Extending private insurance for ESRD patients

[MooseMom]

https://thehill.com/blogs/congress-blog/healthcare/407236-congress-has-a-chance-to-improve-insurance-options-for-people

I stumbled across this opinion piece published on The Hill's website.  It basically makes a case for extending private health insurance by an extra 3 months over the already allowable 30 months for those with ESRD, and then using that money saved (from having said patients on Medicare for those three months) to help fund treatment programs for those with opioid addiction.

I've read this article several times, and something about it doesn't quite sit well with me.  I can't put my finger on it, so I thought I'd post it here for the rest of you to read.

What do you think?

[Michael Murphy]

What bothers me is for the first 3 months you are on private insurance, then 30 months later you must start Medicare.  So it’s already 33 months are they add 3 months to the 33 making it 36.

[Charlie B53]

Either way, the Insurance Companies are SAVING money for those people eligible for private insurance, whether that person or a family member is the employed.

Any time Insurance Companies can limit their pay outs and force an insured out of coverage and onto Medicare it is a great big Win for the Company.  As the 'Insured' is LOSING coverage for the things Medicare limits, or flat out does not cover, like Part B, Vision, Dental, limited Psych, etc.

The Insurance Companies can afford the Lobbyists to wine, dine Legislators and make contributions to campaign funds.

There needs to be Laws preventing Most Lobbyist, and very strict laws on who and how much can be contributed to campaign funds.

We, the People, lose every time.

[Rerun]

Those of us under 65 are VERY blessed to be on Medicare.  I had not seen the new statistic of 700,000 of people with ESRD.  The first 30 days if you are under 65 is not covered by Medicare at all to pick up the 20%.  I'm surprised Medicare just doesn't pull out of the Kidney people under 65.

[Simon Dog]

I think you can beat the 30 day rule by doing home dialysis.

[Charlie B53]

I truly Believe that I am Blessed.

As a Service-Connected Disabled Veteran the VA has handled EVERYTHING, all at no charge.   Since I got ouot in June 75 the VA has saved my legs twice, and my life at least three times.

The only bill I ever see is an $8 co-pay, or less, for meds.

AND, they pay me travel for EVERY trip, even Dialysis.

SSD is about a quarter of what my working take-home was.  It is difficult enough to make ends meet ever month.  That travel pay adds up and saves me some months.

Gas is never going to cost stupidly.

[Bill Peckham]

https://thehill.com/blogs/congress-blog/healthcare/407236-congress-has-a-chance-to-improve-insurance-options-for-people

I stumbled across this opinion piece published on The Hill's website.  It basically makes a case for extending private health insurance by an extra 3 months over the already allowable 30 months for those with ESRD, and then using that money saved (from having said patients on Medicare for those three months) to help fund treatment programs for those with opioid addiction.

I've read this article several times, and something about it doesn't quite sit well with me.  I can't put my finger on it, so I thought I'd post it here for the rest of you to read.

What do you think?

The problem I have with it is that they are taking resources from the provision of dialysis and moving it to the tragic opioid problem. This is not the first time that legislators have seen the money spent on people with CKD5 and thought why them? Why not childhood leukemia? or cystic fibrosis? or any of the other dread diseases?


My answer is that you - Congress - made CKD5 your problem with the 1973 legislation. Congress is already underfunding the provision of dialysis and has allowed this sector if medicine to become a poster boy for regulatory capture. By law CKD5 is Congress's problem, the beneficiaries who rely on dialysis need structural improvements to the system, COngress should not be taking away our 'pay fors' no matter the worthiness of the other need.

[Rerun]

Yes, but kidney people get greedy.  We want ALL transplant medicines paid for for LIFE and we want to stay on Medicare even though the person is 35.  That makes Congress think... hey, why them why not Children with Cancer. 

And then Dialysis Companies get greedy and keep charging more and more hoping Medicare will finally PAY for what they want.

[Michael Murphy]

I went on Medicare after 33 months on dialysis, not because I wanted to, but I was forced by the law to switch to Medicare.  On private insurance my insurance paid 1500 dollars per treatment.  On Medicare each treatment cost 350 a treatment.  On Medicare the provider makes about 10% profit.  So Fresinius makes 35 dollars for each treatment instead of the 1115 dollars they made from Aetna when I was on private insurance.  Now congress sees a large pot of money and plans on taking from Peter to pay Paul.

[Rerun]

AND you want Universal Health Care for All? 

Love this!  I am screen printing your post! 

[PrimeTimer]

AND you want Universal Health Care for All? 

Love this!  I am screen printing your post!

My thoughts exactly.

[Michael Murphy]

Remember your Republican president and congressional leaders tried to cut funding for Medicare, raise by a factor of 5 the price of insurance for those over 50, and allow exclusions for preexisting conditions and you think the democrats are a problem in health care. Medicare for all would cap costs, and reign in the obscene profits in the health care industry.

[Alexysis]

I went on Medicare after 33 months on dialysis, not because I wanted to, but I was forced by the law to switch to Medicare.  On private insurance my insurance paid 1500 dollars per treatment.  On Medicare each treatment cost 350 a treatment.  On Medicare the provider makes about 10% profit.  So Fresinius makes 35 dollars for each treatment instead of the 1115 dollars they made from Aetna when I was on private insurance.  Now congress sees a large pot of money and plans on taking from Peter to pay Paul.

I guarantee that your private insurer was not paying out $1500/treatment. Yes, they may BILL them $1500, but in the end there are 'adjustments' that will be made. Of course, Aetna will send you a statement showing that they were BILLED $1500, just so you don't complain about how much you are paying in premiums. It's really all just a game....

Frankly, I think that medical billing statements include fewer facts than political speeches!

[Michael Murphy]

No my private insurance plan simply billed the sponsoring company the 1500 and took a 150 dollar admin fee.