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Cardis and Coffee

@corgisandcoffee.bsky.social
269 followers 178 following 83 posts

Corgis, coffee, econ, all things knitting and sewing

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Reposted by Cardis and Coffee
hilzoy @hilzoy.bsky.social · 09/10/2026
Gift link. www.nytimes.com/2026/10/09/b...
nytimes.com
Private Medicare Plans Are Raising Costs And Forcing Millions To Find New Insurance (Gift Article)
As enrollment for Medicare Advantage begins this month, older Americans are confronting fewer options because insurers are discontinuing coverage in many areas.
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Cardis and Coffee @corgisandcoffee.bsky.social · 02/10/2026
The Part B late enrollment penalty is a lifetime 10% surcharge on the Part B premium for every year you should have been on Medicare but didn’t sign up. For example, if you waited 24 months to sign up, your penalty is 20% on top of the Part B premium.
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Cardis and Coffee @corgisandcoffee.bsky.social · 01/10/2026
Anyone who has a Medicare Advantage plan is also enrolled in Medicare Parts A, B & D and pays their Part B premium as well as their MA premium, so they won’t face late enrollment penalties. Part A is premium-free for almost everyone. Part D is only available through private insurance providers.
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Cardis and Coffee @corgisandcoffee.bsky.social · 01/10/2026
Medicare Advantage folks whose plans leave the market have guaranteed issue rights for Medigap plans if they want to switch. No underwriting. They would also have to enroll in a standalone Part D plan is they switch back to Original Medicare + Medigap.
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
The U.S. needs to rethink the entire system, not just insurance, if we want better outcomes at lower cost
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
Gate-keeping access helps keep costs low. So does negotiating drug prices and setting a national formulary. Unless you need a med that’s not available. It also really helps that providers don’t graduate with six figures of student debt. That’s why the UK can pay their junior docs $40K/year.
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
You actually want *Medicaid* for all or at least the version my state has. No premiums. Dental coverage. In home personal care. Full drug coverage. Health-related social needs are covered, too. /2
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
It’s entirely possible to go bankrupt on Medicare. Medicare has deductibles, a 20% co-pay and no out-of-pocket max. People pay for a supplement or MA avoid catastrophic medical bills. Also, Part D drug coverage is only available through private insurance. There is no public option. /1
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
Except they do. All have some form of basic universal coverage. Only 6 EU countries + the UK have healthcare systems that are almost entirely publicly-owned. The rest are all some mix of private insurance and providers and govt-subsidized coverage. They all manage to deliver care more cheaply.
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
Google “UK junior doctors strikes”. Then take a look at the official NHS Waiting Times Tracker. The grass is greener, in some ways. It’s not paradise though. ukgovernmenttracker.com/nhs
ukgovernmenttracker.com
NHS Waiting Times Tracker | Waiting List, A&E & Ambulance Data
Live NHS England performance data with charts and explainers: the waiting list and 18-week standard, A&E four-hour performance, ambulance response times, cancer waiting times and GP appointments.
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
The $2K maximum out of pocket only applies to Part D drug coverage. Original Medicare has no MOOP. www.ncoa.org/article/what...
ncoa.org
What You'll Pay in Out-of-Pocket Medicare Costs in 2026
When choosing a #Medicare plan, it’s important to understand what your out-of-pocket costs might look like. Here’s what you should consider before making a decision.
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Cardis and Coffee @corgisandcoffee.bsky.social · 04/09/2026
Or that 1 in 7 are dual eligible for Medicaid. 68% of those beneficiaries have Medicare Advantage plans. Or that 3M Medicare beneficiaries have no supplemental coverage of any kind.
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Reposted by Cardis and Coffee
Claire Willett @clairewillett.bsky.social · 28/08/2026
"every pharmacist is a hallway" and "the raccoon protocol" killed me
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Cardis and Coffee @corgisandcoffee.bsky.social · 15/08/2026
Welcome to Portland!!!
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
Amazon self-insures and handles all of their own pharmacy benefits. I’m not sure they are a good comparator.
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
To extend your pricing model, a family of four would pay $1,548/mo and still have no dental/vision/hearing/alternative medicine benefits
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
The least expensive plan for me is $45/mo. Medicare Part B is $202.90 A the least expensive Medigap plan that provides the coverage you want is $200 for a healthy, non-smoking 65-year-old in my mid-sized city. There are still zero-dollar Part D plans. Standalone dental/vision adds $100
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
Or they might just stop providing care. It’s pretty clear you dislike and resent hospitals, healthcare providers and insurance companies equally.
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
Interesting. My employer-based coverage for my family of four costs less than Medicare + Medigap + Part D would cost to cover myself alone. It also covers more.
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
Basic universal access to healthcare is something we should have. I simply disagree that the M4A model is a good one.
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
That is the fundamental challenge with M4A. The underlying costs remain the same. People who can afford to pay put-of-pocket for expensive, private Medigap plans and Part D will continue to have a fundamentally superior healthcare experience. Poor folks will still struggle to get care.
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
So we agree then. People with employer-based coverage pay more to cover the losses on Medicare and Medicaid patients. Medical groups, especially primary primary care, limit and close their practices to Medicare and Medicaid patients for this exact reason.
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
This will also be news to hospitals and physicians, especially to the numerous practice groups that have closed to new Original Medicare patients. The rapidly-growing concierge practice business should probably be told about all the money they are leaving on the table, too.
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Cardis and Coffee @corgisandcoffee.bsky.social · 10/08/2026
This will be news to hospitals and physician groups.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
It’s kind of a ‘pick your poison’ situation. amp.dw.com/en/how-to-fi...
amp.dw.com
How to fix Germany's costly health care system
A special commission has presented a raft of proposals aimed at curbing Germany's spiraling health care costs. But whether the government can impose them is another matter.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Medicine is direct-entry, not post-bac. Nursing is not an academic degree in many EU countries. They all make much, much less than their U.S. peers. This helped us import the healthcare workers we needed until now. It’s also why NIH junior docs keep striking.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Replacing the current system with one that reimburses at less than 50% of private insurance and which requires people to pay for supplemental insurance would not give you the outcome you want. You’d just get a net loss of available healthcare services.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Americans feel entitled to the newest, most expensive care all the time and without waits or barriers. Most Americans would be less than pleased with a system that cost them a lot in taxes and then regarly told them “no”. You might want to remember Europeans complain a lot about their systems too
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
They generally have systems that look a lot like the ACA. Mandated minimum coverage through private insurance and a public safety net. They aren’t free. Access is gate-kept. Private supplemental insurance is common. Also, providers aren’t trying to pay off six-figure student loans.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Insurance companies started offering Medigap policies almost immediately. Why? Because the 20% coinsurance can add up to a lot of money if you’re on a fixed income. Fun fact - the addition of Part D under Bush I was opposed by half of seniors at the time.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
It would also help tremendously if we were the size of Switzerland (which uses a private insurance model), with a fairly homogeneous population.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
We could. If we were willing to reprioritize the same amount of money to extensively subsidizing all levels of healthcare education, if Americans lowered their expectations regarding how quickly they should be able to see a provider, which provider they see and what interventions they should get.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
“In 2022, across all hospital inpatient and outpatient services (including both facility and related professional claims), employers and private insurers paid, on average, 254 percent of what Medicare would have paid for the same services at the same facilities.” www.rand.org/pubs/researc...
rand.org
Private Health Plans Paid Hospitals 254 Percent of What Medicare Would Pay
In 2022, prices paid to hospitals by employers and private insurers for both inpatient and outpatient services averaged 254 percent of what Medicare would have paid for the same services. Prices varie...
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
www.aha.org/2024-01-10-i...
aha.org
Infographic: Medicare Significantly Underpays Hospitals for Cost of Patient Care | AHA
While Medicare has historically reimbursed hospitals below the cost of providing care to patients, new data shows that Medicare payment levels hit record lows in 2022.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
www.medicaleconomics.com/view/medicar...
medicaleconomics.com
Medicare reimbursement rates explained: Why they keep declining, and what the future holds | Medical Economics
Physicians have complained that Medicare reimbursement rates have not kept pace with inflation, and now in 2025, are dealing with a 2.83% reimbursement cut. There's little chance of relief in sight. H...
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
I am referring to Medicare. Medicare pays, but it pays extremely poorly. The same is true for Medicaid. Employer-based health insurance reimbursements are much higher. This is why hospitals and ambulatory facilities actively push for non-Medicare beds.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
We did. We called it the ACA. The R’s gutted it. The MfA fever dream leaves out the economic realities of the providers. Countries with more-or-less universal healthcare don’t have providers with 6-figure student debt. They also pay their providers poorly compared to the U.S..
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Magical thinking.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Care is delivered through the for-profit system. Medicare just pays (some of) the bills. Providers cost-shift. Medicare reimbursement often doesn’t cover the cost of delivery, so they increase charges to non-Medicare patients and limit the number of Medicare patients they see.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
The flip side of your argument is that your doctor can also force you to change. Providers routinely close their practices to Medicare patients. Medicare reimbursements are extremely low, so providers limit the number Medicare pts they see. It’s a serious problem.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Or Medicare simply says the service isn’t covered from the start. There is a reason Medicare has a long, draw-out appeals process, the final step of which is filing suit in Federal Court.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Medicare A and B plus a supplement and Part D from private insurance companies are much, much more expensive than MA. The cost may not be a problem for you, but the many seniors are. Wealthy retirees get good coverage. As ever, regular folks get a lot less.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Original Medicare only covers 80% of the cost of covered services. Beneficiaries are on the hook for the rest - with no maximum out-of-pocket cap - if they don’t have MA or a private Medigap policy + private Part D insurance. Where I live the total is about $400-$500/mo total for 65-year-old.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Reminder - Private insurance companies contracting with CMS process Medicare claims. They are incentivized to “reduce wasteful spending”. CMS is currently running a multi-state trial that aims to reduce utilization of specific interventions by “recommending non-payment of claims”.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
Medicare Part D (drug coverage) is only available through private insurance companies. If you are on Original Medicare and want drug coverage, your only option is a federally-subsidized private insurance plan.
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Cardis and Coffee @corgisandcoffee.bsky.social · 09/08/2026
I have some sad news for you: Medicare denies claims, too. Medicare claims are and have always been processed by private insurance companies, not federal employees. CMS is running a six-year pilot project which gatekeeps specific medical interventions in hopes of saving money.
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Cardis and Coffee @corgisandcoffee.bsky.social · 31/07/2026
Or providers simply opt out completely
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Cardis and Coffee @corgisandcoffee.bsky.social · 31/07/2026
Young people who want Medicare for All have never dealt with the reality of Medicare coverage. It costs a lot more than they think and covers a whole lot less than they imagine. Medicare is old-school 80/20 medical insurance with no dental or vision benefit.
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Reposted by Cardis and Coffee
Philip Bump @pbump.com · 23/06/2026
I, like you, am tired of I-talked-to-a-Trump-voter-in-a-diner stories. But newly published research that involved weeks of contact with conservatives and their communities offered some novel insights that I hadn't considered. So I wrote about it. Gift link: shorturl.at/3FeaO
shorturl.at
The mistake many people make when trying to understand Trump voters
A new study suggests concerns about democracy may not resonate with Trump supporters the way many assume.
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Cardis and Coffee @corgisandcoffee.bsky.social · 24/06/2026
“What works for the GOP will not work for you” See: Jasmine Crockett
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