One week of lurking, and I am convinced, Owen. You just know too much (and are passionate) about too many things not to pay for it. I mean surfacing "gravamen" alone is worth the price of admission. PBM's are one of my favorite topics, but there aren't that many to choose from. As a Medicare Part D customer, I tend to pick the one loosest about granting formulary exceptions: Covering a drug that they don't already since all the formularies suck to start with. What is better about the two PBM's you link to? Shall we talk about the banditry of Medicare Advantage vs. Traditional Medicare??
First, let's distinguish between medical insurance and medical care. Assholes who call Medicare "socialized medicine" haven't a clue. It's insurance.
The basic point is Medicare is in the business of paying benefits. Premiums are covered by taxes. Traditional Medicare has no prior approvals required for patients to consult a specialist -- a standout feature. Commercial insurers offering Medicare Advantage are in the business of collecting premiums and work hard (in everybody's experience) to avoid paying benefits.
So are you really gonna be suckered by a sliver of dental and hearing benefits (and Joe Namath?) to move your health insurance coverage from a benefits grantor and give it to a premium pig? Apparently millions are. The two plans are now at parity in enrollment, mostly due to television advertising. A terrible shame. Especially since the government reimbursement structure means private insurers cost taxpayers tons more than Traditional Medicare. To my mind, that's simply the best health insurance offered in America -- to anyone but top corporate executives.
One week of lurking, and I am convinced, Owen. You just know too much (and are passionate) about too many things not to pay for it. I mean surfacing "gravamen" alone is worth the price of admission. PBM's are one of my favorite topics, but there aren't that many to choose from. As a Medicare Part D customer, I tend to pick the one loosest about granting formulary exceptions: Covering a drug that they don't already since all the formularies suck to start with. What is better about the two PBM's you link to? Shall we talk about the banditry of Medicare Advantage vs. Traditional Medicare??
And thanks for the positive feedback
The two linked PBMs use cost plus pricing -- some cost plus a fixed amount. Not clawbacks, no spread pricing, less total cost for plan members.
MA is coming. :). Those pieces take longer to write...but Wendell potter already does a great job, so I'd recommend him too!
First, let's distinguish between medical insurance and medical care. Assholes who call Medicare "socialized medicine" haven't a clue. It's insurance.
The basic point is Medicare is in the business of paying benefits. Premiums are covered by taxes. Traditional Medicare has no prior approvals required for patients to consult a specialist -- a standout feature. Commercial insurers offering Medicare Advantage are in the business of collecting premiums and work hard (in everybody's experience) to avoid paying benefits.
So are you really gonna be suckered by a sliver of dental and hearing benefits (and Joe Namath?) to move your health insurance coverage from a benefits grantor and give it to a premium pig? Apparently millions are. The two plans are now at parity in enrollment, mostly due to television advertising. A terrible shame. Especially since the government reimbursement structure means private insurers cost taxpayers tons more than Traditional Medicare. To my mind, that's simply the best health insurance offered in America -- to anyone but top corporate executives.