Medicare Will Require Prior Approval for Certain Procedures

[Minerva]

Wrong.

See Post #81

 

[bomberfox]

Interesting! At a time when many health insurers are easing back a little on requiring prior authorization for care (Health insurers move to streamline prior authorization process, promising quicker care) in the wake of public and health care provider outcry, the whole Luigi thing, and government pressure, traditional Medicare is about to lean into it.

Starting next year, Medicare will be paying AI companies to preemptively deny care for Medicare beneficiaries in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington State.

On the one hand, it’s not necessarily a bad thing if Medicare gets more comfortable saying no more. We’ve got finite resources and a large and growing portion of them are going to retirees. On the other hand, I’m not sure paying third party tech bros a bounty for each service their AI denies is likely to produce optimal outcomes. The DOGE experiment so far not had a very good track record of eliminating more actual waste than valuable spending, so extending it to deciding which of grandma’s procedures are “waste, fraud, and abuse” (and letting the techies pocket some of the savings from denials) seems a bit premature. Not to mention politically fraught.

Medicare Will Require Prior Approval for Certain Procedures

Oh god damnit…. People are going to ****ing die.

 

[Greenbeard]

I wonder how much of that wealth is in pensions, which are going the way of the dodo

The Fed puts defied benefit pension entitlements at ~$11.0T of their $106.7T in assets.

 

[TamleeB]

FALSE again. There's a difference between unearned and earned income. Unearned income does not go towards social security nor medicare nor medicaid. Honestly, it is astonishing how Americans will do everything negative to just hoping there's some 'money' saved for them when they already know taxes don't go down. Only up, inflation is used as a tax by the government to screw you over.

Of course there is a difference.

What Does Medicare Mean on my Paycheck? - Medicare.org

When Medicare was enacted as a federal law in 1965, the funds to support the program became a payroll tax on earned income. The payroll taxes required for the Federal Insurance Compensation Act (FICA) are to support both your Social Security and Medicare benefits programs. Your employer makes a...

www.medicare.org

Your statement is partially true.

Chicago Investment Advisory Council

Chicago Investment Advisory Council assists clients with various investment strategies and financial planning goals. Our unique approach centers largely on client education and interaction. This approach allows clients to be a part of the team rather than bystanders.

www.ciacinc.com

 

[Stealers Wheel]

Just to set the record straight, the so-called 'death panels' included in Obamacare were about compensation for doctors to have end of life counseling for their patients. Things like wills, DNRs, powers of attorney, etc.

It was never about denying coverage.

 

[Metric Mouse]

A better designed universal health care system could help significantly, as well.

Most people agree.

Health insurance companies didn't like that idea.

It's specifically why Obama pushed to for his bill, instead of gathering support for universal health care. We are still dealing with the fallout of that.

 

[NJBob]

Most people agree.

Health insurance companies didn't like that idea.

It's specifically why Obama pushed to for his bill, instead of gathering support for universal health care. We are still dealing with the fallout of that.

Obama pushed for a healthcare bill that he hoped would allow at least some Republicans to sign on. It was basically a Heritage Foundation plan.

His thinking was it had a chance as opposed to a universal plan which would have been very tough to pass.

 

[Helix]

Most people agree.

Health insurance companies didn't like that idea.

It's specifically why Obama pushed to for his bill, instead of gathering support for universal health care. We are still dealing with the fallout of that.

It's too bad that the goalposts weren't set differently when there was a chance. However, looking at it now, it probably would have been repealed successfully instead of sabotaged by Republicans like the ACA.

 

[Metric Mouse]

Obama pushed for a healthcare bill that he hoped would allow at least some Republicans to sign on. It was basically a Heritage Foundation plan.

Why would he do that?

Literally zero Republicans voted for it... and it still passed.

How the **** did he mess that up so badly?

And since zero Republicans were going to vote for whatever he wanted, why not just make a good bill that wasn't a Heritage Foundation plan, and instead helped all people?

What the **** was he thinking? Just dollar signs from his donors?

 

[Metric Mouse]

It's too bad that the goalposts weren't set differently when there was a chance.

The President set the goal posts. He knew what he was doing. Enrich health insurance companies and make desperate Americans pay.

At least the forced payments have been ended. That was the most obvious gift to large corporations; ending those while still forcing them to provide services was a small step forward.

 

[Greenbeard]

Just to set the record straight, the so-called 'death panels' included in Obamacare were about compensation for doctors to have end of life counseling for their patients. Things like wills, DNRs, powers of attorney, etc.

It was never about denying coverage.

They sort of retconned it be about that later. The original Palin quote was:

The America I know and love is not one in which my parents or my baby with Down syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil.

Which is definitely not about reimbursing your doctor for his time if you want to do some advance care planning. I think sometimes we undersell just how unhinged these people were at that time.

 

[Helix]

The President set the goal posts. He knew what he was doing. Enrich health insurance companies and make desperate Americans pay.

At least the forced payments have been ended. That was the most obvious gift to large corporations; ending those while still forcing them to provide services was a small step forward.

Nah. I think he had good intentions, but better solutions didn't have support because elected Democrats thought they could save their seats by going with a version of the Heritage Foundation compromise. In hindsight, the ACA worked out better than I expected, especially considering the constant Republican sabotage efforts.

 

[Stealers Wheel]

Why would he do that?

Literally zero Republicans voted for it... and it still passed.

How the **** did he mess that up so badly?

And since zero Republicans were going to vote for whatever he wanted, why not just make a good bill that wasn't a Heritage Foundation plan, and instead helped all people?

What the **** was he thinking? Just dollar signs from his donors?

Obama was in his first term, literally in the first year of his first term. He was 1) very naive, believing his colleagues in Congress would act in good faith, regardless of their rhetoric on the campaign trail. 2) he was unaware of the meeting in which Mitchell McConnell ordered all GOP legislators to oppose ALL bills supported by Obama.

Then, in a naive attempt to gain bipartisan support, Obama started stripping the bill. One provision after another fell away until it was a mere shell of itself. "Will you vote for the bill NOW?"

"Oh yes," came the answer. Of course, they looked him right in the eye and lied to his face.

 

[Stealers Wheel]

Nah. I think he had good intentions, but better solutions did n't have support because elected Democrats thought they could save their seats by going with a version of the Heritage Foundation compromise. In hindsight, the ACA worked out better than I expected, especially considering the constant Republican sabotage efforts.

You're referring to the Blue Dog Democrats who were Dems from conservative states and districts. They opposed the ACA because they thought their constituencies would reward them with re-election. The majority were dead wrong. Over half of them lost their seats to Republicans in 2010.

 

[NJBob]

Why would he do that?

Literally zero Republicans voted for it... and it still passed.

How the **** did he mess that up so badly?

And since zero Republicans were going to vote for whatever he wanted, why not just make a good bill that wasn't a Heritage Foundation plan, and instead helped all people?

What the **** was he thinking? Just dollar signs from his donors?

If you were paying any attention at the time you would know why he tried to work with Republicans.

Either you’re too young to remember or you have selective memory.