president-elect barak obama disparages medicare advantage plans and the insurance companies contracted by the government to manage these plans ...

During his press conference on health care this morning a severely mis-informed President-elect Barak Obama took issue with the Medicare Advantage Plan Program and the insurance industry, blaming both for high expense and little if any improvement on health care delivery for Medicare Beneficiaries. This is unfortunate, because there is much that can be adapted from the Medicare Advantage Plan Program towards solving some of the medical and economic problems that face our country.

Economics and healthcare do hold hands with each other, and there is one Benefit now available to all Medicare Beneficiaries, who choose Medicare Advantage Plans, that was previously available only to those Medicare Beneficiaries, who could afford to purchase a Medicare Supplement Plan, or who had earned a similar type Retirement Plan. In earlier postings to this Blog attention has been drawn to the "OOP" -- Out of Pocket Maximum.

OOP -- Out of Pocket Maximum: The Unsung Hero and Untold Story of the Medicare Advantage Plan Program:

The singular, profound, most outstanding Benefit available (in most counties at no additional monthly premium cost) to all Medicare Beneficiaries, who choose an Advantage Plan, is OOP coverage.

A Medicare Beneficiary today, who cannot afford the secondary coverage of a Medicare Supplement, who does not carry secondary insurance in the form of a Retirement Health Plan [modeled after the Medicare Supplement model], and who does not choose the optional Medicare Advantage Plan, will find that TRADITIONAL MEDICARE DOES NOT INCLUDE "OOP" COVERAGE.

Since OOP coverage sets an annual limit of financial obligation as to the amount of medical expenses (exclusive of premiums or Part D Drug expenses) a Medicare Beneficiary must pay in a calendar year (typically $1000 to $4000, depending on the Plan) and THE INSURANCE FIRM PICKS UP THE FINANCIAL OBLIGATION TO THE BENEFICIARY THAT EXCEEDS THE OUT OF POCKET MAXIMUM, this means that a profound protection exists to the bank accounts and homes of millions of Medicare Beneficiaries previously unprotected from the potential shock of extraordinary medical expense.

At a time in history of historical foreclosures on homes and bankruptcies, many of which can be associated with one or more extraordinary medical expense -- with or without insurance coverage -- the OOP benefit can protect Medicare Beneficiaries, the most vulnerable segment of our citizenry, from financial ruin and devastation.

There are other important, though less profound benefits provided by Medicare Advantage Plans. For example, some Plans designed for low-income Beneficiaries include a set number of planned non-emergency transportations to and from a Medical Provider. To the poverty stricken Beneficiary with a broken leg needing to see Medical Provider in the dead of winter or in a location not easily accessible by public transportation, such a benefit can mean the difference between accessing or not accessing timely healthcare. Other Plans may include Hearing benefits or Dental Benefits or Vision Benefits otherwise not affordable to the Medicare Beneficiary.

But, the OOP benefit stands out as the unsung, untold heroic benefit of Medicare Advantage Plans.

Now, as an American with or without health insurance in today's economy, ask yourself:

"Suppose I could obtain a health insurance policy for myself and my family that included OOP protection, so that I am not faced with the possibility of financial ruination due to any extraordinary medical event in any given calendar year...?"

This is where the Medicare Advantage Plan could be a model for all health insurances!

president elect barak obama appoints tom daschle and jeanne landrew

President-elect Obama chose this morning's press conference to announce his appointment of former senator Tom Daschle to the Cabinet post of Secretary of Health and Human Services. Obama also announced his simultaneous appointment of Tom Daschle as Director of the White House Office of Health Reform. Daschle's co-author on health reform, Jeaane Landrew, will be Daschle's Deputy Director.