Mitch McConnell and Healthcare

Sometimes I truly wonder how supposedly smart people can say the things they do. Take for example Mitch McConnell’s piece in today’s Herald-Leader.

“…..my bill returns the SCHIP program to its original intent: insuring low-income children.

While Kentucky runs a responsible program, that's not the case in every state. Many states have exploited a loophole in the law to divert their programs to cover adults instead of children. New Jersey, for example, spends nearly half of its CHIP money on adults.

No Senator, what is outrageous is that 46.6 million Americans are uninsured.

“The number of uninsured Americans reached an all-time high in 2005,” said Robert Greenstein, executive director of the Center on Budget and Policy Priorities. “It is sobering that 5.4 million more people lacked health insurance in 2005 than in the recession year of 2001, primarily because of the erosion of employer-based insurance.”

Senator you need not only to care for children, you also need to care for their parents.

McConnell refers to the “slippery slope toward government-run health care” and in the same article praises the “successful Medicare Advantage program”.

A fair assessment of the Medicare Advantage Program would also point out that:

Many advocates involved in representing Medicare Advantage plan care enrollees find that the system is fraught with difficulties. Beginning with the absence of clear explanations, and thus clear understandings on the part of enrollees, as to what services may be covered under what circumstances, to the concern of advocates that economic issues, rather than quality of care, guide some coverage determinations, the Medicare Advantage system can present great problems for enrollees. The requirements that enrollees use only the HMO's providers and that specialty care must be approved in advance are often viewed as disadvantages to the Medicare Advantage program. This difficult situation is compounded by an appeals system that is often vague and can involve frequent delays.

Another problematic area has been private insurance marketing activities. Although certain marketing techniques are prohibited, including the prohibition of activities that would mislead, misinform, confuse, or defraud Medicare beneficiaries, abuse by some companies has been an ongoing problem. Unfortunately, the regulations provide no direct remedies that the beneficiary subjected to prohibited marketing activities may pursue.

On the other hand, there are some advantages for HMO enrollees. For many enrollees, deductibles or coinsurance payments are reduced or eliminated. In addition, there are no claim forms to be filled out and some plans offer benefits not covered by Medicare.

Each year, many Medicare Advantage plans have decided to withdraw entirely from the Medicare market due to insufficient profits. Under current law, HMOs may decide each year whether to offer a Medicare plan and may discontinue the plan after providing their enrollees with written notice 60 days prior to termination. The closing of plans in many areas of Connecticut and the nation has been frightening and confusing for enrollees.

These uncertain circumstances, variations in the services that a plan may offer, and the charges that plans may impose point out how important it is for a prospective enrollee to examine carefully the benefits and costs of the services offered by the HMOs. A comparison of these benefits and costs with the original Medicare program, combined with coverage from a Medicare supplemental policy (Medigap), should be conducted before enrolling in a Medicare Advantage plan.

Medicare beneficiaries of modest means should also carefully review eligibility for the Qualified Medicare Beneficiary Program (QMB) and Connecticut's prescription drug program (ConnPACE) as a possible alternative to Medicare Advantage enrollment.

But the bottom line is this. There are over 46 million people that do not have adequate health care in this country. A single payer health insurance plan would address that problem.

Senator McConnell do you have another solution?