KEY AREAS OF FOCUS:
On June 17, 2021 SCOTUS rejected the challenge to Obamacare concluding that none of the plaintiffs suffered any injury. Legally this may be accurate but we have experienced over 500,000 deaths due to underlying conditions that are exacerbated by Obamacare and the overall failure of our health care system to improve the health of the American people. After over 10 years, Obamacare covers only 11.3 Million Americans. Meanwhile we have over 30 million Americans that can not afford health insurance under this program. Medicare Advantage covers over 24 Million Americans, most over the age of 65. It is the most popular health plan in the United States and one of the most cost effective. Using the Medicare Advantage platform as a template for All Americans can lower our Healthcare GDP (NHC-GDP) conservatively by $1.3 Trillion Dollars to 12% of the total GDP by reducing or eliminating more than half of our chronic illness. A successful program of this kind will be a catalyst for much greater savings in the total national health care expenditure. This web site's "Program That Works" and the "True American" pages describe our proposed plan. The other Key Areas of Focus listed above give you the background on how the United States charted its way into this health care perfect storm, the healthcare Bomb that we are all sitting on, and how our proposed Medicare-Advantage-For-All.com plan can keep us from sinking as a nation and while doing so, save us a lot of money.
As a nation, we have to do more than Build Back a Better Obamacare. Our challenge is to simultaneously reduce the cost while improving the quality of healthcare for everyone in the United States. We know how to do this. The carriers administering Medicare Advantage have an impressive track record of arranging for cost effective high quality health care. But because Obamacare is delivered by a cartel of insurance carriers and pays for most health services on a fee-for-service basis, not only is it too expensive for the vast majority of unisured Americans, it is costing the tax payers a fortune. People don't get that! Most Americans have health insurance through their employer. Many of them never understood their health insurance. And, health insurance is not something they want to understand or even hear about. As a result, the average American did not see the magnitude of our health crisis and they don't see it conn ected to people dying from Covid. Perhaps the 500,000+ unnecessary Coronavirus deaths will shake us all a bit?
Before Corona Virus we do not associate the cost of health care with our health. But, now people understand that underlying health conditions can kill them. The leading indicators of our national health condition are dire! In order to keep Americans from dying of Corona Virus and lower the cost of health care in the United States, we have to dramatically improve the health of the American people. It is that simple.
This is going to require a transformational change in our health insurance and in the way that our physicians deliver medical care. Our health is NOT an important thing in our lives, it is the MOST important thing! Successfully delivering cost-effective quality healthcare is one of the most complex human endeavors. Politicians proposing simplistic, one size fits all solutions, traditional Medicare government-run bureaucracies, to lower the cost of health care, are basically lying to the American people.
KEY AREAS OF FOCUS:
Medicare Advantage - This page exposes the "Health Care BOMB" and how the Medicare Advantage Plan can defuse it!
National Policy - This page summarizes national health policy and some recent history.
Our current Medicare Advantage is a successful health insurance brand and consequently, an ideal model for any new national health plan. Twenty years ago Medicare Advantage was conceived of by the private sector, brought into being with strong bipartisan support in Congress, and further enhanced by HHS. This program works well with health care providers and insurers nationally. It is administered by highly skilled and competing health insurance carriers. It has evolved into the most popular health insurance program in the United States. It is a consumer-driven program with well over 25 Million American seniors enrolled. These seniors and their insurance carriers are the drivers of this program and with increasing enrollment, the program is growing like a weed.
For years, Medicare Advantage carriers have made incredible progress in lowering the cost of health care for our elderly and retiree population. Medicare Advantage has pioneered the use of tele-health coverage for its subscribers, which is one of the cornerstones of the federal government's approach to effectively deal with Coronavirus. The major Medicare Advantage insurers have waived all the tel-health out-of-pocket costs and are providing 100% coverage for the service. This makes it possible for worried consumers to check with a doctor regarding their symptoms without actually having to go to a doctor's office.
Medicare Advantage is Truly American. It is not modeled after some socialist idea of national health. It was created and operates in a Truely American way. We Americans believe in our right to choose. We believe our freedom comes from having a balance of countervailing powers in our systems of government and our society. A balance of power protects us from tyranny. This balance of power is particularly important in our health care system.
Our health care is delivered to the American people by some of the most powerful companies and professional groups on earth. Our health care industry is the sixth-largest employer in the United States. We spend Trillions of Dollars on health care annually. The revenue and profits from this activity are massive. We Americans can not trust any individual branch of our government or government bureaucracy to have sole responsibility for our liberty. And, we certainly should not trust in the health care providers (we pay for health services) not to take advantage. And, there is also no way we should trust the same health insurance companies that monopolize the Obamacare program to have complete control.
In fact, the Teflon Truth is the only people we can trust to ensure our health care are ourselves, as consumers. We need a balance of power. The government should watch the private sector and consumers must have affordable choices of competing health plans at all times. Health insurance carriers understand competition and the importance of delivering superior service. There is a lot to be said for the value of free markets and the power of the consumer. The Medicare Advantage market place is dominated by a few major carriers but there is a lot of competition that keeps them on their toes. HHS keeps the carriers under close supervision insuring that no American senior is disadvantaged by the system.
We also desperately need incentives to be responsible for health care consumers. We must be able to choose between competing health plans for our health insurance. We need transparency and knowing how much things are going to cost, especially when we have to share in that cost, is key. We also need protection from surprise billing. And, we have to be able to lower our premiums by improving our own health and/or freely changing the health plan to our advantage. we freely choose for our coverage. A well designed Medicare Advantage Plan will ensure that "We The People" stay in control of our health care.
THE DEMOCRATS PLAN:
Progressive Democrat politicians are promoting the popular traditional Medicare program as an answer to all our problems. Medicare is too expensive. the Trust Fund is bankrupt (runs out of money in 2026). Traditional Medicare is NOT the way to provide affordable health care for all Americans. Currently, over 90% of our population is covered by health insurance. The immediate public challenge is to take care of the uninsured 10% by making our health care more affordable and therefore more accessible. The propaganda suggesting that forcing everybody into Medicare is crazy!
Our traditional Medicare program is over fifty years old. People like it because it pays for everything after certain co-pays and deductibles. The program was started to pay for basic health services for a relatively small elderly population. Over time it has evolved into an agglomeration of health insurance payment policies that threatens not only the health and well being of our seniors, but also their very access to quality health care overall. In addition, the senior population has grown to the degree that traditional Medicare can no longer be supported by the payroll taxes of working Americans. And, the bloated expense of the current program presents a particularly massive future tax burden on the American people. Senator Bernie Sanders has a 10 year $50 Trillion Dollar vision for America, which includes approximately $32 Trillion Dollars for his proposed Medicare for All plan. If you ask him today how much it is going to cost, he simply says, it will coast a lot, because Elizabeth Warren said it would cost 50 Trillion Dollars. He really doesn't know how much it will cost and neither do we.
The Trustees of the Medicare Trust Fund are alerting us to the fact that the Fund will be bankrupt in 2026. Extending this program to all Americans is simply not a feasible solution to our pressing health care problems. To think otherwise is grossly naive and disingenuous. The federal government's most recent attempt to fix health insurance by enacting the Patient Protection and Affordable care Act of 2010 (also known as Obamacare) made problems worse. It dramatically increased costs (see our Finance page) and reduced both the quality and the number of approved health insurance carriers in the marketplace. Obamacare has been the most expensive health insurance program on the planet. Now, we have an opportunity to learn from our mistakes and improve upon those things that are currently working for the betterment of the American people. We can solve the nagging problems with cost, quality, and accessibility, by advancing the popular successful Medicare Advantage brand. Tweaking Obamacare will not work. As Trump says, "Obamacare is a disaster."
A Medicare Advantage plan will NOT be an extension of the current Medicare Advantage program for seniors. The current Medicare Advantage for our seniors will not change. We are proposing a Trump Medicare Advantage plan that attracts Americans under age 65 who need health insurance. If it is done right, the program will facilitate an improvement in the wellness and well being of the American people and save money. It will require changes in the pattern of medical care delivery and lower health care costs while improving quality. This much-needed improvement in the delivery of value-based medical care is a hallmark of the documented accomplishments of Medicare Advantage Plans throughout the United States.
What we have to do is transformative. We have to design health plans that deliver a different level of medical care that will improve the health of the American people, lower the cost of our health care, and make it affordable for All Americans. First, we propose re-packaging Medicare Advantage into Bronze, Silver, Gold, and Platinum options that have been so popular in Obamacare. We will re-design the scope of benefits to cover the basic benefits necessary to support the physical and financial security of every American. At the same time, we will integrate health and wellness program benefits to improve their health and wellness.
Americans need the basics. The basics in Obamacare seem to be deductibles and co-insurance as well as "essential" benefits that are not essential for everybody. Over and above wellness benefits, we find most healthy Americans would be satisfied with four (4) non-deductible primary care physician visits a year and low co-pays for generic drugs. We don't believe it is "essential" to pay for benefits that some people don't need.
The price structures for benefit packages will allow for riders so consumers that need more, can customize their programs to buy more. However, all the Trump plans will be required to have an integral Wellness and Well Being program designed to facilitate improved general health. American businesses health successfully managed wellness programs for their employees over the last twenty years. We know what works. We know what saves money. We know what attracts participation and generates positive returns on investment. And, we know the savings that can be generated and how to share those savings with the participants.
We propose that these programs be supervised by the Department of Health and Human Services. Ultimately, the plans will allow participants to get more benefits and/or lower premiums in return for the achievement of higher health status. So, if you reduce your health risk, you will get an immediate reward. All participants will have an incentive to exercise more personal responsibility for improving their health status and ability to lower the cost of their health premiums.
Secondly, medical care is undergoing something of a paradigm shift in the diagnosis and treatment of illness. There is a renewed focus on the prediction and prevention of illness, especially chronic illness like diabetes and obesity. This change will require benefit structures to incentivize more primary care physician intervention, closer monitoring of emergent patients' health and more reimbursement for routine care, and more emphasis on dietary education and exercise.
The financial structures of health insurance plans, starting with the current capitation models of Medicare Advantage Plans and ending with ACO risk-bearing models of physician reimbursement, will be required to cover the Predictive, Preventive, Personal Medical Care Model (PPPM) that we believe produces value-based outcomes. Financial incentives will, in some cases, need to be turned upside down and a participant's health status will need to be included. Americans deserve to be rewarded for improving their health. The way health care has traditionally been financed is the healthy pay for the sick. This was the concept that Peter Orszag sold President Obama on when they introduced Obamacare. The ACA failure, according to this kind of thinking, was too few people signed up, but it was really so much more than that.
We have to move beyond traditional underwriting concepts toward incentivizing medical providers and insurers to lower the degree and cost of illness, in order to reward those that are doing their part to stay healthy. Reduce the cost overall and there will be plenty of money left over to reward those Americans that maintain and improve their health.
Medicare Advantage has been around now for decades. It runs largely on government capitation reimbursement to the carriers. This not only keeps the cost and liability for the programs of the government's debt ledger, but it also places that financial risk squarely on the shoulders of the health care providers and the insurance companies, where it belongs. New incentives will encourage insurance carriers to take the risks and manage the health care of their subscribers for less money than capitation reimbursement. The logical way for them to make more money is to lower the cost of care.
This doesn't necessarily mean cheating their subscribers, like Elizabeth Warren and Bernie Sanders suggest. Health insurance companies are not vicious capitalist enterprises set up to prey upon the people they serve. Remember, Trump plan subscribers have choices. If they feel they are not getting the service they need, they can change plans. With a government-run system, they are stuck! Fifty percent (50%) of Americans have only one Obamacare plan available now, and this exclusive market doesn't incentivize them to lower the cost or improve their service.
Under a competitive Trump plan, there would be a point beyond at which it is not possible for carriers to lower the cost. The best remaining way for Trump Medicare Advantage plan carriers to produce a higher profit would be to lower the volume. To do that, without inconveniencing their subscribers, the competing carriers will have to help their subscribers need fewer services, i.e. produce "better" health among their customers. This is where value-based health care and predictive preventive medical care come in. This is what CMS is trying to get the Accountable Care Organizations (ACOs) to do with some success. Minimum loss ratios and administrative expense levels will still be important but incentives (not blanket regulations) will be geared to reduce them both. This is the true American way.
Humana recently released its annual Value-Based Care Report (VBC). Humana Medicare Advantage members in Value-Based Care arrangements had 27% fewer hospital admissions (131,200) and 14.6% fewer Emergency Room visits (110,700) when compared with patients in traditional Medicare. In their VBC arrangements, prevention screenings, improved medication adherence, and effective patient management created a 20.1% reduction in medical costs, amounting to $3.5 Billion Dollars of avoided medical expenses that would have been incurred had the patients been enrolled in the traditional Medicare program that the Democrat proposals are trying to push for All Americans.
The medical profession is like an ocean liner. The captain can turn the wheel but it takes a long time for the ship to change direction. Ninety percent of our annual health care expenditure is for chronic illness. All chronic illness disorders develop gradually over a period of time. It takes years for most chronic illnesses to reach a level where they can be definitively diagnosed and corrective treatment initiated. We need to create the incentive for a fundamentally new strategy to detect and prevent diseases long before they clinically manifest themselves. The Centers for Medicare & Medicaid Services (CMS) readily acknowledge that compensating physicians for quality instead of quantity can be a game-changer in improving population health and providing financial stability. To further this transition, CMS is launching new direct-contracting pay models in 2020 that will provide opportunities for the 24.7 Million Medicare Advantage subscribers and an additional 9.3 Million covered by traditional Medicare.
The Preventive Predictive Personalized Medicine (PPPM) is an evolutionary system of medical care that is gaining popularity in Europe and Asia. Any financial incentives associated with volumes, clinical settings, and intensity will need to be re-focused toward producing quality outcomes and improved lifestyles in the way Humana has demonstrated is possible. The government, medical providers, and insurance companies will be paid and rewarded with capitation and value-based arrangements for healthy outcomes. To the extent possible, "better" outcomes will produce lower costs, which in turn will produce more money for the providers and insurance companies and healthier customers. The payment models will reemphasize the importance of the focus on early detection and targeted prevention in nutrition, behavior, and physical activity and the aversion of conditions like diabetes mellitus, hypertension, kidney disease, COPD, cardiovascular illness, cancer, obesity, and sleep disorders. There is also an important pharmacological aspect to PPPM. DNA sequencing and genomic research is producing significant breakthroughs that improve the diagnosis and treatment of illness and reduce the cost of care. In addition, reimbursements will be structured to encourage insurer and provider risk-taking, the lowest cost delivery, and the highest quality outcomes.
APOLLO AND MARS PROGRAM GOAL:
Finally, it should be mentioned that in order for a new insurance plan design like this to succeed, we need an Apollo like Space Program approach and commitment, so we can focus the attention of our people on the need to improve our health. Now that COVID as killed over 500,000 Americans, maybe our attention to our health and Public Health programs can change things.
Before these COVID deaths, the CDC and independent studies declared almost "zero" progress on improving our mortality. There has been a wholesale deterioration of our national health condition by almost every measure, and a rapidly increasing incidence of chronic illness. Concomitant with these conditions is the escalation of health care costs and health insurance. This is causing the Democrats to seek sweeping government solutions, which was the same dilemma in Europe. Millions of Americans are unable to afford health insurance and as the Republican Study Group recently pointed out, there is a real risk of damage to the access and quality of care that our elderly and working men and woman. In short, we have to declare a national emergency, as we did with Coronavirus, and equip the insurance industry to handle the emergency. And, enlist the support of the American people to reduce their risk of illness and death.
We suggest that the President of the United States challenge the American people to reduce the nation's health care GDP to the lowest level of all the industrialized nations of the world by 2030. We believe, as he does, that the American people can do anything we set our minds to do. This will avoid the health care bomb we have been afraid is set to go off. This is just as important to our survival and dominance on the world stage as our ability to put a person on Mars. And, one of the best things about this challenge is that it actually doesn't cost us anything, because we will save more money than the cost of this program. That has to be an acceptable and politically advantageous thing to do. Declare that we will "Build Back American Health".
PLEASE JOIN US AND BECOME A SUPPORTING MEMBER OF OUR ORGANIZATION. PLEASE REVIEW ALL OF THE DETAILS IN THIS WEB SITE, DOWNLOAD OUR KEY DOCUMENTS AND SEND US A CHECK TO SUPPORT THIS GRASSROOTS EFFORT TO MAKE OUR COUNTRY THE HEALTHIEST DEVELOPED COUNTRY IN THE WORLD. THE HEALTH AND WELL BEING OF OUR PEOPLE DEPEND UPON IT!
REPUBLICAN STUDY COMMITTEE HEALTH CARE PLAN
The Republican Study Committee Health Care Plan is a framework for personalized, affordable care that will accept our Medicare-Advantage-for-All plan perfectly. It equalizes the tax advantages of health insurance between American employers and our citizens, covering preexisting conditions and allowing seamless transfers between plans.
KEYNOTE REMARKS BY SEEMA VERMA AT BETTER MEDICARE ALLIANCE
This Keynote Address on July 22, 2019, is the latest NEWS on the current state of health insurance and health care delivery in the United States. As the head of CMS, Seema Verma is in charge of the largest national insurer in the country responsible for Medicare, Medicaid, and Obamacare exchanges. She sees the challenges of government-run programs first hand. These remarks are a road map for Medicare-advantage-for-All.Com and should be a sign to All Americans that this web site and our movement are exactly what we need to get the "Better" health and the "Better" health insurance that we deserve.
THE AMERICAN PEOPLE ARE SITTING ON A BOMB
This May 2018 release is our second general mailing to All the members of Congress (the first was April 2017) and all of the policymakers, media, and health policy Wonks in Washington, D.C. It has pictures and graphs (and for those that remember Arlo Guthrie) it includes circles and arrows and paragraphs on the back of each one! This brochure shows how Medicare Advantage can be made to save the taxpayers $1.3 Trillion Dollars a year and reduce our NHC-GDP to 12%, but the United States on a path to accomplish our true goal to have the lowest NHC-GDP of any developed nation in the world and establish an improved health condition and an internationally competitive Health Care GDP. It is designed to get the reader interested in visiting this website and learning how America can become the healthiest most successful nation on planet earth.
The “Legislative Appeal.” It was mailed to every member of Congress and the Trump Administration back in April 2017. It was meant to expose the Medicare Advantage idea and spark Congress to use Medicare Advantage to replace Obamacare. The second document, “The Best Bipartisan Answer to Repeal and Replace Obamacare” was hand-delivered to the Heritage Foundation, HHS, and Congress during the recess week of August 13th, 2017. At that time, BCS Consultants arranged the delivery of this Plan Document to most of the Senators in the Finance Committee and Health (HELP) Committee and the House Representatives in the Energy & Commerce, Ways & Means, Budget, Tuesday Group Committees, and the Freedom Caucus, including the leadership of both bodies on both sides of the aisle. Based on the amount of feedback we received after the distribution, it is likely that both documents were ignored. THE FIRST LEGISLATIVE APPEAL
THE TRUE ADVANTAGE OF MEDICARE ADVANTAGE FOR ALL AMERICANS
This is an Op-Ed piece that lays out the case for Medicare Advantage For All in such a way as to stir the soul with the logic of this movement. "The True American" doc (a reference to Cassius Clay's famous KY Journal) is an Op-Ed succinctly making the case for Medicare Advantage. THE TRUE ADVANTAGE OF MEDICARE ADVANTAGE FOR ALL
THE 28 POINTS OF LIGHT
This document is a 28 point marketing piece summarizing the benefits of promoting Medicare Advantage For All that we are currently using with Congress to promote the program. 28 POINTS OF LIGHT.
THE BEST BI-PARTISAN ANSWER TO REPEAL AND REPLACE OBAMACARE
This Best Bi-Partisan Document is a well-referenced expose of how we, as a nation, got into the ACA and why Medicare Advantage is the best way to get us out. Congress is still struggling to find a solution to the problem of affordable health insurance that is fair and equitable for everybody. Hillary Clinton was the First Lady to use the title Medicare C - Twenty-Five (25) years ago when her husband Bill was President. After that, she tried to pass a Medicare Buy-In Program. Hillary kept this idea alive for her entire career. The Democrats only abandoned the idea when they successfully passed the ACA.
Medicare C is the sole source of revenue, earnings, and organic growth of the larger health insurance carriers. Analysts at PricewaterhouseCoopers (PwC), the Gorman Health Group, and the A.M. Best team believe that the Medicare Advantage market is poised to grow throughout 2018. PwC projected that MA enrollment will grow by 8 percent to a total of 21 million beneficiaries, almost three times larger than the ACA enrollment. The previous research from A.M. Best and the Kaiser Family Foundation also found that MA premium revenues grew from $69.9 billion in 2007 to $187.5 billion in 2016, indicating an upward trend in popularity among the people. (Reference) MA now covers over 35% of all Medicare beneficiaries, and of the 11,000 citizens aging into eligibility for the Medicare program each day, approximately 50% of them are choosing a Medicare Advantage program. They choose an MA because there are no pre-existing condition exclusions, they don't have to buy an additional supplemental insurance policy to get better coverage, they don't have to buy an additional drug insurance policy to pay for RX prescriptions and in most cases, the program is fully paid for by the federal government. The federal government can afford to pay the full premium because the insurance companies handling the MA programs are doing it so well that they actually end up saving the federal government billions of dollars. They administer these programs for less money than it would cost the taxpayers to cover these people under the "fee for service" traditional Medicare program. This is a win/win proposition for all involved, unlike Obamacare where the taxpayers, the federal government, the insurance carriers, and the participants all lose. THE BEST BI-PARTISAN ANSWER TO REPEAL AND REPLACE OBAMACARE
TRUE COST COMPARISON BETWEEN THE ACA AND MEDICARE ADVANTAGE
Obamacare care annual per capita costs are significantly more expensive than Medicare Advantage. In total, Obamacare cost us even more than our Medicare Fee-for-Service Program. It is the most expensive federal health insurance program on the planet Earth. Medicare Advantage For All.Com has completed a groundbreaking Cost Comparison study below comparing the annual per-person cost of Obamacare side-by-side with our other federally
sponsored health insurance programs for the years 2015 and 2016. The results are logical, however by displaying Obamacare, Medicare Advantage, Commercial Individual Insurance, and Medicare fee-for-service all together on the same page allows you can really appreciate the dramatic differences in cost.
DIRECTOR OF THE CONGRESSIONAL BUDGET OFFICE - Peter Orszag’s TESTIMONY BEFORE CONGRESS IN 2007.
Peter Orszag was the Director of the Congressional Budget Office (CBO) from January 2007 to November 2008. During his tenure, he repeatedly drew attention to the role of rising health care expenditures in the government's long-term fiscal problems—and, by extension, the nation's long-term economic problems. In 2008, he was appointed by President Obama as Director of the Office of Management and Budget. He was clearly one of the architects of Obamacare and this testimony before Congress can be considered a harbinger of the ACA program.
ARTHUR JACKSON WHEELER, CHC - RESUME
Arthur Jackson Wheeler founded www.Medicare-Advantage-For-All. Com. He is a Certified Health Consultant, who graduated from the University of Hawaii with a B.A. in Political Science & Law. He worked at Blue Cross Blue Shield for fifteen years and retired as a Director of Special Accounts. He started his own Health Insurance Brokerage and bought and sold Group and Individual health insurance products, including Obamacare and Medicare Advantage Plans. He basically has spent his entire professional career working with insurers, health care providers, and the largest employers in the United States in the administration and sales of health insurance products.