4 A
❘
WEDNESDAY EDITION
❘ JULY 29, 2017
Siuslaw News
P.O. Box 10
Florence, OR 97439
NED HICKSON , EDITOR
Opinion
❘ 541-902-3520 ❘
NHICKSON @ THESIUSLAWNEWS . COM
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Published every Wednesday and Saturday at 148 Maple St. in Florence, Lane County, Oregon. A member of the
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L ETTERS
The future of tradional Medicare?
T
he future of health-
care coverage should
be of particular inter-
est to Florence’s significant
number of Medicare
enrollees. While the latest
proposal to repeal and
replace the ACA has failed,
all indications are that con-
servative policy makers still
want to replace govern-
ment-provided traditional
Medicare with free-market,
profit-based Medicare
Advantage.
Conservatives contend
that free-market principles
of competition and profit
will provide choice and effi-
ciencies.
Medicare Part C —
Medicare Advantage —
allows private health insur-
ance companies such as
HMOs and PPOs to contract
with CMS, The Centers for
Medicare and Medicaid
Services, to provide
Medicare Part A and Part B
benefits and, sometimes,
Part D prescription drug cov-
erage.
Unfortunately, selling
health care isn’t like selling
cars or clothing. As econo-
mists point out, people don’t
know when they will get ill.
It can be cripplingly expen-
sive when they do, treatment
choices can be bewildering
and insurers have a profit
incentive to avoid providing
policies to those most at risk.
Medicare Advantage
plans, structured by private
insurers, will often include
eye and dental care, along
Medicare Advantage reim-
burses providers on the basis
of procedure codes.
Medicare Advantage
codes include a “risk score”
code designed to pay them
higher rates for sicker
patients. According to the
nonprofit, non-partisan
Center for Public Integrity,
GUEST VIEWPOINT
A RNOLD B UCHMAN
CIGNA H EALTHCARE ’ S
RETIRED HEAD OF LEGAL SUPPORT FOR
WESTERN DIVISION
with benefits such as gym
memberships, as well as fill
gaps in coverage that with
traditional Medicare are
filled by so-called Medigap
or supplemental insurance
— all typically for lower
out-of-pocket costs than tra-
ditional Medicare.
In exchange, members
must use in-network doctors
and hospitals, the composi-
tion of which may be prob-
lematic for a given individ-
ual, especially one coming to
need specialized treatment.
Like all third-party payers
of medical benefits,
manipulation of this code
resulted in nearly $70 billion
in “improper” payments to
Medicare Advantage plans
from 2008 through 2013.
Attempts by CMS to cor-
rect this continuing drain of
tax dollars have been unsuc-
cessful.
The result?
Ongoing costs from
Medicare Advantage mis-
takes, abuse and fraud in the
billions exceeding estimated
traditional Medicare costs.
By increasing eligibility
age, AHCA would have
attracted younger and health-
ier seniors from traditional
Medicare to Medicare
Advantage. This would
instantly shrink the risk pool
to a higher proportion of
more costly older members
exacerbating higher cost-
sharing in a smaller risk
pool.
Proposed premium sup-
port vouchers would encour-
age enrollees to shop among
competing “free market”
Medicare Advantage poli-
cies.
Because traditional
Medicare premiums and out-
of-pocket costs are geared to
total Medicare payments, the
stage would be set for an
insurance death spiral and
the end of traditional
Medicare.
Sweetening “free market”
Medicare Advantage would
sour “socialized” traditional
Medicare, leaving the older
and less healthy enrollees
without the safety net that
traditional Medicare now
provides.
Something to keep in
mind while debate continues
about future proposals to
refom the ACA and
Medicare.
TO THE
P OLICY
E DITOR
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ria.
Send letters to:
nhickson@thesiuslawnews.com
WHERE TO WRITE
Pres. Donald Trump
The White House
1600 Pennsylvania Ave.
NW
Washington, D.C. 20500
Comments: 202-456-1111
Switchboard: 202-456-1414
FAX: 202-456-2461
TTY/TDD Comments:
202-456-6213
www.whitehouse.gov
Gov. Kate Brown
160 State Capitol
900 Court St.
Salem, Ore. 97301-4047
Governor’s Citizens’ Rep.
Message Line:
503-378-4582
www.oregon.gov/gov
U.S. Sen. Ron Wyden
221 Dirksen Senate Office
Bldg
Washington, DC 20510
202-224-5244
541-431-0229
www.wyden.senate.gov
U.S. Sen. Jeff Merkley
313 Hart Senate Office
Bldg
Washington, DC 20510
202-224-3753/FAX: 202-
228-3997
541-465-6750
www.merkley.senate.gov
U.S. Rep. Peter DeFazio
( 4 th Dist.)
2134 Rayburn HOB
Washington, DC 20515
202-225-6416
541-269-2609
541-465-6732
www.defazio.house.gov
State Sen. Arnie Roblan
( Dist. 5 )
900 Court St. NE - S-417
Salem, OR 97301
503-986-1705
FAX: 503-986-1080
Email: Sen.ArnieRoblan@
state.or.us
State Rep. Caddy
McKeown
( Dist. 9 )
900 Court St. NE
Salem, OR 97301
503-986-1409
Email: rep.caddymckeown
@state.or.us
West Lane County
Commissioner
Jay Bozievich
125 E. Eighth St.
Eugene, OR 97401
541-682-4203
FAX: 541-682-4616
Email:
Jay.Bozievich@
co.lane.or.us