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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:03 PM
Original message
$318 billion cut in Medicaid/Medicare?
Am I understanding that correctly? HUH?
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FrenchieCat Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:08 PM
Response to Original message
1. Read....
Edited on Thu Feb-26-09 10:09 PM by FrenchieCat
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:21 PM
Response to Reply #1
2. Obama hasn't said it's Part D that he's eliminating but he has said it includes cuts to hospitals.
If he wants to renegotiate drug prices to save the money, that's great. But if he's going to cut plans, eliminate access or raise premiums to seniors who can't afford them now, this ardent Obama supporter will fight him tooth and nail on this part of the proposal.
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FrenchieCat Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:27 PM
Response to Reply #2
3. This just means you didn't bother to read either one of Barack Obama's books,
Edited on Thu Feb-26-09 10:28 PM by FrenchieCat
and that you don't really understand Barack Obama's politics,
and that you didn't follow his campaign or hear him speak at his rallies.

His mom died of Cancer at the age of 53, and had to fight the insurance companies,
who questioned her cancer as a pre-existing condition.

Do you really think that kind of individual is going to cut benefits, eleminate access,
and raise medicaire Premiums on seniors? How cynical are you? :shrug:

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EraOfResponsibility Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:37 PM
Response to Reply #3
5. it's fear, Frenchie. It gripped me too. Remember when I was bugging you about
social security whether Obama would take it away? Same thing, it's from not knowing and the panicking when you hear or see something.
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FrenchieCat Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:41 PM
Response to Reply #5
8. Yes, but y'all have to feel you know Barack Obama.....
See, I did my homework.

I'm not saying he's perfect, but he is a true progressive when it comes to social services in particular.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:59 PM
Response to Reply #8
12. See Post #10.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:58 PM
Response to Reply #5
11. See post #10.
It's not fear. Why is it wrong to ask for details?
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uponit7771 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:44 PM
Response to Reply #3
9. Patience, remember our LazyMsM is in full "we're surprised" mode even though Obama said
...multiple times that he was going to do something about social security.

I haven't read everything either, it just by now I trust Obama will do the right thing regardless of the "oh shit" responses from the LazyMsM and some freepers posing on DU
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:59 PM
Response to Reply #9
13. SO NOW I'M A FREEPER?
Are you kidding me??
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uponit7771 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 03:56 PM
Response to Reply #13
40. No
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:58 PM
Response to Reply #3
10. Wow - I'll let that slide. Once. How disappointing.
You obviously don't pay attention much around here - I thought much better of you Frenchie. I'm one of his biggest supporters here or anywhere, I've read everything he's written, read most things written about him, know his life and history well and his philosophy, searched for articles and interviews and speeches that didn't make mainstream media to learn more about him, defended him to the very end off and on DU, and worked my ass off for him during the primary and the election.

I simply want details to assure that my two parents who rely solely on Medicare for their desperately needed health care won't have their benefits cut or eliminated and now I'm cynical and ignorant? Because I simply want more information? Because I recognize that not everything put forth by our new President will be 100% Obama, nor will I agree with it 100%. But because I dared question the specifics, I'm now uninformed and witless?? Are you serious??

Yeah, you get one and this was the one. But I doubt my opinion of you will ever be the same again. What a mistake I made about you!
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OwnedByFerrets Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:53 PM
Response to Reply #10
24. Rec'd!!
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 12:08 AM
Response to Reply #24
31. Thanks
:)
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FrenchieCat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 12:22 AM
Response to Reply #31
33. You just got a rec from someone who has barely if has ever supported
Edited on Fri Feb-27-09 12:23 AM by FrenchieCat
Barack Obama.

You got that poster's recognition only because of what you said to me
that was negative. Poster loved it. Far as poster is concerned,
you put me in my place (I guess).

Look, to be frank.... not everyone has read all what Obama has written.
My only point was that if you really have that kind of fear in your heart,
just by hearing entitlement reform coming out of Barack Obama's mouth,
then it is not a big jump to suspect that it is possible that you really
haven't heard Barack Obama's view on entitlement reform.
I'm not calling you anynames, just saying that it is a logical
conclusion that I can come to.

I'm going to repost below what is at the link that I provided,
and then you can confirm if either you never heard any of the things
barack Obama has said about entitlement programs,
or whether you just simply don't feel that you can believe him,.

It has got to be one thing or the other.

I'm not sure why you are taking personal offense as to what I said.
There are plenty of folks who have supported a pol, and not necessarily have known
where he stood on every issue.



Raise the cap on the payroll tax on wealthy individuals
What we need to do is to raise the cap on the payroll tax so that wealthy individuals are paying a little bit more into the system, if we are going to deal with this problem specifically. Right now, somebody like Warren Buffet pays a fraction of 1 percent of his income in payroll tax, whereas the majority of the audience here pays payroll tax on 100 percent of their income. I’ve said that was not fair.
Source: 2008 Facebook/WMUR-NH Democratic primary debate Jan 6, 2006

No privatization; but consider earning cap over $97,500
Q: We all know that Social Security is running out of money, but people who earn over $97,500 stop paying into Social Security. The Congressional Research Service says that if all earnings were subject to payroll tax, the Social Security trust fund would remain solvent for the next 75 years.
A: I think that it is an important option on the table, but the key, in addition to making sure that we don’t privatize, because Social Security is that floor beneath none of us can sink. And we’ve got to make sure that we preserve Social Security is to do the same thing that Ronald Reagan and Tip O’Neill were able to do back in 1983, which is come up with a bipartisan solution that puts Social Security on a firm footing for a long time.
Source: 2007 YouTube Democratic Primary debate, Charleston SC Jul 23, 2007

Privatization puts retirement at whim of stock market
Q: Would you raise the cap for Social Security tax above the current level of the first $97,500 worth of income?
A: I think that lifting the cap is probably going to be the best option. Now we’ve got to have a process back in 1983. We need another one. And I think I’ve said before everything should be on the table. My personal view is that lifting the cap is much preferable to the other options that are available. But what’s critical is to recognize that there is a potential problem: young people who don’t think Social Security is going to be there for them. We should be willing to do anything that will strengthen the system, to make sure that that we are being true to those who are already retired, as well as young people in the future. And we should reject things that will weaken the system, including privatization, which essentially is going to put people’s retirement at the whim of the stock market.
Source: 2007 Democratic primary debate at Dartmouth College Sep 6, 2007

Stop any efforts to privatize Social Security
Obama believes we need to preserve Social Security by stopping any efforts to privatize it and will work across party lines to maintain Social Security’s solvency for generations. Obama wants to make private saving easier, cheaper, & more automatic for middle-class workers. He supported the Save More for Retirement Act, which encourages automatic 401K enrollment. Obama also voted for new rules to force companies to properly fund their pension plans so taxpayers don’t foot the bill.
Source: Campaign website, BarackObama.com, “Resource Flyers” Aug 26, 2007

Raise cap on payroll tax for 3% of earners over $102,000
Q: The Republicans are keeping a running total of all your plans. They say it’s $662 billion over four years.
A: Right.

Q: They say for all your promises not to raise taxes on the middle class, that, in fact, you want to raise the cap on the Social Security payroll tax, and you also want to increase capital gains.

A: In terms of raising the cap on the payroll tax, right now everybody who’s making $102,000 or less pays 100% of payroll tax on 100% of their income. There are about 3% to 4% of Americans who are above $102,000 in income every year. So if you want to talk about who’s middle class, me giving cuts to folks making $60,000 or $70,000, and potentially asking more from friends of mine like Warren Buffett. That’s a debate I’m happy to have with John McCain, because it’s the people making $75,000, $50,000, $60,000 who are hurting.
Source: 2008 Fox News interview: presidential series Apr 27, 2008

Must capture new revenue; no new Social Security Comission
OBAMA: We’re going to have to capture some revenue in order to stabilize the Social Security system. You can’t get something for nothing. And if we care about Social Security, which I do, and if we are firm in our commitment to make sure that it’s going to be there for the next generation, and not just for our generation, then we have an obligation to figure out how to stabilize the system. I think we should be honest in presenting our ideas in terms of how we’re going to do that and not just say that we’re going to form a commission and try to solve the problem some other way.
CLINTON: With all due respect, the last time we had a crisis in Social Security was 1983. President Reagan and Speaker Tip O’Neill came up with a commission. That was the best and smartest way, because you’ve got to get Republicans and Democrats together. That’s what I will do.

OBAMA: That commission raised the retirement age, and also raised the payroll tax. So Sen. Clinton can’t have it both ways.
Source: 2008 Philadelphia primary debate, on eve of PA primary Apr 16, 2008

Raise the cap on the payroll tax on wealthy individuals
What we need to do is to raise the cap on the payroll tax so that wealthy individuals are paying a little bit more into the system, if we are going to deal with this problem specifically. Right now, somebody like Warren Buffet pays a fraction of 1 percent of his income in payroll tax, whereas the majority of the audience here pays payroll tax on 100 percent of their income. I’ve said that was not fair.
Source: 2008 Facebook/WMUR-NH Democratic primary debate Jan 6, 2006

$2000 tax credit for Working Families Savings Accounts
Obama today proposed Working Families Savings Accounts to increase retirement security and give families a greater incentive to save. “The best way for our government to help ensure that every American can retire with dignity is to provide incentives for middle-class families to save for the future,” said Obama. “My Working Families Savings Accounts plan gives working men and women earning up to $50,000 per year the opportunity to put money in a retirement plan, whether it’s an IRA or an employer based 401(k), and have that money matched with a 50 percent tax credit for contributions up to $2,000.“
Today, only about half of workers participate in an employer-based pension plan. Participation rates in other savings plans are substantially lower. Only about five percent of people contribute the maximum amount allowed each year to an IRA or 401(k).
Source: Press Release, “Increase Retirement Security” Jul 7, 2004

http://www.ontheissues.org/2008/barack_obama_social_security.htm










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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Fri Feb-27-09 09:21 AM
Response to Reply #33
35. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 01:05 PM
Response to Reply #33
37. FC, I read that the first time you posted it; and I've read it elsewhere
However, it doesn't have anything to do with the specific questions I have on this new proposal and the Medicare cuts I'd simply like more details on (especially since Social Security and Medicare, while very related and somewhat intertwined at times, are two different programs).

And what is so wrong with just asking for more information?
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WinkyDink Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 12:31 PM
Response to Reply #33
52. SS is totally regressive. Payment into the system should NOT HIT THE LOWEST RUNGS, but the TOP!
UNLESS we had the national fortitude to DENY SS BENNIES to the wealthiest.
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Honeycombe8 Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 12:29 PM
Response to Reply #3
51. I think he did say he was going to ask that wealthy seniors pay more.
But correct me if I'm wrong.

I'm 55 years old. I'm prepared for some cuts. I think they're inevitable, given the state of our economy. They would probably be scaled according to ability to pay, plus be more restrictive on amounts paid for certain procedures. That might, in turn, cause more providers to drop accepting Medicare patients, but there will be such a volume of baby boomers on Medicare, that there should still be a lot of providers accepting them, I'd think.

Of course, I'll be delighted if there are no cuts. But I think that's a dream.
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AllentownJake Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:34 PM
Response to Original message
4. Medicare Part D is a gift to Big Pharma from Bush
Edited on Thu Feb-26-09 10:35 PM by AllentownJake
It doesn't really lower costs for seniors that much and the government gets no credit or right to negotiate prices based on the amount of drugs they are buying. Every other insurance program in the country negotiates quanity discounts and rebates.

Its essentially welfare for Big Pharma.
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FrenchieCat Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:39 PM
Response to Reply #4
6. Exactly!
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uponit7771 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 10:39 PM
Response to Reply #4
7. Yeap, the irony is Obama can officially say that he "reformed" parts of social security before any..
...GOPer could.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:00 PM
Response to Reply #4
14. Yes, but it doesn't specify Part D.
I want to get rid of it too and if it specified that I'd be jumping for joy. And not insulted by various DU'ers throughout this thread.
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Cleita Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 04:57 PM
Response to Reply #4
56. Tell me about it. I cut out prescription drugs I couldn't afford.
Edited on Sat Feb-28-09 04:59 PM by Cleita
I can't afford the extra premium for part "D" so I don't have it, but since it was passed, my prescriptions drugs have doubled and one tripled in cost, so I've been screwed regardless. It was a big bonanza for PhRMA by cheating old people out of the money they need for prescription drugs and funneling them to Wall Street and executive excesses instead.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:02 PM
Response to Original message
15. I was hoping for an actual discussion - not childish name calling and insults.
Anyone care to join me at the grown-ups table??
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EraOfResponsibility Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:06 PM
Response to Reply #15
16. Nobody called you names, but you posted a panicked post
not criticizing you for that, God knows I've made my share of posts like that. Frenchie never insulted you.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:09 PM
Response to Reply #16
17. It's not "panicked." I looked online for about 35 minutes before posting here.
Edited on Thu Feb-26-09 11:10 PM by AZBlue
When I couldn't find the information for myself I posted this to try to get more information from DU'es.

See, I don't panic. First you've called me fearful, then you've said I've panicked - you obviously don't know me at all so please stop trying to portray me.

I simply want facts and answers to a question, what is wrong with that?

You and Frenchie both insulted me with your false, inane and insulting characterizations about me. Take responsibility for what you wrote.
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EraOfResponsibility Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:13 PM
Response to Reply #17
18. from fearful to hostile
and I'm taking full responsibility for what I "wrote". And I ain't changing a damn thing. I meant what I said. Don't like it, too bad, so sad.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:15 PM
Response to Reply #18
19. I'm not asking you to change it, I don't care. But admit that you were rude.
Edited on Thu Feb-26-09 11:17 PM by AZBlue
'Cause you really were.
"Don't like it, too bad, so sad, truth hurts sometimes, huh?"




Yeah, you really do sound that immature. So please refer to post #15 - if you'd like to be mature and have a discussion, I'm all for it. Otherwise, just let me thank you for the bump but I won't be responding to any more childish blather.
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EraOfResponsibility Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:18 PM
Response to Reply #19
20. How was I rude? Because I said you posted out of panic? LOL
Edited on Thu Feb-26-09 11:28 PM by EraOfResponsibility
that's alright, because I got the last word anyway. :)
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:58 PM
Response to Reply #20
27. Ah, Ignored.
Edited on Fri Feb-27-09 12:10 AM by AZBlue
This is the DU member formerly known as EraOfResponsibility.
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EraOfResponsibility Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 12:17 AM
Response to Reply #27
32. mmmhm, sure. :)
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Mojorabbit Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 02:01 PM
Response to Reply #20
38. You were rude.
I am waiting for more details about medicare myself.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 08:21 PM
Response to Reply #38
41. If I get any, I'll let you know!
:)

I'm sure it's a concern for many.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 08:22 PM
Response to Reply #38
43. See post #39
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Mojorabbit Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 11:39 PM
Response to Reply #43
47. Thank you! nt
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windbreeze Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:54 PM
Response to Reply #15
25. I can tell you one thing...from what I have been told...
Medicare needs to be overhauled..private medical insurance co's and their advantage plans need to be thrown right the hell out of the middle of it...there would be billions more monthly, for the regular medicare/medicaid plans if they were...wb
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 12:00 AM
Response to Reply #25
28. Absolutely!
There are many who are on the program who don't need it at all, money is wasted to a level that should be criminal - and the entire drug situation is set up only to benefit big pharma, no one else. And I'm hoping that's what is going to change, I'd just like to know.
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windbreeze Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 10:58 PM
Response to Reply #28
45. read this.....and take heart....
"For this budget allocates $634 billion over the next decade for health reform. That’s not enough to pay for universal coverage, but it’s an impressive start. And Mr. Obama plans to pay for health reform, not just with higher taxes on the affluent, but by putting a halt to the creeping privatization of Medicare, eliminating overpayments to insurance companies."



YES YES YES......NOW DOESN'T THE LAST HALF OF THAT LAST SENTENCE SOUND LIKE WHAT WE WANTED TO HEAR???? FROM omg, I forgot...who's journal???let me go back and check..it was written by Paul Krugman....AVIATION PRO'S JOURNAL...wb
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Zynx Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:19 PM
Response to Original message
21. If that's over ten years, that's not actually that big of a deal.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:21 PM
Response to Reply #21
22. Is that what it is? Because you are right.
I didn't see that anywhere but if I missed it - or of course if the biased media conveniently left that out - then that makes a huge difference. That is probably those who shouldn't be on Medicare anyway due to their incomes or net worths.

Thanks!
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mvd Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:38 PM
Response to Original message
23. The thing is, all of the articles I've read go into no detail
Edited on Thu Feb-26-09 11:39 PM by mvd
For all we know, Obama is just trimming waste from that insurance industry-oriented system in favor of changes where people will be better off under his reform.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Feb-26-09 11:55 PM
Response to Reply #23
26. And that's probably what it is - but like you I can find no detail and I'd like some.
This is a very important issue.
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biopowertoday Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 04:09 PM
Response to Reply #26
54. Obama ONLY sent a blueprint of his budget for congress to fill in. But have
Edited on Sat Feb-28-09 04:11 PM by biopowertoday
you seen this?

The talks are secret-which is why we can not find the details at this point.


Its where the details will be filled in:



http://www.nytimes.com/2009/02/20/us/politics/20health.html?_r=1&ref=health&pagewanted=print


February 20, 2009

Health Care Industry in Talks to Shape Policy
By ROBERT PEAR

WASHINGTON — Since last fall, many of the leading figures in the nation’s long-running health care debate have been meeting secretly in a Senate hearing room. Now, with the blessing of the Senate’s leading proponent of universal health insurance, Edward M. Kennedy, they appear to be inching toward a consensus that could reshape the debate.

Many of the parties, from big insurance companies to lobbyists for consumers, doctors, hospitals and pharmaceutical companies, are embracing the idea that comprehensive health care legislation should include a requirement that every American carry insurance.

.........
The talks, which are taking place behind closed doors, are unusual. Lobbyists for a wide range of interest groups — some of which were involved in defeating national health legislation in 1993-4 — are meeting with the staff of Mr. Kennedy, Democrat of Massachusetts, in a search for common ground.

.................

While President Obama is not directly represented in the talks, the White House has been kept informed and is encouraging the Senate effort as a way to get the ball rolling on health legislation.

...............

“While there was some diversity of views,” it said, “the sense of the room is that an individual obligation to purchase insurance should be part of reform if that obligation is coupled with effective mechanisms to make coverage meaningful and affordable.”

The ideas discussed include a proposal to penalize people who fail to comply with the “individual obligation” to have insurance.

......................................
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Princess Turandot Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 12:02 AM
Response to Original message
29. I believe that one of P. Obama's campaign points involved the payment structure of Medicare HMOs..
When the Republicans voted to approve a voluntary HMO option for Medicare recipients, they decided to pay insurance companies a rate that was higher than average annual fee-for-service payments per Medicare patient. The reason that they did that was that the insurance companies expressed no interest in taking on this line of business without the additional monies. I think that he has cited that as an imbalance which needed to be fixed. That impacts the Part A (Hospital) and Part B (Physician) programs.

That would not affect Medicaid however, at least not directly, since Medicaid HMOs negotiate with the states, not the Feds.

I would also guess that he is looking into getting price discounts from pharmacy companies re: Part D.

That does not mean that he is not considering other changes to Medicare reimbursement or to Medicaid. However, Medicaid is already so poorly reimbursed that folks who theoretically have coverage have no access. (In NYC, most Medicaid patients go to hospital based clinics since private MDs won't take the patients. Hospitals do, since while they lose money on the clinics, the inpatient rates in some cases exceed private insurance HMO rates, at least in NYS. The clinics are also necessary for the teaching (residency) programs.)
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 12:07 AM
Response to Reply #29
30. That would be a great place to make cuts.
Medicare is riddled with abuses and excess. Like every other health-care system in this country, it benefits the medical and pharmaceutical industries far more than the patients and that has got to change. Bush and his cronies of course took further advantage of those least most needing assistance - disgusting!

What's going on in NYC is horrible! And I thought it was bad in AZ - nothing like that! I'm so sorry to hear that.
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Princess Turandot Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 12:37 AM
Response to Reply #30
34. I actually did not mean that as an extreme negative, re: NYC..
at least in NYC, Medicaid patients can get care. The clinic ambience may not be the greatest, but generally speaking, the care is not substandard. My main point was that private MDs won't take the ridiculously low fees. In NYC, at least there are an abundance of nonprofit teaching hospitals which pick up the slack. In rural Mississippi, someone may have Medicaid but literally have nowhere to go (within reason) to use it.

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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 01:02 PM
Response to Reply #34
36. Then AZ must have great Medicaid care - private doctors do accept it often.
There's really no problem getting care once you're accepted into Medicaid here. Maybe it's the proliferation of seniors we have here, but it seems we're much better off than many. I wish everyone had the same situation everywhere!
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Born_A_Truman Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 03:04 PM
Response to Original message
39. Cut or Saving??
http://www.whitehouse.gov/omb/assets/fy2010_new_era/Jumpstarting_The_Economy.pdf

You can read the entire budget at omb.gov

Financing health Care Reform.

The reserve fund is financed by a combination of rebalancing
the tax code so that the wealthiest
pay more as well as specific health care savings
in three areas: promoting efficiency and accountability,
aligning incentives toward quality, and
encouraging shared responsibility (see Table 1).
Taken together, the health care savings would
total $316 billion over 10 years while improving
the quality and efficiency of health care, without
negatively affecting the care Americans receive.

These savings include:

• Reducing Medicare Overpayments to Private
Insurers Through Competitive Payments.
Under current law, Medicare overpays Medicare
Advantage plans by 14 percent more
on average than what Medicare spends for
beneficiaries enrolled in the traditional feefor-
service program. The Administration
believes it’s time to stop this waste and will
replace the current mechanism to establish
payments with a competitive system in
which payments would be based upon an average
of plans’ bids submitted to Medicare.
This would allow the market, not Medicare,
to set the reimbursement limits, and save
taxpayers more than $175 billion over 10
years, as well as reduce Part B premiums.

• Reducing Drug Prices. Prescription drug
costs are high and rising, causing too many
Americans to skip doses, split pills, or not
take needed medication altogether. The Administration
will accelerate access to make
affordable generic biologic drugs available
through the establishment of a workable
regulatory, scientific, and legal pathway for
generic versions of biologic drugs. In order
to retain incentives for research and development
for the innovation of breakthrough
products, a period of exclusivity would be
guaranteed for the original innovator product,
which is generally consistent with the
principles in the Hatch-Waxman law for traditional
products. Additionally, brand biologic
manufacturers would be prohibited from
reformulating existing products into new
products to restart the exclusivity process,
a process known as “ever-greening.” The Administration
will prevent drug companies
from blocking generic drugs from consumers
by prohibiting anticompetitive agreements
and collusion between brand name
and generic drug manufacturers intended to
keep generic drugs off the market. Finally,
the Budget will bring down the drug costs
of Medicaid by increasing the Medicaid drug
rebate for brand-name drugs from 15.1 percent
to 22.1 percent of the Average Manufacturer
Price, apply the additional rebate
to new drug formulations, and allow States
to collect rebates on drugs provided through
Medicaid managed care organizations. All
the savings would be devoted to the health
care reserve fund.

• Improving Medicare and Medicaid Payment
Accuracy. The Government Accountability
Office (GAO) has labeled Medicare as “highrisk”
due to billions of dollars lost to overpayments
and fraud each year. The Centers
for Medicare and Medicaid Services (CMS)
will address vulnerabilities presented by
Medicare and Medicaid, including Medicare
Advantage and the prescription drug benefit
(Part D). CMS will be able to respond more
rapidly to emerging program integrity vulnerabilities
across these programs through
an increased capacity to identify excessive
payments and new processes for identifying
and correcting problems.

• Improving Care after Hospitalizations and
Reduce Hospital Readmission Rates. Nearly
18 percent of hospitalization of Medicare
beneficiaries resulted in the readmission of
patients who had been discharged in the hospital
within the last 30 days. Sometimes the
readmission could not have been prevented,
but many of these readmissions are avoidable.
To improve this situation, hospitals
will receive bundled payments that cover not
just the hospitalization, but care from cer
tain post-acute providers the 30 days after
the hospitalization, and hospitals with high
rates of readmission will be paid less if patients
are re-admitted to the hospital within
the same 30-day period. This combination
of incentives and penalties should lead to
better care after a hospital stay and result
in fewer readmissions—saving roughly $26
billion of wasted money over 10 years. The
money saved will also be contributed to the
reserve fund for health care reform.

• Expanding the Hospital Quality Improvement
Program. The health care system
tends to pay for quantity of services not
quality. Experts have recommended that
hospitals and doctors be paid based on delivering
high quality care, or what is called
“pay for performance.” The President’s
Budget will link a portion of Medicare payments
for acute in-patient hospital services
to hospitals’ performance on specific quality
measures. This program will improve the
quality of care delivered to Medicare beneficiaries,
and the higher quality will save
over $12 billion over 10 years. Again, the
money saved will be contributed to the reserve
Fund for health care reform.

• Reforming the Physician Payment System to
Improve Quality and Efficiency. The Administration
believes that the current physician
payment system, while it has served to limit
spending to a degree, needs to be reformed to
give physicians incentives to improve quality
and efficiency. Thus, while the baseline
reflects our best estimate of what the Congress
has done in recent years, we are not
suggesting that should be the future policy.
As part of health care reform, the Administration
would support comprehensive, but
fiscally responsible, reforms to the payment
formula. The Administration believes Medicare
and the country need to move toward
a system in which doctors face better incentives
for high-quality care rather than simply
more care.

• Reducing Itemized Deduction Rate for Families
With Incomes Over $250,000. Lowering
health care costs and expanding health
insurance coverage will require additional
revenue. In the health reform policy discussions
that have taken place over the past
few years, a wide range of revenue options
have been discussed—and these options
are all worthy of serious discussion as the
Administration works with the Congress to
enact health care reform. The Administration’s
Budget includes a proposal to limit
the tax rate at which high-income taxpayers
can take itemized deductions to 28 percent—
and the initial reserve fund would be
funded in part through this provision. This
provision would raise $318 billion over 10
years.



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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 08:22 PM
Response to Reply #39
42. You rock!
Thank you for posting this!!!!!
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thevoiceofreason Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 10:11 PM
Response to Original message
44. Read it first.
It penalizes the "privatization"
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AnnitaR Donating Member (958 posts) Send PM | Profile | Ignore Fri Feb-27-09 11:24 PM
Response to Original message
46. Get Rid of Medicare Part D?
Get rid of Medicare Part D? I can't believe you guys are saying this!

I am the first one to admit it has got problems that need to be addressed now. The dumb ass "doughnut hole" problem needs to be addressed. Also it needs to be fixed where the government has the ability to negotiate for lower prices.

Like I said there are problems with it that absolutely have to be addressed but before you decide that the whole thing should be gutted please talk to Seniors who have no other way to pay for their medicine. My parents are those Seniors. My parents only source of income is their Social Security checks. We live in Tennessee & in July 2005 our so-called Democratic Gov Bredesen booted millions of Seniors off the Medicaid (called TennCare) rolls. Certainly TennCare was badly in need of a overhaul & they needed to crack down on fraud. However his solution was disgusting for several reasons. The main one being that in Jan 2006 Medicare Part D was to go into effect. Well instead of waiting a few short months for that program to go into effect he chose instead to end TennCare for millions of poor Seniors in our state. He couldn't wait those few short months so those Seniors lost their TennCare & as a result many had no way to pay for their medications. Most Seniors like my parents relied on TennCare to help them afford their medications. It was their lifeline! They were on their own for those months to pay for their medications. As a result of the high costs of their medications they were forced into bankruptcy because they got behind on all of their other bills. I will never forgive Bredesen for what he did to my parents & millions of other poor Seniors in this state! I never considered him a real Democrat after that. What he did goes against everything I stand for as a loyal Dem!

Some in this thread have stated that Medicare Part D doesn't really help Seniors pay for the medications. I have to say you are sadly mistaken. It does really help low-income Seniors. With Medicare part D my parents only pay small amounts for each of their medications. If it weren't for Part D it would cost them hundreds of dollars for the medicine they desperately need.

I am mostly a lurker on this board but I just had to share my parents story. Medicare Part D has problems but the solution can't be to get rid of it. My parents were forced into a horrible situation because of budget cuts here in Tennessee. Our Governor chose to save other programs at the expense of low income Seniors. I desperately want Universal Healthcare in this country - I have for a long time - but why should it also have to be at the expense of low income seniors? I just can't watch them go through that again. Especially from another Democrat!
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Mojorabbit Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-27-09 11:45 PM
Response to Reply #46
48. During the campaign
He said he was going to redo the part that doesn't let the govt negotiate lower prices for meds. I think this is where the change will come in and that will lower costs.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 12:20 PM
Response to Reply #48
50. That would be excellent and would help everyone!
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biopowertoday Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 04:28 PM
Response to Reply #48
55. That correction was passed by the House last spring but stalled in the Senate.
-i think it was last spring.
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AZBlue Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 12:20 PM
Response to Reply #46
49. It shouldn't be gotten rid of but it should be revised - cost savings could help more seniors.
Thank you for your post!!
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backscatter712 Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Feb-28-09 12:45 PM
Response to Original message
53. IIRC, part of it was fixing Part D, and part of it was getting rid of overpayments to insurance cos.
Obama was planning to allow Medicare to negotiate with the pharmcos on drug prices - that will save quite a bit of cash right there. Medicare Part D is going to need to be fixed - Bush threw that together specifically as a gift to the pharmcos, and to try to kill Medicare with the starve-the-beast strategy.

Also on the chopping block are the overpayments from Medicare to insurance companies, which are pretty much pure profit for the insurance industry.

There's lots of wasteful crap that can be cut from Medicare without compromising patient care one bit.
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