It's never enough, for some people (
by Dan Burns
May 2, 2023, 7:30 AM

Medicare is being privatized, right in front of our faces

Having the greedhead parasites take over Social Security and Medicare, and subsequently run them into the ground in their standard “profits way, way over people” fashion, has been an ultimate goal for them for a long time. Stand strong, we’re told, and we won’t let it happen. But in fact it’s been happening, with Medicare, for a while now, and relatively little fuss is being made about it all.

I am of course referring to Medicare Advantage plans.

A new analysis released (in February) shows that insurance giants are benefiting hugely from the accelerating privatization of Medicare and Medicaid, which for-profit companies have infiltrated via government programs such as Medicare Advantage.

According to the report from Wendell Potter, a former insurance executive who now advocates for systemic healthcare reform, government programs are now the source of roughly 90% of the health plan revenues of Humana, Centene, and Molina…

“The big insurers now manage most states’ Medicaid programs—and make billions of dollars for shareholders doing so—but most of the insurers have found that selling their privately operated Medicare replacement plans is even more financially rewarding for their shareholders,” Potter wrote. “In addition to their focus on Medicare and Medicaid, the companies also profit from the generous subsidies the government pays insurers to reduce the premiums they charge individuals and families who do not qualify for either Medicare or Medicaid or who work for an employer that does not offer subsidized coverage.”

…”It needs to be ended,” Potter, executive director of the Center for Health and Democracy, said of Medicare Advantage, whose major players frequently overbill the federal government and deny patients necessary care. The program is run by private insurers with government money.
(Common Dreams)

“…deny patients necessary care.” You especially don’t want to be on MA if you have, for example, cancer. The Biden administration is trying to do some reforming, but pulled back on the timing after ferocious lobbying from Big Insurance.

Seniors go with MA because the plans, which often offer (for example) full dental and prescription drug coverage, make more sense for them in the here and now than traditional Medicare does. Well, that plus downright overwhelming, not to mention at times apparently criminal, sales tactics.

The obvious solution isn’t “reforms.” It’s Medicare For All. But that won’t happen until we’ve destroyed the political power, at the federal level and in the judiciary, of Republicans and conservative Democrats alike.

Comment from Mac: I agree that Medicare For All would be the best … sadly, the political disposition in Congress makes that unlikely in my lifetime.

When I turned 65, I was inundated with mail pushing MA plans … and I did not like the fact that the insurance companies were making money on processing these claims. So pigheadedly, I signed up for standard Medicare and paid for a Prescription Drug plan … then when it came time for my renewal, I heard that my region was getting more companies offering MA plans … so I went to a couple of sales pitches … and heard what they offered … my prescription drug plan would be at no cost … they provided Silver Sneakers gym memberships at no cost … they offered selected over-the-counter and healthy foods items at no or reduced cost … and the Medical Advantage policy premium was zero dollars. So I took a deep swallow and signed up. Since then, the MA programs have changed … actually expanding the services covered … I got my shingles shots for $6 instead of the $400 it would have been (now that is covered by all plans thanks to Biden) … they improved the dental plan … and I pay zero for routine doctor visits. My health is good … and am not taking any pharmaceutical drugs, so my expenses under MA are virtually zero.

I don’t know what the costs could be if I got a cancer diagnosis but my policy has a cap on it … and my impression is that MA plans would require me to pay less than traditional Medicare.

How MA plans can make money by giving me a free plan is head-scratcher (I know they make money by processing the claims but how do they make money by providing vitamins, first aid supplies, socks, gym memberships and dental services is perplexing.)

Congress will work to protect MA plans … but also protect traditional Medicare.

The problem that I see is that all areas are not created equal … Minnesota has nine regions … and there are different MA providers for the various regions … for example Blue Cross Blue Shield covers 66 out of the 87 counties in Minnesota … and does not offer a zero cost MA plan in all areas.

Second problem is that the cost of medical care for anyone that does not have insurance is beyond reasonable. After my last physical, my doctor did not like my PSA reading and weight loss (he told me the previous year to lose weight), so he said come back in six months for another PSA test. He, also, wanted me to get a chest x-ray because of the weight loss … I declined since I have never smoked nor worked in a smoke-filled environment. If I didn’t have Medicare, I wouldn’t have come back for the PSA test … even though it would have been only $131.75, I knew that my weight loss had triggered the elevated PSA reading. I got the poke and the PSA results came back as normal … and he is not worried now … and my MA plan paid the full amount for the test. IMO, the doctor was being over cautious … and as long as someone was paying for the tests, he would ask for them.

Yep, I am one of those “Seniors that go with MA because of the expanded services .. it is too good of a deal” … but I wish everyone could get this deal.

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