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No. of Recommendations: 6
The new Medicare part B premium is going from $148.50 for most, to $170.10/month, for an annual increase of $259.20, except for higher income households subject to the IRMAA surcharge. So why such a large jump of 14.55% when the Social Security COLA was 5.9%. Here's the official reason given by Medicare chief Chiquita Brooks-LaSure

“The increase in the Part B premium for 2022 is continued evidence that rising drug costs threaten the affordability and sustainability of the Medicare program,”

Huh???

Drugs? Does she mean prescription drugs covered by a part D plan? This has nothing to do with part B, or at least that was my initial thought. However, Part B does cover prescription drugs administered to outpatients or patients getting same day surgery.

Turns out much of this increase, above 'normal' medical cost inflation, is for a single drug, Aduhelm (Biogen). This drug has conditional approved by the FDA for the treatment of Alzheimers but only for those with mild cognitive impairment or mild dementia rather than more advanced stages of the disease and dementia. Clinical trials have shown it not to be effective in slowing plaque formation unless administered in high doses, which itself carries the risk of brain swelling and inflamation. Its administered in a Dr's office meaning it will be covered by Part B. It is projected to cost about $56,000 per patient per year. The Alzheimer's Association estimates about 500,000 of the about 6,000,000 diagnosed with the disease MAY benefit from the treatment.

But here's where it gets a bit weird. Medicare has not approved Aduhelm for coverage, and so neither have private insurers who offer Medigap and Medicare Advantage plans. Although initially there was a strong public sentiment to push this drug forward, follow-up studies have shown the drug has only a minimal, transient benefit to some. From Dr. Zaldy Tan, who directs the memory and aging program at Cedars-Sinai Medical Center in Los Angeles. "The disease will continue and perhaps the best case scenario is that someone will get a modest improvement in their cognition (from taking the drug). But it's not going to stop the disease from progressing."

Is that worth $56 grand per year? And should 61,212,247 (2022) Medicare beneficiaries be required to pay the $21.60 X 12 = $15.9B in new Medicare premiums, most of which is going for a new drug with limited...if that....application? Or is this all really just more big government at work?


BruceM
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No. of Recommendations: 1
It is "big PHRMA" at work. It is not an effective drug for most people, so it should not have been approved except for very specific patients. Yet it will be prescribed for lots of patients who would not really benefit from the drug. Results-based outcomes should determine payment. No practical result = no payment.
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No. of Recommendations: 1
Part B actually does cover some drugs/prescriptions - e.g. inhaler medications used with
nebulizers are paid out of Medicare Part B

I believe the logic has to do with the devices needed to take the medication - however, I do not
understand what logic they use to come to that conclusion. I was told the same logic for diabetes
test strips - which I believe is nonsense.

Howie52
However, logic is a rarity in any central government program.
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No. of Recommendations: 1
e.g. inhaler medications used with
nebulizers are paid out of Medicare Part B


I believe that has to do with 'durable' medical equipment and supplies which is covered by Part B, not by Part D. Kind of like insulin, which as a medication is covered under part D but if it comes with an insulin pump, is covered under part B.

Weird rules

BruceM
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No. of Recommendations: 7
Isn't the socialist Medicare program touted for it's effectiveness in keeping healthcare costs down? Same as anything else the government gets its mitts on. Sowell said it best when he uttered:

"It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it."
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No. of Recommendations: 2
"It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it."

Not really. Substitute "the military" for "doctors, hospitals, medication".
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No. of Recommendations: 2
"It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it."

Not really. Substitute "the military" for "doctors, hospitals, medication".


Well, I never thought that jerryab2 would attempt to make a case for privatizing the military.
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No. of Recommendations: 0
I predict that this will end up like what happened about 1988. When Medicare added a long term care (nursing home) benefit. The seniors rebelled against the premium increase and they rescinded it all. I think something like that will happen here. And Biden will claim to be the hero who saved seniors from the evil inflationary increase that eats up most of the bigger-than-in-recent-years Soc Sec inflation increase.
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No. of Recommendations: 8
Substitute "the military" for "doctors, hospitals, medication".

National Defense is the constitutional duty of the Federal Government, providing health insurance and running a healthcare system is not.
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No. of Recommendations: 0
National Defense is the constitutional duty of the Federal Government, providing health insurance and running a healthcare system is not.

Guess again. Here, this might help your memory:

https://www.archives.gov/founding-docs/constitution-transcri...

https://en.wikipedia.org/wiki/Marine_Hospital_Service

Or are these "dead" because they are "too old"? LOL !!!
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No. of Recommendations: 2
"It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication somehow think that we can afford to pay for doctors, hospitals, medication and a government bureaucracy to administer it." -- T. Sowell

A single-payer medical-care system would leave the people facing a monopoly.

A single-provider medical-care system would do that AND leave the doctors, nurses, etc. facing a monopsony.

The US government has long regarded monopoly as bad, and lately has recognized that monopsony is similarly bad.
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No. of Recommendations: 4
"National Defense is the constitutional duty of the Federal Government, providing health insurance and running a healthcare system is not."

Guess again. Here, this might help your memory:

https://www.archives.gov/founding-docs/constitution-transcri......


Sorry jerrytroll, but you are wrong again. If you go to

Article. I., Section. 8. it say "The Congress shall have Power To;

To define and punish Piracies and Felonies committed on the high Seas, and Offences against the Law of Nations;

To declare War, grant Letters of Marque and Reprisal, and make Rules concerning Captures on Land and Water;

To raise and support Armies, but no Appropriation of Money to that Use shall be for a longer Term than two Years;

To provide and maintain a Navy;

To make Rules for the Government and Regulation of the land and naval Forces;

To provide for calling forth the Militia to execute the Laws of the Union, suppress Insurrections and repel Invasions;

To provide for organizing, arming, and disciplining, the Militia, and for governing such Part of them as may be employed in the Service of the United States, reserving to the States respectively, the Appointment of the Officers, and the Authority of training the Militia according to the discipline prescribed by Congress;”

And Article. II. Section. 2. say;
"The President shall be Commander in Chief of the Army and Navy of the United States, and of the Militia of the several States, when called into the actual Service of the United States; . . ."

That sounds like National Defense to me. If you read that Wikipedia article that you posted it say
The origins of the system of Marine Hospitals can be traced to the passage, by the 5th Congress of the United States, of "An Act for the Relief of Sick and Disabled Seamen" in 1798.”
, an act of congress not something that is in the constitution. You might want to read A brief history of Medicare in America at https://www.medicareresources.org/basic-medicare-information..., a fairly recent law from 1965 also something not in the constitution.
;-)

C.J.V.
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No. of Recommendations: 1
Sorry jerrytroll, but you are wrong again.

LOL !!!

I wondered if you would try that, and you did. Failed again too.

Here is the part you *chose* to ignore because it is, as you said, part of the US Constitution:

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."

Note the "promote the general Welfare" portion--which comes *immediately* after "provide for the common defence". No reason to omit it unless one was *trying* to hide the clearly stated fact.

Thus, the Act for the relief of sick and disabled seamen falls into two categories:

1. National Defense, AND
2. Promote the general Welfare.

That Act was written *after* the US states approved the US Constitution. The same people involved in the creation of the Act were fully aware of the contents AND the meanings contained in the US Constitution--because they were either directly involved in creating it AND/OR they could ask the actual authors/creators of the US Constitution about what was meant if an area was ambiguous in terms of interpretation. Thus, the health care law was lawful when and how created AND carried out.

Thus, the authority of the federal govt to require *individuals* to buy health insurance is a long-established precedent in the US. That law is far older than the "Party of Lincoln"--and Lincoln supported that law. In order to have people who are *able* to serve in the military, they must be healthy enough to do so. Thus, by definition, health care is a major National Defense issue. The military today says many US citizens are unable to serve in the military due to health care issues that could be be treated if there was a national health care law.
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No. of Recommendations: 1
. . . Note the "promote the general Welfare" portion--which comes *immediately* after "provide for the common defence". No reason to omit it unless one was *trying* to hide the clearly stated fact.

Thus, the Act for the relief of sick and disabled seamen falls into two categories:

1. National Defense, AND
2. Promote the general Welfare.

That Act was written *after* the US states approved the US Constitution. The same people involved in the creation of the Act were fully aware of the contents AND the meanings contained in the US Constitution--because they were either . . .


Sorry JerryTeoll but you liberals have been woofing about the general welfare statement and implying that it means the Federal government can enact any laws it wants. In the case of the Marine Hospital Service the article states;
“The Marine Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the United States Merchant Marine, the U.S. Coast Guard and other federal beneficiaries.
In the early 1800s, the merchant marine, the navy and the coast guard were considered as part of the Militia and was considered “federal beneficiaries”, which fell under Article I, Section 8.

Amendment X of the constitution states;
“The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”, which also you liberals have been trying to ignore for over a century. In Louisiana we have a system of charity hospitals to care for the poor. You might want to read Big Charity: The History of Charity Hospital
by Robert Leighninger which can be found at https://64parishes.org/the-history-of-charity-hospital . it was originally funded by a shipbuilder and was later funded by the state, not the Federal Government.
;-)

C.J.V.
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No. of Recommendations: 1
"promote the general Welfare"

Liberals seem to conflate the words promote and provide. They are two different words with two different meanings.
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No. of Recommendations: 2
I believe it's already firmly established that the Preamble to the Constitution does not, in and of itself, grant the federal government any powers whatsoever.

The means by which the federal government is permitted to "promote the general welfare", together with some restrictions on those means, are detailed in the Constitution itself.
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No. of Recommendations: 0
I believe it's already firmly established that the Preamble to the Constitution does not, in and of itself, grant the federal government any powers whatsoever.

The means by which the federal government is permitted to "promote the general welfare", together with some restrictions on those means, are detailed in the Constitution itself.


I think you all are talking past one another.

The Constitution gives Congress a number of powers, but imposes very few 'duties' on it. Congress has a lot of powers to raise and support federal armies and other matters of national defense, but Congress is not obligated to exercise any of them. Indeed, a number of the Founders had strong feelings about whether to have a national, federal army at all - though ultimately the Congress has always provided funding for national forces.

The Constitution also gives Congress the power, but not the duty, to spend money to provide for not just the common defense, but also the "general Welfare." Whether this allows Congress to spend on anything that it deems to be in the general welfare or whether such spending had to be in furtherance of one of the other enumerated powers was a subject of considerable debate early in the country's history, with Hamilton and Madison disagreeing strongly (Hamilton favored the former, Madison the latter). SCOTUS has consistently ruled in favor of the Hamiltonian approach - Congress has the power to spend money on anything that provides for the general welfare, which is how programs like Medicare and the like are permissible.

Again, Congress has no duty to fund either an army or health care, but has the power to fund either or both if it chooses.

Albaby

Note that the power to spend in furtherance of the general welfare is not the same as the power to regulate in furtherance of the general welfare.
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No. of Recommendations: 0
The Constitution also gives Congress the power, but not the duty, to spend money to provide for not just the common defense, but also the "general Welfare."

That clause, with that interpretation, renders almost all the rest of Article 1 Section 8 utterly meaningless. And therefore, by longstanding precedent, must be considered invalid. And there is LONG precedent for that position: "This specification of particulars [the 18 enumerated powers of Article I, Section 8] evidently excludes all pretension to a general legislative authority, because an affirmative grant of special powers would be absurd as well as useless if a general authority was intended.” - Alexander Hamilton

The question is: is that clause a "tax and spend" clause, or merely a "tax" clause? And if the former, how broad is the "spend" portion?

In the legal environment of the Articles of Confederation, there was a clear need for a "tax" clause. Under the AoC, the federal government could only ask the states to contribute money. Those requests were rarely met in full.

And a "spend" clause? Well, the states that DID contribute, often put strings on it - "we'll contribute half what you asked for, on condition that you spend half of our contribution on digging a canal from here to there to improve our access to markets." Such a constraint was likely legally unenforceable; but if the feds agreed to it and got the money and then didn't spend it as promised, how would that state (and other states) respond to the next federal request for contributions?

A "spend" clause was needed mainly to say that a state couldn't put additional, extra-constitutional restrictions on federal spending.

There is an alternate interpretation saying that meaning of the "general welfare" qualification is that the federal government can't tax the entire federation for a project that benefits only one portion of it - the project as a whole must benefit the entire federation.

Now imagine, for a moment, if the clause in question did not include the word "spend".

Would that mean that the federal government could, per clause 12, "raise and support Armies," and per the next clause also "provide and maintain a Navy," but not spend any money on the Army and Navy?

If your answer is no, then the clause as it actually exists is not the basis of the federal government's authority to spend money.
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No. of Recommendations: 0
Would that mean that the federal government could, per clause 12, "raise and support Armies," and per the next clause also "provide and maintain a Navy," but not spend any money on the Army and Navy?

Yes. However, you have omitted an important point: Elections.

If the voters are paying for something via taxes, how would (to quote you) "the project as a whole must benefit the entire federation"? There would be a quick change of Congress at the next election if people were taxed but not getting what was promised when the money was spent elsewhere.

Remember what happened *in the courts* when money was diverted *from* the military to build walls? The transfers were deemed illegal as they were contrary to what Congress had ordered be done with the money. So who pays back the money to the military? When does the military get their money returned so they can build the facilities Congress ordered be built with the appropriated funds?
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No. of Recommendations: 0
Congress has the power to spend money on anything that provides for the general welfare, which is how programs like Medicare and the like are permissible.

Again the use of the word provide where promote is the constitutional language.
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No. of Recommendations: 2
That clause, with that interpretation, renders almost all the rest of Article 1 Section 8 utterly meaningless. And therefore, by longstanding precedent, must be considered invalid.

That is incorrect. The Spending Clause is an independent grant of power, one that is separate from and additional to the other grants of power in Art. 1, S. 8. Again, this was a subject of a lot of dispute between the Founders early in the days of the country. SCOTUS reviewed the debate about a hundred years ago, and unequivocally interpreted the Spending Clause to be an independent Power of Congress, and it has held to that interpretation ever since:

Since the foundation of the Nation, sharp differences of opinion have persisted as to the true interpretation of the phrase. Madison asserted it amounted to no more than a reference to the other powers enumerated in the subsequent clauses of the same section; that, as the United States is a government of limited and enumerated powers, the grant of power to tax and spend for the general national welfare must be confined to the enumerated legislative fields committed to the Congress. In this view, the phrase is mere tautology, for taxation and appropriation are, or may be, necessary incidents of the exercise of any of the enumerated legislative powers. Hamilton, on the other hand, maintained the clause confers a power separate and distinct from those later enumerated, is not restricted in meaning by the grant of them, and Congress consequently has a substantive power to tax and to appropriate, limited only by the requirement that it shall be exercised to provide for the general welfare of the United States. Each contention has had the support of those whose views are entitled to weight. This court has noticed the question, but has never found it necessary to decide which is the true construction. Mr. Justice Story, in his Commentaries, espouses the Hamiltonian position. [Footnote 12] We shall not review the writings of public men and commentators or discuss the legislative practice. Study of all these leads us to conclude that the reading advocated by Mr. Justice Story is the correct one. While, therefore, the power to tax is not unlimited, its confines are set in the clause which confers it, and not in those of § 8 which bestow and define the legislative powers of the Congress. It results that the power of Congress to authorize expenditure of public moneys for public purposes is not limited by the direct grants of legislative power found in the Constitution.

https://supreme.justia.com/cases/federal/us/297/1/
https://constitution.congress.gov/browse/essay/artI_S8_C1_2/...

Albaby
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No. of Recommendations: 0
Again the use of the word provide where promote is the constitutional language.

The Preamble says promote. The Spending Clause in Article I says provide:

Article I, Section 8, Clause 1:

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;


https://constitution.congress.gov/browse/essay/artI_S8_C1_2/...

Albaby
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No. of Recommendations: 1
Thank you for the correction. It put into question/debate one of several objections I have to Federal government run socialized medicine as well as Government run socialized retirement system.
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No. of Recommendations: 4
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

After considering this for a while, I have come to realize that the clause states "...to provide for ...general Welfare of the United States" it does not say for the people of the United States.

With this distinction in mind, I believe the General Welfare intended to be provided is for the nation as a whole and not for each individual. I would submit then that providing socialist programs does NOT benefit the nation as a whole.
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No. of Recommendations: 1
After considering this for a while, I have come to realize that the clause states "...to provide for ...general Welfare of the United States" it does not say for the people of the United States.

With this distinction in mind, I believe the General Welfare intended to be provided is for the nation as a whole and not for each individual. I would submit then that providing socialist programs does NOT benefit the nation as a whole. - Johnski


---------------

Good observation.

I think "welfare" is appropriate for citizens and legal immigrants for a temporary period to help them get though some crisis, but not as a way of life. Bonafide mental illness should be treated as such and is a separate issue that plain old welfare.

Repeatedly making making poor choices leading to continuing dependency is not a condition that should be subsidized by government (aka taxpayers).
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No. of Recommendations: 2
And yet the Left makes exactly the reverse argument. That redistribution benefits society more than it hurts the "rich b*&#@$^s" who get shaken down. I lean toward the Right on this and most (but not all) issues. But it is scary that only about half of the population pays Federal income tax (I get it that they pay other taxes, but not FIT). They have no skin in the tax law game. The latest tax proposals that were floated to pay for Blow Bigger Bucks (BBB) were downright scary. They could still happen soon or in the not too distant future. And on top of all this endless new spending, they have yet to fix SS & Medicare.
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No. of Recommendations: 1
"Repeatedly making making poor choices leading to continuing dependency is not a condition that should be subsidized by government (aka taxpayers). "

************************************************************************************

But elections do have consequences - especially when people making poor decisions are more
in evidence than those making good decisions.

Howie52
However, eventually people see that voting for the same people produces the same results.
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