DC Watch Murder, Disfigurement, Robbery, Terminal Illness By Carolyn Cormey The Plot: Pass a Health Care Bill, no matter what! Our President, our Democrat and Republican Legislators are all stepping to TV microphones to tell us that the Medicare Trust Fund will become insolvent in 8 years. Of course, sensing the urgency our US Senators are in solution-mode, designing "efficiency" cuts or eliminations in Medicare programs, scheduling further reductions in Medicare reimbursements AND assigning dollar amounts to future elimination of fraud, abuse and waste. By divining or utilizing "DC math," they are talking upwards of a half-trillion dollars!!!! Now - what to do? Should this half-trillion plus dollars be used to extend the life of Medicare beyond the 8 years before it becomes insolvent OR should this half-trillion dollars be transferred out of Medicare and into the new health care bill, "America's Healthy Future," the latest name of the many times re-named Universal Health Care bill now being marked up for vote in the Senate Finance Committee - where our very own Senator Bill Nelson happens to be a member! GREAT NEWS! Apparently, applying the fuzzy-math used on Planet DC, a choice does not have to be made! Over C-Span we were able to watch our crisis-driven, clear-thinking, solution-oriented US Senators use the very same half-trillion plus dollars twice, at the very same time! Once to extend the solvent years of Medicare AND at the same time, use the very same half-trillion plus as part of the funds needed to pay to pay for the new Universal Health Care Solution program soon to be voted on! Huh? . . How is this possible? While this kind of calculation never works in my budget where dollars can only be used once, it is the norm on Planet DC which also engages in the double-speak that the in the cost of this health care legislation, "not a dime will be added to the deficit." (Perhaps the Presidential "out" is that dimes are mentioned but not dollars!) The Victims: Medicare Advantage, Medicare and Medicaid If this health care bill passes into law (in any of its current forms), bye bye Medicare Advantage altogether or at least as you know it. The President has said that he wants this program done away with, calling it a waste of money. Some members (but not the majority) in the Congressional Committees that are charged with marking up this bill, do not share the President's hard-line opinion. They recognize that Medicare Advantage plans provide low cost health insurance with added benefits (yearly physicals, low or free co-pays for doctor visits and drugs, eyeglasses, dental . . . ) to millions of low income senior US Citizens, who simply cannot afford a more expensive premium for a fee for service Medicare plans PLUS a supplemental insurance policy PLUS an additional premium for Part-D Prescription Drug coverage. In some rural parts of the country, Medicare Advantage programs are the only programs available to seniors. The health care legislation is now being marked up in the Senate Finance Committee where amendments are being voted on. In the spirit of implementing the President's statement, "If you like the insurance you have, you get to keep it, nothing in this bill changes that!," Senator Hatch of Utah put forth an amendment to keep the Medicare Advantage Programs unchanged, because there is nothing like them and these programs provide insurance and benefits to seniors who could not afford them. This brought on the back and forth arguments between Senators about the added cost of Medicare Advantage plans which are about 14% more than Fee For Service plans. During this back and forth discussion - our own Senator Nelson, (who has been televised saying; "doing away with Medicare Advantage is a non-starter") jumps in and tells Senator Hatch and Committee Members that this is the wrong amendment to vote for but he would soon be bringing the right amendment to both save the money AND preserve the MA program! WOW! Now, we're talking! The Hatch amendment was voted down on a straight party-line vote, all Democrats voting against it, Republicans voting for it. This has been pretty much the story on all the amendments proposed by Republicans in all Committee Bill Mark-ups since the number of Democrats on the Committee outnumbers them in this Committee and all other Committees. Finally, it was Senator Nelson's turn to present his amendment which apparently would not protect Medicare Advantage for seniors not already enrolled BUT would grandfather in at least some seniors who were currently enrolled. Senator Nelson said; "Those with Medicare Advantage existing will be grandfathered in and will not lose that benefit but on a going forward basis, we're going to squeeze the inefficiencies out of that extra 14% that has gone to Medicare Advantage." I think Senator Nelson said that a Medicare Advantage Insurance provider, "whose plan has bid at or below fee for service," were the ones that were covered by this amendment. Senator Nelson's amendment also suggested a fee be placed on health insurance companies and on brand drug companies to provide an offset for the estimated costs within this amendment. I listened intently and it seemed to me that Senator Nelson was inferring that the insurance companies were taking the 14% as profit which he considered "squeezable." There seemed to be some like confusion among the Senators who pointed out that the 14% was not all insurance company profit but most of it was plowed back into providing seniors with minimal or no co-pay doctor visits and drugs, along with glasses, dental and other benefits AND that Medicare Advantage insurance companies only took profits of about 4%. Some Senators also pointed out that since money paid by Medicare to Medicare Advantage and Fee for Service varied in different areas of the country, this amendment would protect MA in only a small number of counties in the country. Senator Nelson withdrew the bill that he said he would bring it back later after he worked with more Committee Members to bring them on board with his amendment. Preview of coming attractions - more cuts, slashes, and heartbreaks While those we elect continue to figure out how to disfigure or kill Medicare Advantage, rob a half-trillion plus from Medicare, reduce reimbursement payments, while adding more people in to Medicare and Medicaid, ignoring the decreasing numbers of doctors who will accept Medicare or Medicaid patients - our Center of Medicare & Medicaid Services (CMS) sent out official letters to insurance companies, to muzzle them, forbidding them from contacting any of us by letter, email, telephone or using their websites to warn us on how the proposed changes to Medicare Advantage, Medicare or Medicaid will affect the insurance we have AND specifically forbidden, our insurance companies are NOT to tell us to contact our legislators with our opinions and concerns! This letter to insurance companies came complete with threats to pursue enforcement if not complied with! Nobody seems to be coming forth to take the credit for instructing the CMS to send out this letter. It is funny but when AARP was sending out emails, letters and using their website to back the Majority Party proposed changes in the health care legislation - no problem, no muzzle letters with threats to silence them. Well actually, back then, the Chair of the powerful House Energy and Commerce Committee, Congressman Henry Waxman and friends, did have some letters sent out to some insurance companies, asking them for every detail of their company finances, compensation and bonus programs. According to Congressmen and Senators talking to TV reporters, these letters were sent to only certain insurance companies who did not fall into line in support of the Majority Party Health Care Insurance revamp. As we grow the government control over our lives, the stick they use on us grows bigger and hurts more when power is unbridled, as it is right now when just one political party strongly controls everything! If you are a senior on Medicare fee for service or in Medicare Advantage or Medicaid, no matter how they spin it - you are not going to like the changes. Without a doubt Medicare and Medicaid entitlement need fixing but stripping money from it to form another entitlement program only breeds fear and distrust and anger that will only grow stronger when our Legislators next pass amnesty legislation, adding millions more to compete with us for the extremely limited health care dollars and services. Do those we elect have tin ears? www.contactingthecongress.org

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