Fwd: qotd: Correction of automated word insert, with other minor revisions

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-------- Original Message --------
Subject: qotd: Correction of automated word insert, with other minor
revisions
Date: Tue, 8 Apr 2014 12:13:56 -0700
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



Comment by Don McCanne

In an effort to privatize Medicare, conservatives in Congress enacted
legislation to provide private Medicare Advantage plans with a 14
percent overpayment in order to unfairly compete with the traditional
Medicare program. The Affordable Care Act included measures to gradually
eliminate this overpayment. CMS appears to be thwarting the intent of
Congress to correct this injustice.

Because of pressure from the insurance industry, the Obama
administration used chicanery in the first two years of the ACA
implementation to maintain higher Medicare Advantage rates. This year
the reduction was to have been 1.9 percent. So the insurance industry
initiated an intensive campaign to reverse these reductions. Once again,
CMS has used more chicanery to convert their reduction into a 0.4
percent gain - reassuring private insurers that they can continue to
expand their private takeover of Medicare.

There are numerous gimmicks that were used, and some of them are quite
obscure. Perhaps the most important revision was in the "normalization
factors." Because of the influx of baby boomers into the Medicare
program, it was decided to use "a quadratic functional form fit to risk
scores from 2010 through 2013" in the CMS Hierarchical Condition
Category. To provide "transparency around the calculation of the
normalization factors," they showed "the risk scores used to calculate
the normalization factors for 2015." Glad that's clear.

Seriously, CMS has used innovative accounting to increase payments to
Medicare Advantage plans based on the fact that there is an influx of
baby boomers - a subset of Medicare beneficiaries that is younger,
healthier, and less expensive than the older beneficiaries already
enrolled. Taxpayers will pay more for lower cost beneficiaries. I
remember the quadratic equation, but I don't remember it ever being used
to cheat taxpayers and reward the private insurer rentiers.

Rentiers? Those are individuals whose income is derived from capital,
and now capital is being concentrated in the top centile. If you missed
yesterday's Quote of the Day on Thomas Piketty's "CAPITAL," you should
not bother reading the CMS song and dance above, but instead read
yesterday's message.

Congress and the Obama administration are serving the interests of the
rentiers, and this Medicare Advantage payment scam is only one example.
It is time for the people to take control. As Thomas Piketty wrote, "if
we are to regain control of capitalism, we must bet everything on
democracy."

qotd: Thomas Piketty - "CAPITAL in the Twenty-First Century"
http://www.pnhp.org/news/2014/april/thomas-piketty-capital-in-the-twenty-first-century