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From the staff of the Tampa Bay Times

No special Medicare Advantage deal for South Florida, Nelson says



Sen. Bill Nelson's office flatly denied today that a deal sparing some Medicare Advantage plans from cuts only applies to three South Florida counties that are heavily Democratic -- a charge being spurred by a controversial St. Petersburg doctor and has taken on life on the Web.

"That is totally false," said Nelson spokesman Dan McLaughlin. "It is clearly a scare tactic by a minority of folks on the fringes of the debate, on the far right."

Nelson successfully tacked on an amendment to the sprawling Senate health care reform bill that would prevent cuts to Medicare Advantage plans offered in high cost areas -- particularly Florida but also New York and California.

In Florida, about 800,000 people would be protected, according to Nelson's office. Another 100,000 or Floridians would not be affected but they reside in areas where cuts would not occur or would be insignificant, according to Nelson's office.

But St. Petersburg doctor David McKalip has been challenging that and implies Nelson carved out a "special deal" for about 300,000 seniors in Palm Beach, Broward and Miami-Dade counties. McKalip has been demanding answers from Nelson's office and has spread his analysis to media outlets and citizens. Fear has begun to set in, as evidenced to phone calls to the St. Petersburg Times.

"Nelson said the seniors will be protected, we’re not going to do this on the back of seniors," said a 67-year-old man from Palm Harbor who refused to give his name. "But he is protecting a specified group of seniors."

Conservative blogs have picked up on the issue. "Gee, I thought the role of a United States Senator was to insure that all the citizens of that state are protected from federal government over reach. Well our wonderful Senator Bill Nelson is protecting some of Florida's citizens from cuts in Medicare Advantage. Which citizens? Those who live in Broward, Dade and Palm Beach counties." Richard Swier wrote on Red County.

"So what is so unique about these three counties? They are all controlled by Democrats and hold high numbers of loyal Democrat voters. This is legislative fraud, waste and abuse. What about the other 64 counties? Shouldn't we protect all of Florida's citizens from cuts in Medicade (sic) Advantage? Not according to Senator Bill Nelson. This is Chicago politics with Bill Nelson taking from some seniors to give to others."

McKalip in recent years has become an outspoken advocate for property tax reform and conservative causes. His tactics have sometimes caused controversy, such as this summer when he forwarded an e-mail containing an image that portrayed President Barack Obama as a witch doctor in a loin cloth and headdress with bones in his nose. He was forced step down as president-elect of the Pinellas County Medical Association and became less visible.

But the health care debate has brought him into the mix again.

McKalip is basing his assertions on a recent speech on the Senate floor by Sen. Mike Crapo, R-Idaho. Crapo invoked the Nelson amendment and wondered by "just a few" people in Florida would be protected. He then said it was "primarily in three counties" Palm Beach, Broward and Miami-Dade.

It's true those counties would far well if Nelson's amendment is part of the final health care bill. But that's because those areas have a lot of seniors and because medical care is expensive. Nelson's office said there are an additional 500,000 people across the state -- in scores of other counties -- who would also be protected.

McKalip is far from satisfied. He said bill language implies certain counties would get "extra benefits" under complex Medicare Advantage formulas. "All I’m doing is asking questions which aren’t being answered. They will not answer the questions."

The proposal to cut funding to Medicare Advantage, which cost the government 14 percent more than traditional Medicare, seeks to reel in some of those inequities by leveling out costs across geographic regions of the country. For example, it might cost $400 for a procedure in rural Iowa but $1,000 in Miami.

Nelson argued that participants should not be penalized because they live in a high cost area. Crapo, Sen. John McCain and other Republicans aren't trying to fight the idea; they just want all Medicare Advantage recipients grandfathered.

Crapo's office has not yet returned a phone call to the Times.

Nationwide, more than 10 million people are enrolled in Medicare Advantage. Some Democrats, including those from Florida, would rather not grandfather in anyone, saying that the private companies pocket a good part of the extra 14 percent from the government.They pass along some in the form of "goodies" such as vision and hearing care and gym memberships.

What's more, all Medicare beneficiaries pay an extra $3 a month in premiums to subsidize Medicare Advantage, "creating a new form of inequity," according to a report by the Medicare Payment Advisory Commission, which provides research for Congress.

"This is a very important correction for anyone who cares about Medicare and older Floridians," U.S. Rep. Kathy Castor, D-Tampa, told the St. Petersburg Times in September. "Ultimately, with the budget deficit that we have in this country, there is absolutely no reason to be subsidizing private health insurance companies."

[Last modified: Thursday, September 9, 2010 1:10pm]


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