Thursday, February 25, 2010

From our good friend, Jesse Slome, Exec Director of the Am. Assn for LTCI:

My crystal ball is still cloudy in terms of how long term care (LTC) will be impacted by the final provisions of the great health care debate. Chances are it will remain an issue left for another day.

But long term care cannot be ignored for long. The nation’s next great health care debate will focus attention on Medicare and Medicaid. LTC is such a large and growing component of these taxpayer-funded plans that you can’t discuss saving these programs without dealing with LTC.

The proposed CLASS Act (which gained favorable support from many influential organizations) probably gives a good sense of what’s likely to be the basis of proposed LTC plans. Unless the economy comes roaring back and Washington is again flush with taxpayer dollars, the best legislators will be able to accomplish is an underfunded, initially voluntary plan. In simple terms, get a plan in place, but kick the can down the road a bit further in terms of financial solvency.

Is this good or bad for long term care insurance? The answer - yes!

Some good outcomes
Such a significant change provides the industry with an opportunity to “retool” policies. As an example, level premiums really no longer serve the intended purpose (making products attractive for elderly buyers). In fact, they make insurance costly for younger buyers. LTCI supplement policies
(like Medicare Supplement) could gain traction. Finally, some producers are chomping at the bit waiting to compete head-to-head with a poorly financed, minimal-benefit government plan.

Some bad outcomes
Hearing about a new government LTC plan, consumers start to believe they have LTC “covered.” The 15-second media soundbites reinforce this impression. There is less consumer interest, smaller insurers exit the marketplace and the private market rapidly collapses. Stay tuned.

Saturday, October 10, 2009

I thought there would be no cuts to Medicare under Obama's Plan?

According to the latest Congressional Budget Office score, the Senate Finance Comm ittee Health Care Bill has a total cost of $829 billion over 10 years, imposes $424 billion in new taxes and fees over the first 10 years and has over $400 billion in Medicare cuts. I have listed the proposed cuts to Medicare below:

Cuts to Medicare

-$133B Medicare Advantage
-$128.8B Hospitals
-$106.3B Inpatient Prospective Payment System
-$22.5B Medicare DSH payments
-$56B Home Health
-$22.2B Medicare Commission
-$22.3B Medicare Improvement Fund
-$19.8B Medicare Part D
-$14.6B Skilled Nursing Facilities
-$23.1B Part B Schedules, Except Physician Services
-$8B CMS Innovation Center
-$11B Hospices
-$4.9B Accountable Care Organizations
-$3B Medical Imaging
-$800M Power Wheel Chairs
-$300M Comparative Effectiveness Medicare Component
-$100M Medigap

Thursday, October 1, 2009

Intimidation Over 1st Amendment Rights!

Medicare Advantage was created to do what the Center for Health Transformation (CHT) has long fought for: To give all seniors more private choices of higher quality health care. It currently provides almost 11 million Americans coverage through private insurance plans. Recent data shows that these seniors have better health outcomes than those in traditional Medicare.

Current legislation in Washington will gut the program. H.R. 3200 in the House will cut Medicare Advantage by $172 billion. The bill sponsored by Sen. Max Baucus in the Senate will cut the popular program by $123 billion.

If you're just hearing about this now, here's the reason: When Humana (with whom we've worked with in the past at CHT) tried to inform its Medicare Advantage members that Democratic health care reform could lower their benefits, the government ordered them to cease and desist and opened an investigation of the company.

Sen. Jon Kyl (R-Ariz.) subsequently introduced legislation in the Senate Finance Committee to protect the 1st Amendment rights of private insurance companies to criticize health care reform proposals.

Democrats on the committee unanimously defeated the bill.

Thursday, September 3, 2009

Medicare Fraud

A standard power wheelchair costs the government about $4018 to lease to a senior compared with $1048 for suppliers to buy, according to the Department of Health and Human Services. If you ever wondered why Durable Medical Equipment vendors are driving around in pretty new trucks and are housed brand new buildings, now you may begin to know how they afford this luxury.

I am not saying all DME vendors are crooked, but I have personally witnessed fraud like this and it is really disgusting, like a $10 hammer that the government bills for $700. Remember those toilet seats that cost US Taxpayers north of $500 per seat?

People who live in glass houses should not throw stones.

Tuesday, August 25, 2009

School has started. You may be thinking of school kids, like 18 or younger. However, I am talking about Medicare school has started. The time to spend 10-12 hours getting certified to sell Medicare part c and d products (per carrier!) has started...

AHIP certification, face to face training, more online certification - brokers make a huge investment just to get ready to sell during the meager six week AEP. If they are lucky, they get three more months in the OEP to sell - but for what? 10% of what they produced in the AEP? During the 6 week AEP period? Why?

Because brokers are counselors, they are ombudsmen, they care...will someone tell Pelosi, Reid, Obama, Frank, etc., what an agent really does?