How to reduce Medicare spending

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Bootstrap
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How to reduce Medicare spending

Post by Bootstrap »

Here's something important that President Trump's budget gets right.

The Committee for a Responsible Federal Budget pointed this out:
Compared to last year's budget, the focus on controlling Medicare costs is especially important – and the Medicare policies in the budget would all achieve savings by improving efficiency and value of care rather than cutting benefits for beneficiaries.
This is an area where actually negotiating better deals could make a huge difference without affecting care.
Fortunately, when it comes to Medicare, it is possible to save hundreds of billions of dollars without cutting benefits. In testimony to the House Energy & Commerce Committee, CRFB's senior policy director argued that Medicare reform should begin by pursuing "cost benders" that reform the health care system and thus reduce costs (and often improve quality) for individuals and the Medicare program alike. In general, these changes improve the health care system – they do not cut benefits. The Medicare Payment Advisory Commission (MedPAC) and others have identified many other areas where eliminating or reducing unnecessary payments and subsidies could reduce costs without significantly harming access or quality. Similar savings can come from prescription drugs – as recently suggested by Office of Management and Budget Director Mick Mulvaney.
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Bootstrap
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Re: How to reduce Medicare spending

Post by Bootstrap »

Crickets?
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RZehr
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Re: How to reduce Medicare spending

Post by RZehr »

Bootstrap wrote:Here's something important that President Trump's budget gets right.
Bootstrap wrote: Crickets?
Dumbfounded... 8-)
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Josh
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Re: How to reduce Medicare spending

Post by Josh »

The topic of how to reduce costs in providing defined benefit health plans is a complex one (and doing so was my profession for a few years). There aren’t really any easy answers.

I’m a bit wary of various parts of this proposal, but that may stem from my dislike of Medicare in general. Medicare sets pricing, and no private provider can charge the public less than Medicare does, so in a sense cutting costs here could lead to savings for everyone else.

On the flip side, slashing drug spending will mean less money to develop new drugs. That means we will not really see future breakthroughs like we have in the past, particularly drugs that treat geriatric diseases, and America will also lose its vital pharmaceutical R&D industry. There’s a real cost to losing that.
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temporal1
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Re: How to reduce Medicare spending

Post by temporal1 »

i have Medicare, when i began, i was surprised at the out-of-pocket costs.
it’s a big expense for me. worse, i have diabetes, those drugs are expensive.

there were some noticable changes this year.
so far, it appears my out-of-pocket is a few dollars less.
but, i can’t be sure. as the year goes on, i will likely fall into the “coverage gap,” which means my prescription copays increase A LOT. hundreds of dollars. my doctor has been able to give me office samples to help, but, this is uncertain. last year, i was able to get some help directly from the manufacturer, by qualifying .. they have helped people that do not qualify for MEDICAID. again, there is no guarantee, programs can change every year. just figuring out how to pay for these things is an ordeal that goes on over months.

MEDICARE and MEDICAID are two very different programs.
people on MEDICARE pay a lot. others pay more than i do, i’m sure. costs go up every year.
it’s pretty worrisome.

i have Part D and Part G supplements. they cost every month.

medicine, or food? is a real question for a lot of people.

this year, my Part D provider changed approved pharmacies. no more Walgreens, now it’s CVS.
i hope this will mean lower out of pocket costs, but, not yet certain.
i presume they changed to increase their profits.

along with that, the insulin i’ve used is not on their formulary this year.
my doctor will have to tell me what she recommends. i’m still using prescriptions from last year.
i’m a bit anxious about making changes, but, we’ll see. i’m hoping for the best.

no doubt, there is substantial Medicare and Medicaid waste+fraud.

i hope big corrections can be made, esp for the big offenders.
it has to be sufficient to cover the costs of identifying+correcting the problems.
nothing is done pro bono.

When obama was early in his first term, i recall him saying reducing Medicare fraud would go a long way in paying for obamacare. i heard him once, on television, never again. i have not found that speech on the internet. i recall posting about this on MD. i believe Max agreed that his wife heard that same speech.

Either way, substantial waste+fraud are not in question.
What to do about it is the problem. we can hope Trump is successful.
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temporal1
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Re: How to reduce Medicare spending

Post by temporal1 »

i was too tired to think of numbers when i posted above.
but, maybe it would be helpful to add them here. if anyone’s interested. :)

i believe these are standard costs, nothing strictly personal here.
2018 Medicare:
$134/mo automatically deducted from Soc Sec. no choice!
$129.28/mo Part G Supplement. auto-pay, you choose from supplements, or, choose no supplement.
$23.40/mo Part D Supplement. auto-pay, you choose from supplements, or, choose no supplement.

For Medicare Part B, you pay a deductible (i think it’s $180 this year.)

$2-hundreds - copays for prescriptions. copays vary for each prescription.
$0-?? - copays for doctor office visits. copays vary for each doctor, type of visit, etc.

i have not had ER visits or inpatient hospitalization .. not sure.

drug coverage gap.
this causes headaches. i thought i had this taken care of by buying supplemental insurances. nope.

so, there IS out-of-pocket, AND, there’s a lot of juggling. Medicare is not free.
you contribute during your working years, and, you continue to pay, after retiring.

those who receive Medicaid and food stamps, etc., those benefits represent a lot of money.
those who receive no “free” benefits, without substantial income, may easily “net” less at the end of the month, and, wonder why that is, how can that be? :?

this thread is about mitigating fraud.
to go along with that, i wanted to paint a picture of my experience with Medicare, esp to clarify the costs to recipients. i think my experience is common.

i feel sorry for doctors’s offices. the paperwork, trying to deal with so many different combinations of patients, insurances, forms of payments. it’s a wonder anything gets done.
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temporal1
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Re: How to reduce Medicare spending

Post by temporal1 »

It’s that Medicare Open Enrollment Time of Year, again, and, i think, lots of insurance companies offer Open Enrollment at the end of the year.

Motley Fool / 5 Changes for 2019 Social Security
https://www.fool.com/retirement/2018/10 ... -2019.aspx

My mind swirls with all the requisite minutia.
At the end of any year, i think there’s a net loss for beneficiaries between Soc Sec and Medicare.
It’s not easy to tell.

There is talk about COLA increases for Social Security recipients.
Welcome news, when there is an increase.

It’s never put in perspective with Medicare cost increases, which occur at the same time each year, and, are not negotiable. “Uncle Sam gives with one hand, takes away with the other.”

Hopefully, this move will help:
Drug Costs - Gag Clauses
http://forum.mennonet.com/viewtopic.php ... 912#p43912

Most retirees are not insurance actuaries, but, maybe we need to be. :-|
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Josh
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Re: How to reduce Medicare spending

Post by Josh »

Most retirees are not insurance actuaries, but, maybe we need to be.
This is indeed a big problem - the retirement industry is basically full of scams and frauds, with the excuse of the need for a “free market”.
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temporal1
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Re: How to reduce Medicare spending

Post by temporal1 »

2019 - i’m cautiously optimistic this year may go a little easier for me with Medicare. :)
i changed to a MEDICARE ADVANTAGE plan, which is quite different.
i don’t believe i’ll know if it’s a finacial improvement or not, maybe not until the end of the year.

it’s much less per month, BUT, i must save the difference, in case i need to use the deductible ..
of course, that’s unknown. i have not had such medical requirements, but, one never knows.
if i can save this year and next, and continue, then, i should be prepared.

i have to live it, and see how it goes.

But, today! :D
i needed a refill of (disposable needles for insulin, they are tiny!) the RX prescription copay was going to be $88, more than double from last year. 100, use one daily.
it’s not a lot of money for 3 months. but a lot out of my budget.

:idea: so, i thought. i’m going to call the pharmacy to ask for a less expensive brand.
i decided to internet search.
i found a different brand, $9.99, exact specs, and quantity. no tax. free shipping.
it does not require a prescription!
i ordered. they will arrive Thursday. if they don’t work, i have enough to get through.

why didn’t i look before?! :shock:

over years, not one doctor or pharmacist told me i could get these without prescription on the internet. maybe i can get them IN the pharmacy! i do not know.
another step on the healthcare obstacle course!
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Valerie
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Re: How to reduce Medicare spending

Post by Valerie »

My mother is thrilled with her Medicare and it seems to have improved for her. She had $0 out of pocket plus is given an amount every month that she can use to get things such as vitamins for free! My husband is on Medicare & chose Humana- so his Dr. Co-pay is $15 (half of mine, with my health insurance plan which I have an around deducted from my paychecks) and his transplant prescriptions are less than they used to be. It has caused me too almost look forward to Medicare.

Being a cashier in a drugstore I've had customers declare "Trump is going to cut Medicare" & they seem fearful.

Waste seems the biggest issue. What upsets me is seeing what most people purchase that lead to diseases that leads to higher costs for all. It is sickening how much junk people consume - refuse to give up! Or at least minimize. It's also amazing to me the junk food the food stamp card will cover!
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