Comments on: Humana Sucks Money Out of Medicare Advantage http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/ Firedoglake weblog Fri, 17 Feb 2012 23:50:19 -0600 hourly 1 http://wordpress.org/?v=3.1.2 By: garlanddegreeff http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1950219 garlanddegreeff Wed, 05 Aug 2009 17:57:26 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1950219 <p>The U.S. economy depends on continual warfare now, which means money goes to any kind of weapon production–in this case, Big Pharma, or drugs or stem cell-related products, that could be more devastating than nuclear weapons. That is why we will not have single-payor or “government-payor” care anytime soon. This is a hot area because of recent discoveries in neuroscience. Check out Thomas Metzinger’s “The Ego Tunnel: The Science of the Mind and the Myth of the Self,” (Basic Books, 2009):</p> <p>When certain processing stages are elevated to the level of conscious experience and bound into the self-model active in your brain, the become available for ALL your mental capacities. Now you experience them as your OWN thoughts or urges to act—as properties that BELONG to you. They appear spontaneous because they are the first link in the chain to cross the border from unconscious to conscious brain processes; you have the IMPRESSION that they appeared in your mind “out of the blue,” so to speak. The unconsious precursor is invisible, but the link exists. The fact that the conscious experience is just a SLIVER of the process in the brain, and since THIS fact does NOT appear to us, we have the robust experience of being able to spontaneously initiate causal chains. This is the appearance of an agent. The brain is blind to its own inner workings.</p> <p>The science of the mind is now beginning to reintroduce those hidden facts into our ego tunnels. </p> <p>The idea of free will does not exist in our minds alone—it is also a social institution. It is a window connecting us with social practice around us. The assumption that something like free agency exists is a concept fundamental to our legal system and the rules governing societies—rules built on accountability and guilt. These rules are mirrored deep in the structure of our self-model and this incessant mirroring, created complex social networks. If one day, we must tell an entirely different story about what human will is this will affect our societies in an unprecedented way. For example, it would be meaningless to punish people (as opposed to rehabilitating them). RETRIBUTION would then appear to be a STONE AGE concept, something we inherited from animals. </p> <p>When neuroscience discovers the sufficient neural correlates for willing, desiring, and executing an action, we will be able to cause, amplify and modulate the conscious experience of will. It will become clear that the ACTUAL causes of our actions often have very little to do with what the conscious self tells us.</p> <p>We now have an information jungle that is increasing each day. It already is reconfiguring our brain. Perhaps our body perception will change as we learn to control multiple avatars in multiple virtual realities, embedding our conscious self into entirely new kinds of senorimotor loopos. A growing number of social interactions may be avatar-to-avatar and we already know that social interactions in cyberspace increase the sense of presence more strongly than higher-resolution graphics ever could. We may finallly come to understand that a lot of our conscious social life has been all along-and interaction between images, a highly mediated process in which mental MODELS of persons begin to causally influence one another.</p> <p>We already use the the Internet as part of our self-model. We use it for exernal memory storage , as a cognitive prosthesis and for emotional autoregulation. We are learning to multitask, our attention span is shorter and our social rels have a disembodied character.</p> <p>A related problem is management of our attention. The ability to attend to our environment, to our own feelings to those of others as naturally evolved feature of the human braing. Attention is a finaite commodity. Our brains can generate only a limited amount of attention each day.</p> <p>The advertisement and entertainment industries are attacking our foundations for experience and trying to rob us of our scarce attention. New insight s into the human mind by cognitive and brain science “neuromarketing” is one of the ugly new buzzwords. If I am right that consciousness is the space of attentional agency and if it is also true that the experience of controling and sustaining your focus of attention is one of the deeper layers of phenomenal (experience) selfhood, then we are witnessing not only an organized attack on the space of consciousness per se, but a form of depersonalization. New media may create a new form of waking consciousness that resembles weakly subjective states—a mixture of dreaming, dementia, intoxication and infantilization.<br /> Lives can be ruined because we have not done our homework. The price of denial may rise. Many new psychoactive substances of the hallucinogen-type—such as 2C-B (“Venus” or “Nexus”) or 2C-T-7 (Blue Mystic” or “T7”0 are out on the illegal market without any clinical testing; their numbers will continue to increase.<br /> And that’s just the old problems the homework we never did. In our ultrafast, ever more competitive and RUTHLESS modern societies, very few people are seeking deeper spritual experience. They want alterness, concentration, emotional stability, and charisma—things thatr lead to success. In the rich societies of the world, people are growing older than ever before—and they want not just quantity but QUALITY of life. BIG PHARMA knows this. Everybody has heard of modafinil, and perhaps that is already with us in the Iraq war; but there are at least 40 new molecules in the pipeline. There is hope and alarmism is not the right attitude, but the technology is not going away.<br /> Big Pharma, circumventing the border between legal and illegal substances is quietly developing new compounds; they know that cognitive enhancers will reap them hefty future profits from “nonmedical use.” For instance, Cephalon, maker of modafinil has said that 90 percent of prescriptions currently are for off-label used. The spread of Internet pharmacies has given them new ways for distribution and new tools for mass testing potential long-term effects.<br /> Modern neuroethics will have to careat a new approach to drug policy: The key question is: Which brain states should be legal? <a href="http://apocalypse-blues.typepad.com/" rel="nofollow">http://apocalypse-blues.typepad.com/</a></p> The U.S. economy depends on continual warfare now, which means money goes to any kind of weapon production–in this case, Big Pharma, or drugs or stem cell-related products, that could be more devastating than nuclear weapons. That is why we will not have single-payor or “government-payor” care anytime soon. This is a hot area because of recent discoveries in neuroscience. Check out Thomas Metzinger’s “The Ego Tunnel: The Science of the Mind and the Myth of the Self,” (Basic Books, 2009):

When certain processing stages are elevated to the level of conscious experience and bound into the self-model active in your brain, the become available for ALL your mental capacities. Now you experience them as your OWN thoughts or urges to act—as properties that BELONG to you. They appear spontaneous because they are the first link in the chain to cross the border from unconscious to conscious brain processes; you have the IMPRESSION that they appeared in your mind “out of the blue,” so to speak. The unconsious precursor is invisible, but the link exists. The fact that the conscious experience is just a SLIVER of the process in the brain, and since THIS fact does NOT appear to us, we have the robust experience of being able to spontaneously initiate causal chains. This is the appearance of an agent. The brain is blind to its own inner workings.

The science of the mind is now beginning to reintroduce those hidden facts into our ego tunnels.

The idea of free will does not exist in our minds alone—it is also a social institution. It is a window connecting us with social practice around us. The assumption that something like free agency exists is a concept fundamental to our legal system and the rules governing societies—rules built on accountability and guilt. These rules are mirrored deep in the structure of our self-model and this incessant mirroring, created complex social networks. If one day, we must tell an entirely different story about what human will is this will affect our societies in an unprecedented way. For example, it would be meaningless to punish people (as opposed to rehabilitating them). RETRIBUTION would then appear to be a STONE AGE concept, something we inherited from animals.

When neuroscience discovers the sufficient neural correlates for willing, desiring, and executing an action, we will be able to cause, amplify and modulate the conscious experience of will. It will become clear that the ACTUAL causes of our actions often have very little to do with what the conscious self tells us.

We now have an information jungle that is increasing each day. It already is reconfiguring our brain. Perhaps our body perception will change as we learn to control multiple avatars in multiple virtual realities, embedding our conscious self into entirely new kinds of senorimotor loopos. A growing number of social interactions may be avatar-to-avatar and we already know that social interactions in cyberspace increase the sense of presence more strongly than higher-resolution graphics ever could. We may finallly come to understand that a lot of our conscious social life has been all along-and interaction between images, a highly mediated process in which mental MODELS of persons begin to causally influence one another.

We already use the the Internet as part of our self-model. We use it for exernal memory storage , as a cognitive prosthesis and for emotional autoregulation. We are learning to multitask, our attention span is shorter and our social rels have a disembodied character.

A related problem is management of our attention. The ability to attend to our environment, to our own feelings to those of others as naturally evolved feature of the human braing. Attention is a finaite commodity. Our brains can generate only a limited amount of attention each day.

The advertisement and entertainment industries are attacking our foundations for experience and trying to rob us of our scarce attention. New insight s into the human mind by cognitive and brain science “neuromarketing” is one of the ugly new buzzwords. If I am right that consciousness is the space of attentional agency and if it is also true that the experience of controling and sustaining your focus of attention is one of the deeper layers of phenomenal (experience) selfhood, then we are witnessing not only an organized attack on the space of consciousness per se, but a form of depersonalization. New media may create a new form of waking consciousness that resembles weakly subjective states—a mixture of dreaming, dementia, intoxication and infantilization.
Lives can be ruined because we have not done our homework. The price of denial may rise. Many new psychoactive substances of the hallucinogen-type—such as 2C-B (“Venus” or “Nexus”) or 2C-T-7 (Blue Mystic” or “T7”0 are out on the illegal market without any clinical testing; their numbers will continue to increase.
And that’s just the old problems the homework we never did. In our ultrafast, ever more competitive and RUTHLESS modern societies, very few people are seeking deeper spritual experience. They want alterness, concentration, emotional stability, and charisma—things thatr lead to success. In the rich societies of the world, people are growing older than ever before—and they want not just quantity but QUALITY of life. BIG PHARMA knows this. Everybody has heard of modafinil, and perhaps that is already with us in the Iraq war; but there are at least 40 new molecules in the pipeline. There is hope and alarmism is not the right attitude, but the technology is not going away.
Big Pharma, circumventing the border between legal and illegal substances is quietly developing new compounds; they know that cognitive enhancers will reap them hefty future profits from “nonmedical use.” For instance, Cephalon, maker of modafinil has said that 90 percent of prescriptions currently are for off-label used. The spread of Internet pharmacies has given them new ways for distribution and new tools for mass testing potential long-term effects.
Modern neuroethics will have to careat a new approach to drug policy: The key question is: Which brain states should be legal? http://apocalypse-blues.typepad.com/

]]> By: jennifer23 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1950196 jennifer23 Wed, 05 Aug 2009 14:52:36 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1950196 <p>FYI - Humana is your supplemental along with Medicare…You may want to check that. If your involved in Medicare Advantage - Medicare has nothing to do with covering you. You still remain a member in Medicare, however you are not enrolled in the Origional Medicare program and would receieve no coverage or services via the Red, White and Blue card and it is not a supplement. However if you are enrolled in a Medicare Supplement with Humana and a seperate part D then you need to do some research as to the plan that you have and compare prices. All standard Medicare supplements are the same and provide the same benefits. For example in Iowa plan F is only $152.50/mth at 65 for Humana and you get a Silver Sneakers membership - however the same plan F with Mutual of Omaha is as low as $76.20/mth - Mutual of Omaha’s financial strength and name recognition are indisputable. I guess I would take take the $90 and pay for my own senior discount rated membership - even as a member at a Silver Sneakers location you can be involved in the classes and be a non Humana member.</p> FYI – Humana is your supplemental along with Medicare…You may want to check that. If your involved in Medicare Advantage – Medicare has nothing to do with covering you. You still remain a member in Medicare, however you are not enrolled in the Origional Medicare program and would receieve no coverage or services via the Red, White and Blue card and it is not a supplement. However if you are enrolled in a Medicare Supplement with Humana and a seperate part D then you need to do some research as to the plan that you have and compare prices. All standard Medicare supplements are the same and provide the same benefits. For example in Iowa plan F is only $152.50/mth at 65 for Humana and you get a Silver Sneakers membership – however the same plan F with Mutual of Omaha is as low as $76.20/mth – Mutual of Omaha’s financial strength and name recognition are indisputable. I guess I would take take the $90 and pay for my own senior discount rated membership – even as a member at a Silver Sneakers location you can be involved in the classes and be a non Humana member.

]]> By: hipparchia http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949813 hipparchia Wed, 05 Aug 2009 03:02:40 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949813 <p>the insurance companies, and the hospitals too, <a href="http://www.correntewire.com/mutual_of_omahas_wild_kingdom_and_a_compendium_of_health_care_wonkery" rel="nofollow">used to be non-profit</a>, and in general, everyone was focused on delivering, and paying for, the best of care to patients.</p> <p>so yeah, at one time they <em>were</em> useful.</p> the insurance companies, and the hospitals too, used to be non-profit, and in general, everyone was focused on delivering, and paying for, the best of care to patients.

so yeah, at one time they were useful.

]]> By: masaccio http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949688 masaccio Wed, 05 Aug 2009 01:43:02 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949688 <p>Thanks, that’s helpful.</p> Thanks, that’s helpful.

]]> By: iceman15 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949621 iceman15 Wed, 05 Aug 2009 01:02:45 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949621 <p>I agree & disagree with your comment about addding extras. In the U.K. everyone is covered by the (single-payer) NHS system but you can top that up with private insurance (such as BUPA). However, under the NHS it is commonly the case that, e.g. prior to routine surgery the patient is admitted the day before (a shock for most Americans), while those treated under BUPA insurance have the usual 5.00 a.m. same day admission. BUPA patients are typically seen/operated on earlier, but what is fascinating is that the doctor/surgeon is usually the same m.d. in both cases.</p> <p>A real example: my 91 year old father recently had a knee replacement surgery. The doctor told him he would treat him immediately if he ‘went private’ (at a cost of 15,000 pounds ~ $25,000) but would otherwise face the ‘waiting list’. He actaully had to wait a whole 3 weeks! The only real difference between the NHS & BUPA in this case (other than the net $25,000 of course) was that his NHS admission was for 7 days while his private admission would have been 2 weeks. This is a bit of a joke as the treatment was so successful that he persuaded the doctor to discharge him after 4 days. The U.K. spends about 6/7% of GDP on health care not 16% of total income on health INSUANCE/DRUGS.</p> I agree & disagree with your comment about addding extras. In the U.K. everyone is covered by the (single-payer) NHS system but you can top that up with private insurance (such as BUPA). However, under the NHS it is commonly the case that, e.g. prior to routine surgery the patient is admitted the day before (a shock for most Americans), while those treated under BUPA insurance have the usual 5.00 a.m. same day admission. BUPA patients are typically seen/operated on earlier, but what is fascinating is that the doctor/surgeon is usually the same m.d. in both cases.

A real example: my 91 year old father recently had a knee replacement surgery. The doctor told him he would treat him immediately if he ‘went private’ (at a cost of 15,000 pounds ~ $25,000) but would otherwise face the ‘waiting list’. He actaully had to wait a whole 3 weeks! The only real difference between the NHS & BUPA in this case (other than the net $25,000 of course) was that his NHS admission was for 7 days while his private admission would have been 2 weeks. This is a bit of a joke as the treatment was so successful that he persuaded the doctor to discharge him after 4 days. The U.K. spends about 6/7% of GDP on health care not 16% of total income on health INSUANCE/DRUGS.

]]> By: DeanOR http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949620 DeanOR Wed, 05 Aug 2009 00:58:08 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949620 <p>My coverage is with a non-profit HMO with no money going to investors, and there is no insurance company or insurance claim forms, essentially a large non-profit group practice. Incentive to provide good care is based on the desire to keep members, and doctors’ desire to practice good medicine. Medicare Advantage money goes directly and primarily into patient care, not profits or big CEO salaries. This is what we WANT government to do. I would still prefer national single payer for everyone, but short of that, the non-profit model is a good one not to be conflated with groups like Humana.<br /> I worked there and know it from the inside too. A negative side lately is that competition with unscrupulous competitors who offer very low premiums and then deny services led this plan to start offering various lower premium plans, which encourages young healthy people to sign on for an inexpensive plan but adds to administrative inefficiency and detracts from good care when they get sick. Used to be that everyone had the same coverage and same premiums. Doctors discussing cost in exam rooms was a new concept to us. The reasoning for the change was that they were getting the sickest patients who came there knowing they would get needed care, raising costs and making it hard to compete with the crappy for-profit plans that were getting the healthiest patients by offering low premiums. Some serious regulation of the profit plans would reduce this trend., (and it’s another reason for single payer).<br /> Part of the problem is that so many Dems have bought into the conservative concept that public needs can only be met by supporting for-profit private enterprise, that government programs don’t work, and that non-profits are suspect and only to be temporarily funded and have to re-invent themselves every few years. Reagan won that battle (so far). Of course those vaunted for-profit enterprises also support the politicians.</p> My coverage is with a non-profit HMO with no money going to investors, and there is no insurance company or insurance claim forms, essentially a large non-profit group practice. Incentive to provide good care is based on the desire to keep members, and doctors’ desire to practice good medicine. Medicare Advantage money goes directly and primarily into patient care, not profits or big CEO salaries. This is what we WANT government to do. I would still prefer national single payer for everyone, but short of that, the non-profit model is a good one not to be conflated with groups like Humana.
I worked there and know it from the inside too. A negative side lately is that competition with unscrupulous competitors who offer very low premiums and then deny services led this plan to start offering various lower premium plans, which encourages young healthy people to sign on for an inexpensive plan but adds to administrative inefficiency and detracts from good care when they get sick. Used to be that everyone had the same coverage and same premiums. Doctors discussing cost in exam rooms was a new concept to us. The reasoning for the change was that they were getting the sickest patients who came there knowing they would get needed care, raising costs and making it hard to compete with the crappy for-profit plans that were getting the healthiest patients by offering low premiums. Some serious regulation of the profit plans would reduce this trend., (and it’s another reason for single payer).
Part of the problem is that so many Dems have bought into the conservative concept that public needs can only be met by supporting for-profit private enterprise, that government programs don’t work, and that non-profits are suspect and only to be temporarily funded and have to re-invent themselves every few years. Reagan won that battle (so far). Of course those vaunted for-profit enterprises also support the politicians.

]]> By: masaccio http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949601 masaccio Wed, 05 Aug 2009 00:22:38 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949601 <p>I should also say I think that most countries, even those with government run programs, have private insurance companies that fill specific needs. Lots of wealthy people want extras that these companies provide, and lots of not so wealthy people buy it too. Nothing wrong with that.</p> <p>I should also note that sensible planning requires serious thought for the phase-out.</p> I should also say I think that most countries, even those with government run programs, have private insurance companies that fill specific needs. Lots of wealthy people want extras that these companies provide, and lots of not so wealthy people buy it too. Nothing wrong with that.

I should also note that sensible planning requires serious thought for the phase-out.

]]> By: masaccio http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949569 masaccio Tue, 04 Aug 2009 23:30:24 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949569 <p>masslib, good point. I don’t really see why we are doing that. In the posts I have done on insurance company results, I have noted the number of policyholders has decreased as people have been fired or laid off in the current recession. Obviously the companies will benefit if everyone is required to buy their stuff and the government subsidizes the less well off. I don’t see the wisdom of that.</p> masslib, good point. I don’t really see why we are doing that. In the posts I have done on insurance company results, I have noted the number of policyholders has decreased as people have been fired or laid off in the current recession. Obviously the companies will benefit if everyone is required to buy their stuff and the government subsidizes the less well off. I don’t see the wisdom of that.

]]> By: masaccio http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949557 masaccio Tue, 04 Aug 2009 23:26:12 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949557 <p>It’s an interesting question. I’m inclined to think that maybe once they played a valuable role. I don’t think they do today, and in fact, I think they are a drain on an important segment of the system. On balance I think they need to go.</p> It’s an interesting question. I’m inclined to think that maybe once they played a valuable role. I don’t think they do today, and in fact, I think they are a drain on an important segment of the system. On balance I think they need to go.

]]> By: masaccio http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949547 masaccio Tue, 04 Aug 2009 23:22:07 +0000 http://firedoglake.com/2009/08/04/humana-sucks-money-out-of-medicare-advantage/#comment-1949547 <p>tk1200, I think this is an excellent point:<br /></p><blockquote>The Blue Dogs are a symptom of a much bigger problem. They think in terms of markets and monetization of traditionally not-for-profit service models like health care. They do not think in terms of sound macroeconomic policy or consider individual need.</blockquote> <p> Jim Cooper is from Nashville, the home of this kind of nonsense. A good example is Corrections Corporation of America, a Nashville company, that was set up to deal with privatizing prisons. It is obvious that the government can do this cheaper than the private alternative. If not, then it is because they pay less than the public system pays.</p> tk1200, I think this is an excellent point:

The Blue Dogs are a symptom of a much bigger problem. They think in terms of markets and monetization of traditionally not-for-profit service models like health care. They do not think in terms of sound macroeconomic policy or consider individual need.

Jim Cooper is from Nashville, the home of this kind of nonsense. A good example is Corrections Corporation of America, a Nashville company, that was set up to deal with privatizing prisons. It is obvious that the government can do this cheaper than the private alternative. If not, then it is because they pay less than the public system pays.

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