Sensenbrenner favors 19% of seniors, trashes other 81%!

      

By Jack E. Lohman

It was hard to believe my ears.

Either Congressman Jim Sensenbrenner was spinning his vote for the insurance industry, or he truly doesn’t get it.

At a recent town hall meeting Jim boasted that he voted against reducing the funds for Medicare’s Advantage program because some of his constituents like the program. And yep, 19% of seniors have fallen for the claims by Advantage salesmen, as did he.

But in the process, he tossed to the wolves the other 81% of seniors with traditional Medicare!

Medicare Advantage plans cost taxpayers up to 17% more than traditional Medicare, and generally provide less patient care. HR6331 would have lowered the private Medicare payments to equal those of public Medicare, but Jim wouldn’t stand for it.

Forget that “private” should be less costly than “public,” it isn’t.

Medicare Advantage plans (a clever oxymoron) are more costly not because they offer more services to patients — because they take more than they give — but because they waste more money on salesman commissions, actuarial costs (cherry-picking), utilization review (gatekeepers and denial of care), higher CEO salaries and bonuses, and in some cases shareholder profits and even lobbying and campaign contributions that get added to patient costs.

Hereby lies the key: private Medicare Advantage companies can give campaign contributions and public Medicare cannot!!!

So what else would you expect from Jim Sensenbrenner? He also opposes campaign reform, which would greatly reduce the corruption in Washington and fix a lot of our nation’s problems.

The Advantage plans are usually fine, until you get really sick and need care. The Medicare Rights Center found serious problems when, too often, these plans did not provide the care they promise. This has prompted several state attorney generals to sue the companies on behalf of patients.

Among the faults found:

  1. Care can cost more than it would under Original Medicare;
  2. Private plans are not stable;
  3. Difficulty getting emergency or urgent care;
  4. Continuity of care is broken;
  5. Members have to follow plan rules to get covered care;
  6. Choice of doctor, hospital and other providers is restricted;
  7. Difficulty getting care away from home;
  8. Promised extra benefits can be very limited;
  9. People with both Medicare and Medicaid can encounter higher costs.

Worse, in order to pay for the 17% subsidy to the private Advantage companies, congress allowed a 10.6% cut in physician payments from “traditional Medicare” to take effect on July 1st. The obvious result is that physicians will significantly reduce (or sometimes eliminate) the number of new “traditional” Medicare patients they take, and/or start skimping on the number of needed diagnostic tests they perform.

So, many of the remaining 81% of seniors will now have to start looking for lesser-quality and more costly Advantage plans, which is exactly what the private insurance industry wanted!

Thank you, Congressman Sensenbrenner.

Another problem is that most of these plans are “capitated” and paid at a fixed rate by Medicare. So whenever the company can avoid providing tests or surgeries, that savings adds to their bottom line in profits. A major incentive for denial of care.

I asked Jim why, when the taxpayers give politicians health care, he calls it “employee benefits.” But when taxpayers give citizens health care he calls it “socialized medicine.”

Not surprisingly he launched into a tirade defending the federal health care system. He ignored that most seniors have paid into Medicare over the past 40 years, and are subject to the same 20% deductible federal employees are.

Funny how that works, but you have to know the mentality. Sensenbrenner’s gold-plated plan is neither a capitated plan nor a health savings account (HSA), both of which he supports for the masses but not for himself.

Reports on Medicare Advantage Plans:

States Look to Rein In Private Medicare Plans

Private Medicare Plans’ Cost Questioned

Medicare Audits Show Problems in Private Plans

Sensenbrenner’s Republican challenger, Jim Burkee, has promised to self-limit his stay in the House to 6 years, which would be quite a change from Jim’s 30 year stand. His website outlines his disagreements with Sensenbrenner, though he (inappropriately, I think) supports free-market health care.

This bill ultimately passed the senate with a 69-30 veto-proof majority on July 9th, no thanks to Sensenbrenner and Paul Ryan. After Ted Kennedy (D-MA) cast the deciding vote, nine Republicans changed theirs to vote their conscience. To understand why they didn’t vote their conscience in the first place, just follow the money!

That is our corrupt system. Get used to it… or change it!

7 Responses to Sensenbrenner favors 19% of seniors, trashes other 81%!

  1. John says:

    Great point, and thoughtful insights into the Republican mindset. I too have told people over and over to just ask any Republican why they haven’t tried to bring health care costs down by dropping the government-provided care with their incredibly flawed HSA.

    I’ve had an HSA for 6 years, traded down twice, and I’m onto their low ball formula. Every year they increase premiums around $1200 and try to get you to increase your already high deductable. After 5 years, your up to the equivalent of a normal HMO premium but with a very high deductable. Of course, the $1200 increase continues year after year, never stopping. So what if I can shop for a cheap doctor, the insurance will kill you first.

    Keep up the great work. You’re a great source.

  2. Thanks, John. And I can’t help but wonder, if you do get sick and want to change to a regular plan, if they are not then going to deny pre-existing diseases. I know one family that had a surprise diagnosis of diabetes with their 3-year-old, and they have a high-deductible plan. What will now happen when they try to go to a regular plan?

    And I might add, Sensenbrenner seems quite heartless on this, though he is protected with a nice, gold-plated taxpayer-paid plan for life.

  3. YouMoron says:

    Jack,

    Stealing the money from MedicareAdvantage is nothing more than an attempt to reverse the first significant and postive Medicare reform in a two generations.

    Last fall, the Democrats chose to place a 10% cut in provider reimbursements into the Medicare package just so Republicans would be put in this unnecessary position.

    I guess the Democrat’s just don’t want to let people have the option of more and better choices. Instead they are underfunding Medicare and cutting payments to providers – that’s what government run health care gets you.

    You are a great source… for what’s wrong with health care and why liberals should be kept as far away from the system as possible.

  4. I would have expected most people to be able to do the math on this, but obviously not.

    Medicare Advantage, the privatized side of Medicare, is costing taxpayers 17% more than traditional Medicare. The R’s wanted to cut physician payments for public Medicare by 10% in order to continue the 17% private subsidy, or overpayment.

    As I mentioned above, so much for “private” being more efficient than “public.”

    Medicare Advantage should have been cut to equal public Medicare nonetheless, but cutting public Medicare was the conservative’s way of killing Medicare and forcing patients into the more costly private system. They weren’t even smart enough to find the 17% elsewhere, by cutting other spending, so they paid the price.

    How their effort becomes “positive Medicare reform” is beyond me (and the 10% cut was put in years ago, not last fall, and even if it were Bush would have had to sign it into law. The Republican congress did this.).

    But if you happen to be an insurance salesman making a living on private Medicare, I can understand your ire. The 17% bloat will be gone and private insurers will have to meet the public price. To some that’s hard to swallow.

    And besides, physician payments are not what is driving health care costs through the roof. It’s insurance bureaucracy waste, fraud, and overutilization, none of which the R’s (or D’s) want to tackle.

    • Roseli says:

      Can anyone spell b-o-u-g-h-t o-u-t? It is disgusting to see the amount of money our thoroughly corrupt corporate America literally throws at members of Congress! I hope southern Wisconsin will throw this bum out on his rear next time—he’s not representing THEM at all!

  5. The Ins and the Outs of the Medicare Bill

    This article is very telling. The recent Medicare bill that passed was certainly not perfect, but that Bush doesn’t like it tells me that we are better off with it than without it. But all of the details listed points to the reason why the moneyed interests have to be neutralized with public funding of campaigns. Wouldn’t it be nice to have a bill pass without money changing hands?

  6. […] Sensenbrenner favors 19% of seniors, trashes other 81%! […]

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