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> But with Medicare Advantage, "once you're in a Medicare Advantage plan for more than 12 months, you cannot then buy a Medigap plan unless you meet insurance r

> But with Medicare Advantage, "once you're in a Medicare Advantage plan for more than 12 months, you cannot then buy a Medigap plan unless you meet insurance requirements," he claimed. So if you have a preexisting condition, they can deny you coverage and the retiree then has to pay that 20 percent. > Kadereit argues this state of affairs is being allowed to happen by Congress to avoid tough decisions about how to deal with spiraling healthcare costs. And business accounts departments like it because there's profit to be made. But what we should really worry about are Obamacare death panels.

fragmede 3y ago
In hindsight, the argument about Obamacare death panels should defer to the fact that they already existed, the question is do you want insurance adjusters on your panel, or doctors?
- anonymouskimmer 3y ago
  Neither, really. Doctors are famous for not wanting heroic measures taken.
  - nativeit 3y ago
    Who said anything about heroes? We just need choices about medical necessity to be made by something other than how it might benefit some company’s bottom line. It’s not exactly donning a cape.
    - anonymouskimmer 3y ago
      In case you didn't know: https://en.wikipedia.org/wiki/Heroic_measure https://en.wikipedia.org/wiki/Heroic_measure And yes, it's far better for triage to be done by trained medical people than by insurance adjusters. But if given the option, I'd prefer just me and my loved ones making medical decisions about me. Of course we don't have this option, but it should still be something to strive for.
      - RHSeeger 3y ago
        > But if given the option, I'd prefer just me and my loved ones making medical decisions about me. But, in a system with limited resources, it makes not sense to have individuals that need the resources (but don't pay them) making the decisions. Clearly, nearly _everyone_ would say to use every possible medical option on themselves and their loved ones; even if doing so cost other people (with more established and inexpensive treatments) their lives. For any system where lots of people pay in, and everyone shares the resources, the decisions on how the resources are distributed _must_ be made by something other than individuals in the group that need them.
        anonymouskimmer 3y ago
        > For any system where lots of people pay in, and everyone shares the resources, the decisions on how the resources are distributed _must_ be made by something other than individuals in the group that need them. Actually it might be nice if all such decisions were made by a panel of people from just such a group. Regular people may prioritize some classes of people over others, but are probably less likely to than an elite panel.
        RHSeeger 3y ago
        > a panel of people from just such a group Oh, certainly; though I'd argue they should have input from medical and financial experts, too. But regardless... > just me and my loved ones making medical decisions about me The decisions made by only the person needing treatment (and their loved ones) is definitely going to result in the resources being bled dry way too quickly.
- CogitoCogito 3y ago
  This was a standard rebuttal at the time. It was obvious then (as it is now) that insurance companies were playing the same roll as the supposed death panels. But the voices saying “government death panels” were just louder than the rebuttals which wasn’t that surprising since it was repeated ad nauseum by a certain political party as well as the largest news organization in the country.
  - pyuser583 3y ago
    Death panel is kind of a vague phrase. My recollection is something about in the UK where they won’t spend a million pounds to do a 90 year old can live to 90.001. If that’s the case, insurance companies are not death panels. They don’t make determinations about the value of life. They refuse to cover ineffective treatments, but they don’t make evaluations based on age or quality of life. The fact that something like 80% of health care spending occurs in the last six months of life was something being talked about. Still is. “Death panel” is an inflammatory word, and nobody is going to acknowledge running one. But I really don’t see how insurance companies can pushed into the definition.
    - anonymouskimmer 3y ago
      Some insurance companies are a bit worse than death panels. https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims https://www.propublica.org/article/cigna-pxdx-medical-health... > Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said. <rubber stamping computer algorithm's initial approval or denials> https://www.propublica.org/article/how-to-appeal-insurance-denials-too-complicated https://www.propublica.org/article/how-to-appeal-insurance-d... > It’s especially complicated in oncology, said Dr. Barbara McAneny, a former president of the American Medical Association who runs a 6,000-patient oncology practice in Albuquerque, New Mexico. > McAneny told me she spends $350,000 a year on a designated team of denial fighters whose sole job is to request prior authorization for cancer care — an average 67 requests per day — and then appeal the denials. > For starters, she said bluntly, “we know everything is going to get denied.” It’s almost a given, she said, that the insurer will lose the first batch of records. “We often have to send records two or three times before they finally admit they actually received them. … They play all of these kinds of delaying games.” > Her theory is that insurance companies save money by delaying spending as long as possible, especially if the patient or the doctor gives up on the appeal, or the patient’s condition rapidly declines in the absence of treatment. > For an insurance company, she said, “you know, death is cheaper than chemotherapy.”
- phpisthebest 3y ago
  In every case I pick the private market over government. Private markets are run by contract and have at least minimal check via the court system via lawsuits Government actors are immune from all liability, and can not be sued unless the government gives you permission to sue them So do i want insurance death panels.... no. But I would prefer them over government death panels
  - bobsmooth 3y ago
    The government has a vested interest in my continuing to live via taxes. The insurance company would prefer you die quickly. I would prefer not having to sue while I'm dying to get an insurance company to do what I paid them to do.
    - emj 3y ago
      There is more; the government has a vested interest in your whole family and friends, they are all affected if you die. They are just liabilities if you buy an insurance.
    - phpisthebest 3y ago
      this should not even be something i need to say in a forum of adults, but let me make this very clear... The government does not care about you, at all, not even a little. The government has no more concern for your well being than the insurance company, the government has the ability to simply create more money out of nothing. They do not need nor care about your taxes, your taxes is just a method of control and to provide some manner of legitimacy to their system on control.
      - bobsmooth 3y ago
        This should not even be something I need to say in a forum of adults, but let me make this very clear, a government without citizens is nothing. The USA is not a small island nation with a lot of natural resources that can ignore it's people. Don't let your childish hatred of rules make you think that being ruled by corporations is a better alternative.
ghaff 3y ago
I looked through Medicare stuff recently and I came to the conclusion that, given that Advantage plans almost look too good to be true, and that every insurance company in the country is super anxious to sell you one, the catches (probably mostly about out-of-network) are more than one may want to deal with. Which is pretty much what I've read in the New York Times and elsewhere. They probably can be a good deal but are also probably something of a gamble relative to doing Part A, B, and D plus (probably) Medigap.
- dpkirchner 3y ago
  The biggest clue that Medicare Advantage is a bad deal is that it is advertised using bulk/junk mail and on daytime TV.
  - ghaff 3y ago
    The basic pitch seems to be that you get Medicare PLUS all this additional stuff at no additional charge which doesn't make a lot of sense. It may work and work out for some but you're obviously giving up something.

fragmede 3y ago

In hindsight, the argument about Obamacare death panels should defer to the fact that they already existed, the question is do you want insurance adjusters on your panel, or doctors?

anonymouskimmer 3y ago
Neither, really. Doctors are famous for not wanting heroic measures taken.
- nativeit 3y ago
  Who said anything about heroes? We just need choices about medical necessity to be made by something other than how it might benefit some company’s bottom line. It’s not exactly donning a cape.
  - anonymouskimmer 3y ago
    In case you didn't know: https://en.wikipedia.org/wiki/Heroic_measure https://en.wikipedia.org/wiki/Heroic_measure And yes, it's far better for triage to be done by trained medical people than by insurance adjusters. But if given the option, I'd prefer just me and my loved ones making medical decisions about me. Of course we don't have this option, but it should still be something to strive for.
    - RHSeeger 3y ago
      > But if given the option, I'd prefer just me and my loved ones making medical decisions about me. But, in a system with limited resources, it makes not sense to have individuals that need the resources (but don't pay them) making the decisions. Clearly, nearly _everyone_ would say to use every possible medical option on themselves and their loved ones; even if doing so cost other people (with more established and inexpensive treatments) their lives. For any system where lots of people pay in, and everyone shares the resources, the decisions on how the resources are distributed _must_ be made by something other than individuals in the group that need them.
      - anonymouskimmer 3y ago
        > For any system where lots of people pay in, and everyone shares the resources, the decisions on how the resources are distributed _must_ be made by something other than individuals in the group that need them. Actually it might be nice if all such decisions were made by a panel of people from just such a group. Regular people may prioritize some classes of people over others, but are probably less likely to than an elite panel.
        RHSeeger 3y ago
        > a panel of people from just such a group Oh, certainly; though I'd argue they should have input from medical and financial experts, too. But regardless... > just me and my loved ones making medical decisions about me The decisions made by only the person needing treatment (and their loved ones) is definitely going to result in the resources being bled dry way too quickly.
CogitoCogito 3y ago
This was a standard rebuttal at the time. It was obvious then (as it is now) that insurance companies were playing the same roll as the supposed death panels. But the voices saying “government death panels” were just louder than the rebuttals which wasn’t that surprising since it was repeated ad nauseum by a certain political party as well as the largest news organization in the country.
- pyuser583 3y ago
  Death panel is kind of a vague phrase. My recollection is something about in the UK where they won’t spend a million pounds to do a 90 year old can live to 90.001. If that’s the case, insurance companies are not death panels. They don’t make determinations about the value of life. They refuse to cover ineffective treatments, but they don’t make evaluations based on age or quality of life. The fact that something like 80% of health care spending occurs in the last six months of life was something being talked about. Still is. “Death panel” is an inflammatory word, and nobody is going to acknowledge running one. But I really don’t see how insurance companies can pushed into the definition.
  - anonymouskimmer 3y ago
    Some insurance companies are a bit worse than death panels. https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims https://www.propublica.org/article/cigna-pxdx-medical-health... > Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said. <rubber stamping computer algorithm's initial approval or denials> https://www.propublica.org/article/how-to-appeal-insurance-denials-too-complicated https://www.propublica.org/article/how-to-appeal-insurance-d... > It’s especially complicated in oncology, said Dr. Barbara McAneny, a former president of the American Medical Association who runs a 6,000-patient oncology practice in Albuquerque, New Mexico. > McAneny told me she spends $350,000 a year on a designated team of denial fighters whose sole job is to request prior authorization for cancer care — an average 67 requests per day — and then appeal the denials. > For starters, she said bluntly, “we know everything is going to get denied.” It’s almost a given, she said, that the insurer will lose the first batch of records. “We often have to send records two or three times before they finally admit they actually received them. … They play all of these kinds of delaying games.” > Her theory is that insurance companies save money by delaying spending as long as possible, especially if the patient or the doctor gives up on the appeal, or the patient’s condition rapidly declines in the absence of treatment. > For an insurance company, she said, “you know, death is cheaper than chemotherapy.”
phpisthebest 3y ago
In every case I pick the private market over government. Private markets are run by contract and have at least minimal check via the court system via lawsuits Government actors are immune from all liability, and can not be sued unless the government gives you permission to sue them So do i want insurance death panels.... no. But I would prefer them over government death panels
- bobsmooth 3y ago
  The government has a vested interest in my continuing to live via taxes. The insurance company would prefer you die quickly. I would prefer not having to sue while I'm dying to get an insurance company to do what I paid them to do.
  - emj 3y ago
    There is more; the government has a vested interest in your whole family and friends, they are all affected if you die. They are just liabilities if you buy an insurance.
  - phpisthebest 3y ago
    this should not even be something i need to say in a forum of adults, but let me make this very clear... The government does not care about you, at all, not even a little. The government has no more concern for your well being than the insurance company, the government has the ability to simply create more money out of nothing. They do not need nor care about your taxes, your taxes is just a method of control and to provide some manner of legitimacy to their system on control.
    - bobsmooth 3y ago
      This should not even be something I need to say in a forum of adults, but let me make this very clear, a government without citizens is nothing. The USA is not a small island nation with a lot of natural resources that can ignore it's people. Don't let your childish hatred of rules make you think that being ruled by corporations is a better alternative.

ghaff 3y ago

I looked through Medicare stuff recently and I came to the conclusion that, given that Advantage plans almost look too good to be true, and that every insurance company in the country is super anxious to sell you one, the catches (probably mostly about out-of-network) are more than one may want to deal with. Which is pretty much what I've read in the New York Times and elsewhere. They probably can be a good deal but are also probably something of a gamble relative to doing Part A, B, and D plus (probably) Medigap.

dpkirchner 3y ago
The biggest clue that Medicare Advantage is a bad deal is that it is advertised using bulk/junk mail and on daytime TV.
- ghaff 3y ago
  The basic pitch seems to be that you get Medicare PLUS all this additional stuff at no additional charge which doesn't make a lot of sense. It may work and work out for some but you're obviously giving up something.