PrintJune 3, 2010
ObamaCare Propaganda Mailer
Kathleen Sibelius (Obama's Health czarina) sent me a reassuring message about Medicare under Obama's new law. It came as a shiny, expensive pamphlet inside the first-class official business envelope from the Department of Health and Human Services (Penalty for Private Use $300) titled: "Medicare and the New Health Care Law -- What it Means for You." The brochure includes "A Message from Kathleen Sibelius" -- complete with her official title. She seems afraid I might be worried about what the new health care law really means for me.
She starts out on page one: "The Affordable Care Act passed by Congress and signed by President Obama this year will provide you and your family greater savings and increased quality health care." Clearly, she's going to give me better care for less money. She adds: "...you, your family, and your doctor -- not insurance companies -- have greater control over your care." Better yet! Then she promised me: "Your guaranteed Medicare benefits won't change -- whether you get them through Original Medicare or a Medicare Advantage plan. Instead, you will see new benefits...." Now, I'm feeling great! After all the doubts the nasty Republicans spread about ObamaCare, thank you Kathleen, I should have had more faith!
I opened the shiny brochure and read the inside: Sibelius is sending me $250 if my Medicare prescription benefit tops out this year. That's about one month's worth of some of my pills, but it's more than I get now on reaching the ceiling. If I reach the cutoff in later years, she'll give me a 50% discount on: "...covered, brand-name, prescription drugs"; that discount will rise later. Guess I'd better hope my meds are covered!
Next year, she promises new preventive cancer screening, mammograms and a free annual physical. But my wife and I have those now with Medicare Advantage. She's giving me something I already have -- but folks with the regular Medicare should benefit.
Then she says: "The new law levels the playing field by gradually eliminating Medicare Advantage overpayments to insurance companies." Overpayments? Medicare Advantage pays a flat fee per patient to the providers, often HMO's, not insurers. The fee amount is set each year by the government. Kathleen is just cutting funding for Medicare Advantage and blowing smoke over it.
Sibelius's explanation continues: "Beginning in 2014, the new law protects Medicare Advantage members by taking strong steps to ensure that at least 85% of every dollar these plans receive is spent on health care, rather than administrative costs and insurance company profits." Medicare Advantage pays that flat fee per member; the provider has to care for the member with it and can keep any surplus but must endure any losses. It's an inducement to be efficient. Competition made Advantage HMO's provide members better benefits than regular Medicare; it's been growing fast. Kathleen has replaced that successful Advantage idea with price control -- a cost plus 15% fee apparently. And if providers must pay for sales, administration and any profit out of the 15% left over after Kathleen's 85% reimbursement, the Advantage is gone even if the name remains.
Comparing the beginning of this brochure to what's inside, Kathleen is speaking out of both sides of her mouth. Everything will be cheaper and better; nothing will be lost as she says on page one, doesn't match up with killing off Medicare Advantage as she describes on page two. Suddenly, Sibelius doesn't seem very honest.
On page three, she announces: "The law increases the number of primary care doctors, nurses, and physician assistants to provide better access to care through expanded training opportunities, student loan forgiveness, and bonus payments. Support for community health centers will increase, allowing them to serve some 20 million new patients."
I think she's saying that there will be more family doctors because we will subsidize their educations via forgiving their student loans. She's not saying they will earn less because Medicare payments to doctors are being cut and the amounts doctors can charge are price controlled -- but that is the case under the new law. Cutting doctors' fees is a bizarre way to attract hordes of eager students to med school. She doesn't estimate how many new doctors will be needed to see her 20 million new patients or how many new community health centers will have to be set up. Or how any of these changes will make my care cheaper as she promised; none of those new doctors or new clinics are free or presently available.
She goes on: "Community health care teams will provide patient-centered care so you won't have to see multiple doctors who don't work together." That means, I won't often be referred to a specialist; those primary care teams are going to take care of me. ObamaCare was set to pay specialists the same as primary care doctors, so why will there be any specialists? The extra years and training will be worthless (and pointless) -- from a new doctor's point of view.
She closes page three with: "Insurance companies will be prohibited from denying coverage due to a pre-existing condition for children starting in September and for adults in 2014...Young people up to age 26 can remain on their parents' health insurance policy starting in September." Insurers don't cover pre-existing conditions at the same price as the healthy for obvious reasons; how is my care (page one) going to be cheaper when I have to subsidize the pre-existing conditions of other people? If the kids can't find work and stay home, how will care be cheaper for parents who have to pay for their children's upkeep? Finally, how will I get better care with fewer specialists?
Sorry, Kathleen; the inside of your fancy brochure doesn't match the page one claims; the way you wrote it looks like a shyster attorney swindling a widow out of her saving. I guess truth in advertising doesn't apply to ObamaCare. Those Republicans weren't nasty, they were right.
