What Good Has Private Medicare Done for Shareholders?

Wall Street seems to have lost faith in publicly traded HMOs.When the Medicare Modernization Act was passed in late 2003, it was seen as a major boon to the health plan business. Without a doubt the revenue and profits that have accrued from the privatization of Medicare have been more than substantial.But what good has Medicare privatization done for shareholders?The first week of January 2005,

McCain Would Increase Medicare Part D Premiums for High Income Seniors--A Small Step in the Right Direction

As part of his broader speech on economic issues John McCain today called for high income seniors to pay more for their Part D drug coverage. Couples making more than $160,000 a year would pay higher premiums.This is a good idea and a down payment on something I believe is ultimately unavoidable--means testing for entitlement programs.It isn't news that the cost of senior programs--Medicare,

Part D Medicare Drug Plans See Major Price Increases--Why?

The Part D Medicare drug program's weighted average monthly premiums will increase 17% in 2008 and 23% since the program's January 2006 inception. The 2008 increase is well above basic pharmacy cost trend meaning the insurers are doing some rate catch-up. The average is weighted by actual enrollment.Premiums for the top two Part D Plans (PDPs) by enrollment are up dramatically. According to a

When It Comes To Drug Prices the Europeans Are Better Health Care Capitalists Than We Are!

Sometimes I think the government-run European health care systems do a better job of using market tools to control their drug prices than we do in the U.S. market.For example, some government-run systems in Europe, France for example, are not afraid to take a drug off their official formulary if they don't get a competitive price.In January, the Democratic House passed a bill requiring Medicare

Good Riddance to Karl Rove--How Part D Left an $8 Trillion Debt and Got Them Nothing

It seems to be the Washington summer sport to pile on Karl Rove in the wake of his announcement that he will be leaving the White House.Let me add my own good riddance.America’s health care dilemma is one of our greatest problems. Our inability to provide basic health care services at an affordable cost to all of our people is nothing to play around with.Politicians—Democrats and Republicans

Medicare Drug Negotiation Bill Fails in the Senate

Democrats fell short of the required 60-votes to pass a bill that would have allowed the Secretary of HHS the power to negotiate Medicare Part D drug prices. Democrats did get 55 votes while 42 Senators opposed the bill. The vote generally followed party lines.The Medicare Part D drug negotiation bill was little more than a political charade anyway since the bill would not give HHS any leverage

The Medicare Part D Drug Benefit: "The Ugliest Night I Have Ever Seen" - "60 Minutes" Report on How the Medicare Drug Benefit Became Law

As any any of you who know me, or who have regularly read this blog, know, I have great disdain for the Part D Medicare drug benefit--the way it was passed and the horrible health care policy it represents.I do believe seniors are entitled to coverage for their drugs. But instead of layering $8 trillion of unfunded liability (the whole of Social Security has a $4 trillion unfunded liability) on

Part D Was “Financially Irresponsible”—The Medicare Part D Drug Plan Liability is Twice That of the Social Security System!

The passage of the Medicare prescription drug benefit—Part D—was a “financially irresponsible” thing to do. Those were the words of U.S. Comptroller General David Walker on CBS’ “60 Minutes" this past weekend.Amen to that.The Medicare Trustees, in May of 2006, reported that Medicare’s long-term debt is estimated to be $32.4 trillion dollars (over 75 years). The new Part D drug benefit is a

Sierra Health Announces It's Already Losing Money in its 2007 Part D Medicare Prescription Drug Plan

Sierra Health, the leading health plan in Nevada, is already losing money in its 2007 senior Medicare Part D prescription drug program.For 2007, Sierra offered two primary Part D programs--a basic Part D drug plan and an enhanced plan that covers senior's medication in the "gap" or "donut hole." This "gap" lies between the first layer of coverage and the catastrophic insurance that Part D

Medicare Payment Advisory Commission (MedPAC) Finds Medicare Advantage Plans “Overpaid” by 12%

Told you so—Part Deux.On top of this week’s CBO report saying Medicare could save $65 billion by equalizing Medicare Advantage payments made to HMOs with the traditional Medicare plan, MedPAC dropped the second shoe saying the very same thing in their annual report released yesterday.MedPAC is a commission created by Congress to advise on Medicare payment policy. It is composed of 17 members from

If Medicare Advantage Rates Are Going to Be Cut, Why Have the Big Medicare HMO Stock Prices Been Up Since the Election?

That question came from Matt Holt today over at his blog: The Health Care Blog.Good question.As any regular reader of this blog knows, I have been arguing that the Democratic Congress is going to cut Medicare Advantage payments to HMOs as soon as they get their hands on the federal budget.If that is a good bet, why wouldn't Medicare HMO stocks be reflecting that risk? Instead, they have generally

Congressman Waxman Ought to Ask AARP How Much Money It's Making on Medicare Part D

House Oversight and Government Reform Committee Chair Henry Waxman recently sent a letter to the CEOs of the 12 largest Part D insurers. In it, he asked them to provide the Committee with information on their Part D profit, drug discounts, rebates, and administrative costs.Two of these insurers--Kaiser Permanente and Highmark--are "not-for-profit" insurers.I am more curious about another "

President Bush Has a Proven Strategy to Fix the Individual Health Insurance System!!!

The Bush administration has already implemented an individual health insurance system that is voluntary, community rated, and excludes no one--no matter what their age or health status.President Bush's recent proposal to reform the health insurance system (see post) is based upon greater use of the individual health insurance system. He would eliminate the employee tax exemption on

Waxman Investigates Part D Medicare Drug Plans

When the Democrats took over the Congress I pointed out that not only would they launch a health care legislative agenda of their own but they would also focus on the oversight of existing health care policy.Their greatest interest was always going to be the new Medicare Advantage plans and the Part D Medicare drug benefit. While the Democrats don't have the votes to repeal either of these

Grassley and Baucus Key to Any Drug Negotiation Compromise

In earlier posts, I have made the point that the House bill to require the federal government to negotiate Part D prescription drug prices will not pass the Senate.Developments in recent days have confirmed that opinion for me. The ranking Republican on the Senate Finance committee, Chuck Grassley, has said he would lead a filibuster of the House bill on the Senate floor and has said he is

The House Part D Drug Negoatiation Debate is Heating Up!

I was quoted in the Washington Post today reiterating my concern that the House Part D drug negoatiation bill is a hollow political charade on the part of the Dems:"The federal government can get lower prices, but only if it's willing to exclude a certain number of drugs from the formulary," said Robert Laszewski, a nonpartisan health policy consultant in Washington. "And that's a huge political

More on the Democratic Part D Drug Negotiation Debate

A friend in big pharma responded to my earlier post on Part D disagreeing with me that the Democratic proposal is not a threat to the drug industry.He made two points:The Dem bill does not prevent the government from requiring each and every plan to prior authorize a medicine for which it is unable to negotiate an "acceptable" price. They see such restrictions as possible because this would not

The Democrats' Hollow Part D Proposal

The House Democrats have announced the form their Part D prescription drug legislation will take.Throughout the 2006 campaign, they had pledged to lower senior prescription drug prices by requiring the federal government to negotiate directly with the drug companies--something the 2003 Medicare Act specifically prohibited. The Democrats went further saying that these negotiations would make it

More Trouble for Humana's Part D Program

Boston's mayor has been sharply critical of Humana for raising his city's Part D premiums by 130%. Get in line Mr. Mayor, they've done it to millions of seniors who bought their plans!Joe Paduda, in his Blog "Managed Care Matters" has a post today that hits the nail right on the head.You can read more about how Humana got itself into this position in an earlier post I did on the subject of Part D

Part D Profits––Not Yet the Great Results the Industry Hoped For

Part D—Some Results Starting to Come InTo say the Part D business has been controversial this year would certainly be an understatement. It’s not news that many in the industry have questioned its sustainability as a business—including me.During 2006, the profitability data hasn’t been credible. In fact, it will likely be another year before we get a good sense for what’s really going on. While