total of $4 for each of me and my wife.

    So, the employer plan you mention may not really not offering much of a benefit and with that $5K deductible may not be a wise choice if you do have hospitalizations from time to time as the extra you pay up to 5K instead of $2100 may be more than the $88 per month we pay on average?

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    • You make a good case, but you misinterpreted my plan. My maximum out of pocket each year is $1750 including the $750 deductible. After we reach total spending (not out of pocket), of $5,000 we are reimbursed 100%.

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      • I am trying to understand what you are saying. On the high ded F plan after 2100 in spending all costs are covered 100%. We are responsible for that initial 2100. You are saying max out of pocket of 1750 so what is the relevance of the 5K? If no out of pocket aren’t you then at 100% for the overage?

        Can you have 5K of spending but not have to have paid the 1750? Maybe that is a difference between your coverage and medicare?

        For medicare I only have to pay the 20% part B and the part A ded if hospitalized. When those amounts equal 2100 there is 100% coverage meaning no payments for me. The part medicare covers (which is all the part A hosp except for part A ded and the 80% of part B) are always paid by medicare so I am only concerned with the amounts I have to pay.

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      • My coverage is an employer plan for retirees that supplements Medicare. Let’s say I incur bills in 2017 that total $6,000 allowed by Medicare for which I am responsible for 20% or $1200. My deductible is $750 plus I get nothing back on the 20% until it exceeds $1,000 or 20% of $5,000. In this example I pay $750 plus $1000 and get back $200 or 20% of $1,000 and I get back the full 20% for the rest of the year.

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