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August 1, 2014

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Letter to the editor:

Know truth about Medicare cuts

As a retiree, I am growing tired of hearing Republican presidential candidate Mitt Romney and Sen. Dean Heller talk about how President Barack Obama is cutting Medicare. They are trying to mislead and scare seniors.

The truth is that the cuts are only for tax dollars that go to the big health insurance and medical supply companies. The new health law finally cracks down on Medicare paying more of our money than it should to these corporations.

The new health law does not cut benefits for seniors. It actually increases them by lowering the cost of prescription drugs, closing the “doughnut hole” coverage gap and providing free annual checkups for serious diseases.

Repealing the new health law, which Romney and Heller want to do, would cut Medicare by taking away these benefits for retirees.

The author is the president of the Nevada Alliance for Retired Americans.

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  1. It's refreshing to see the truth rather than the GOP claim that $716 billion was removed from Medicare to pay for the Affordable Care Act.

    The ACA helps hospitals by requiring health insurance for all and reducing their losses for treating uninsured patients. Some of these savings in the form of reduced charges are passed on to privately insured patients as well as to Medicare. Thus, the $716 billion deduction in Medicare costs is a reduction in future charges not a reduction in benefits. As the writer correctly pointed out, Medicare benefits are improved under the ACA.

    By contrast the Romney/Ryan voucher plan is a reduction in Medicare benefits. It limits benefits to whatever a fixed insurance premium can purchase after paying for insurance company overhead and profit margins.

    AARP, the principal advocate for retirees, entirely supports the ACA.

  2. Obamacare cuts $716 Billion from Medicare over 10 years to defray the increasing costs for it. Plus Obamacare adds, starting in 2013, at least 18 new taxes on Americans, including the middle class, for almost ONE TRILLION dollars over the next 10 years. These facts and amounts are from the non-partisan Congressional Budget Office findings and reports. Go to the web site and read them.

    CarmineD

  3. "AARP, the principal advocate for retirees, entirely supports the ACA."

    AARP, and I'm a member, does not have accountants, actuaries and economists for researching and analyzing the dollar impact of policies. The CBO does. Accordingly, choose your sources to believe wisely.

    CarmineD

  4. Believe what you want. There will be $716 billion cut from Medicare over ten years Ask the Medicare advantage subscribers who will be dropped from the Medicare rolls and see their premiums increase. I am perfectly content with my Medicare benefits,and AARP supplement,and drug benefits. . No co pays or deductibles that are not covered. Never have been turned down by any doctor. It does not get any lbetter than that. I do not want my Medicare exposed to a major reduction in the benefits funding.
    I will be voting to maintain Medicare without a reduction, and without the new panel.

  5. The Romney Ryanplan retains the fully paid for traditional Medicare plan as one option. Fact check it.

  6. This entire matter for most breaks down along partisan lines. If you are for the ACA you are for Obama. If you are for Romney you are for reforming the ACA in some way. I am for reforming the Act. I would like a number of features included in the reformed plan.
    Elimination of pre existing conditions.
    Eliminate life time cap on benefits
    No termination except for failure to pay premium.
    Retain child on parents policy until 26 if in college.
    Open insurance across state lines

  7. So what else is new coming from the GOP?

  8. The Mitt Romney campaign is one of lies, distortions, and misleading statements all designed to confuse the undecided voters.

    Every that has done their homework and investigated the Medicare and Medicaid issue will find that the President has strengthen both programs, and Mitt Romney is proposing to eliminate Medicare and reduce Medicaid through the Paul Ryan budget.

    This issue is clear, the President will strengthen Medicare and Medicaid. Mitt Romney will eliminate Medicare as we know it, and reduce the benefits from Medicaid.

    Mitt Romney is the most dishonest candidate running for highest office in land in recent history. Based on how Mitt Romney is lying and changing his position at the drop of a hat, its clear that past political candidates have done the same. It is also clear that politicians like Mitt Romney use lying as a campaign tool against weak minded voters.

    Medicare will be strengthen under President Obama's plan. No doubt. President Obama wins re-elections by 6 to 8 points.

  9. Both Obama and Romney are loose with their facts on most all matters. Read the Washinton Post fact check on the debate. Both guys were not all on point with their positions. Trying to pin Romney as a liar and not dealing with Obama's distortions and mistatements is not realistic or honest.

  10. The following is what is really wrong and it spans parties.

    When Bush and Congress decided we had to fight the war on terror, they should have gone to the public and said we need to raise taxes on everyone to pay for this. Instead, they just tacked the cost onto our credit card. The war on terror was a worthwhile goal but to actually ask Americans to 'sacrifice' for it... oh no, we couldn't do that! The result was huge debt!

    Fast forward to 2008. Obama and Congress decide we really need to help provide health insurance to those who don't purchase it or cannot purchase it. They should have gone to Americans and said we need to raise taxes on everyone to pay for this. Again, the goal was worthwhile but to actually ask 'all' Americans to share in the cost? Oh no, we can't do that! Instead they reduced Medicare payments to doctors and others that accept Medicare, took that money and allocated it to help pay for the ACA to insure the uninsured.

    The result will be lower payments to doctors and others that accept Medicare. That difference will have to be made up by the Medicare Advantage plans, who will of course, raise their premiums, which will of course, reduce the amount of SS seniors with a Medicare Advantage plan, have to live on.

    What a great idea!!! And the AARP supports this??? Alert to seniors... Does this organization really advocate for you????

    This is the problem. No matter the party, our government makes decisions (some even good decisions) but then NEVER (anymore) asks 'all' of us to cover the costs. Either they borrow or print the money, tax only one group of Americans, or they lie and say Americans won't be affected by the costs (like the ACA) and then rob SAM to pay PAUL.

    This is why our country is failing and both parties are responsible.

    Michael

  11. Bob,

    I'll say it again. We need many more people like you. You support Romney and R's, but you clearly see that they don't tell us the unvarnished truth and are not afraid to say it. I don't see many like you in this forum that support R's and I struggle to name anyone on the D side that supports Obama, that is willing to admit that the side they support also is unwilling to provide the unvarnished truth.

    Michael

  12. Thanks Michael. The same goes for you. I read the Washingtom Post fact check yesterday and found it revealing and honest. Here it is for all who wish to understand where both candidates were correct and not correct.

    http://www.washingtonpost.com/blogs/fact...

  13. So what's the Romney-Ryan plan to insure 51 million Americans without health insurnce? Let them buy insurance across state lines? That's totally lame! As though buying insurance from Lloyds of Rapid City will save anyone a bundle.

    Every time the uninsured land in one of our Emergency Rooms that's a real tax on the middle class, not an imagined one.

  14. Jim Weber,

    Emergency room visits by the uninsured are a real tax on all of us and Romney Ryan don't have a plan to fix that. However, unfortunately, the ACA doesn't fix it either. They are reducing payments to doctors and others that accept Medicare and that will cost seniors more out of pocket and cause higher premiums for Medicare Advanatage plans. In addition, the ACA costs will be such that either more deficit spending or higher taxes on someone will have to be instituted. Why is that?

    Because as usual, with both parties, we were not told the truth and we were not 'all' asked to 'sacrifice' by paying higher taxes so people who don't buy or cannot afford health care insurance could obtain it. And because no 'real' effort was made to contain costs.

    You can criticize Romney/Ryan and R's for not providing a plan and I am with you. However, when the plan that is offered is not one that does what it claims, will require deficit spending or higher taxes and shifts money from Medicare for seniors to younger people, I am going to call that plan out a 'bad' plan.

    Michael

  15. This is where I have to just chuckle at Mike.

    Here's the truth about Medicare Advantage: it's a huge waste of taxpayer money. Only a quarter of beneficiaries are voluntarily enrolled in MA, the other 75% are members of traditional Medicare.

    Medicare Advantage was created because Congress became convinced that the free market would mean MA would provide efficiency and cost savings. The reality is: Medicare Advantage plans cost an average of 115% more than traditional Medicare. MA Private Fee For Service plans cost even more. In 2009, George Washington University found that the average extra payment for MA enrollees was $1138. PER ENROLLEE.

    NBER found that after the government began risk-adjusting payments to MA insurers in 2004, the differential payments totaled 8% of total Medicare spending.
    http://www.nber.org/papers/w16977

    So what did the ACA do to these MA plans? Most importantly, the ACA pegged federal payments to MA plans to quality ratings. In fact, this year, plans which received high quality ratings actually received bonus payments. Plans which do not meet quality goals will see their payments reduced.

    And for all Medicare enrollees, their preventative services are now free. Immunizations, cholesterol tests, screenings for diabetes and cancer? There's no co-pay. Mammograms, which can detect breast cancer early and thus help it be treated faster and cheaper, do not cost enrollees a dime. In the long run, this will keep seniors healthier while decreasing costs.

    Prescription drugs? The Medicare Part D donut hole is closing.

    See, this whole issue is where Mike's veneer falls apart. He's admitted, in the past, that his spouse is on Medicare Advantage. She takes advantage of this expensive, inefficient system. Mike benefits from this waste of federal resources, so he wants it protected. He wants the government to keep overpaying so that he can benefit.

    His rhetoric of shared sacrifice falls apart when he's asked to sacrifice.

  16. Medicare Advantage is a medicare benefit. To have some leftist flame thrower who grovels at the lap of Obama try to disenfranchise millions of American seniors who are on the plan, is dispicable.The destruction of this Medicare benefit is a direct impact of Obama's $716 billion cut in Medicare under the ACA. If Romney is elected this injustice will be prevented.

  17. Everyone already knows what the letter writer is saying. Especially those on Medicare. My wife who is on Medicare started getting data when the healthcare law was passed. Many of these distortions were rated the biggest lies of the year by various factions organizations.

    Regarding Medicare advantage. If you look at the statistics only 16% of Medicare recipients subscribe to advantage plans. The vast majority of Medicare recipients just walk around with their Medicare card.

  18. Does anybody else see the irony here? The republicans are always stating that government cannot do anything efficiently, then when the democrats do something to improve the cost effectiveness of medicare, the republicans try to paint it as a negative.

  19. The right always talks a big game of reducing government inefficiency and waste.

    Then they institute programs which waste taxpayer money on private insurance subsidies.

    And when the Democrats try to clean up their mess, the right melts down. When Democrats offer facts and policy, the right melts down. When Democrats point out the right's hypocrisy, they melt down.

    Medicare Advantage is a failed system which is inefficient and lines the pockets of insurance companies while bankrupting Medicare for the 75% of enrollees who need it.

    That the GOP would sacrifice Medicare for all to protect their subsidies to private insurance companies is the real shame.

  20. Could you Mr. Watts say something about the roughly 50% of doctors who won't take any more medicare patients because they can't afford to?

  21. My data was a bit stale. Mr. Sandoval is correct. Currently 25% of Medicare beneficiaries are enrolled in advantage plans.

  22. "Does anybody else see the irony here? The republicans are always stating that government cannot do anything efficiently, then when the democrats do something to improve the cost effectiveness of medicare, the republicans try to paint it as a negative."

    Exactly. This point can't be emphasized enough.

  23. Mr. Fritz, large numbers of doctors have never taken Medicare and Medicaid patients. They don't like the low reimbursement rates. That's just the way it is. People enrolled in Medicare and Medicaid have to accept clinic-based medicine. My wife sees Carolyn Dechaine who belongs to the" Internal Medical specialist Group" in northwest Vegas. Carolyn is a physician's assistant and my wife sees her exclusively. The level of care she provides is outstanding. My wife gets exactly what she needs and the cost is very reasonable.
    Medicare and Medicaid pay out nearly and $900 billion a year. That amount goes up every year and enrollment goes up every year. It's a substantial amount of money and Doctors shouldn't be whining.

  24. Michael -

    Medicare Advantage is a scheme devised to take seniors out of traditional Medicare by paying insurance combanies about a 14% subsidy per senior they sign up. Reducing that subsidy is about 1/5 of the $716 billion savings in Medicare that the Rs are crying about despite the fact that the subsidy does not purchase any healthcare directly and adds to the insurance companys' bottom line.

    As you can tell, I'm not sympathetic to Medicare Advantage because it misuses Medicare funds for other than medical costs and most of the Medicare Advantage Plans are HMOs or PPOs where you can't choose your own doctor or see a specialist without a referral.

  25. Here are a couple of the real life examples of problems with Ksand99's arguments.

    Example One: I have someone I know whose husband died a horrible death from Cancer. Even though she is not age eligible at 58, she got SS and Medicare under her husband. However, when she tried to sign up for Medicare Advantage, she was denied because she is under 65. The mental and physical stress of caring for her dying husband then resulted in her having to have back surgery (which was botched) and many other medical problems. Medicare paid 80 % but since no Medicare Advantage, she is saddled with the other 20 %, which amounts to thousands of dollars, which she has no way to pay.

    Example two: One day, my wife, who is on Medicare and Medicare Advantage, started having chest pains. I took her to emergency since it was a weekend evening. They kept her for several hours and took several tests. Luckily, she is ok, but the bill came to over $ 6,000 (for a few hours in emergency). I paid $ 65 but without the Medicare Advantage, the bill would have been $ 1,200. I hate to think what would have happened if she'd been admitted, which was discussed and did not have Medicare Advantage.

    Our health care / insurance system is really messed up and I'll say again, I give the President credit for making an attempt to make things better. Unfortunately, he outsourced the specifics to Congress, the legislation was lobbied to death and the ACA, while it contains some good provisions, is not going to do much to make the overall system better and it's costs will not be covered as the President claimed.

    Kevin is entitled to his opinion, but the future will prove me correct (unfortunately) and will show Kevin to be someone who seems to think anything an R does can't be any good and everything a D does cannot possibly have problems.

    Michael

  26. Jim,

    I am not a fan of Medicare Advantage. However, when health care is so expensive, a non wealthy retiree can't afford to buy private insurance and the government support plan (Medicare) only pays 80 %, if you go without Medicare Advantage and you get hit with a big Medical issue, you are done financially. Even 20 % of a huge medical bill is an amount of money most seniors cannot come up with.

    Do I think Medicare Advantage is great? No. Do I think seniors without it are playing medical Russian roulette? Yes, I do.

    Our government could do something about the abuses in Medicare and Medicare Advantage but instead, and as usual, the 'cure' is not a very good one.

    Michael

  27. "The Romney Ryanplan retains the fully paid for traditional Medicare plan as one option. Fact check it."

    Right Mr. Jack. As you and I and perhaps others know it was a subject of an exchange at the Wed night debate under the segment 3 of Entitlements. Romney beat the Prsident on it hands down.

    President Obama contradicted himself on the matter. And Romney called him on it. On one hand, President Obama stated that Medicare is more efficiently run than private health care insurers. Then, shortly after said that the private insurer options would gradually squeeze out Medicare recipients and Medicare would disappear over time.

    Governor Romney rebutted,. correctly, saying if Medicarer is more efficient then more recipients will stay in it and the private insurers would be squeezed out and disappear. Saying competition leads to the survival of the best providers, be it government or private.

    CarmineD

  28. "Here are a couple of the real life examples of problems with Ksand99's arguments."

    Actually, neither of your stories are actual counterarguments, Mike.

    We're discussing the ACA's affects on Medicare Advantage. The ACA does not affect the eligibility age of enrollees, so your first example has no relevance to the discussion. Are you saying you want more individuals enrolled in an inefficient and expensive program? And doesn't that contradict virtually every public stance you've taken in the past year?

    Secondly, your wife is currently covered by Medicare Advantage, correct? You're portraying a world without Medicare Advantage. The ACA doesn't remove all subsidies for MA. It reduces the growth of future payments to MA insurers and puts a framework in place to increase payments to providers who meet quality goals. Are you likely to see a small bump in your co-pay for MA? Sure. The cost of health care is increasing. This is a reasonable request. But the ACA doesn't eliminate Medicare Advantage plans, so your argument here is predicated on a myth.

    You expect a family of four making $30,000 to pay more in federal income taxes, but you can't pay a little extra in co-pays for your premium Medicare Advantage plan?

    I guess all that rhetoric about everyone having skin in the game doesn't apply to everyone after all.

  29. "Our government could do something about the abuses in Medicare and Medicare Advantage but instead, and as usual, the 'cure' is not a very good one."

    What, specifically, should they do, Mike?

    What is your vision of a "good" cure?

    Mitt Romney has pledged to repeal the savings in Medicare found in the ACA. That will bankrupt the system faster. And you're going to vote for Romney in November.

    Romney would keep in place expensive subsidies that do not encourage actual competition, that have failed to lower the rate of medical cost inflation, and that only add to private insurance profitability, rather than actual care for enrollees. And you're going to vote for Romney in November.

    How does your vote for Romney square with your concerns about the long-term viability of Medicare and Medicare Advantage?

  30. Kevin,

    It seems useless to say this to you but what I'd like to see is a good and affordable health care system. We didn't have one before the ACA. R's don't have a proposal for one and the ACA isn't going to provide one either.

    If the government thinks Medicare Advantage is a ripoff, come up with a 'good' alternative. I know you think that is the ACA but it isn't.

    Michael

  31. Kevin,

    Honestly, I don't know what 'the' solution is. The issue is very complex. We may be forced to go to a National Health Care system because we can't seem to effectively fix the one we have.

    One thing I do know is that with all the powerful players in the insurance and health care industry, if we leave campaign funding and lobbying as it is now, as soon as any 'good' idea hits Congress, we can all be assured that the lobbies for there powerful interests will see to it that they and their profits are always protected, no matter what.

    Michael

  32. Romney answered all these questions President Obama asked about ACA with a simple answer. Let the states decide what's the best and implement it just as Massachusetts did. With the following caveat that Governor Romney added on debate night: Federal government will be the safety net of last resort IF and WHEN the states' programs get into financial difficulty.

    CarmineD

  33. Bykepi,Your 5 posts starting at 6:35am,6:44am,7:18am,7:31am.and your last one at9:05am. They were very informative and also very helpful to seniors not well versed on health insurance.Thanks for sharing your excellent posts for all of us to view.

  34. Future,

    You understand something that too few Americans understand. 'There is no such thing as a free lunch'.

    Both parties are making promises they cannot keep. We can't increase military spending and not increase taxes, as Romney claims. We cannot insure the uninsured without raising taxes on the middle class, as Obama claims. It's all bogus!

    When government spends, it has to tax, borrow or print money. The parties say it isn't so, but math says it is so. The reason so many Americans buy this crap must be because they want to buy it.

    Michael

  35. Kevin,

    Without large increases in taxes, neither SS or Medicare are financially sustainable into the future unless changes are made to how they work and the benefits they pay. The math says that and it is the truth. Romney doesn't have a plan that will save those programs as they are and neither does Obama. Neither man seems willing to talk about much higher taxes to support all the new participants. Neither man seems willing to admit that future participants are very likely to have to accept smaller benefits.

    That's reality, but Americans and their leaders are not about reality anymore. They prefer fantasy.

    Michael

  36. "Without large increases in taxes, neither SS or Medicare are financially sustainable into the future unless changes are made to how they work and the benefits they pay. The math says that and it is the truth."

    Sorry, but you seem to prefer fantasy as well.

    The truth is that the ACA made VERY modest changes to the way Medicare Advantage is reimbursed, leading to VERY modest increases in co-pays for recipients of MA subsidies, yet even you freaked out, envisioning a world without Medicare Advantage altogether in the very near-term.

    The ACA also made VERY modest increases in the taxes collected from those who earn more than $250,000 a year. The Medicare tax increases by 0.9 percent on earnings over $200,000 for individual taxpayers and $250,000 for married couples filing jointly. And the ACA imposes a 3.8 percent tax on unearned income for high-income households.

    You seem to be under some fantasy belief that I (and Democrats as a whole) think that ACA fixes everything. It doesn't, and not one Democrat I know thinks that reforming our health care system is done or finished. It's a ludicrous charge that has no bearing on what I've written or what I think.

    Medicare needs tweaking. There are solutions to Medicare that don't involve putting our seniors' health care at risk. Lowering the cost of prescription drugs by allowing the government to negotiate prices, and/or allowing the importation of safe drugs from Canada. Speeding cheaper generic drugs to the market. Allowing younger adults to "buy-in" to Medicare at 50 or 55, supplementing the government program with younger, healthier individuals paying premiums, or even opening up the program to all as an efficient public option can put real downward pressure on escalating health care costs, and can keep Medicare solvent for decades.

    The GOP doesn't favor these approaches. They favor the Romney-Ryan plan turning Medicare into CouponCare and forcing seniors onto the open market to fend for themselves. That's perhaps the biggest fantasy of all: forcing seniors onto the open market would only INCREASE premiums for everyone else. The pool of individuals insured by private plans would become MORE risky, not less, thus increasing the out-of-pocket expenses for everyone.

    And really, you have no actual ground to stand on in regards to Medicare's financial solvency, as you favor the Medicare Advantage program which is a large driver of excess spending in the program. Repealing the ACA and destroying the modest reforms found within, as your candidate for President favors, would only hasten the bankruptcy of Medicare.

    You can't, on one hand say that benefits need to be cut and the program need more resources and then immediately freak out when that exact path is taken. It's disingenuous and perhaps a little revealing that you're all for changing benefits and increasing taxes on others, but have no willingness to put your own skin in the game.

  37. And all of the 'restored' Medicare money will bypass the recipients and go straight into the coffers and offshore bank accounts of the healthcare executives, lobbyists and contractors, etc.

  38. Have any of you considered that a very large number of people who turn 65 have medical issues from years of being uninsured or being uncovered for prior conditions, or having exhausted lifetime limits? Their first years in Medicare have been characterized by "catch-up" expenses paid for by Medicare. Under Obamacare, these conditions will now get treatment BEFORE they become a charge against Medicare, reducing health care expense under Medicare.

  39. Naive. Cut what Medicare will pay doctors, hospitals, corporations and they won't see you, won't take you as a patient--just like now when many doctors will not see Medicaid patients.

  40. Romney's been inconsistent in what he says and non specific on details and he's been criticized for that. He is running in an election and candidates usually lack consistency and specifics. Those that dislike Romney say he must be held to the fire for what he's said and done in the past.

    I have to ask though, how many of you really believe that the government did a poor job of helping the victims of Katrina because they were African American? The response was less than it could and should have been but that was caused by incompetence, not racism.

    Our current President said the response was lousy due to racism and he said it in a recorded speech. Should he be held responsible for what he said and what he apparently believed?

    I am really tired on this double standard.

    Michael

  41. Mike, all politicians should be held accountable for what they have said.

    I largely agree with President Bush and Obama, our response was shameful, whether guided by incompetence or racism.

    Obama's words echo those of Bush:
    http://www.thedailyshow.com/watch/wed-oc...

    But I have to ask, since it's such a non sequitur, what does this have to do with Medicare? Why change the subject?

  42. Michael,

    The two examples you gave are excellent, and can be multiplied over and over. One thing I liked was that it was about people, instead of entities and ideologies.

    The 80/20 Traditional Medicare is correct, with one additional factor. The 80% relates to "covered services". Not all services are "covered". And if they aren't covered, you pay 100% of uncovered services.

    Also, Medicare Advantage has a variety of types of MA offerings. Their are advantages and disadvantages between them. It puts more responsibility on the people to choose according to what they can afford. Not all MA's are the same.

    For those who can afford more choice, that is good. However, there are many others who cannot afford more than the capitated HMO's. That doesn't mean they lack excellent healthcare, just that they have a few more hoops to jump through.

    There is one more thing. Some of the cost can be placed on the degree of seriousness of patients health, and how many conditions they have. This is one reason why a shift toward prevention in healthcare services is good.

  43. I have to laugh over the issue of about 'doctor boards'. This has been going on in private insurance companies for at least 40 years. Anyone who doesn't believe costs and profits aren't involved is in a parallel universe. Costs are a concern whether private or public.

    The cost to people relates to premiums vs taxes. The public programs are not dealing with making a profit, although they may be concerned with savings that would be used in the program itself based on needs or priorities as health crises develop.

    Professional boards are a legitimate private/public healthcare practice dealing with costs and quality of care, by health professionals. They are compensated by either private/public entities.

    It won't be any different in public healthcare boards. However, the quality of the professionals and their input may be of a higher quality.

    Since the healthcare industry has been able to go wild for profits and lobby on behalf of their profits, we have a financial gorilla on our backs.

    I still insist that a single payer universal healthcare system is the answer. That doesn't mean it cannot offer different types of plans, from basic, to the whole enchilada for a price, which gives people choice, but it has more control over costs and quality. It could also offer a private option.

    During the time of the last election campaigns, around 50% of physicians surveyed in physician organization surveys were for a single payer plan. There has been much movement among physicians, and comments did not reflect fears of loss of quality.

    That may reflect a difference between political ideological more than a true patient centered view on the part of those who are against it.

    I agree that the ACA could have been alot better had the industry lobbyists were not the main force behind making a muck of it, and the need to compromise to get it done.

    Still, for people who cannot afford standard insurance, they desperately need something, and the only hope for them is through the government's efforts. Without the ACA, even if imperfect, the healthcare industry will continue to price people out of receiving healthcare, because it has a rapacious appetite more and more profits.

    In time the ACA may evolve into a more effective health plan. It could with politician's who were really looking out for the people, rather than having to cow tow to the industry because it is the only way to get anything done. It is up to our politicians to change that dysfunctional process.

  44. Michael,

    First, I would like to say that in relation to Katrina victims, those who had Medicare were in better shape for healthcare. I don't know how they fared under Medicaid since that is more State designed, even if matching funds are provided by the federal government.

    Had the ACA been in place, perhaps more people would have fared better in relation to healthcare needs.

    It is ridiculous to deny that racism doesn't exist today or six years ago.

    After living in TX, I can say that in general blacks were third rung citizen's in many instances, and the more excluded of the three major racial groups. Bush was a Texan. TX is part of the South.

    Many people think they aren't racists, but clearly they are. There are many ways it is expressed, even with the many improvements since the Civil Rights Movement.

    Obama, obviously has a closer connection to the black race, and more experience of what they experience in reality from many different life experiences. He should be better able to identify racism than people from other races and life experiences.

    However, I think it is more about political capital as the reason, with race linked to, or secondary, for many politicians.

    Given that blacks are more likely to be Democrats, they may not have provided the necessary political capital for the Bush Administration.

    Example from other natural events:

    "House Majority Leader Rep. Eric Cantor (R-Va.), after rushing home from Israel to survey earthquake damage in his district said, "The federal government does have a role in situations like this. When there's a disaster there's an appropriate federal role and we will find the monies." But the fact is, Rep. Cantor, played a key role in cutting $20 million from the budget of the United States Geological Survey, the organization that warns and prepares Americans for earthquakes."

    "This spring, Sen. Richard Shelby (R-Ala.), immediately pledged support and government intervention for rebuilding after tornadoes swept through northern Alabama. Yet three years prior, Sen. Shelby quashed legislation meant to fund the rebuilding of portions of Alabama's Gulf Coast that were decimated by Hurricane Katrina."

    http://loop21.com/content/katrina-proves...

    I want to also mention that medical care is also a need in natural disasters, and sufficient funds and programs should be in place to care for people.

    It cannot end without mentioning that in the Katrina disaster, there was an huge outpouring of help from private citizens and organizations. Some went to help the victims of Katrina, from medical services to rebuilding homes, to clean up. It wasn't enough for such a massive disaster.

    There were also many unscrupulous businessmen and contractors who did terrible things to the people in need and suffering. As though they had not been victims enough, they became the victims of greed and corruption as well.

  45. kepi,

    ;-)

  46. It's party survival for the Republicans and nothing more.They are only interested in winning the Presidential election.This is why they have not produced a replacement for the ACA which Gov.Romney says he will repeal if elected. With what? Just like everything else that they want to change,no answers only stalls.Time for voter's to take a hard look at what's at stake in this presidental election.

  47. You can quote the "experts" all you want to, but the reality is that if the government starts paying less to medical providers and insurers, they will slow down or stop taking new medicare patients. It ticks me off so much to hear people whine about the "thieves" in the medical business. Our costs don't go down because we treat medicare patients, seniors, or anyone else. At the office, we have a huge bill for personnel, equipment, rules and regulations, malpractice & other insurance, rent, utilities, and maintenence. Then we go home to another whole set of bills. All of these expenses go up every year, but the liberals want to reduce what they pay us to take care of people. That will work real well when most of us decide to drop out of the system and go to a boutique-type of practice, which many docs have done. Price controls don't work well when it's one-sided.

  48. My first concern is people, all patients, not protecting the financial privileges of the providers.

    My second concern is the establishment of a single payer universal system wherein providers can practice there art for the good of humanity first.

    Business expenses are deductible on taxes.

    Personal expenses are a choice as to the extent one chooses a lifestyle. That is not a mandatory requirement, nor the responsibility of patients to support.

    Providers determine what they will charge, even if they are not paid what they want. Often those charges reflect an increase to establish a higher profile with the third party payer, whether private or public.

    The fact is that the healthcare industry has driven and continues it's best to drive it's own pricing ahead of the current payments by third party payers.

    As a result, other entities have found it necessary to try to control the cost.

    There is a growing number of healthcare providers who want the game to end, and support a single payer universal plan. It offers a more efficient and stable operation, as well as the ability of practitioners to focus on quality care for their patients.

    Additionally, group practices which share technology are more practical than individual practices that causes more expense for a single provider.

    A single payer universal system can allow for private practices that want to treat patients that have the wealth to support them.

    Many physicians and other providers, if not most, are already dependent on third party payment systems. A single payer system is less complicated than trying to deal with multiple guidelines, cost controls, and quality expectations.

    Many providers feel a sense of "privilege" and do as they please, while those who are in "entitlement" programs, especially those who paid into them through taxes, are threatened with abandonment by some providers, when they are most needed. A window into the soul. Seems a bit like blackmail threats.

    If doctor's begin being selective of who they will treat and who not and leave, they will drive us toward a single payer system faster. Others will come into practice under a new system. Perhaps, there will be a return to larger physician population that truly cares about their patients.

    There are always a certain number of detractors of universal healthcare, often from lack of understanding. However, there are far more who love their systems and don't want to endure what Americans do. Plus, the quality does not suffer, and shows in quality care statistics in developed countries.

    The US is only number one is one category, cancer treatment. We also have higher unnecessary deaths than many others.

    Our system must change, making healthcare a universal right, rather than a privilege as determined by the healthcare providers.

    It is more critical than ever, as serious diseases are on an increase, necessitating care for everyone as a defense against disaster.