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Healthcare IssueHealthcare is currently ranked as the number 3 issue for our nation - after security and the economy! Healthcare costs have been skyrocketing each year, why? It’s not the actual cost of the care being provided but instead the profit motivation of the healthcare system; loaded with middlemen, kickbacks, and price fixing. Here are a few of examples:High Administrative CostsExpensive Testing and Treatment MethodsHigher Wages for Specialists, Doctors and NursesCosts of “Defensive” Medicine - the overuse of tests and procedures because of fear of malpractice litigationHospitals’ new business model: price gouging and predatory billing Costly Prescription DrugsPharmacy Benefit Managers (PBMs) are paid commissions and kickbacks. (Why are drugs that have been around for 50 years now spiking in price?)Pregnancy Crisis Centers – giving impressions that they are medical centers! But in reality, there no healthcare providers – only preachers hired by tax payer’s moneyFor centuries, medicine was based on an intimate relationship between doctors and patients. But behind the scenes, a gigantic industry emerged: buying, selling, and trading our medical services. Healthcare stakeholders are playing a game, marking up the price of medical care, then secretly discounting it to health insurance industry. The result is a bloated medical-industrial complex where a lot of stakeholders are reporting record profits. In an?analysis published recently, it was found that 48% of all spending by the U.S. federal government now goes to healthcare in all its hidden forms. Dr Martin Makary asks: have you ever wondered how it is that academic medical centers are the bastion of scientific genius, yet no one can give you a simple price? Not only that, but hospital billing practices are intentionally difficult to understand, and payment is aggressively pursued. Johns Hopkins began a?series of studies on hospitals billing practices and they learned that one-third of hospitals in one state had sued patients, some very aggressively. NPR followed up with stories on “when hospitals sue for unpaid bills”. The stories are heart breaking:In New Mexico, a hospital had sued Jennifer, the mom of four children, two with special needs. The hospital garnished her meager paycheck for an unpaid medical bill from a hospital-acquired infection. She made too much to qualify for Medicaid and was afraid to approach her doctor about the bill!A waitress in VA, explained how she had her paycheck garnished by the local hospital after experiencing some morning sickness, causing her to go to the hospital during a pregnancy 7 years ago. A single mother of three kids, she had to take a second waitressing job to put food on the table.One-third of women in the U.S. with stage 4 breast cancer report being harassed by medical debt collectors. Hospitals are not car dealerships, but Republicans believe the same free market principles apply; why else would they deregulated hospitals (HB21). So many Americans may have their injuries treated but their lives ruined! Should billing quality be as important as medical quality? Should there even be billing at all? This brings us to the next issue: “Medicare for all” or “Single Payer”? This short piece doesn’t allow us to dig into pros and cons of each model – but it gives us an opportunity to briefly tell you about 2020 Medicare Advantage plans, its rising costs, and the confusion about billing practices.THE BIGGEST LIE TOLD BY THIS ADMINISTRATION “Trump Administration drives down Medicare advantage and Part D for Seniors”In actuality, the standard monthly premium for?Medicare?Part B?is?projected to hit $144.30, an increase of $8.80 in?2020, based on initial figures from?Medicare's?trustees, according to this article in The Wall Street Journal. And most clients saw their?Medicare?Part B premiums rise to $135.50 from $134 from previous years.While premiums and copays go up for Medicare beneficiaries on Medicare Advantage plans, their benefits have actually decreased. Table 1 illustrates Aetna Medicare Advantage plan changes for 2020.Table 1 – Aetna Medicare Advantage Plan ChangesITEM20192020Ambulance Services - CopayYou paid $250 You will pay $260 Dental Services - AllowanceYour benefit was $900Your benefit will be $750Diagnostic Lab – Copay$0 for each test$2 for each testDiagnostic Rx – CopayYou paid $50You will pay $125Primary Care – CopayYou paid $0You will pay $15Vision Eye wear – AllowanceYour benefit was $300Your benefit will be $150A 2018 law and new CMS regulations allow Advantage plans to offer different bells and whistles and charge different cost-sharing to enrollees with certain health conditions.Part D enrollees can still face hefty out-of-pocket costs that vary significantly from plan to plan. And people with high drug costs face an addedchallenge next year: The total out-of-pocket spending required to reach “catastrophic” jumps to $6,350, up from $5,100 in 2019.For decades Democrats have fought for the simple idea that everyone should have some basic security in health care. In 1965, when President Johnson signed Medicare into law, we were able to provide that security to America’s seniors. In 1997, Democrats passed the Children’s Health Insurance Program (CHIP), which currently covers 8 million kids.In 2010, despite unanimous opposition from Republicans, Democrats were finally able to pass comprehensive health reform into law. With Affordable Care Act, discrimination based on pre-existing conditions became illegal and more than 20 million Americans gained healthcare coverageOnce again, Americans look to Democrats to solve the healthcare crisis. As Republicans talk about how to finance the broken healthcare system, Democrats talk about how to fix it! ................
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