Wednesday, October 24, 2012

Romney says those about to retire need not worry. So, who does?

If you’re 35 years old or younger, you might not be paying much attention to the Medicare debate. You probably should tune-in because it is you who may stand to lose the most.

Under Paul Ryan’s plan, supported by Governor Romney and Congresswoman Lummis, the current Medicare health insurance program ends in 10 years. If you are anywhere near 35 today, it will be your parents’ Medicare that will first be replaced with a voucher. You’ll be left to deal with their confusion and be expected to step up to pay for whatever medical care the voucher doesn’t. Interested now?

Despite the phony claim that Obamacare was a government takeover of health insurance, many felt its biggest shortcoming is that it wasn’t. Instead, the compromise included keeping the private insurance companies as the vendors of health insurance policies. As a result, we still have innumerable companies selling policies that are all different in one form or another, all with little to no effective regulation. Just try buying health insurance. See what the elderly will soon experience, encountering a range of different co-pays, deductibles, coverage limits, preferred providers, networks and penalties for using a doc who is not a member.

That is the lion’s den into which seniors will be thrown ten short years from now if Ryan-Romney Medicare reform plan becomes law.

Do you remember 2005 and 2006 when Part D, the drug prescription plan was implemented? The program was fraught with problems and apocalyptic predictions. Confused seniors enrolled in plans that didn't cover all their medications or missed deadlines to enroll at all. Medicare was inundated with phone calls. Patients waited on hold for hours without getting answers. Pharmacists were filling prescriptions without knowing whether they would be paid.

Imagine the day Medicare closes its offices and millions of seniors, including your elderly parents, receive that voucher in the mail. Now what? Undoubtedly it will include lengthy instructions and a website. Seniors will be given a list of insurance company agents, their addresses and phone numbers. Of course, most of these companies will be initially ill equipped to deal with the numbers of new, elderly clients and their questions.

But they’ll sit down with the elderly and ask all the questions they should ask. The agent may even have some of the answers. What co-pay and deductible would you prefer? Do you have a physician that you would like to keep seeing? Oh I’m sorry, she’s not in our network. What specialists do you anticipate you’ll need? Let me explain prior authorization, deductibles, co-pays and exclusions. This policy covers x, y, and z. This one covers a, b, and c. If you don’t need x but would like b or c, we have another policy. Sorry, we can’t include z and b but you can buy a, b, c, and y. Oh, and each has its own list of exclusions.

The senior will also want to know if deductibles need to be met before any services can be used. What percent will be paid after deductibles, what percent they’ll pay if a doctor, hospital, or specialist out of network is consulted, and what co-payments are for visiting doctors, hospitals, or emergency rooms?

Mom and dad are looking at you now.

When those questions and others have been answered, your elderly parent will proudly present the agent with the voucher. “Oh,” says the agent, “that will cover only part of the premium.” Your elderly parent may say, “I don’t understand. Medicaid paid for these things. Why do I have to pay so much more?” The agent will say, “I’m sure your congressman explained that Medicare was replaced with a voucher to save money. How could they save money if they provided the dame health care under this voucher that you had under Medicare?”

Now mom and dad are looking at you again. You may be 30 years away from being eligible for Medicare but you may stand to lose the most. 

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