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Of them joining me now small business -- Clint -- founder and CEO of the Greenleaf book group and doctor Scott Gottlieb a practicing physician.
A former senior policy advisor.
For the Centers for Medicare & Medicaid Services welcome -- both great to have you both here.
Doctor -- I'll start with you since you're right on set with me here are you surprised.
About this cut back.
What surprises is an eight point eight to 9% cut Medicare Advantage part of that cut is a 2% tax on health care plans as a result of obamacare some of the other cut is because medical.
-- haven't grown as much is expected -- taking back some of the money.
What's surprising is -- taking away the ability of -- plans to manage those cuts by adjusting benefits so essentially.
The cuts are gonna come out of the bottom line of the plans they can't do anything to try to adjust the plans to offset these.
These cuts what do you make -- -- well I think they're trying to squeeze Medicare event plants.
They're trying to squeeze Medicare Advantage as you know that was a program that was put in place by George W.
Bush presents never been a fan.
-- click -- you know your small business owner.
Country have friends who are on Medicare Advantage yesterday we had news that insurers we're gonna face an additional tax.
To pay for Obama -- when this is all gonna.
-- -- an unfortunate -- -- gonna and on my back because I'm gonna keep on paying more fees and in my rates keep on going up.
In order to help bridge the differences these insurance companies are going to be getting from -- the Medicare Advantage.
It's now well I think you're right I think.
You know we -- have lots of evidence that private sector folks are having a hard time with this.
Just gesture that yesterday the Kroger CEO who has some 300000 employees said some companies might opt to pay.
-- Pratt the penalty rather than offer coverage would have been hearing rumors about this the Dunkin' brands CEO Nigel Travis saying.
Maybe we needed just -- to find full time Scott what do you make of that.
Molly good to -- allow these changes in the marketplace does business try to adjust to find ways to get out from under the mandate so.
Doing business is wanna go from you know forty hours of work weeks to bury our recent tornado -- signal come -- when the mandates they want to keep themselves under cap if fifty employees again.
-- they can avoid -- obamacare mandates wherever they set these artificial threshold in the marketplace you gonna see businesses trying to -- Johnson's gonna pay a lot disincentives to hiring.
You know at -- we're getting a lot about FaceBook comments on this.
And that I was really struck by one from Jim being used as I think that America will have socialized medicine just like they do in Canada Britain and many other countries -- -- -- I think you look at this.
It seems like it's all coming back to -- we're gonna have to foot the bill the costs are going to be socialize.
Is going to be regulated from Washington not -- my doctor.
Right in Portugal we're gonna have as equality is gonna come down because right now we have the freedom to go out -- -- free market we can actually going to care we need.
But if you start forcing all -- honest were eventually get out get the same really crappy care -- nobody really wants to have that's really the big risk I think and that's that's -- gonna get pension and.
That's that's a key point I mean insurance and -- no change to get created basically is gonna be degraded insurance is gonna be something better than Medicaid managed care but not a whole lot better.
So people get moved -- those exchanges basically anyone in the individual market is small group market it's gonna find probably the coverage they're getting isn't as good as what they have before.
To be very narrow networks when they go out of those networks can have very high coinsurance.
While that's not a positive high -- out.
-- we were promised course it wouldn't keep our doctor remember that Scott.
We gotta face the -- about that Beverly says I'm more worried my doctor relieved that their -- my doctors leave their profession.
And I have to tell yet if it it's more and more we're hearing that OK you might not have the doctor that you -- and what's more -- -- -- -- have a doctor in May be in nurse practitioner.
-- had a gonna make up the cause of gonna have a -- on physician providers lot of or that interest.
While some cases it's fine other cases by not as good as sort of page was accessing before but what you gonna find in this is basically -- -- -- Washington is the way these plans are gonna.
Come in under the budget caps and maintained their inexpensive.
You know coverage is by having very narrow network should not gonna have a lot of choice of physicians in the obamacare changes.
-- I can help but notice today apparently 12012 W -- there's gonna get an extra added little line for employer provided health insurance.
So it -- just you know not reference -- yet in the W -- now they are what is their secret little -- do you think.
Well life and -- them a CPA and I don't either admit that and in public and -- -- I mean all.
But I can tell you what what this is gonna do it's gonna help set the rates -- -- that we actually have to pay an -- every -- back on in the future and point fourteen so in 2014 you're gonna see people getting hit.
With it based for the refunds are gonna evaporate and -- start seeing a bigger says individuals.
This is a step to get us.
Acted to eliminating that advantage because let's face -- the one thing that keeps the system going as it -- Is that companies have a big fat tax break when they offers health insurance.
So they are happy to do -- Scott what happens when that goes away.
But part of thinking here's a -- let employees know how much the health benefits cost W two form if you drop coverage and put them into the exchanges the hope is that if they knew what they're getting before.
You would see employers got to make up some of that money by giving -- accident and some other form of compensation that's -- they wanted to transparent.
I mean look at I did I hear what you're saying but at the end of the day it sounds to me like they're just readying -- for another tax increase essentially.
Here's what -- be right here -- we we have a system that worked at and click I want to weigh in on this.
After -- war to win a system that was put in place essentially employers provided coverage they get a tax break to do it it worked it cost the government almost nothing about.
A 160 billion dollars these days when you count it all up.
Why do we just keep that.
Why don't we acting in a much more expensive plan that we can't afford and Tibet you know throwing up throwing away the one system that didn't work in this country.
And that's employer sponsored carrier.
Right I think it's -- -- the doctor with a broken arm and heading in stable does this is caused because you -- so we should chop off your legs.
And then you'll never trip again your your arm -- somehow he -- -- it's a broken system and the fact we're trying to fix our medical system with obamacare just doesn't make any sense at all Scott last sort.
-- essentially federally regulated the entire health -- -- through this and insurance industry.
Yeah and is that good or bad in your Cuban's gonna do get the ideas the -- -- -- down for the same low standards he can provide part of coverage that's been her.
That are meaning not is -- lead.
Care isn't isn't dead we can't get what we needed at the end of the day I think it's going to be a big disappointment for all of us.
Scott McClellan thanks for coming on tonight great to have both of you here.
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