9/15/17 Erik Paulsen Correspondence Corner : MathGuy pushes for changes in Medicare Advantage plans

PREFACE :
Erik Paulsen regularly issues a video Correspondence Corner in which he responds to constituent questions.
It is a great ploy — Congressman Paulsen determines what question is to be answered … thus, providing him an opportunity to portray himself as effectively responding to issues that he wishes to address as if they are the most critical issues that voters want addressed.
The MN Political Roundtable will be evaluating Congressman Paulsen’s responses and encouraging readers to offer their own assessments.

Yesterday’s topic, Meals On Wheels

Today’s topic, H. R. 3727 to require Medicare Advantage plans to include telehealth services as a base benefit beginning in 2020.

Yesterday, seniors got a lesson in how the #MathGuy approaches the budget — $218 million increase for NASA to prepare for human space travel while maintaining the Meals On Wheels at level funding.

Today, before reviewing the second response on the Paulsen’s Correspondence Corner, let’s pose a question :

What would you think if a Congressman responded favorably after being approached by a pharmaceutical company saying that their new vaccine (let’s say to address meningitis B) would save lives and should be included in ObamaCare’s Essential Health Benefits ?

Would you say “Yeah, my Congressman is looking out for my family.”
Or, would you say, “NO, Obamacare must not dictate services.”
Or, would you say, “I understand what’s going on here — the American healthcare systems is influenced by corporations desire to increase market penetration and profit. And, pharmaceutical companies know that they have an inherent advantage when their products are included in Essential Health Benefit programs.”

As you ponder that question, let’s review the second half of Paulsen’s Correspondence Corner responding a request from Ann of Maple Grove (who works with the TeleHealth services) requesting Congressman Paulsen support access to TeleHealth.

Congressman Paulsen was quite proud that the House Committee on Ways and Means unanimously passed H.R. 3727.
The legislation would require Medicare Advantage plans to include telehealth services as a base benefit beginning in 2020. Currently, insurers can offer telemedicine as an add-on benefit … and likely paid through additional premiums … under this legislation, MA contracts would have to include that as a standard whether you wanted it or not.

Hmmm …. I guess that whole argument of “unelected bureaucrats dictating healthcare” isn’t valid since this is being done by our elected officials instructing insurers to include this provision in their Medicare Advantage plans.

Hmmm …. sure sounds like a request to include TeleHealth as an Essential Health Benefit in Medicare Advantage plans.

So, if seniors opt for a Medicare Advantage plan (sold by insurance companies), they know that they will be paying for it … but if this is such a necessary and good practice, why isn’t it included Medicare (as provided through the federal government) ?

As of now, Medicare can offer telemedicine only in rural areas and only if the patient goes to a clinic. Medicare Advantage plans, on the other hand, avoid those restrictions because the insurer picks up the tab for the services — which is passed down to the consumer. An inherent advantage that insurance companies know is that nearly everyone will pay out their last dime to keep themselves and their loved ones alive and well. However, they also know that if some companies offer tele-medicine and some do not, they will be at a disadvantage … but if all insurers offer the same telehealth services, all consumer will be buying the “essential health benefit“.

Congressman Mike Thompson (D-CA-05), who co-sponsored H. R. 3727 requested that Congress commit to expanding telehealth coverage under Medicare parts A and B.
For example, H.R.2556 – Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017 has 19 sponsors (9 Republicans [Erik Paulsen is not one] and 10 Democrats) would make changes to the basic Medicare program … and the cost would be borne not by the policyholder but provided through Medicare funding.

So, why isn’t tele-medicine included in basic Medicare ???
Ateev Mehrotra, MD, told Congress last year that telemedicine could lead to over utilization of Medicare benefits. “The very advantage of telehealth, its ability to make care convenient, is also potentially its Achilles’ heel,” he said. “Telehealth may be ‘too convenient.’”

Hmmmm … so is Congressman Paulsen for tele-health or is he only for tele-medicine when MA providers want it included to increase their profits ?

Tags: , ,