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Title : Undue Advantage--The Washington Postal Service Calls For Medicare Wages Cuts

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Undue Advantage--The Washington Postal Service Calls For Medicare Wages Cuts

Tuesday's Washington Post had an editorial on the debate over whether HMOs should last paid to a greater extent than than Medicare receives for the same senior's wellness care.

Originally, the Congress decided to pay somebody health plans to a greater extent than every bit a agency to "prime the pump" to encourage both private wellness innovation insurers too seniors to turn over the novel Medicare Advantage plans a try. Both had to a greater extent than or less bad experiences inward the slowly 1990s when government payments to private Medicare plans sustained big cuts too both seniors too wellness plans fled the somebody programs.

Now, the health plans are disceptation the extra payments ought to last made permanent.

While in that place is a legitimate debate over simply how many years it should have got to equalize payments, The Post has it virtually right.

Undue Advantage

The House was correct to scale dorsum the insurance industry's subsidies for seniors.

Tuesday, August 21, 2007; Page A14

KAREN IGNAGNI, principal lobbyist for the health insurance industry, had an of import point. Testifying earlier Congress in 1999, Ms. Ignagni argued that private insurance plans offering coverage for seniors ought to operate on a "level playing field" amongst regular fee-for-service Medicare, nether which doctors are reimbursed straight past times Medicare. Back then, the somebody plans were existence paid less than what regular Medicare providers were making. Ms. Ignagni decried what she called the "fairness gap" too argued that the private plans "should non have disproportionately depression regime payments."

Times have got changed. Instead of existence paid less than somebody providers on the theory that they tin operate to a greater extent than efficiently, such plans, straightaway known every bit Medicare Advantage, are existence paid on average 12 percentage more. And Ms. Ignagni too her group, straightaway called America's Health Insurance Plans, are lobbying furiously to continue that, well, advantage.

Some of the coin is plowed dorsum into extra benefits to attract to a greater extent than seniors into the plans, too the lure is working: Close to ane inward 5 are straightaway enrolled inward somebody plans, which hit from HMOs to networks of preferred providers to the most outrageous too expensive organization of all, private fee-for-service plans, which terms a whopping xix percentage to a greater extent than than regular Medicare.

The extra spending -- to a greater extent than than $50 billion over the side past times side 5 years -- makes an already financially unstable Medicare program to a greater extent than expensive. It also unfairly raises premium costs for all seniors, who subsidize the extra benefits of those who sign upwardly for managed-care plans.

A mouth approved past times the House this calendar month would phase out the excess payments to Medicare Advantage plans too devote the savings to the State Children's Health Insurance Program, which provides coverage for children inward low-income families that earn every bit good much to qualify for Medicaid. The House would also move to a greater extent than or less of the savings to aid pay for changes inward the Medicare program, including extra aid for low-income seniors.

Defenders of the existing payment construction debate that patch Medicare Advantage plans may terms the regime more, the 12 percentage differential is inflated, too that flattening the rates would induce the plans out of existence. They debate that the plans, fifty-fifty if in that place is a higher terms to the government, lower overall health-care spending past times providing to a greater extent than preventive care. They also country that the plans render of import too otherwise unaffordable benefits to low-income seniors.

We grip that private plans tin play an of import too useful business office inward delivering practiced medical aid to seniors. But if the occupation is providing extra aid to low-income seniors, in that place are to a greater extent than efficient agency of doing therefore than overpaying Medicare Advantage plans for every senior, needy or not. And nosotros don't sympathize why the score playing plain the somebody plans ane time therefore avidly sought is straightaway non practiced enough.

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