The Privatization of Medicare

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    • #432123
      • Total Posts: 9,978

      If Medicare Advantage plans were in truth better or better deals financially than traditional Medicare Parts A and B, plus Part D, the companies offering them wouldn’t be resorting to the aggressive and costly promotional campaigns they currently employ, with sales reps calling older people’s phones day and night endlessly and making major ad buys on TV networks and the internet. They wouldn’t be resorting to costly come-ons like offers of free gym memberships and dental and drug insurance coverage either (which Congress in its “wisdom” bars government Medicare from doing in its traditional plans). The health care industry is the biggest advertiser on television and ads for Medicare Advantage are a big part of that spending, especially on networks whose viewership skews heavily toward older persons, like CBS.

      The main “advantage” Medicare Advantage plans offer, in fact, is not a benefit to subscribers, but rather to shareholders and corporate executives in the C-suites. It is an advantage that the companies get over traditional Medicare courtesy of Congress, which has been actively encouraging people to move out of government insurance and over to the private sector. The big carrot is a bonus paid annually to insurance companies for enrolling patients who are characterized as sicker, frailer, older or more seriously injured — a bonus that traditional government Medicare does not get.

      Medicare Advantage insurers received an annual fee of over $12,000 for each subscriber from the federal government. But at the same time, it’s getting those fees, the industry also stands accused of sucking up more federal money by misclassifying upward the medical problems of its subscribers, for which it then receives higher reimbursements for its coverage of their medical bills. Federal investigators claim that over the past three years, Medicare Advantage insurance firms have bilked taxpayers and the Medicare program by over $30 billion by inflating patient health conditions and risk classifications that led to over-compensation by Medicare for their costs of covering subscriber hospitalizations. In 2015 an audit by the Health and Human Services Inspector General’s Office found Humana, another major player in the Medicare Advantage business, bilked Medicare of $200 million just for its plan in Florida by overstating how ill their patients actually were.

      The annual fees alone for signing up 24 million elderly and disabled people into MA plans and keeping them or luring them off the traditional government Medicare rolls came to $288 billion in 2020. Total spending on Medicare that year was $776 billion meaning that the payment to the MA industry for patient care to their covered patients that year represented more than a third of the total federal outlay on the program! No wonder the industry is advertising for new subscribers so aggressively.


      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

    • #432147
      • Total Posts: 4,257

      That the network that skews toward older people is named “See B.S.”

      Corporate America consists of totalitarian entities laser-focused on short-term greed.

    • #432177
      • Total Posts: 589

      is there anything left to pay the medical bills?

      i have traditional medicare, need to back it up with blue cross for deductibles, co pays, and drugs. my wife has an advantage plan. it has covered everything so far, but i do not trust any corporation that can declare bankruptcy and leave us with pre existing conditions.

    • #433283
      • Total Posts: 58

      “costly promotional campaigns they currently employ, with sales reps calling older people’s phones day and night ”

      At 400 or 500 rupees per day, (~$6.50 per day) those sales reps calling you might not be so costly to insurance companies as you think.


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