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Medicare Bill Passed


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In a dramatic vote that took almost three hours to complete, the House narrowly passed a Medicare and prescription drug bill and sent it to the Senate for final consideration.

Is this a needed Bill to help Seniors buy drugs ?

Or is it Hitlery-Care writ large with $40 billion in entitlements each year for 10 years ?

Or is it a needed bill of reform to allow health savings accounts and personal choice ?

Here is a summary of this plan:

Legislative Details

Details of the Medicare bill to provide older Americans a prescription drug benefit and overhaul the government-run health care program for 40 million older and disabled Americans.

Interim Drug Card: In 2004 and 2005, older Americans would qualify to purchase a discount card that the Bush administration estimates would yield savings of 15% or more off the cost of drugs. Low-income seniors would get an annual subsidy of $600 to defray costs further.

Main Drug Benefit: Beginning in 2006, Medicare beneficiaries could sign up for a stand-alone drug plan or join a private health plan that offers drug coverage. They would be charged an estimated premium of $35 per month, or $420 per year. After meeting a $250 deductible, insurance would pay 75% of drug costs up to $2,250.

Coverage gap: No coverage for drug costs between $2,250 and $3,600 out of pocket.

Catastrophic coverage: When out-of-pocket spending reaches $3,600, insurance covers 95% of drug costs or requires a modest co-payment.

Low-income subsidies: The premium, deductible and coverage gap would be waived for people earning up to $12,123 a year. To qualify for the subsidy, seniors could have no more than $6,000 in fluid assets. The subsidies would be phased out between $12,123 and roughly $13,500 in yearly income.

Retiree coverage: Would provide tax-free subsidies, perhaps worth as much as $70 billion, to employers who maintain drug coverage for retirees once Medicare drug benefit begins in 2006.

Other Changes: Doctor and other out-of-hospital coverage (Medicare Part B):

Premium: By law, Medicare beneficiaries pay 25% of the Part B premium and the government pays the rest. Individuals with incomes greater than $80,000 would pay a larger premium. The size of their premium would increase on a sliding scale, topping out at 80% for people with incomes over $200,000.

Deductible: Would rise from $100 to $110 in 2005 and thereafter be indexed to the growth in Part B spending. Role of private companies:

Private firms would administer the drug benefit on a regional basis. Would provide $12 billion in subsidies to private insurers that choose to offer basic health insurance. Those include preferred provider organizations, which encourage use of certain doctors but allow patients to go elsewhere if they pay extra, and private fee-for-service plans, which allow patients to see any doctor.

Beginning in 2010, traditional Medicare also would face competition from private plans in six metropolitan areas in which at least two private plans enroll at least 25% of Medicare beneficiaries. For those who remain in traditional Medicare, premium increases would be capped at 5% a year and waived for low-income seniors. The competition would last six years.

The government would provide drug coverage in any region that does not have at least one standalone drug plan and one private health plan.

Rural health: Would spend about $25 billion to increase payments to rural hospitals and doctors, among others.

Generic drugs: Would speed generic drugs to the market by limiting ability of pharmaceutical companies to block cheaper equivalents.

Drug importation from Canada: Would maintain the ban on importing prescription drugs. Would allow such drugs from Canada, but only if Department of Health and Human Services certifies safety, something it has declined to do. Would authorize a study of safety issues.

Hospital payments: Would allow hospitals to avoid future cuts in payments by submitting quality data to the federal agency that runs the Medicare program. At the same time, would increase payments through Medicaid to hospitals that serve a large number of disadvantaged patients.

Would impose 18-month pause in development of new specialty hospitals and limit expansion of existing ones.

Physician payments: Would block planned cuts in physician payments in 2004 and 2005 and instead provide a 1.5% increase.

New benefits: Would cover an initial doctor's appointment for new Medicare beneficiaries and screening for diabetes and cardiovascular disease. Would provide benefits for coordinated care for people with chronic illnesses. Would increase payments for doctors administering mammograms in hope that more are given.

Health-related tax savings accounts (Health Savings Accounts): Would allow people with high-deductible health insurance policies -- at least $1,000 a year for individuals, $2,000 for couples -- to shelter income from taxes. Individuals younger than 65, employers or family members would make pre-tax contributions equal to the deductible, up to a maximum of $2,600 a year for individuals and $5,150 for families. After 65 years of age, earnings and distribution also would be tax free, provided the money is used for health expenses, including insurance premiums, prescription drugs and long-term care. Otherwise, a 10% penalty would apply.

Home health care: Would cut payments to home health agencies, but not require co-payments from patients.

Cost containment: When general revenues constitute 45% of Medicare spending, Congress and the administration would have to review Medicare's finances.

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It is the first step i fear towards;

1. Drug price controls which will destroy the US pharma industry and its great R&D which is keeping people the world over - alive and healthy.

2. Socialised universal health access for US citizens. This will cost US taxpayers a huge amount of money and would stop the US' high technology innovation in health care products and services. This would have repercussions the world over.

This bill is large, complex and contains too many plans and ideas.

It should have been targeted to 1 or 2 areas that need reform with other bills targeted likewise so the public and even the politicians can make sense of it.

Frankly after reading parts of it, i don't understand what they are trying to do - except spend $40 billion per year to cap drug prices and gain senior votes and sometime after 2006 start HSA's which i agree with, but fail to see how that offsets the $400 billion in entitlement spend.

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Yeah, I agree Craig. It's a big bill and some of it is definately unwarrented. But that fact that it barely passed the House and the Dems are planning on filibustering the bill in the Senate makes me wonder how many times bigger this deal would be if the Libs could get their way. Some could make the case that Bush is moving to the left here, but I think he's just trying to take this issue away from the Dems come 04.

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Today I want to discuss the coming crisis in Medicare. Now I know most of you have heard that the medicare/medicade system is in danger of failing or you would have had coverage not been canceled to regale us with the latest from the Scott Peterson, Kobe Bryant or lately the Michael Jackson scandal. The GOP and the Bush Cartel have to love the bait and switch that passes for journalism now. But that is another story and this one is about health care.

The need for a prescription drug benefit was a hot button topic in the last election cycle as both parties called for an end to seniors being forced to choose between food, rent or the drugs that keep them alive. The need still exists but lets be honest the current quick fix that the GOP and some Republican-Lite Democrats are pushing will not fulfill that need.

As the Center on Budget and Policy Priorities points out, the bill will force millions of beneficiaries to pay more for drugs, thanks to a provision that cuts off supplemental aid from Medicaid. Poorer recipients may find previously affordable drugs moving out of reach. It will also allow private insurers to cherry-pick healthy clients in selected cities, and it will heavily subsidize private plans competing with traditional Medicare. Meanwhile, the bill prohibits Medicare from using its bargaining power to cut drug prices; drug company stocks have soared since the bill's details became public

You see folks, the idea behind this bill is not to help seniors or the poor but rather to help the legal drug cartels, private health insurers and politicians line their pockets. Now I know that those on the supply side like to scream government waste whenever social spending comes up but in truth Medicare is much more efficient then private plans and costs the taxpayer much less then what is lost yearly to the uninsured use of emergency rooms for primary care.

What is needed is not more money, tax breaks and incentives to managed care groups but rather government regulation of the health industry. Now I know that ever since the 80’s we have lambasted anyone who even thought of regulating business in this country but it is de-regulation that has led us to the sorry state we are now in. We have de-regulated the power industry and now we pay higher power bills. We have de-regulated Wall Street and now we see corporations stealing from the people who invest in them. We have seen de-regulation of the airlines and we saw a rise in the number of accidents. The list goes on and on. But it is the de-regulation of the healthcare industry that has really put seniors and the poor into such dire straights.

Simply put we need to install price controls on the drug and insurance companies. Now I can already hear you nay-sayers screaming about how drug companies will lose the ability for research and development if we bring price controls in. The problem with this argument though is that we give these same companies billions, yes I said BILLIONS in tax incentives for research and development.

According to Representative Pete Stark: "Nonsense. Drug industry profits are already threefold higher than all other major industries. And my bill doesn't change the current system of research tax credits at all unless companies refuse to fairly price their U.S. products. This bill simply tells PhRMA that U.S. taxpayers will no longer subsidize lower prices overseas with our tax code. Research and development is important and that is why we give these huge tax breaks, but they do consumers little good if they can't afford the product."

There you have it folks. This bill is nothing more than a give-away to special interests by the Bush/GOP party machine. It is you and your children who will pay for it. But what of the aged, you ask? Well they are the ones who are really screwed as they have to choose between no coverage and scant coverage. Will this fix the much ballyhooed problem of seniors skimping on their medicines to find rent/food money? No. But it does work well for making sure that the rich keep their wealth at the expense of your grandparent’s health…

This is Liberalman signing off and begging you to call your congressperson and let them know you are watching their actions as they sell out the old and the infirm while quietly planting their lips on the collective backsides of the insurance and medical campaign contributors who have supplanted the American people as the real power behind the throne.

Peace

Liberalman

Aka Casey Nees

Addendum from Faer Lee Balanced:

AARP has come out in favor of this bill, arguing that what it proposes is better than what we have now. While this may be true on the surface, Congressional insiders admit that passing this bill will effectively put an end to the prospects for universal coverage for prescriptions. That, coupled with the bill’s illegalization of Canadian drug imports, means that all the research and development in the world won’t make most of us any healthier. This bill is a perfect example of a safety net made of gauze. Those that can afford a harness will make, and the rest of us won’t.

Questions/ Comments?

[email protected]

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Mostly nonsense. What you are advocating is socialised medicine. Rationed health care. No technology, no doctors and waiting lines, and no pharma industry.

Good one.

This bill is bad. It is too large and too unfocused and costs too much. I don't buy that HSA and regional health competition will keep prices down.

But the impact on the budget -- and the economy -- will be far more significant in the following years, beginning in 2008, when the first wave of baby boomers -- the group of nearly 80 million Americans born during and after World War II -- begin to retire.

"There's a massive build-up of future Social Security and Medicare spending that will explode, and this makes the problem much worse," said Chris Edwards, director of fiscal policy at the Cato Institute, a fiscally conservative think tank in Washington. "This makes the problem much worse."

"The next generation of young workers will be crushed by gigantic and rising payroll taxes to pay for all of this," Edwards added.

Jagadeesh Gokhale, a scholar at the conservative American Enterprise Institute (AEI), has suggested that the shortfall in unfunded future Social Security and Medicare benefits could total a whopping $44 trillion without the prescription drug bill and between $51 trillion and $56 trillion with it.

"The Medicare prescription drug benefit advancing through Congress will cost much more, and do less good, than many legislators realize," Gokhale told a congressional subcommittee this summer.

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Looks like Bush has been taking lessons from Jean on how to buy votes with your children's money.

Most Conservatives will eat this one for the time being as it ensures the War on Terror wil continue but all the Democrats need is a candidate that backs the action in Iraq and they might get in.

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The only defense of this initiative is that it leaves the Dumbos without much to cry about.

-Economy is booming

-Within one year Iraq will be under control and Hussein dead

-Health Care reform [although it is nothing of the sort] can be a political tool to steal moderate votes

-Next on the agenda - Social Security reform and namely - tax free savings account [about time], in lieu of having gov't steal your money from your wage for SS payments

Bush can redeem himself on this poor Medicare bill by;

-Stop bashing China

-Get rid of the steel tariffs

-Reform social security.

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