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WASHINGTON — The Trump administration is signaling it will pursue significant changes to Medicare that could put beneficiaries on the hook for higher costs.

In an informal proposal on Wednesday, federal health officials hinted at several new pilot programs it may implement in the months ahead. One idea would give doctors more latitude to enter into so-called private contracts to charge Medicare beneficiaries more for certain services, if the patients were willing to pay. Elsewhere in the document, officials indicated they might offer more incentives to encourage beneficiaries to join private Medicare plans, known as Medicare Advantage plans. Democrats and other experts said the language suggested interest in the controversial “premium support” model long favored by Republican policymakers.

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    • Sorry but you do not know how Medicare works. Almost everyone gets Part B, the first supplement (that is literally Part B ‘s name). Almost everyone with that supplement also supplement A and B with C or private insurance. Almost everyone with private insurance supplements that with Part D. Some also add dental insurance.

  • CMMI, as described in this article, is a “slippery slope” in terms of coverage and cost to the individual. Too little has been done regarding non-pharmacologic health prevention and maintenance, thus increasing overall expense of and need for health care. We need to discuss and to determine if we, as a society, can find consensus on whether or not healthcare is a right or a privilege. Personally, if one has a religion or a philosophy that includes caring about others, how can we not care for those who need help with healthcare? This is a huge question, but needs to be given our fundamental attention to move off of dead center and away from remedies that are fragmenting and complicating healthcare and payment for same.

  • Terry
    You must be ignorant of how insurance works (in addition to a person with no ability to discuss issues and therefore only able to write cute street protester signs). The fact that you have had no trouble with Medicare is meaningless. Insurance works on averages. Medicare is so bad that 98 percent of us on Medicare have bought two, three or more mostly private policies. If you are part of the 2 percent who have not you are either very rich or very fool hardy

  • Medicare is a great program. Congress does not need to touch it. Today, all people aged 65 are eligible. Congress needs to make Medicare available to everyone. Let each individual purchase their own supplement coverage.

  • I am opposed to further industrializing, privatizing medicare, especially anything that removes caps on medical billing. If people are primarily focused on making money let them go into banking, real estate, armaments, etc and not into exploiting the elderly , and disabled. If anything I think we need to move more into nationalized health care.

  • I have not read the HHS requests for comments but this article seems to lack a total understanding of how United States Medicare works today. Not that anyone would read this leftist web site for information about Medicare if they were in their early to mid 60s and about to sign up for Medicare, but ignore this article in terms of actually learning anything. It is scary that leftist political ideologues like this writer depending on the deplorable leftists at Brookings, the Medicare Rights Center and the Center for Medicare Advocacy can twist facts that might harm seniors in this way.

    For example, nothing puts beneficiaries more “on the hook for higher costs” than just plain old current Original Medicare, passed by LBJ in 1965 and changed little since then. It has very high co-pays and deductibles, lifetime and per-incident limits on how much financial protection is provided, and no annual out of pocket spending limit in addition to the many things not covered at all.

    As for the private contract capability, if “the patients were willing to pay,” that is totally their choice. The proposal described here seems little different than today’s rules described in “Medicare and You, 2018” except that the Globe propagandist in his or her ignorance seems to be totally conflating current Medicare private contract rules with 50-year-old Medicare balance billing rules with the 20-year-old networking rules of Managed Medicare. These are three different subjects. Most important, no one on Medicare is “on the hook” for anything unless they choose it and almost everyone on Medicare (98%) already chooses something else other than Original LBJ Medicare itself because Original LBJ Medicare itself is such bad financial protection and limits the services it covers so much (as described in the paragraph above)

    The Globe propagandist’s opinion that “the language suggested interest in the controversial premium support model” is absurd. There is nothing controversial about premium support. Almost everyone in the United States today — whether Medicare age or younger — except a relatively few people percentage wise on Original LBJ Medicare have their health insurance paid for by the “premium support model.” Premium support in the Medicare context was “invented” by two Democrats in 1995 and signed into law by President Clinton in 1997. There is absolutely nothing new or controversial about it. The premium support portion of Medicare is now the most popular choice with over 50% of the people today fully signing up for Medicare for the first time choosing the premium support model

    And “value based purchasing of prescription drugs” is considered a Democratic Party idea.

    Globe, please hire someone that knows something about Medicare to write articles about Medicare.

  • And anyone who thinks we should entrust our health care to government management, is either insane or deeply invested in Democratic political power.
    They only want GASP (govt as single payer) to convert millions of private sector free market insurance/billing workers to public union dues payers, reliable Democratic voters forever. Dammm the results, full speed ahead.

  • If this administration is really serious about supporting small business and providing quality care, then maybe they could use some of their rulebreaking authority and a portion of the one billion to increase reimbursment and cut the red tape, EMR and paperwork burden of rural hospitals, small and solo medical practices and community pharmacies. They are losing their shirt on Medicare.

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