Privatizing, one step at a time

On the Presidents Day holiday, “scores of state workers” (what, the reporter couldn’t count em?) rallied at the Capitol. Many were DOH employees worried that the recent sell-off of DOH equipment meant privatizing of some jobs.

“I don’t know where they get that idea,” said Delegate Mitch Carmichael, R-Jackson.

How about selling off Worker’s Comp? How about creating centralized services that charge back to state agencies for their work? (as in the Office of Technology and Tourism’s media people)  All through state government, positions on the books are vacant while contractors do those jobs, and Joe Manchin claims he’s cut state government.

Privatizing one step at a time.

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2 Responses to “Privatizing, one step at a time”

  1. Concerned Says:

    PEIA did this. Did you know that don’t get to choose whether you want Original Medicare or Medicare Advantage? Your former employer does, and you have to go to Medicare Advantage, which is really private Medicare DISADVANTAGE, to keep you supplement, if they chose it. Medicare Advantage, has to give similar services, but not all the same services, nor pay the same rate, nor have all the Medicare providers. They can operate it as a PPO (Preferred Provider Organization), which will probably and most assuredly be a much, much smaller network. They do not have to have all the Original Medicare providers, or even a small part of them. The Advantage Plan need meet only “CSM ratios”, Central Medicare Services Ratios, which means so many providers of a certain types within so many minutes, of so many plan participants. Since each of these private plans is small, with a small number of participants, when compared to Original Medicare, you could end up with a very small network. Say there are 5 nursing homes in you town, and 2 aren’t in you plan, and 2 are full; you end up in the worst nursing home in town. Remember the farther you live away from your former employer, the less of a network you will probably have, since it’s based on the number of participants in a given area. Also you could have problems going to specialists and better hospital outside your home area. Say you need to go Sloan Kettering or John Hopkins, if they’re not in your plan, even through they take Original Plan, then you could end up paying say 30 to 40 % more to go there, than those with Original Medicare. So in order to Original Medicare providers not in you Medicare Advantage network, you will have many additional charges. There will probably be double coinsurance charges, double deductible, double Out Of Pocket Maximum , same as out of network costs in other private insurances. Also the Medicare Advantage Plan can add other out of Network fees. You will also be paying the difference between the Medicare Advantage rate and the Original Medicare rate, if out of network. Of greater concern is that no one will be setting usual and customary charges when out of network, which means you could have to pay and additional 20% to 35% of the bill. All this to use a provider, that everyone gets to go to if they have original Medicare, but we have to pay more with Medicare Advantage. It would work the same way with a Medicare Advantage Private Fee for Service Plan (PFFS) if you go to an Original Provider who doesn’t take their rates, then we have to pay the difference, to use an Original Medicare provider under Medicare Advantage, than when using that provider under Original Medicare with a supplement from our former employee. Lastly the network or Medicare Advantage provider can be changed yearly by your former employer, so you really can’t count on anything. Also Original Medicare allows a second supplement, and Medicare Advantage does not. Original Medicare has a really broad network, all providers in the country who accept Medicare, so it’s near impossible to be out of network, and have all those extra costs. Medicare Advantage costs us more of our tax dollars, while the Medicare DIS- Advantage companies make outrageous profits on our tax dollars just to give out our own tax dollars and supplement premiums, and severely limit our access to many of the Original Medicare providers. We lose choice and it costs us more.

  2. Wvstate tax | Jeffsussman Says:

    […] Privatizing, one step at a time « The State of the State of WVMedicare Advantage costs us more of our tax dollars, while the Medicare DIS- Advantage companies make outrageous profits on our tax dollars just to give out our own tax dollars and supplement premiums, and severely limit our access to many of the Original Medicare providers. […]

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