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Fri 13 Jun, 2003 01:25 pm
Prescription benefit for Medicare. It appears to be a done deal. Is there a link where one can find details of the legislation?
Hmm.. Well the Senate version got out of committie today but there is still a long way to go before we see what teh final bill will be. There are differing versions in the House and Senate bills. From CNN's WWW site:
Quote:The House and Senate bills vary considerably in details, but at their core they are similar. Both cover a portion of drug benefits and the proposed PPOs, which would offer preventive care as well as a cap on out-of-pocket health care costs.
Both would give private companies a stronger role in the government-run program, although the House proposal goes further, with proposals certain to stir controversy.
In addition to raising the deductible on so-called Medicare Part B, both bills would impose higher patient fees for some tests done in labs housed in doctors' offices or hospitals.
The House bill envisions $18 billion over five years in government savings by holding down the growth in payments to hospitals.
It also requires well-off Medicare recipients with higher drug costs to pay more in out of pocket expenses than others. "People who make $120,000 as a couple in retirement should at least be expected to pay a couple more dollars out of their pocket ... so the program can work for all," said Rep. Bill Thomas, R-California, the chairman of the House Ways and Means Committee.
Additionally, the House bill would inject a larger, more controversial dose of free-market competition. Beginning in 2010, it would require the national government-run health plan to compete for business with private insurance companies.
http://www.cnn.com/2003/ALLPOLITICS/06/12/congress.medicare.ap/index.html
Fishin
I read that the prescription benefit will have $35 /mo premium and a $275 deductible. Grand total cost of $635 up front. What if one yearly bills do not come up to that amount or you already have a prescription benefit as part of supplemental insurance. Would we still have to participate and pay the premium? I wonder? I get Leary when the government says they are giving us a benefit.
From what I've been able to gather up so far (which has been very little. Most of this stuff was just passed today so it won't show up on thomas.gov until mid-next week..) there is an "opt-out" provision where people could maintain medicare coverage as it exists right now.
I'd think that since these bills will be in House/Senate negotiations shortly there will be a lot of press in the next few weeks looking at what it means to all of us.
I think there's going to be a double ceiling on the benefits. The first ceiling is someting like $3.750, then there's no coverage up to some amount. After that, there's a 90 percent coverage. c.i.
Some Doubts About Logic of Senate Plan for Drug Aid
By DANIEL ALTMAN
[]ou will not find the prescription drug benefit plan approved by the Senate Finance Committee in any textbook on health insurance. The bill has the support of senators from both parties, but its features leave some economists baffled."This just seems like a creature of political expediency or compromise," said Frank R. Lichtenberg, a professor of business at Columbia University who is an expert on the economics of health care and prescription drugs. "It's not plausible to me that there's really an economic logic to the political policy that's being proposed."
http://www.nytimes.com/2003/06/14/business/14DRUG.html?ex=1055649600&en=9d57b7f8ac506852&ei=5059&partner=AOL
The senate version and the one congress is leaning toward Here's how it works: You pay a $35-a-month premium. You have a $275 deductible. The government pays 50% of your drug bills up to $4,500. Then it stops. Then it starts again if you pay more than $5,800 a year. In other words, a senseless stop-and-go ladder system that applies to all Medicare recipients regardless of income.
And its bottom line? You have to spend $1,200 in premiums and deductibles and co-pays before the government spends $1,201. About 35% of seniors would pay in more than they get back
And Who would reap the benefits. I expect the Insurance industry. They must be salivating over the plan.
Beware of Greeks bearing gifts. If you opt out of the plan should you be hit with a catastrophic illness I would suspect you are S.O.L.
Therefore seniors will be forced into taking out this insurance policy.
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