I was curious about the manifesto and did a Google search to find a copy. Interestingly, I could not find it but I found a bunch of articles from so called reputable publishers telling me their opinion about the manifesto without giving me a copy of the manifesto.
I would appreciate if anyone can share here a copy of the manifesto.
P.S.: I came across a clip where Mayor Adam called Luigi Mangioni a terrorist. Seems like Mayor Adam is happy to do the bidding of the ruling class now that he made it there.
Comments
The above information was retrieved by the DuckDuckGo search engine on the Firefox browser, using Mac OS12.7.4 ("Monterey").
Well articulated and to the point. Interestingly, all the well known publishers issuing opinion pieces have scathing commentary about the manifesto and Mangione, without giving us a copy of the manifesto. It makes me wonder how systemic the problem laid out is that media business came out guns blazing against while the ordinary man is sympathetic to Mangione. This probably proves his point that it is not an issue of awareness at this point.
I can never read these publishers again with the open mind with which I was reading them. Was I always gullible or the world has changed on me!?
Noam Chomsky, "The Common Good:"
The smart way to keep people passive and obedient is to strictly limit the spectrum of acceptable opinion, but allow very lively debate within that spectrum – even encourage the more critical and dissident views. That gives people the sense that there’s free thinking going on, while all the time the presuppositions of the system are being reinforced by the limits put on the range of the debate.
https://archive.li/2025.01.02-105153/https://www.wsj.com/health/healthcare/how-health-insurers-racked-up-billions-in-extra-payments-from-medicare-advantage-9d4c8a89
P.S.: For me, any thread I start is always shown as read, not allowing me to know if there are new posts. So, if I do not respond / acknowledge a post in a thread I start, it is likely I am not aware of the post.
• At the upper left of any Discussion Page there is a large blue "Start New Discussion" icon/box.
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• At the upper left click on "Notification Preferences".
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Medicare Advantage covers you with a PRIVATE insurance plan of your choice. Everything I've heard tells me that M.A. is suitable only if you're still very healthy, and don't need doctors, tests, surgeons. With M.A., you're dealing, still, with the same sort of limitations and filters and networks and wait-times; all the junk you had to put up with before you became eligible for Medicare.
Which is why I chose traditional Medicare, with a supplemental Medicare plan. My "Medigap" Plan happens to be with Massachusetts BC/BS. I have the "F" plan, which has already been sunset-ed. No one else can get in, now. (Though MA BC/BS calls it by their own stupid name: "bronze.") Even my DEDUCTIBLES are covered. The next-best plan might be "G." As in, "goodness gracious!"
So, once I meet my annual threshold, Trad. Medicare kicks in. As long as Trad. Medicare covers something, then my Medigap plan will also cover the remaining 20%. (I did not start out with the "Cadillac" plan I have now. After surgery, I was left withy a big bill which prompted me to switch to F (bronze.) I've certainly been utilizing it to good advantage. Every year, my monthly premium rises a bit. They like to play word-games, calling it a gradually "diminishing discount." ...And don't forget "D" coverage for DRUGS.
https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
Any bill I see these days is a mistake, or else the hospital or provider simply bills me before my secondary plan gets around to actually paying them. I fret no more over medical expenses, though what I'm paying for coverage is extortion: $264/month in 2025.
Thanks, Crash. I likely will buy supplemental (medigap). I currently have the cheapest plan available in the market and pay $850 per month (I have to check how much they charged for 2025). A few years to Medicare. If insurance and care are not available when one needs it, it does not matter how healthy one is before hand. Let us see where our HC system is in a few years.
It is important to know the distinction between PPO and HMO Advantage plans when buying one of these plans. PPO gives much greater flexibility for out of network (and out of state) hospital and specialist care. No referrals needed. My new plan with Excellus Blue Cross PPO plan costs me $34/month in 2025. For the past 4 years prior, I had a zero cost plan from Aetna with all the same coverage. With most of these plans, all routine dental visits are paid for and $1500 for specialized dentistry, extractions, crowns, root canals, ect...
FWIW, at least in my area, there are many groups or organizations that help seniors with these decisions. In fact, they do all the work of finding the best policy "for you" given your medical needs. There is no cost for the assistance and in fact, they do all the work of applying for coverage for you at no cost to you. Maybe this is common in all areas, I don't know.
Did any one experience the Med Ad PPO plans to have smaller nextworks than Med Sup plans? I am trying to figure out the economics for the insurance companies offering the former plans to be able to offer plans with comparable service to end customers. May be Medicare pays them enough. Do we know of insurance companies that offer both plans in the same State?
Someone like @msf or @yogibearbull may know the answers.
However, while out of network providers will still be covered with the PPO. your copay/coinsurance will be higher than for an in-network provider.
Did you mean to compare Medicare Advantage PPOs with Medicare Advantage HMOs? A company's network can vary depending upon the particular plan, let alone the type. I've seen Humana offer three different HMOs with three different networks in the same county, let alone a PPO that may have had yet a different network.
Insurers offer plans on a county-by-county basis, not a statewide basis. I'm sure if you check with the majors (e.g. UnitedHealthcare, CVS (Aetna), Humana, and the Blues (owned by different insurers in different states), you'll find that they often offer HMOs, PPOs, Medigap, and Part D plans all in the same county.
When my time comes, these are the two plans I would compare and evaluate. (I know Medicare Advantage PPO is not as widely available as Medigap.) The value of insurance is known only when one has to use it. I do not want to assume my current health needs would be the same forever and that can change with little notice. Is there a plan where my insurance company does not get to dictate what treatment I would get? I feel like I am caught between the payors (insurance companies) and the variable pricing of the providers. To some extent, I use insurance for their negotiated pricing.
A couple examples in my policy comparing in and out of network:
- specialist $45 vs $50
- lab work $0 vs 30%
- x-rays $50 vs $60
- outpatient hospital $375 vs 30%
- hospital care $450/day for days 1-5, vs $450/day for days 1-28
- urgent care $45 vs $45
- emergency room $110 vs $110
IMO, looking at this cost list, you want to have a dollar value associated to a benefit. A % is an added gamble since that cost is not defined and could run pretty high. These policies all have a max out-of-pocket, so you do know the worst that can happen financially (my policy o-o-p max is $8900 in netw vs $11700 out of netw).
I typically think of higher insurance premiums as a gamble that the insurance company will win 9 times out of 10. I'm pretty healthy, so I tend to gamble knowing I have enough coverage that I won't suffer large financial consequences if I do encounter a health problem.
Do you still need pre- authorization for non-routine treatment when you go out of network? If so, I guess the insurance company can still say, NO.
How do insurance companies control their costs when the insured goes out of network? The providers probably can bill at list price.
I currently buy insurance on the exchange. So, for each plan, everyone living in my zip code, my gender and my age will pay the same premium - individual prior history has no relevance. Is that how it works for Advantage and Medigap plans as well or each person’s premium is unique?
Unless they smoke. https://pmc.ncbi.nlm.nih.gov/articles/PMC7704470/
Also, premiums cannot be based on gender. And to be pedantic, zip codes can cross county lines. So two people of the same age could be charged different premiums. if they lived on different sides of a county line.
https://www.kff.org/policy-watch/protecting-people-with-pre-existing-conditions-isnt-as-easy-as-it-seems/
https://www.city-data.com/forum/new-york/462568-zip-two-counties.html
How do insurance companies control their costs when the insured goes out of network? The providers probably can bill at list price.
That's the key. With individual (ACA) PPO insurance, the OON provider can charge anything it wants. The insurance policy will say something about UCR (usual, customary, and reasonable) charges. The insurer uses this amount, if less than the amount billed, for calculating benefits paid.
For example, suppose you have a procedure that is billed at $250 while the insurer says the UCR is $100. If you have a $50 OON copay, then the the insurer will pay $50 ($100 UCR - $50 copay), and you'll be left with the bill for the remaining $200.
But with Medicare, providers either accept the Medicare fee schedule amount (they're called "participating providers"), or they accept the Medicare amount plus 15% ("non-participating providers"). That extra 15% is called an "excess charge".
Participating, non-participating, and opt-out providers
So Medicare is different. The Medicare provider (even if OON) cannot bill an arbitrary amount. And with the low payments that Medicare makes, even a 30% co-insurance requirement is not astronomical except for extensive or unusual care.
The 15% excess charge that non-participating providers may bill isn't covered by Medicare Advantage plans. It also isn't covered by most Medicare Supplemental Insurance Plans. Only Plans F and G cover it.
https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
Do you still need pre- authorization for non-routine treatment when you go out of network? If so, I guess the insurance company can still say, NO.
There are two different questions here. Do you need pre-authorization for any OON care? No you don't. Can the insurance company deny payment for that care? Yes, if it is not medically necessary. Which is why you'll want to seek authorization before you have a treatment that is subsequently denied. https://www.cms.gov/Medicare/Health-Plans/HealthPlansGenInfo/Downloads/ppofinal.pdf
At the risk of gross generalization, it seems I do not need to be overly concerned about the size of the MA PPO plan network as long as I can find Dr that accepts Medicare.
My Dad’s supplemental PPO allows him to go to which ever primary care or specialist Dr without pre approval / referral. Do MA PPO plans offer the same privilege to the insured? I know that is what a PPO plan means but I do not want to assume there are no exceptions.
My current insurance co doesn’t offer Medicare plans.
Do Medicare plans’ premiums differ based on a person’ pre-existing conditions?
I was told that once you are on a MA plan for a couple of years, you can’t switch to a Supplemental plan, unless MA plans are no longer offered in your area. It is good to know you can switch between MA HMO and PPO plans.