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Readers sound off on Medicare

Medicare for All

By David and Carol Butler
The Tennessean, Letters, Oct. 25, 2015

Re: “Medicare for all would solve many problems,” by Vanderbilt and Meharry medical students, Oct. 19.

We were pleased to see this op-ed proclaiming the need for a truly universal single-payer system of health care such as one finds in all other "developed" countries.

They differ in many details of operation, but all provide greatly superior health outcomes than we get, and at far less cost.

Opponents love to come up with "horror" stories out of some of those systems.

We have seen many more such problems here in America.

We lived four years in Canada and one in France and have spent a good deal of time in Great Britain, Switzerland, Holland and Germany where we still have many contacts.

These friends, in spite of their complaints, would not trade for the American system and cannot understand how we can be so backward and so callous as to fail to recognize the civilized need to assure basic health care to everyone.

One close friend in Canada, now deceased, and one like a "daughter" in Northern Ireland, who is now dying of cancer, received excellent and prolonged care over several years and were given, against all odds, added years of good-quality life before the final phase set in.

And that has not bankrupted their families!

Let's try Medicare for all!

David and Carol Butler reside in Hermitage.

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Try standard Medicare

By Dorothy M. Gager

​Re: “Vanderbilt, BCBST hit Medicare Advantage impassed,” Oct. 21.

The story about Blue Cross/Vanderbilt Medicare issues failed to mention a vital part of the issue.

The so-called "Advantage" plans are required to provide a core set of services that are also covered by standard Medicare.

They are paid a per capita rate for each enrollee, ​regardless of the amount of medical care provided to that individual.

They are allowed to be more tightly "managed," meaning that their provider lists might be much more restricted, with the private insurance companies being able to determine length of stay and kinds of services authorized in each situation and to dictate the funding formula for authorized providers.

They can also add additional services, generally targeted at healthy Medicare recipients who are much less likely to require the costly care needed by those with chronic or severe illnesses.

For the insurance company, the incentive is to attract healthy enrollees and keep the amount of money paid for medical care to a minimum, since they receive the same funding for each enrollee.

Therefore, they spend huge amounts of money in advertising to attract the healthiest people eligible for Medicare.

Standard Medicare, on the other hand, provides the same basic services, only paying medical providers for services rendered and being accepted by a much larger pool of medical providers.

The legislation creating the "Advantage" plans gives them permission to advertise and specifically prohibits any advertising by the standard Medicare program.

Many people nearing the age for Medicare eligibility are not even aware of the option of standard Medicare, assuming from the barrage of advertising that they have to enroll in an "Advantage" plan.

Dorothy H. Gager, M.Div., LCSW, resides in Nashville.

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Be careful at enrollment

By Clark Meyer

I'm 79 years old. I had to change Medicare supplemental insurance companies for the 2015 year.

Having had the same primary care doctor for over 10 years, with each new insurance company I considered, I insisted that I would only sign with them if indeed I could keep my doctor.

A number of companies could not make that promise — until Humana came along.

They made that promise, I signed up.

A few weeks later they sent me that little plastic card that listed benefits, co-pays, etc. — and sure enough on the back of that card my doctor was listed as the doctor I insisted on having.

Four months into the plan, Humana informed me that that was not possible as they had no contract with that particular doctor and that they had assigned me to a doctor that I did not know.

After a lot of calls with numerous Humana folks the story was, "sorry" we messed up and we cannot help you.

Contacting my doctor of choice he informed me that Humana has done the same thing to a number of his patients.

So, old folks beware of promises made to you during the upcoming enrollment period.

What "they" tell you may not be true. You sign up, they profit from the misinformation, and you don't get what they promised.

Clark Meyer resides in Nashville.

http://www.tennessean.com/story/opinion/readers/2015/10/26/letters-edito...