Medicare Cuts Aborted, Funds Restored

At least the Senate did one thing right today. It passed the bill to restore Medicare funding that the House passed in June. And, it's veto-proof.

The vote was 69-30 -- "a veto-proof margin," said Paul Precht, spokesman for the nonprofit Medicare Rights Center. Pres. Bush had threatened to veto the bill if passed.

The cuts went into effect July 1. They included an $1,800 cap on outpatient physical, occupational and speech therapy.

I know about this because this weekend I got a letter from the TL mom's nursing home saying that her therapy would end July 1 unless she agrees to pay 100% of the cost due to the Senate not getting its act together before the recess to pass the House bill that would extend the deadline for the cuts to take effect. It failed to pass the bill then by one vote. The cuts were passed in 2005 but every year Congress has voted to extend the date the cuts take effect.

Other aspects of the bill: [More...]

This bill would allow people in Medicare to maintain access to their doctors, improve benefits for low-income, prevention, and mental health programs, and boost quality through national e-prescribing.

This bill is why Ted Kennedy was in the Senate voting today. Thanks, Sen. Kennedy. And if you want to see the list of the worst 30 Senators in Congress, those who voted against the bill, here's the offical vote tally.

Press releases are flying through the Internet with everyone, from drug companies to advocacy groups to doctors organizations praising the bill. Every member of congress who voted for it is sending out a release letting their constituents know they supported it. Here's one from Sen. Harkin, Rep. Stephanie Tubb Jones and Sen. Obama.

This doctor in TN is already castigating her Senators for voting against it. Here's the American Diabetes Association. Another from the National e-Prescribing group and one from the National Rural Health Initiative. One from the angioplasty folks.

What got this bill passed? I'd say lobbying by all these groups. While researching it this weekend, every group from the American Heart Association to the AARP to a major organization dealing with strokes had lobbied Congress. Lobbying isn't always a bad thing.

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    I cannot wait to tell my very republican doctor (5.00 / 1) (#1)
    by athyrio on Wed Jul 09, 2008 at 06:23:17 PM EST
    that he needs to be grateful to Teddy Kennedy for not cutting his prices lol....He will choke I am sure...:-)

    hehehe (none / 0) (#4)
    by andgarden on Wed Jul 09, 2008 at 06:26:46 PM EST
    I know someone that (none / 0) (#36)
    by splashy on Wed Jul 09, 2008 at 09:42:54 PM EST
    Tried to blame the Dems for the cuts that were coming, and when I said it was enacted originally when the Repubs were in power he said "well, why don't the Democrats stop it?" He is a surgeon.

    Did my heart good to be able to post that they did, with the help of a few Repubs!

    He was complaining about it, because he's against universal health care. He claims we just need to go back to everyone paying and cutting out the insurance companies, as though that's going to help those that are suffering because they can't pay! He's all "well,they can work something out with the doctors" as though the doctors are going to go for that with people that don't have two dimes to rub together, not to mention the humiliation of having to beg for care.


    I was watching when he made his entrance (5.00 / 1) (#2)
    by andgarden on Wed Jul 09, 2008 at 06:25:24 PM EST
    as soon as I realized who it was, I had to giggle. Reid and Schumer played the Republicans on this one--they had one more vote than they did last time, and didn't let on.

    I Was Waiting For This Post (5.00 / 1) (#3)
    by JimWash08 on Wed Jul 09, 2008 at 06:25:47 PM EST
    With health care and medicine (and of course politics) being subjects of great importance to me professionally and personally, I was really happy about the outcome today.

    But this war will never be over. Not at least for another couple of years. Bush has threatened to veto the passage of the bill, so what's new?

    At least Obama had the sense to do the right thing on this one, and I'm so happy that Clinton, both MI Senators and of course, T-Kennedy (he has won back my respect, partly at least) voted for it too.

    Supposedly veto-proof majorities, but if there's a (none / 0) (#12)
    by jawbone on Wed Jul 09, 2008 at 06:53:03 PM EST
    revote can always return to their fealty to Bush the Unworthy.

    IIRC, re: children's healthcare, the Repubs actually did exactly that on the last revote. (Some of them voted for it before they voted against it, heh.)


    Medicare cannot be fixed (5.00 / 2) (#16)
    by caseyOR on Wed Jul 09, 2008 at 06:59:58 PM EST
    until we fix the big problem of healthcare for all. Medicare payments are not wildly out of line with prevailing costs. In fact, many doctors will not treat Medicare patients because the payments are so small.

    Bush and the Republicans are trying very hard to kill Medicare. Just take a look at the Medicare Advantage program. That program funnels Medicare recipients into private insurance plans that cost the Medicare program a whole lot more money than traditional Medicare. One of the reasons Bush is threatening to veto the bill passed today is that this bill will pay for the reinstated services by taking the money that subsidizes Medicare Advantage.

    Universal Health Care is the solution.

    Republican cowards (5.00 / 3) (#20)
    by Steve M on Wed Jul 09, 2008 at 07:16:51 PM EST
    They filibustered this bill by 1 vote because Sen. Kennedy wasn't able to be there.

    Then the vote was rescheduled, and Sen. Kennedy showed up to cast the missing vote - and suddenly NINE Republicans switched sides and voted to end the filibuster, to try and prevent the Medicare vote from being used against them.

    I sure hope the Democrats manage to use it against them anyway.  They filibustered it once and only switched sides once they realized they would lose.  Sleazy.

    Schumer was on the floor today and he (5.00 / 1) (#23)
    by andgarden on Wed Jul 09, 2008 at 07:24:31 PM EST
    looked giddy. He knows how to use this.

    I don't know why but (5.00 / 1) (#29)
    by nycstray on Wed Jul 09, 2008 at 07:51:05 PM EST
    Schumer was on the floor today and he looked giddy.

    that totally cracked me up. Maybe it was the image that flashed in my brain. Schumer is kinda cute when he's giddy  ;)


    Steve M, (5.00 / 1) (#25)
    by clio on Wed Jul 09, 2008 at 07:31:19 PM EST
    You have a list of Rs who were for medical care for the aged after they were against it?

    I can make one (none / 0) (#28)
    by Steve M on Wed Jul 09, 2008 at 07:50:44 PM EST
    Alexander (R-TN)
    Chambliss (R-GA)
    Corker (R-TN)
    Cornyn (R-TX)
    Hutchison (R-TX)
    Isakson (R-GA)
    Martinez (R-FL)
    Specter (R-PA)
    Warner (R-VA)

    Alexander, Chambliss, and Cornyn are up for election this year.  Just sayin.


    I don't trust them on the revote (after veto) n/t (none / 0) (#39)
    by jawbone on Wed Jul 09, 2008 at 10:29:59 PM EST
    Just promise Arlen Specter more (none / 0) (#40)
    by Rhouse on Wed Jul 09, 2008 at 11:44:15 PM EST
    money for oncologists and he'll vote for it.  It's been a pet project of his to raise the rates of reimbursement for these Doctors ever since his first bout with cancer.  To be honest, my  Oncologist is worth every penny my health insurance pays him, I just don't think his medicare reimbursement rates should derail this bill.  (See what happened with Specter the first time around - arrgh now I can't find the link.)
    Anyhow he almost help scuttle this bill in favor of higher payments to just Oncologist.

    this is really picky, but (5.00 / 1) (#27)
    by denise k on Wed Jul 09, 2008 at 07:44:57 PM EST
    shouldn't the title be Medicare "Funding" Restored?  or something like that.  The "cuts" have not been restored, they have been reversed.  The money has been restored.  

    just sayin'...

    good point (5.00 / 1) (#32)
    by Jeralyn on Wed Jul 09, 2008 at 07:58:42 PM EST
    I'll fix it

    what needs to be done is to take the insurance (5.00 / 3) (#30)
    by athyrio on Wed Jul 09, 2008 at 07:55:53 PM EST
    company costs out of the equation...then by eliminating "the middle man", and everyone paying into one universal health care coverage, you would see the costs go way down...

    in payments to doctors will be funded by eliminating bonus payments to private insurance companies for Medicare Advantage.  These so called "competitive marketplace" programs receive 13% higher payments than regular Medicare for exactly the same services and are allowed to cherry-pick both their markets and their patients.

    Like the Medicare prescription drug program, which forbids the government to use competitive bidding to reduce drug prices, Medicare Advantage plans are direct transfers of tax dollars to private corporations.

    This bonus program has been a windfall of profit for the insurance industry for which they have not provided even as much service as government run Medicare does.

    I'd have to disagree w/some of these points (3.00 / 1) (#35)
    by vicndabx on Wed Jul 09, 2008 at 08:43:06 PM EST
    While various incentives are offered, there is a certain amount of adminstration that goes into private insurers offering these plans as well as increased risk due to the population.  Those costs should be covered.  In addition, these programs also offer beneficiaries the ability to stay with certain doctors once they for example, move from their current health insurance while working to that which is available when they retire.  Not all private doctors participate in the Medicare program and accept assignment.  Consequently, some beneficiaries would lose their current doctor and be forced to choose a new one once Medicare-eligible.  Re: services offered, it makes sense to give folks the ability to choose the type of coverage they need (thus offering the potential for savings) vs. pigeon-holing everyone into the same coverage.  Most plans however offer the same if not better coverage than that offered by Medicare (they often include prescription drgu coverage, for example.) While there are I'm sure some plans out to gouge beneficiaries, not all do it.  Full disclosure, I am employed by a private insurer who offers such programs.

    I have to disagree with you (5.00 / 1) (#41)
    by SamJohnson on Thu Jul 10, 2008 at 12:47:36 AM EST

    You just made a sales pitch based on the needs of  companies such as yours selling such plans, not on behalf of quite a large percentage of people who rely or who should be able to rely on Medicare. Well, if McCain is elected President and Republicans still have any power in the House or Senate, as McCain said today, we'll put everything on the table and fix that nasty social security system that those poor 21 year olds have to pay taxes into.

    Tell me which plans offer a reasonable amount of coverage (say, over a $2,500 cap on medications) that people with chronic illnesses or disabilities can chose from. For people with chronic hepatitis C or HIV, to take two of many examples, almost every offered plan doesn't cover anything near adequate coverage. And since many states (check out those of the Senators who voted against this bill) leave indigent and soon to be indigent people to try to get on Medicaid (or SSD - have fun waiting at least 18 months for that after your first few perfunctory denials) which is only available for children in many "red" states, these plans know full well they are cherry picking a group of people based on actuarial tables and disease progression staging.

    I could just set up a warehouse of generic diabetes drugs, for example, and sell a plan that "specializes" in covering people with diabetes. The original Medicare Part D program was an extremely generous gift to both large and small businesses, at the expense of people who are the cost drivers of health care costs - the elderly, chronically ill and those who need expensive treatments for rarer diseases.  The Director of CMS and this ahole President can't leave soon enough.  


    First off, I didn't make a sales pitch (none / 0) (#43)
    by vicndabx on Thu Jul 10, 2008 at 11:16:25 AM EST
    I'm not in sales at all.  I'm in Electronic Data Interchange (EDI).  I'm in the area responsible for automating receipt and delivery of eligibility, claims and payment data to/from payers/providers.  I've worked for both private insurers and gov't contractors that process Medicare claims, and yes, there are plans that provide the coverage you ask about.  I'm not going to argue the pro/cons, morality & motivations of either my company or any other insurance company for that matter.  All I will point out is that as someone who has some experience dealing w/all sides (providers, payers, and beneficiaries/subscribers) I will tell you the insurance company is not always the bad guy.  I know it's easy to scapegoat the big insurer, but if we are truly serious about fixing healthcare, every aspect of healthcare needs to be looked at.  I was trying to make a point about how we shouldn't always believe what we hear when it comes to politicians and healthcare.  I also hope you don't think Medicare is free and not w/o it's own limitations/caps/hoops to jump through, cuz it ain't.  Even if everyone is on Medicare, significant improvements outside of the payer's system need to be made to cut down on the administrative costs associated w/healthcare - or you'll just have the same issues w/have today albeit w/a single, large payer.  An example - a doctor's office w/staff who calls insurers (or Medicare for argument's sake) all day verifying coverage can see significant long-term savings if they automate the process using EDI.  Does every doctor's office do this?  No, because there are initial setup costs to do so, and to be blunt, some doctors don't want to pay these costs.  In addition, the insurer needs to pay for folks to answer the phone when the doctor calls.  So yes, you can setup a plan but how are you going to give out your subscriber's enrollment data?  How are you going to let a doctor know his/her claim was paid?  What if the doctor has a question about a specific drug's coverage?  Offering a plan to a certain demographic is nice as long as you can do things to make it affordable.  Affordability is not simply how many people pay into the pot.   Affordability involves reducing the overhead associated w/providing coverage and receiving care.

    Oh and btw, I have Type 1 Diabetes - which as you've pointed out require long-term, maintenance drugs.  So my interest here is not simply to put more money in the insurance company's pocket (although I would like to keep my job - another consideration for the many folks who have jobs in healthcare and thus contribute to the economy.) So your plan might work for me - as long as the premiums & copays are less than what I'm paying now.


    Like I said (none / 0) (#45)
    by SamJohnson on Thu Jul 10, 2008 at 02:16:53 PM EST
    Name the plans. Thanks for your perspective. If, instead of eliminating nurses and other health care professionals from their offices and institutions in response to rising health care costs the federal government actually created several hundred thousands decent paying jobs for case or entitlements managers I'm not so sure we'd need more than a single payor system. But I guess that whole hospital based management scheme where CEOs stole tens of millions of dollars might have demonstrated that there was big money to be had and no Republican was going to turn up that option.

     Several non-profit agencies are testing out this concept now, although the push is more to eliminate coverage of case management services covered by Medicare than to actually address what the true driving costs of the system are. I just don't agree with the concept that the delivery of health care services should be outsourced to for-profit companies, competition amonsgt whom is supposed to create an environment where costs are reduced and passed on to "consumers".  What happens is that those running the business just think of ways to pay their executives higher salaries. With such large government subsidies, why would efficiency lead to reduced costs for consumers? It doesn't. It just leads to fewer companies who won't completely walk away from the "market".

    For at least the last twenty years health care has been a commodity that is traded on the stock market. That idea does not work so well. That's why we will never be able to reduce health care costs. Applying Bush style corporate approaches to the health care system is a huge crock of pay for what you can afford and get what you can pay for.

    We'd probably get the same level of services while reducing overhead by making Medicare management part of the Faith-based initiative, or at least issuing RFAs for non-profits.


    Like I said, (none / 0) (#47)
    by vicndabx on Thu Jul 10, 2008 at 03:22:37 PM EST
    I'm not going to get into a tit for tat over which plans offer what - I really don't have the time.  Nor will I name any plans my own company offers as I am commenting as a private citizen here.  I will tell you (if you are looking for this info for your own purposes) you can go to this site sponsored by CMS and do your own research for Medicare replacement coverage plans currently offered.

    Your comments illustrate that you have bad information when it comes to the current state of healthcare and how it is delivered.  Healthcare providers (i.e. nurses, doctors, therapists, etc.) aren't being laid off (at least in my city/state).  Indeed, healthcare providers such as nurses are in high demand.  Have you seen those Johnson & Johnson "be a nurse" commercials?  Administrators; i.e. office people, those who's work can be done using an electronic transaction, maybe.  Coincidentally, regarding the case managers you refer to - there's an EDI transaction called a ANSI ASC X12 278 that contains the information case managers write up or call in.  So maybe that's why you've seen them getting laid off.  They're still needed, but as hospitals and docs move to these transactions, their need becomes diminished - this is an example of the admin overhead I referred to in my prior post.  Healthcare is actually one of the few industries you can get a job in right now provided you have the right skill set.  

    You say,

    But I guess that whole hospital based management scheme where CEOs stole tens of millions of dollars might have demonstrated that there was big money to be had and no Republican was going to turn up that option.
     That's a hospital mgmt issue, not an insurance company issue.

    You also state

    I just don't agree with the concept that the delivery of health care services should be outsourced to for-profit companies, competition amonsgt whom is supposed to create an environment where costs are reduced and passed on to "consumers".  What happens is that those running the business just think of ways to pay their executives higher salaries. With such large government subsidies, why would efficiency lead to reduced costs for consumers? It doesn't. It just leads to fewer companies who won't completely walk away from the "market".
     OK, I understand you don't agree w/outsourcing to private companies, that's your opinion and won't argue w/you about it.  However, I will say that Contractors that do this type of work and offer plans on behalf of the federal government are subject to rigorous RFP/bidding processes w/the gov't choosing the most cost-effective bidder.  The company is given a set amt of $ to handle the contract and is required by law to use that $ solely for the gov't's business.  Don't matter if you find out later that you don't have enough $ to do the work (e.g. a mandated change occurs and you need to pay employees overtime to make system changes in time for a deadline,) too bad, you have to do it anyway.   You do it w/no addt'l funds from the gov't.  It is actually not profitable to do this type of work because of this.  There are a lot of companies that are actually getting out of contracting for the gov't because of it.  Companies do it anyway because there are obvious public perception gains to be had (see earlier comment about the big-bad insurance company.)

    Again, not trying to downplay your experiences or prove I'm right and you're wrong.  I just feel the need to try to dispel myths so we can have an honest dialog as citizens.  Thanks for your feedback.


    Thanks (none / 0) (#51)
    by SamJohnson on Sun Jul 13, 2008 at 04:00:46 AM EST
    We could debate this a while. When the skills set required by a clinician becomes electronic processing of records, the ten to twenty year gap in actually having had to develop those skills makes it very difficult to hire clinicians. It's the big push of CMS and the feds these days and it's not going to happen overnight.  In my state healthcare providers are being laid off at a very alarming rate, and no one is applying for the jobs with the new descriptions on the skill sets required. I had a 60 year old doctor drain a stomach infection in a hospital side room because he nor anyone on staff knew how to bill for it to get reimbursement at the level required by the insurer's guidelines. It contradicted years old SOP for that condition.  

    A case manager who knows how to bill can draw higher salaries than many clinicians. Then again, in Alabama and Mississippi, for example, they are advertising worldwide for clinicians because no American ones will work under the new reimbursement environment. I think the answer is going to be a little bit of everything and a far steeper learning curve that anyone wants. But bclaims adjusters, billers and their electronic support staff have become quite the guild. That's all I have to say about that.


    If everyone was covered with Medicare (none / 0) (#38)
    by splashy on Wed Jul 09, 2008 at 10:02:41 PM EST
    Or something like that, many of those problems would go away.

    Of course, you might have to change jobs, or alter your job description somewhat.


    Is the $1800 cap in effect or not in effect? (none / 0) (#5)
    by Saul on Wed Jul 09, 2008 at 06:30:35 PM EST

    It went into effect July 1 (none / 0) (#8)
    by Jeralyn on Wed Jul 09, 2008 at 06:42:52 PM EST
    but the nursing home letter said not to worry if Congress acts within the next two weeks. So I guess they did not go into effect.

    Thanks, my wife will be glad to hear this (5.00 / 1) (#10)
    by Saul on Wed Jul 09, 2008 at 06:47:54 PM EST
    She is an Occupational Therapist.  She see patients daily  at their homes through home health agencies  which are 90 percent Medicare supported.

    My 90 year old mother (none / 0) (#19)
    by clio on Wed Jul 09, 2008 at 07:11:44 PM EST
    just had her second total knee June 2.* Since she had her first knee done in November she's was in 3x/week PT December through May. If this bill had not passed she could not have had any rehab/PT, which is the reason she's walking so well, for this second knee replacement until December.  

    Fortunately it did and the $1800 cap has been rescinded for separate procedures done in the same 12 month period or if the patient can make further progress in therapy.  This allows for individual evaluation, personal medical circumstances and professional judgment.  Imagine that!

    *(This operation and recovery was much easier  than the first one.  Experience.  Now that I really know how to do it we're out of knees.)


    It would be really good if (none / 0) (#6)
    by RalphB on Wed Jul 09, 2008 at 06:32:04 PM EST
    instead of going on about SS being in crisis, we could acknowledge the very real problems with Medicare.  These are the problems that have to have solutions and in the next few years at the latest.

    The problem is that it isn't universal (5.00 / 1) (#37)
    by splashy on Wed Jul 09, 2008 at 09:57:22 PM EST
    If everyone was included, there wouldn't be a problem, since the healthy would be contributing.

    i'm not surprised the AARP is praising this... (none / 0) (#7)
    by john b on Wed Jul 09, 2008 at 06:34:29 PM EST
    These bills always seem positive when they pass (who doesn't like e-Rx's, mental health, and higher MD payments?), but they are going to bankrupt our government's entitlement spending eventually.  Medicare is entirely too expensive and growing too quickly.  This is irresponsible spending.  At the very least they need to curb Medicare's growth if they aren't going to cut the spending.  

    It's one thing to provide a permanent fix (5.00 / 4) (#9)
    by Jeralyn on Wed Jul 09, 2008 at 06:44:17 PM EST
    that would be great. It's another to cut off life sustaining services to the elderly and poor while you're dickering over how to fix it.

    it's like building a dam... (none / 0) (#13)
    by john b on Wed Jul 09, 2008 at 06:54:01 PM EST
    ...in New Orleans.  You can keep building it up to stave off the threat of immediate deaths, but eventually, the whole thing will collapse and kill everyone.  Congress needs to stop patching the funding holes and fix it for good.  And btw, if these bills actually focused all the $$ on the needy, I wouldn't be against them.  But they don't.  There's some $$ for the needy, sure, but a lot of it is only exacerbating other problems.    

    The Dutch have built excellent dikes and dams== (5.00 / 1) (#15)
    by jawbone on Wed Jul 09, 2008 at 06:56:15 PM EST
    Europeans also do excellent universal healthcare. There are variations, but they all have universal care.

    At far less than we pay.

    We need some European engineering and healtcare plans!


    Want to ensure the solvency of Medicare? (5.00 / 3) (#11)
    by andgarden on Wed Jul 09, 2008 at 06:52:43 PM EST
    Support a plan that would let everyone, regardless of age, buy into the program. Of course, if your agenda is to destroy Medicare, you'll just complain about how it's going bankrupt.

    your solution doesn't make it solvent... (none / 0) (#14)
    by john b on Wed Jul 09, 2008 at 06:56:06 PM EST
    ...you'll only accelerate the collapse of our welfare spending.  Unless we control it's rate of growth, putting more people under it only makes things worse.  I am against Medicare, but I'd prefer that if we decide to stay with it (which is almost certain), that our solutions actually help it.  

    Of course it would (5.00 / 3) (#18)
    by andgarden on Wed Jul 09, 2008 at 07:03:23 PM EST
    If you let all age groups buy in, you'll get many more healthy participants who won't need expensive coverage.

    But since you don't support Medicare, an actual fix is not an option for you.


    All age groups ARE buying in.... (none / 0) (#21)
    by john b on Wed Jul 09, 2008 at 07:20:44 PM EST
    ...through their taxes.  While young ppl certainly won't cost as much as the elderly, they'll still add some costs, without adding more $$ than they already are to the system (most ppl still pay for healthcare in some way or another, which goes to the same places...hospitals, MD's, etc. as current Medicare payments).  And you still haven't cut Medicare's rate of growth.  That is all that matters.  It's a compound-interest problem.  If something grows faster than inflation, it will be a problem sooner or later.  Obviously, I'm as invested as everyone else.  Medicare is here to stay.  In any case, no matter what my preferences are, the math doesn't lie.    

    If Medicare acts as an alternative (5.00 / 3) (#22)
    by andgarden on Wed Jul 09, 2008 at 07:23:57 PM EST
    to private insurance, with anyone allowed to buy in at a reasonable rate, most will almost certainly put in more than they take out. Ideally we'd make it mandatory, which is why Social Security works.

    if that were true... (none / 0) (#24)
    by john b on Wed Jul 09, 2008 at 07:29:27 PM EST
    ...Medicare wouldn't be in trouble now.  We have a huge amount of everyone's taxes funding it as it is, and it's costs keep rising.  In other words, it has plenty of funding, but it's rate of cost growth is out-stripping our ability to pay for it.  If you add people, even if that were to add more funding (which studies have shown it won't, check Thomas Saving's book on Medicare funding), that funding would dry up as the cost continued to grow at a faster-than-inflation rate.  SS is different since it's just a pay-out - it isn't sensitive to technology, drug innovation, hospital costs, etc. like Medicare.  

    It sucks that humans get sicker as they get older (5.00 / 3) (#26)
    by samtaylor2 on Wed Jul 09, 2008 at 07:39:46 PM EST
    Just push them out on a glacier

    Did you call (5.00 / 3) (#33)
    by Molly Pitcher on Wed Jul 09, 2008 at 08:15:00 PM EST
    medicare welfare spending????????????

    I didn't mean it in a critical way... (2.00 / 0) (#34)
    by john b on Wed Jul 09, 2008 at 08:21:15 PM EST
    ...simply that Medicare spending falls under the umbrella of the welfare safety net.  

    Medicaid (none / 0) (#46)
    by Molly Pitcher on Thu Jul 10, 2008 at 02:31:13 PM EST
    is the welfare safety net.  Is not Medicare more along the lines of SS--prepaid, etc.  Monthly premiums for B, I think it is, are nearly $100.  Now that Congress has cut the cuts, people at the lowest income level will have help covering the deduction. Though if you believe SS is welfare, then so is Medicare, I suppose.

    i guess this is more a semantic argument... (none / 0) (#48)
    by john b on Thu Jul 10, 2008 at 04:47:59 PM EST
    ...than anything.  Medicare has pay-as-you-go aspects, and it has redistributive aspects.  

    I have an elderly neighbor who is on PT for her (none / 0) (#17)
    by jawbone on Wed Jul 09, 2008 at 07:03:07 PM EST
    second foot's neuropathy leading to what used to be called a club foot.  She was diagnosed with diabetes about 8 years ago, initially controlled sugar levels with diet, now does so with diet and pills.

    The scary thing is she never had terribly high blood sugar levels--yet 3 years ago she lost control of her right foot. The tingles and odd feelings, occasional pain of neuropathy started afer just a couple yeasr. She went through two rounds of PT for the right foot and did gain enough muscle control to continue driving and walking, with a brace. Now, the left has gone.

    Her doctor says he can't explain why she's had so much nerve damage--but diabetes is a miserable and dangerous disease.

    She's a tenacious and tough woman, does her home exercises, and works really hard to make the most of the PT. Thanks goodness she can continue.

    i guarantee you (none / 0) (#42)
    by cpinva on Thu Jul 10, 2008 at 06:53:57 AM EST
    the republicans will shout that this actually constitutes an increase in medicare funding, much as they asserted that the failure to reduce tax rates actually resulted in an increase in taxes. those spendthrift democrats are at it again!

    vaporized (none / 0) (#50)
    by Jeralyn on Thu Jul 10, 2008 at 08:19:17 PM EST
    the account, thanks.