To say that President Obama is not an enthusiastic backer of the two Medicare programs that offer seniors private insurance options would be something of an understatement. Over the years, Obama has repeatedly derided Medicare Advantage — the program that lets seniors enroll in subsidized, private insurance. He once called it "wasteful," and said it amounted to "giveaways that boost insurance company profits but don't make (seniors) any healthier." Obama has been equally harsh when it comes to Medicare Part D — the drug benefit President Bush signed into law that relies on privately run plans. In his 2006 book, "The Audacity of Hope," Obama blasted the program, saying it "somehow managed to combine the worst aspects of the public and private sectors." As president, he said it gave overly generous "taxpayer subsidies to prescription drug companies." Both programs, it turns out, have been wildly popular with seniors and, by most measures, big successes. But Obama nevertheless appears determined to undermine them with sharp cuts in payments and sweeping new regulations. Started back in 1997 — and initially called Medicare+Choice — the Medicare Advantage program pays private insurers a set amount per enrollee to provide comprehensive benefits and anything else they can afford to offer. The idea was that private insurers could better co-ordinate care and manage health costs than the old fee-for-service Medicare, and so provide more comprehensive benefits. While enrollment in these private plans was flat for the first several years, it has skyrocketed since 2005, to the point where almost one in three seniors are covered by a private health plan. And, contrary to Obama's claim, these seniors tend to get better quality health care than those in traditional Medicare.
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