Who would have guessed that skimming off 15% of the actuarial value of your Medicare benefit to fund fraudulent marketing claims and an unGodly level of excessive Executive Compensation would impact the quality of the care delivered to the patient? Is the Silver Sneakers gym membership of any value to the typical cancer victim?
When future patients decide which plan to select and what they are willing to pay for it, they should realize they are accepting certain risks. They will do better if they make the right choice guessing what their future needs will be.
Choices do not make it easier for them. They might complain if Uncle Sugar makes the choices for them, but then they don’t have choices to make.
Except they apparently don’t. When folk are defending their personal decisions for choosing an MA plan, I don’t recall anyone articulating a willingness to accept suboptimal care. I suspect that most either don’t accept what these articles are spelling out WRT limited access to care…or that they might actually be one of the folk in a position to need that high level of care in the future.
Additionally, the article is mainly concerned with access to treatment after a diagnosis of cancer. It’s worth thinking about compromises to actually getting a diagnosis in the first place. For most folk, this is likely to be at the level of primary care…where the impact of reduced reimbursement of MA plans is going to be felt. Possibly to a greater degree than in the specialty setting…and not confined to the folk with MA plans.
We have Social Security because many people were unable to save enough for a comfortable old age. We have Medicare because many people did not retire as CEOs with a fat, company paid, medical benefit.
My dad was a financial idiot. College educated, with a white collar job, and never saved a nickle. Were it not for Social Security, and a company paid pension, back when that was still a thing, he would have had nothing to live on. Are we prepared to have financial idiots, like my dad, starve on the street? Or would “big gummit” step in, give the spawn of financial idiots a lecture on “personal responsibility”, and the bills for their parents maintenance, so the next generation can’t save anything for retirement, and repeats the cycle of old age poverty?
My point was my father lacked the ken to provide for himself. Had not the government, and his employer, looked out for him, he would have been a beggar. After retiring at 65, drawing SS and a company paid pension, he also worked, as long as he was physically able, at a garden nursery place, and pedaled Amway. In spite of all the money coming in, he continued to pile up debts. You should have heard the credit card companies cry when I told them he was dead, and I wasn’t going to make them whole. I have two cousins who are also clueless about handling money.
Conversation I had with dad, some 50 years ago:
me: if you saved your money, you could pay cash and save a lot of finance charges.
him: I can’t save anything, so, if I want something, I finance it, so I have to forego other things because I have to pay the bill.
The guy had the common sense of a potholder. Are we, as a society, willing to accept having people like that panhandling on the street, because they could not provide for themselves, in spite of a middle class income before retirement? Are we, as a society, willing to accept multi-generational poverty, because the young, even if responsible, are bankrupted by spendthrift parents?
My father was the same way. I only care about today. Tomorrow takes care of itself Then he had to retire at age 46 for medical reasons and was unqualified to do anything else. He took his pension as a lump sum. (He was a cop in Philadelphia). It was gone inside of two years. I didn’t notice that we suddenly had a bunch of nice new stuff around the house so I don’t know where it went. It just got worse after that even though the kids were eventually moving out in sequence (except one brother.) Every few years after that he’d have another heart attack then a few strokes.
[quote=“intercst, post:13, topic:91572, full:true”]
Business loves the uneducated. Nobody ever lost money betting on the racism, ignorance and innumeracy of the American people.
Ya know, I can completely understand how, in any large population, there will be a cadre of people who are that way. Lots of people so you’ll have all kinds. But I really don’t understand how there can be as many as there are. Full grown adults. The age old question: Are people really that dumb? Answer: Yeah, I guess
Part of this is the transition from company sponsored pensions with the company standing behind it to the defined contribution plans like 401K. That makes the individual responsible for managing those funds to provide for retirement.
Does anyone think the average Joe can do that successfully? Many can but probably not the average Joe. So maybe they get good advice. Or maybe they don’t.
The clock is ticking. One day those geese will come to roost. We can expect far more homeless or people moving in with relatives or living in Hoovervilles.
Unless someone is willing to pay, this seems where we are heading.
That is coming here. Several years ago, the government made it legal for companies to automatically enroll employees in the 401k and start deducting money from their paycheck, with the employee being able to opt out within the first month or two. Of course, who is going to start a new job, and immediately start making waves by rejecting their 401k?
I don’t recall if it has been enacted yet, but the next step being advocated is making 401k participation mandatory, and offering a government run defined contribution plan for people working at a company that does not have a 401k.
No it’s not. If anything, it’s a redundant question. How much of a choice are adults actually making in the context of a MA plan if they’re unaware of exactly what they’re purchasing? If they are aware (after reading numerous articles like the one in the OP) and make the choice anyway, how much personal responsibility do they actually shoulder in exchange for their choice? If/when the fertilizer unexpectedly hits the fan, do they tell their doctor not to bother trying to fight with the insurance company to get their necessary and expensive treatment/medication covered? No they do not.
The expectation is that their needs are going to be met without discrimination based upon insurance coverage. Rightly so. So the real question is who pays? What compensates practices for the time taken away from providing patient care in order to spend increasing amounts of time on such an exercise? Well, the simple answer is nothing. There is no compensation so the shortfall in reimbursement is made up by less clinical time available for every patient … not just the MA beneficiary. Folk like me, in other words.
I’m enough of a “collectivist” to be content for folk who’ve cut corners with their medical coverage to receive the same care that I do…but not because my care is dumbed down to a sub optimal level because of that.
Bankruptcy is not that simple. The “adults” in the lending departments are not so adult. There are no ethics involved in letting people go into a medical bill induced bankruptcy. To see 80 years go through that is cruel and ignorant as a society.