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Friday, November 06, 2009

Why You Can't Get Social Security If You Refuse Medicare!

MrKen will turn 65 next year, and has been researching articles on Medicare in an attempt to ascertain whether it's worthwhile or not to sign up. On balance, the Medicare system may not represent an especially good value for seniors, both on the issues of access to certain tests and treatment options--not to mention the pressing issue of economic viability--a nice way to say it is careening towards insolvency.

Make no mistake about it, should a version of "ObamaCare" somehow become law this year or early in 2010, much of the putative 'savings' will come out of the Medicare budget; some experts estimate payments to doctors and hospitals next year would drop as much as 20%, the obvious result being that many more physicians than heretofore will refuse to accept Medicare patients. To quote a paragraph in a recent New York Times editorial entitled "Medicare Scare Mongering"- 9/26/09 -

Republican opponents have also been warning that planned cuts in payments to hospitals and other health care providers might make them less willing or able to serve Medicare patients. If true, that is a problem that Congress will have to address in the future.

"If true" - ! That certainly does not indicate that the Times has done particularly careful research on the matter. In fact, many diagnostic tests and treatments are not covered by Medicare even now, and wholesale fraud is rampant in the system, as a recent "60 minutes" documentary revealed.

But all that is NOT the point of this post.

Incredible as it may seem, if I decide to forego enrolling in Part A of Medicare--the basic hospitalization coverage--I would lose my Social Security Retirement benefits, present and future! Not only that, but since I chose early retirement at age 62, if I opt out of Health Insurance at age 65, I would have to pay back to the government ALL the benefits previously collected!

And here's why...

On August 30, 1993, the Social Security Administration added two substantive rules to its “Program Operations Manual” to address the fact that “ Some individuals entitled to monthly benefits have asked to waive Hospital Insurance (HI) entitlement because of religious or philosophical reasons, or because they prefer other health insurance.” -These rules, while promulgated by SSA, are enforced by both SSA and HHS-[Health & Human Services].-

The first rule reads:

“Individuals entitled to monthly benefits which confer eligibility for HI may not waive HI entitlement. The only way to avoid HI Entitlement is through withdrawal of the monthly benefit application. Withdrawal requires repayment of all Retirement, Survivors, Disability Insurance (RSDI) and HI benefit payments.”

The second rule reads:

“To withdraw from the HI program, an individual must submit a written request for withdrawal and must refund any HI benefits paid on his/her behalf … An individual who filed an application for both monthly benefits and HI may:

• Withdraw the claim for monthly benefits without jeopardizing HI entitlement; or

• Withdraw the claim for both monthly benefits and HI. The individual may not elect to withdraw only the HI claim.”

Notice this Clinton rule change allows you to yield your SS benefits and keep Medicare, but you may not keep your SS retirement checks and yield your Medicare enrollment.

To read the rest of the article, go to...

Still skeptical? No, I have never heard of the "floppingaces" website either. But 'The Wall Street' in an editorial dated 10/28/08 wrote:

Senior Liberation Act

Why You Can't Get Social Security If You Refuse Medicare

For all of America's cherished belief in choice and freedom, it remains an astonishing fact that the U.S. government forces citizens over the age of 65 into a subpar health plan of its choosing. And so it is with some hope that we greet a new federal lawsuit (Hall v Sibelius)* that aims to allow senior citizens to flee Medicare. *per MrKen

The suit comes courtesy of Kent Masterson Brown, a lawyer who has previously tangled with the government over Medicare benefits. Mr. Brown represents three plaintiffs who are suing the federal government to be allowed to opt out of Medicare without losing their Social Security benefits.

Amazingly, this is not currently allowed. While the Social Security law does not require participants to accept Medicare, and the Medicare law does not require participants to accept Social Security, the Clinton Administration in 1993 tied the programs together. Under that policy, any senior who withdraws from Medicare also loses Social Security benefits.

For the rest of the article, please follow this link:

And a follow up Journal article on 10/4/09:

'...Last week, Washington D.C. District Judge Rosemary Collyer handed a victory to three plaintiffs seeking that right. President Obama's Department of Health and Human Services had sought to dismiss the suit challenging so-called POMS rules that say seniors who withdraw from Medicare Part A must also surrender their Social Security benefits. (Part A covers hospital and outpatient services.) The judge ruled the plaintiffs have standing to contest their claim on the merits.

POMS were imposed in 1993 during the Clinton Administration and set forth rules that aren't in the statute or regulations governing Medicare. The three plaintiffs—Brian Hall, John Kraus and former U.S. House Majority Leader Richard Armey—all had health-care plans they preferred to the coverage they were compelled to receive through Medicare.

In her ruling this week, the judge said that "neither the statute nor the regulation specifies that Plaintiffs must withdraw from Social Security and repay retirement benefits in order to withdraw from Medicare." Article I of the Constitution gives Congress sole power to legislate—so when agency rules conflict with federal statute, the statute takes precedence.

The Obama Administration argued that the case should be dismissed because the plaintiffs had not exhausted the available administrative remedies for challenging POMS. Judge Collyer rejected that notion, noting that one plaintiff had sought an administrative hearing but "received no response from the SSA for approximately three years." Exhaustion of remedies was therefore "futile." A three-year wait is precisely the kind of bureaucratic hassle, or deliberate stonewalling, that government is famous for...

The response of the Obama Administration to this lawsuit is revealing about its principles, as opposed to its rhetoric. President Obama says his plan for a "public option" wouldn't be coercive, saying that "If you like your health-care plan, you keep your health-care plan. Nobody is going to force you to leave your health-care plan." But here is a case where federal bureaucrats are using their power to force Medicare on seniors. Let's hope the courts restore a genuine right to choose....(emphases MrKen)

Link to full story:

Apparently SSA conjured the requirement to sign up for part A of Medicare out of thin air "without public notice and comment."


MrKen is growing increasingly frustrated and alarmed with the Obama Administration. Along with comedian & libertarian Bill Maher, I really cannot see very much difference between Bush & Obama's increasingly reactionary policies. Are the aforementioned the kind of "choices" we can expect from the Administration's so-called Universal Health Care?

And no thoughtful person can seriously expect another huge new government program to actually save money over the next ten years. According to the WSJ, Medicare is now 37 times more costly (taking into account inflation) than at its inception. And it is nearly bankrupt. Considering the looming trillion dollar plus deficits on the horizon due to massive overspending and yet another expensive, open-ended military adventure -Afganistan- where exactly will the money come from? The same Times editorial optimistically opines:

...The Obama administration and Congressional leaders are hoping to save hundreds of billions of dollars by slowing the growth of spending in the vast and inefficient Medicare system that serves 45 million older and disabled Americans. The savings would be used to help offset the costs of covering tens of millions of uninsured people. (italics mine)


As I noted, where will the money come from?


On Oct. 13, lead counsel for the plaintiffs, Kent Masterson Brown, discussed the lawsuit and recent judicial rulings re Hall v Sebelius at a Capitol House Briefing. Also speaking was Michael F. Cannon, Director of Health Policy Studies, Cato Institute, and co-author of Healthy Competition: What's Holding Back Health Care and How to Free It.

How Government "Competes": Grab Arm, Twist Cato Institute: Capitol Hill Briefing

(Simply click on the above text to view video)

Finally, for an overview of articles on this lawsuit & related issues, go to "The Fund For Personal Liberty" website at

While this site appears to be a conservative mouthpiece (quoting the Washington Times, etc.) it does contain many interesting and useful references-e.g., Ron Paul on Medicare [it's broke].

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**Capitol House Briefing Curtesy of the Cato Institute-

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Anonymous Anonymous said...

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