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Author Topic: Obama Paints a Picture - Speech 10-01-2008  (Read 2401 times)
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WhiskeyGirl
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« on: October 01, 2008, 08:31:25 PM »

I watched part of the Obama speech today.  I've always wondered why McCain doesn't raise my hackles as much as Obama.  I've decided it's because Obama paints a picture of his vision.  McCain isn't a good verbal painter of pictures.

The problem with the Obama paintings in my mind is that they raise many more questions than they answer.

Do the Obama paintings raise questions in anyone else's mind?  What imagery comes to mind when someone listens to an Obama speech?
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All my posts are just my humble opinions.  Please take with a grain of salt.  Smile

It doesn't do any good to hate anyone,
they'll end up in your family anyway...
WhiskeyGirl
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« Reply #1 on: October 01, 2008, 09:11:44 PM »

Healthcare for everyone? 

What kind of program does Obama propose to provide healthcare for everyone?

From what I've been able to determine, healthcare would continue to be a patchwork of programs, with a blank checks issued by the government.

Who would pay for all these programs?  How would Obama make these programs affordable?  If heart attack treatment costs $100,000 who is going to pay?  Maybe the victim will pay like $100, but who is going to pick up the tab for the balance - $99,900?

Medicare for some, Medicaid for some, the plan available to members of Congress, the Obama National plan that is "like the plan available to member of Congress" (but NOT the same plan), and remnant private health plans that may survive the Obama changes/legislation/surcharges.

Quote
Obama also said he would save money by allowing the federal government to negotiate drug costs with pharmaceutical companies and would cut other Medicare costs.

"We should stop sending $15 billion a year in overpayments to insurance companies for Medicare and then we should go after tens of billions of dollars in Medicare and Medicaid fraud," he said.

There is money to be had. Nonpartisan congressional investigators have found that some private insurance companies in a program known as Medicare Advantage charge more to administer services than traditional government-run Medicare. About a fifth of Medicare recipients are in those private plans. Other studies have found that Medicare and Medicaid fraud is occurring.


http://minnesota.publicradio.org/display/web/2008/10/01/obama_fact_check/

Why not one plan for everyone?  Aren't we all in this together?  Why do some get Medicaid, and others the plan available to members of Congress?  Perhaps there are different benefits and reimbursements to providers?

Is there a difference between the following prices -

- prices negotiated with drug companies
- prices based on a fair profit for drugs
- prices based on language that ensures that Americans pay the same or lower prices for drugs that drug companies charge others

It seems easy for some companies to waive a $10,000/month drug therapy in front of a dying person...what if the fair and reasonable price of that drug? 

Obama also mentioned his mother.  I could not find the quote on-line, but found an older similar story -

Quote
"I remember my mother. She was 53 years old when she died of ovarian cancer, and you know what she was thinking about in the last months of her life? She wasn’t thinking about getting well. She wasn't thinking about coming to terms with her own mortality. She had been diagnosed just as she was transitioning between jobs. And she wasn’t sure whether insurance was going to cover the medical expenses because they might consider this a preexisting condition. I remember just being heartbroken, seeing her struggle through the paperwork and the medical bills and the insurance forms. So, I have seen what it's like when somebody you love is suffering because of a broken health care system. And it's wrong. It's not who we are as a people."

http://www.swamppolitics.com/news/politics/blog/2007/09/obamas_mother_in_new_ad.html

Would treatment options/coverage have been different if his mother was on Medicaid?  Medicare?  The plan for members of Congress? 

What about the number of providers willing to care for his mother?  IIRC, providers are free to choose the programs they accept.  Reimbursement rates may be different.

When it comes to healthcare programs, are we all in this together? 

Shouldn't members of Congress have the same access to healthcare as those on Medicaid?

Medicare Advantage

Quote
NEW YORK - Health insurance companies fell with the broader market Monday as concerns over the credit market linger and the sector faces uncertainty with the future of Medicare Advantage reimbursement levels.

In order to reverse a cut in reimbursement for doctors, Congress has proposed spending less on the government-sponsored Medicare Advantage plans, which are run by health insurers and serve about 9.5 million seniors. Several health insurers are poised to lose revenue from the programs through the cut.

BMO Capital Markets analyst Dave Shove said Monday that Medicare Advantage plans will likely continue to be a target for legislators, though they could still be somewhat profitable. Furthermore, he said, U.S. senator and presidential candidate Barack Obama highlighted worries over lower reimbursement when comments during a debate Thursday suggested he would accelerate cuts to the program if elected.

http://www.forbes.com/feeds/ap/2008/09/29/ap5484280.html

Quote
About 20,000 people in Wisconsin are enrolled in the two plans that Anthem Blue Cross plans to stop selling, said Shawn Schaeffer, who helps oversee the company''s Medicare plans in Wisconsin.

In all, the company has about 50,000 people in Wisconsin enrolled in its Medicare Advantage plans.

Quote
The SmartValue Enhanced plan costs $29 or $60 a month, depending on the county. The SmartValue Enhanced Plus plan costs $62 or $98. The higher prices apply to Milwaukee County.

The plans offered more benefits than Anthem Blue Cross'' other Medicare Advantage plans, and the health insurer basically priced the plans too low, according to the company.

http://insurancenewsnet.com/article.asp?n=1&neID=200809301180.3.129_dd50000001b84831

Quote
Medicare Advantage is an important coverage option for minority and low-income seniors, according to the latest data from the Medicare Current Beneficiary Survey (MCBS).

"These data underscore the value Medicare Advantage plans provide to low-income and minority beneficiaries," said Karen Ignagni, President and CEO of America's Health Insurance Plans (AHIP). "These plans provide lower out-of-pocket costs, offer additional benefits, and emphasize prevention and the management of chronic conditions."
According to the MCBS data for 2006, 48 percent of all beneficiaries enrolled in Medicare Advantage in 2006 had incomes of less than $20,000. Moreover, 71 percent of minority Medicare Advantage enrollees had incomes below $20,000.

To view the Medicare Advantage data analysis, visit www.ahipresearch.org.

America's Health Insurance Plans - Providing Health Benefits to More Than 200 Million Americans

SOURCE America's Health Insurance Plans
http://www.ahip.org


http://www.marketwatch.com/news/story/ahip-low-income-minority-seniors-depend/story.aspx?guid=%7B7E0E72FC-1B12-4D28-BF83-8A734C380268%7D&dist=hppr

I wonder how many seniors would have more out of pocket expenses and pay more under the Obama plan?

The other thing that comes to mind, the 'state' has no interest in keeping older/disadvantaged citizens alive.  When an older or disadvantaged citizen dies, the state saves money on pensions, welfare payments, healthcare, and other benefits.

It's one thing when an individual decides they have lived a good life and accept that their life is at it's end.  It's another when the state pulls the plug or decides to restrict treatment options based solely on age...

Is 'prevention' part of the Obama solution for older citizens?  If not 'prevention', what?

Why isn't there on healthcare system for everyone?  Aren't we in this together?

(I'm not getting any younger, so this is a real concern for me.  Also, no one has ever asked me what I think of the program.)
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All my posts are just my humble opinions.  Please take with a grain of salt.  Smile

It doesn't do any good to hate anyone,
they'll end up in your family anyway...
WhiskeyGirl
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« Reply #2 on: October 01, 2008, 09:35:44 PM »

My my brief journey into the Medicare Advange programs show that ~ "These plans provide lower out-of-pocket costs, offer additional benefits, and emphasize prevention and the management of chronic conditions."  In my simple brain, this appears to be apples and oranges compared to traditional programs.

Was there any analysis to show if these added programs provided better outcomes for seniors?  Are MA enrollees healthier?  Are their conditions better managed?  Are there long term savings?

Quote
Two reports released in the early days of September criticized private Medicare plans. A Sept. 5 report sponsored by The Commonwealth Fund cited what it called "extra" payments to Medicare Advantage (MA) plans totaling $8.5 billion in 2008.


Quote
In a separate analysis of MA plan payments, Brian Biles, a professor of health policy at George Washington University who has issued similar reports for many years, estimates that extra payments to MA plans will reach $986 over fee-for-service (FFS) costs for each MA enrollee, totaling more than $8.5 billion in 2008 - and up from $3.9 billion in extra payments, or $795 per MA enrollee, in 2004 (see charts, below).

According to Biles' analysis, MA plans will be paid an average of 12.4% more per enrollee in 2008 than what an enrollee in FFS would have cost. He estimates that even if payment reductions to MA plans mandated by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) — scheduled to take effect starting in 2010 — had been fully implemented in 2008, MA plans still would have been paid 10.6% more than expected FFS costs.

http://www.aishealth.com/Bnow/hbd093008.html

See the OIG report at http://www.oig.hhs.gov/oei/reports/oei-01-06-00050.pdf and Biles' report at http://www.commonwealthfund.org/publications/
publications_show.htm?doc_id=702557
.
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All my posts are just my humble opinions.  Please take with a grain of salt.  Smile

It doesn't do any good to hate anyone,
they'll end up in your family anyway...
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