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Rounds Lies: Weiland Supports Medicare as Public Option, Not Single Payer

Mike Rounds is lying again. After yesterday's State Fair debate, the Rounds campaign issued a press release making these false claims:

Key points in today’s debate include:

  • Rick Weiland’s belief that everyone should be on Medicare; creating a single payer system.

Gov. Rounds disagrees.

“Rick is the only candidate in America who believes in signing everyone up for Medicare. Why? Because it’s a terrible idea that will ruin Medicare for every South Dakota senior” [Rounds for Senate campaign, press release, regurgitated by Pat Powers, Dakota War College, 2014.08.29].

Rounds dishes three errors:

  1. The semicolon in his fragment bullet point makes no sense. If creating is a participle modifying everyone should be on Medicare, the punctuation should be a comma.
  2. Rick Weiland is not advocating that everyone should be on Medicare. As Weiland has stated consistently throughout his campaign and as has been reported regularly by multiple new outlets, he supports opening Medicare enrollment to all willing customers, of any age. That is not single-payer... unless Medicare is so good that, given the chance, everyone would choose it over the private insurance that Mike Rounds sells. Ah, so that's what Mike is afraid of....
  3. Signing everyone up for Medicare (which I support) or even signing several million new policyholders up (which Weiland proposes) does not ruin Medicare for any South Dakota senior. Insurance 101, Mike: the surest way to strengthen a risk pool is to sign up more members, especially more members who pose less risk than the average member of your current pool. It's not as if Medicare only has $492 billion to spend on health benefits and new enrollees will be slicing that pie into smaller pices, forcing Grandma to wait for her new hip. Weiland's new enrollees would be younger working people, adding their premiums to Medicare's $576 billion in revenue and drawing less out in benefits than their older counterparts. Letting my family and millions like us buy into Medicare makes Medicare stronger for my parents.

Mike Rounds the insurance agent knows full well that Weiland's Medicare-as-public-option proposal would make Medicare stronger the same way that all of us coming into Fischer Rounds to buy our insurance would make his company stronger. But the last thing Mike Rounds the insurance agent wants is a stronger Medicare that cuts his personal profits. That's why, almost every time Mike Rounds opens his mouth about Medicare, he lies.

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  1. 96 Tears 2014.08.30

    Lies and personal attacks? Shame shame, Mike! Not the heroic golden boy the scribes at the Argus make him out to be.

  2. Liberty Dick 2014.08.30

    Setting aside Mike's spin, Medicare fixes the price for a procedure and almost always below market value. Is health care going to get better or more accessible as more doctors will not be accepting Medicare patients because they can't keep doing procedures at less than cost? The free market is finding ways to cut the costs on their own like the surgery center in Oklahoma advertising its prices. Only in a war zone do you go in and do what needs to be done and afterwards ask what the damage was.

  3. owen reitzel 2014.08.30

    Lies are the name of the game with Rounds. Like most Republicans they slam a program and, of course, offers no viable solution.
    I don't think the free market is going to help here and hopefully doctors remember the oath they took.
    My question Liberty is even if the "free market" is used how is that going to help the people who don't have insurance? How long with this process take and how many people will die before it helps?

  4. Donald Pay 2014.08.30

    To have political viability, it would have to be a separate program in Medicare. Most people my age feel they pay into Medicare their entire working life, and that when the reach 65 they have earned their coverage.

    Basic Medicare is by no means a "cadillac plan." Attracting paying customers who are mostly younger and healthier into the plan may actually bolster it.

    It could be called Medicare Part E for "Everyone." It could have to be set up with exchange-like options for levels of coverage, co-pays, premium levels, etc.

  5. JeniW 2014.08.30

    Medicare is an insurance, just like any other type of insurance. It covers some things, but not others, and only for a certain amount.

    I recommend to people, that when they reach the point of being eligible for Medicare, if they can possibly afford it pay for both plans, and to purchase an external supplemental insurance, such as BCBS (there are others,) and pay for Medicare D (prescription.) It is misleading to tell people that Medicare is totally free and covers everything.

    The thing too with Medicare is that people who have pre-existing conditions could have Medicare (if they meet the other qualifications of Medicare.) It was not until more recently that those with pre-existing conditions could purchase health insurance.

  6. Jenny 2014.08.30

    Are doctors in the field to make a nice profit only, Liberty Dick? I just don't buy that argument that doctors across the country will stop accepting Medicare patients.
    Mayo Clinic's total revenue has gone up the first half of 2014 and some say it's b/c of the ACA. Over 169,000 Minnesotans are insured now, thanks to MN Sure. More people in the pool is good for business.

  7. jerry 2014.08.30

    Owen you ask a very good question that Donald Pay answers. Medicare has been broken down into the same plans for all insurance companies with the plan A being the basic plan so it already more or less exists. The standardized plans, all alphabetically listed, cover all basic medical coverage that is very inexpensive as in free in some provider markets. The supplement that gives you the gateway to all of this costs at least $104.90 per month that you purchase from the federal government, with that you will get into a very nice plan. From there, you can go up for even more benefits with always remembering, the better the plan, the more the cost.

    The doctors in Oklahoma are costing procedures for the under 65 crowd and that is good they post them. Savvy folks, that want control of their budgets can do the same by asking the hospitals and surgeons their fees before they get the saw out. There was a case in New York City of hospitals that were within a 10 mile distance that had a discrepancy of several thousand dollars for the same procedure. We certainly do not need to feel confident that a hospital posts their prices, we need to feel confident that we have done our due diligence and examined the rates and quality of service even further. Just because you post your numbers does not mean you are the best game in the area. What if the dude is a quack and has twofer Tuesdays for brain surgery? I think I want to dig a little deeper for quality as well as the bottom line.

    Something else, these hospitals all get federal and local tax benefits for taking in indigent folks on approved schedules (I am clueless on how that works for some and does not for others). The fee schedule that is allotted for procedures is not so odorous as to deny patient access. What denies patient access is the lack of providers. Think you can go see your doctor in a jiffy? Think again, you may be on the curb waiting for 6 weeks to see your primary physician. My wife was told that not so long ago and at that point, the Urgent Care was the place to go for immediate treatment. What will be needed and is in the process already is more in the healthcare field. Take a look at the construction that is going on with hospitals and outpatient clinics and tell me that the docs are suffering. Don't believe the hype, just open your eyes while you are driving down the highway with Miss Daisy and look at what is being built. The ACA is working man, it is what the doctor ordered!

  8. Jenny 2014.08.30

    That is, over 169,000 MORE Minnesotans are insured now by enrolling in the MN Sure program.
    95% of Minnesotans are insured now. I just can't see how that is not good for both Medicare and the private insurance industry. Sorry for always bringing MN into these discussions Cory, but sometimes I just think that SD can learn so much from how MN does business. What a selling point Daugaard could have if he had that percentage of SD insured.

  9. Liberty Dick 2014.08.30

    More people to the pool. Cool story bro, tell it again. How many more doctors got added to that pool as well? How many doctors will want to remain servicing that growing pool doing procedures that cost them money and don't make them a dime? You can sit back and claim (x) amount of people are now "covered" til you are blue in the face but it won't do them any good when in a few years there won't be enough doctors to do the procedures they need.

  10. Jenny 2014.08.30

    We have a growing field of PAs and CNPs that will help in that aspect, LD. We need to give incentives for low and middle income students to be able to afford med school and not have a quarter million dollar loan when they get out. Make the cost of med school more affordable.

  11. jerry 2014.08.30

    Good on Minnesota with their Medicaid Expansion, clearly there are business people in Minnesota who understand the economic issues. In Wyoming, Governor Mead is getting ready to turn the key on Medicaid Expansion there and that is the home turf of Darth Cheney. So, the Cowboy State is getting ready to lasso in some serious revenue to help keep Wyoming vibrant. PS South Dakota, thanks for educating and sending your teachers to us. We will provide them with quality healthcare and a healthy paycheck you fools.

    Here in South Dakota, the sadistic and poor, very poor business practices of the governor and his minions, will cost our state millions yet again this year. The republican business people that are not involved in government, are truly amazed at the lack of business savvy that represents them.

    They say that Daugaard was in the banking business? That is a lie. As a banker, he would have had to have some knowledge of business basics to be able to make judgments. Oh, now I know the answer, he went to politics because he does not know a damn thing about business, now I get it. The reason Rounds choose Daugarrd as his sidekick is because they both know how to fleece a crowd with lies and damn lies.

  12. JeniW 2014.08.30

    There are thousands of doctors across many specialties, how many of them have said that they will discontinue their practice before retirement age because of the ACA and Medicare payment rate?

    Let's use a local example of a specialty that treat many individuals who have Medicare insurance, Vance Thompson Vision. One of their specialties is removing cataracts. Almost everyone, who lives long enough, will develop cataracts.

    At the moment Vance Thompson Vision is thriving because of their skills to remove cataracts. Has Vance Thompson indicated that they will stop treating people who have cataracts who happen to have Medicare for insurance?

    Is the "threat" of doctors discontinuing their practice due to ACA, or Medicare payment rate a real threat, or is that fear-mongering?

  13. larry kurtz 2014.08.30

    Doctors, listen to the teachers: leave South Dakota now.

  14. jerry 2014.08.30

    JeniW, you raise an interesting question about discontinuing their practice. I think that might not be a bad thing as you certainly do not want an angry upset tea party doctor working on your vital organs. Let them close the doors and allow some other younger more qualified physician to take their place. I think if the student loans were to be relaxed or eliminated if you came to work in a rural area or small state, that would take care of that. The sooner we rid ourselves of these pain in the ass takers that continue to bemoan the help for our working people, the better we will be. Let them retire and move to the Dakota Dunes and be around the rest of the moaning shoddy.

  15. larry kurtz 2014.08.30

    Rick hammered Rounds and Daugaard for forcing patients away from their home hospitals to Sioux Falls and Rapid City because docs won't stay in the hinterlands while PAs and CNPs can't do more than simple surgeries.

  16. Liberty Dick 2014.08.30

    You can't drive down the costs of higher education until you start allowing people to declare bankruptcy on student loan debt. The schools and banks are in this racket together holding hands and singing along as young impressionable people are convinced they need a college education to survive in this world, take out debilitating loans, forcing them to live at home after graduation, and all of it is guaranteed to the school and banks while this generation of kids get a crappier education that costs more. Oh yeah and you aren't pumping out PAs and CNPs fast enough to take on the nationwide numbers of supposedly millions of people newly covered. There are doctor shortages already in this state! The VA hospital in Sioux Falls didn't even have a dermatologist last year when I needed one!

  17. larry kurtz 2014.08.30

    Survival wages: how conservative, Dick. Young people: flee South Dakota while you still can while the VA and IHS should be the hospitals of last resort.

  18. aaron 2014.08.30

    LD, I usually come down on the conservative side of most arguments and am pretty much ignorant to the actual workings of a healthcare enterprise but this idea that docs are loosing money on Medicare patients just makes no sense to me. I mean there are guys out there who's patients are 80-90 %+ Medicare or medicaid and they still are making a really good living which I do believe their skill sets demand btw. But I mean c'mon they can't all be making up their looses plus getting a 300-400K income on less than 10% of their patients. The fact is you take away Medicare (which as a side point is an argument I would entertain) and patients ability to pay goes way down which would imply less money for everyone in the health care arena which last I checked was a good paying career field all around. To me common sense dictates that that just could not be the case if every Medicare patient was a money looser. Am I missing something here?

  19. Roger Cornelius 2014.08.30

    I'm not necessarily buying that providers are rejecting Medicare patients as a universal truth because of the lower reimbursement rate, the providers I know like Medicare as guarantees their profit margin. Ask Dr. Bosworth how much she depends on Medicare and Medicaid.
    I'm aware of two doctors in Rapid City that have built their pediatric clinics and solicit Medicaid patients, the same is true of other clinics that willingly accept Medicare.
    The Community Health Center of the Black Hills is one of many clinics around the country that accepts Medicare and Medicaid patients, they not only accept the lower reimbursement but can reduce the 20% patient cost to a few dollars.
    The last report I saw on patient visitations was about two years ago and those visits were approaching near 75,000 annually. If providers do not want to accept Medicare, the community health center does.
    There aren't community health centers in every city or town, but the one nearest to you will provide necessary services.
    Medicaid Expansion is a perfect fit for community health centers, if doctors reject the health care needs of the poor and working poor based on a lower reimbursement, the health centers welcome them and will expand and prosper.

  20. jerry 2014.08.30

    Sam Wang is on the right track, but lets help him out and let the little man face the music of his corruption while staying right here in South Dakota. Why should we taxpayers foot the bill to bring this common thief home for his just due. A vote for Rick Weiland is a vote to help end corruption nationwide.

  21. Deb Geelsdottir 2014.08.30

    In MN, and other large population areas (SF & RC too?), there are health care clinics which do not accept Medicare. In those areas it's not difficult to find clinics that do.

    I'd be surprised to learn that providers in rural areas don't accept Medicare. If they are the sole provider, don't they have to? If those small town docs and hospitals did not accept Medicare, they'd probably be out of business.

    Given that information, how would Medicare Part E do anything harmful to the overall health of South Dakotans?

  22. Deb Geelsdottir 2014.08.30

    BTW, a shortage of family doctors is not only SD's problem. It's looming in MN too. I think reductions in costs for students is very important. A connected issue is time. The U of MN is looking at decreasing the length of med school from 4 years to 3.

    They aren't planning to omit any education. Most of one year is spent doing rotations in a variety of specialties to help the students choose their own focus. For students who already know, especially family practice students, the rotation part would be omitted.

    One less year means a sizable cost reduction, 25%. That also lessens pressure on students to choose a specialty that promises big income.

    Win/win/win. What do you all think?

  23. jerry 2014.08.30

    The IHS had the commission corp that provided doctors into the reservation areas. Dr. Tom and Edie Welty were doctors that I know of that were in Cheyenne River and also in Sioux San that were as good as you can get anywhere. My point is that doctors and CNP, Rn's along with the rest of that alphabet, could get their education furnished by taxpayers for a commitment to do service in rural areas. Who knows, they may love it like the Doctor in Philip, South Dakota more than they did their home in South Africa and decide to stay. There are many ways to skin the buffalo if you just take the time to map it out for your needs. A robe one way, a buffalo hide tipi, another way. All ways are useful and have a great end result if you work together.

  24. mike fro iowa 2014.08.30

    Mercy Medical clinics in several small,rural towns in iowa accept Medicare. Hospitals affiliated with Mercy do,as well. There are Sanford affiliated clinics around,but I don't know if they accept Medicare. I suspect they do.

  25. mike fro iowa 2014.08.30

    Sanford Health Plan sells Medicare supplemental insurance. The Sanford Senior Care Clinic in Sheldon iowa hospital accepts medicaid but not Medicare.

  26. Jana 2014.08.30

    The former governor also hit all the GOP high notes on the bogey man under the bed issues of EPA, Department of Education and regulating the dust from farms and putting meters on cows asses.

    So easy for him to play the shorter version of "oops" Rick Perry, but he has no plan for what would take the place of these organizations or how it would affect the people he purports to represent outside of his "corporations are people" constituency.

    Maybe he can breathlessly tell us it sounds sincere.

  27. Loren 2014.08.30

    Seems as if the Republicans would have very little to run on if it weren't for hate and fear!

  28. jerry 2014.08.30

    The former governor got his house bailed out from a flood from his poor management, got his state bailed out because of his poor management. So instead of a meter on a cows ass, voters should put a bullshit meter on his mouth.

  29. larry kurtz 2014.08.30

    What did Mike Rounds know before he built his house in a swamp that Lake Sharpe was filling with silt and when did he know it?

  30. jerry 2014.08.30

    I am sure we will never know the taxpayer cost of all that this little weasel has taken from us. With the EB-5, we know it is in the millions, but what about everything else? If only we had someone that has the power to actually do investigative work, and then prosecute the perp, alas, it seems not.

  31. Maddog49 2014.08.30

    If Medicare is opened up for anyone, and doctors are faced with more procedures for less money, doctors will stop accepting Medicare. When that happens, health care suffers for all. If anyone on this forum is dumb enough to think that the government can run our health care as effectively and efficiently as private enterprise can, God help you. All that you need to do is take a look at where all the innovation in treatment is coming from. That is right. Right here in the good ol' US of A. That's because a portion of the money made goes back into research, because many of the hospitals are "non-profit". They take the profit they would normally claim as profit and pay it forward to fund research and support research associates. That's where most if not all of the progress comes from in medical treatment worldwide. I'd say Weiland is lying. He doesn't want Medicare for those who choose it, he really wants Medicare for everyone. The first position is just a stepping stone to the second. It's how Democrats (socialsists) accomplish their agendas, a small step at a time. Then you don't actually realize it's happening until it's already happened.

  32. larry kurtz 2014.08.30

    pp has escaped the star chamber!

  33. Deb Geelsdottir 2014.08.30

    Purely outstanding Jerry.
    "So instead of a meter on a cows ass, voters should put a bullshit meter on his mouth."

    Maddog49, Medicare has lower overhead than any of the for profit plans. So does the VA. If Republicans hadn't passed a law forbidding negotiating drug prices, those good numbers would be even better.

    BTW, it sure looks like Republicans didn't have much faith in the private market when it comes to medications. Otherwise, why would their good friends, Big Pharma, write the bill for Republicans to pass, thwarting their Great God, Private Enterprise?

    In addition, the medication that has been approved for Ebola was developed in a Scandinavian country. (I don't remember which one.) There are many more examples. It is silly to claim that the US has a monopoly on science.

  34. Jenny 2014.08.30

    Obviously, Larry. Even more annoying than the Sibster. Anxiety diagnoses, I'm sure, must run rampant among republicans these days.
    The CMS (Centers for Medicare and Medicaid services) is continuously recalculating its payment rates all the time. Most doctors work for hospitals (do they not?)and if a hospital gets a higher proportion of Medicare patients it will receive an adjusted add-on payment to the base payment rate.
    I suggest anyone that wants to know how Medicare truly works to look up their website under CMS. There is a lot of fear out there about doctors quitting, etc. Medicare is actually run quite efficiently and everything is out there for all to see.

  35. jerry 2014.08.30

    Maddog, Jenny has some sound advise. As you really do not understand the procedures of how Medicare works, if you follow her direction, you will see that if you do any kind of procedure, there is a CPT code that allows payment for that. Simple stuff, the more procedures you do, the more CPT codes that get you paid for. The code book was designed a couple of decades ago at least and as new procedures are developed and approved, they are listed with the proper billing code. Don't be so scared man, fear will drive you mad.

    By the way, Medicare for all would not be a bad thing. We would all pay into it just the good folks who are 65 and over. Go ask them how they like their Medicare and then tell them that you would like to take that from them. Look out for the broom handles then, those little elderly gals will knock the snot out of you with a statement like that.

  36. jerry 2014.08.30

    Also Maddog, you may want to read about this. It speaks of why our healthcare system is so inferior to western Europe, Japan and a host of other countries. We can and must do better with our resources. We spend way too much for a system that covers way to little of all of our citizens. Scare tactics from right wing noise machines do nothing but keep the status quo on those that fleece us with impunity.

  37. jerry 2014.08.30

    Ruh oh, along with red state Wyoming, now add red state Tennessee to the list of the Medicaid Expansion team. My my, these republican led states are finally coming to their business senses (or businessmen have been kicking their behinds) I go with the latter. Anyway, the working poor of Tennessee will now have access to life giving medical care from all kinds of doctors and other providers, saints above.

    Meanwhile in the center of South Dakota in a secret location not even known to himself, Daugaard sits in quite solitude admiring himself in the mirror. Yes Governor Daugaard, you really are a fool and worse of all, everyone knows it. Why don't you do something positive for this state instead of robbing her with your nonsense? We know of your dislike for working people and especially the working poor, but cast all that aside for a moment and think of what the expansion would do for the economy here and how it would take a huge thorn in your side regarding the costs of Medicaid without the expansion. Get a calculator or take your shoes and socks off, but seriously figure this out.

  38. Roger Cornelius 2014.08.30

    Honestly, who chipped this maddog character out of the Republican glacier?
    If socialistic programs were discontinued or stripped from our government our economy would collapse. Socialism affects every element of our society, government, and economy.
    ALL political parties are responsible for it and most Americans are effected by it in some fashion or other. Like Jerry said, try taking grandma's Social Security check and Medicare away and see what happens. I've seen some pretty pissed off grandma's and wouldn't want to be the recipient of their tirade.

  39. JeniW 2014.08.30

    Once upon a time, and not all that long ago, I remember it well, and so should all the "Baby Boomers," most medical doctors had a private practice rather than working for a healthcare system such as Avera, Sanford, and etc.

    When I was growing up Dr. John McNally (now deceased,) was our family doctor. He had a private practice. His staff consisted of one nurse. So he had to do all the paperwork associated with his practice/business.

    The private practice doctors had "hospital privileges" in the hospitals in the community where they had their practice. They in essence, owned a small business.

    It takes a lot of money and time to run a small business, plus the cost of malpractice insurance was increasing every year, as people filed and won lawsuits against the doctors. It was becoming cost prohibitive to have a private practice.

    Some doctors, no matter how good of a doctor they are, are not good at running a business, and other doctors want to focus on what they were trained to do rather than deal with the business side of their practice.

    The doctors got together with a hospital, or created a partnership with other doctors to help run the business side of the practices (including filing for insurance claims,) and be able to purchase malpractice insurance at a group rate.

    Even in the 1970's there were doctors who had private practices accepted patients who were receiving public assistance to what was each states' version of Medicaid was. Some new doctors agreed to accept Medicaid payments just to get their medical practice/business going.

    There are some doctors who have private practices, but most of them are specialty doctors such as ENT, Orthopedics, plastic surgeons, but they are typically in a partnership with other doctors. Most General/Family Physicians are connected with a healthcare system.

    Doctors who accept patients with Medicare or Medicaid insurance, also have patients who either have private insurance, or are enrolled in group insurance, so the doctors are not totally dependent on Medicaid/Medicare payments. Also, some individuals who have Medicare as insurance also have supplemental insurance to pay for what Medicare does not pay. That means that doctors are not necessarily practicing at a loss.

    Will doctors in private practice go out of business because of Medicare payment amount, probably so if they are 100% dependent on Medicare payments to support their business.

  40. Steve Sibson 2014.08.31

    "Mike Rounds the insurance agent knows full well that Weiland's Medicare-as-public-option proposal would make Medicare stronger the same way that all of us coming into Fischer Rounds to buy our insurance would make his company stronger."

    Medicare is subsidized with payroll taxes. Where is the subsidy going to come from for the new so-called customers, who have yet to spend 40 years paying payroll taxes matched by the employers such as Fischer Rounds?

  41. larry kurtz 2014.08.31

    Roger, we all know that Social Security pays most of the property taxes in South Dakota as well as much of the nursing home care: the state would be bankrupt more than just morally and ethically.

  42. jerry 2014.08.31

    Medicare is subsidized with payroll taxes that is for sure. We pay into Medicare each time we get a paycheck or when we file taxes. Medicare is hospitalization only while Medicare Part B is for outpatient goods and services that you pay additionally for. This is not a free ride as some folks like to call an "entitlement", this is an insurance product that you the consumer, pay for out of your own pocket.

    If you did make Medicare for all a reality, it would not be a burden on taxpayers whatsoever, in fact, it would ease that burden and make the whole system that much more viable for the future.

    One only has to look across the ponds in either direction to see how well something like this works and why those countries have a much better grasp on what healthcare costs are. The real culprit in this healthcare dilemma that we have here in America is the right wing and their insistence on not being able to negotiate with big pharma for drugs like the VA does for an example. You can buy the same drugs in Europe that you can purchase here at Walgreen's or Walmart for a third of what the price is here. Same quality, same shelf life same same, with the exception of price.

    Medicare for all is not socialistic in the least, it is fair. Why should we not embrace a way of reducing costs through smart business practice. The doctors and hospitals over there are not closing the doors. The doctors and practitioners there are not destitute and without the means to live in their wonderful homes and take their vacations without worry. Medicare for all is just like what was said about the ACA, a bunch of lies made by lying liars that do the bidding of their benefactors, big pharma and big insurance companies that have gamed the system. Medicare for all would also help to level the playing field by then allowing more funds for things that could help us with public transportation and general infrastructure improvements. The more you know about how to solve this huge burden on the taxpayers with Medicare for all the problem solver, the better. By the way, over there, you actually get a 30 day vacation that is paid without being in the military.

  43. Tara Volesky 2014.08.31

    I watched the Senatorial debate and it made me sick to think that people could actually vote for Mike Rounds. We need to look at ourselves in the mirror and quit listening to the BS machine. Sibby had a great letter to the editor about Crony capitalism. You should post it Cory.

  44. bearcreekbat 2014.08.31

    Maddog49 makes a popular but unsustainable arguement, since it is premised on false stereotyping. Maddog argues, "If anyone on this forum is dumb enough to think that the government can run our health care as effectively and efficiently as private enterprise can, God help you."

    This argument incorrectly evidences a view of "government" as some sort of independent entity. But upon reflection, it is obvious that "government" is simply a name given to a group of individuals working together, just as groups of individuals work together in private companies. Objectively, the only real difference is that in private companies, the individuals must work to maximize profit, which necessarily means charging what the market will bare, with no regard for the needs of those patients being served. Those human beings that work in "government" organizations, however, have a completely different incentive - reducing cost while assuring adequate care for patients.

    I have seen Maddog's arguments repeated in a variety of contexts, but all carry the same flaw. They all see "government" as some sort of independent living entity with terrible motives. The fact is that "government" is not an independent entity with any motives, it is a descriptive term identifying those people who come together to accomplish public purposes, rather than private profits.

  45. bearcreekbat 2014.08.31

    JeniW, I always appreciate your comments. An early comment on this thread raises some questions that you may be able to help me with. You stated, "I recommend to people, that when they reach the point of being eligible for Medicare, if they can possibly afford it pay for both plans, and to purchase an external supplemental insurance, such as BCBS (there are others,) and pay for Medicare D (prescription.)"

    I have BCBS and am eligible for Medicare. As best I can tell, however, I would get little or no benefit from joining Medicare Part B, and absolutely no benefit from joining Medicare Part D, as my BCBS covers meds in the same way as Medicare Part D and will cover my family's doctors visits too, with a small co-pay. As best I can tell Medicare Part B coupled with BCBS would possibly reduce the $25 co-pay for each doctor visit, but would add no other benefits.

    In these circumstances, it would seem best to either drop BCBS and sign up for Medicare Parts B and D, or keep BCBS and decline Medicare B and D. Can you tell me where I might be on the wrong track? If I can keep BCBS at about the same cost as Medicare B and D, based on employer retirement subsidies, which is better for my family - BCBS or Medicare Part B and D?

  46. JeniW 2014.08.31

    Bearcat, I am not going to pretend that I know all about insurance and what would be best for you. There are insurance agents who can serve you much better than I can. I believe there is an agent on 41st near Inca's Restaurant, who is better qualified to answer your questions.

    I can only tell you of my experience. When I became eligible for Medicare, I signed up for the basic coverage (part A, I think,) and for hospital coverage (part B, I think.) I decided to go with BCBS as a supplemental insurance because I would automatically qualify, and even though I was in pretty could shape at the time, I knew that anything could change in a matter of a few seconds.

    I was not able to purchase health insurance because I have a pre-existing condition, so I jumped at the chance to get the supplemental insurance. I am so glad that I did because I ended up in a hospital's ICU, went to a skilled nursing care facility for recovery and therapy. I sweat blood the entire time because I had wondered how was I going to pay all those expenses.

    My supplemental insurance paid for what Medicare did not pay. You cannot imagine my relief!!

    Medicare D came later in my life, and I hopped on that opportunity as soon as I could even though I was not taking very many prescription medications. It has proven to be useful for those times that I needed a medication that was expensive for a short period of time.

    I see insurance as insurance for the future. All it takes is one second for something to happen to us to can affect our physical condition and financial situation.

    Things are working for me, and I am one of those that if it works, and not broken, no need for change.

    Best wishes to you, and I apologize for not being able to answer your questions as to what is best for you.
    What I am recommending is that people, for as much as they can, and for as much as they can afford to, get as much coverage as possible. Talk to an expert, or contact Center for Active Generations who can probably give you resources to contact.

  47. jerry 2014.08.31

    There is no charge for Medicare Part A hospitalization as that is automatic. The cost of Part B varies with the minimum being $104.90 per month (you must have this to get the Medicare supplement). The Part D is strictly for prescription drugs and varies from insurance company to insurance company. The Part D must be purchased as it is mandated and if you do not purchase it, you will be penalized when you finally decide or have to purchase it and it is one of those that does not go away, the penalization price at the time you purchase it, will always be at least that. The mandate (thanks to George W. Bush along with the republican congress) does not apply to you if you presently have creditable coverage like a major medical plan either through a group or individual. Talk to an agent and show them what you are now taking for medications to find the best plan for you and then compare the price of the Part B and Part D along with the Medicare Supplement to see what fits your needs and your pocketbook the best. A friend of mine just went through this and all together paid for the Part B to the government of the $104.90 along with the Medicare Supplement of about $130.00 and about a hundred bucks for the prescription drug plan as the drugs taken are several, the Part D. So the whole package was about $350.00 bucks a month for everything and you still have to pay for co pays on your drugs. This is not an entitlement at all as some right wing nuts would have you believe. This is an insurance policy and is certainly not free. My friend was getting slammed to the tune of about $1,000.00 bucks a month so this Medicare deal will save some serious money. Contact Blue Cross for one and ask for an agent in your area, that seems to work pretty good. As JeniW said, there are no pre existing issues that could come back to bite you so there is nothing to prevent you from checking it all out to start saving yourself some walking around money.

  48. jerry 2014.09.01

    As this article from TPM notes, even uber conservative states like Wyoming see the light on why they need the ACA. Wismer is spot on about the continuation of pushing our arrogant leader into allowing that for our working poor. Like the legislators (more or less the same make up of a one party system) and the governor of Wyoming himself states, they have no love of Washington (just the money baby, just the money), but they will reluctantly accept it. Here in our state, our governor does not like the plan because there is no way he can pocket any of the loot for himself or his comrades so it does not fit his needs. The dude needs to go and be replaced by an actual leader that has integrity and the intelligence to help bring South Dakota out of its territory attitude to bring it into a state that actually can do something. Start with the removal of the governor to open the windows of clean government and then lets go to work on this do nothing legislature to finally air this cesspool of cronyism out of our politics

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