ADVANTAGE? FOR WHOM?

A few days ago, I emailed the following to my local networks:

Hi Guys.

Way back in the day, Carol and I rejected Medicare Advantage basically because we didn't trust For-Profit interests -- namely the private insurance companies -- to look out for our interests. We wanted to feel that if -- God forbid -- we had a very serious medical condition, we would be able to go to a very big city like New York, or Boston, for the best doctors available, and not be restricted to the network offered by any Medicare Advantage Plan.

After all, we thought, unlike traditional Medicare, which pays by procedure, the government pays Medicare Advantage insurance companies a fixed amount per client, regardless of what is or isn't wrong with them.  So the less the insurance company spends on your care, the more money they make.

I then saw a release by AHIP -- the American Health Insurance Plan trade group -- which promotes the virtues of big insurance:

America’s Health Insurance Plans (AHIP)
February 7, 2019
AHIP Thanks Congress for the Overwhelming Support for Medicare Advantage


368 bipartisan leaders in Congress signed their support for the Medicare Advantage program. On behalf of the nearly 22 million Americans who depend on Medicare Advantage, America’s Health Insurance Plans (AHIP) thanks the 66 members of the United States Senate and the 302 members of the House of Representatives who signed bipartisan letters to express their strong support for the program.

There followed two links -- the first to a letter from the Senate, with 66 signatures,

Letter From the Senate

and the second to one from the House, with 302 Signatures

Letter From the House

I checked out the Senate letter and was relieved to see that neither New York Senator Gillibrand nor Schumer had signed it. I checked the House letter and was unsurprised to see that it had been signed by the newly elected Congressman from CD19 (our district) who, during the primary and general election campaigns, had made no secret of his coolness -- if not outright hostility -- to Single-Payer. I'm not including his name here because he is not the main issue -- which is welfare to Big Insurance.

I did, however, mention his name in the email I sent to my networks, including McCanne's admonition that

This is a clear rejection of single payer since most of the efficiencies and the egalitarianism of single payer are lost under a multi-payer system that includes private insurers...[It]  automatically eliminates any consideration of a bona fide Single Payer Medicare for All program.

What a brouhaha ensued! Many folks wrote me to say that they were going to seek clarification from our Congressman, who was shortly to appear at a local activist organization, which in turn asked me to inform "my people" that this was a benefit (for themselves, not the Congressman), so that coming to speak with him would cost them $19 each -- a fact which set off another round of emails. In the slew of emails was one from someone who said she had used Medicare Advantage for 10 years, and though she lives in Hunter, had never been prevented from seeing her doctors in New York City and on Long Island.  I saw that I needed to learn more about Medicare Advantage.

So I checked out an article by Austin Frakt in the New York Times, August 18, 2014: Medicare Advantage Is More Expensive, but it May be Worth It. 

Medicare Advantage Is More Expensive but it May be Worth It.

I urge you to read it, not only for the article itself, but also for the comments, which I found very revealing.  For one thing, apparently not all Medicare Advantage plans are the same, and some clients professed themselves satisfied with the service they receive. But the majority were critical of Frakt's article, claiming it was inaccurate at best and biased at worst. I urge you to confirm this for yourself. You'll see, among other critics of Medicare Advantage, the words of  a doctor from Albany, California, who wrote:

Can't we just be honest about this? The so-called "Advantage" plan is nothing but a poison pill to destroy a vital protection senior citizens of our nation now have. Dressing it up to make it appear to be slightly better in the short term does not alter the reality that without true Medicare to compete against we will be right back where we were before its inception. We really need to focus on quality, single-payer health care for all now, not down-spiral to another for-profit scheme that will continue to skim the cream from the middle working class.

Medicine is very hard work. Medical personnel require long, extensive and expensive training, supported by costly infrastructure. There is no "profit" for share holders and CEOs in good medical practice.

Darla Totten, MD

From Syracuse, NY, came these blunt words:

Medicare Advantage is corporate welfare, plain and simple. People who want to buy these plans should be able to do so, but the taxpayers should not have to subsidize insurance companies to make these plans feasible.

When the GOP kept criticizing Obama for "Medicare cuts," they were talking about cutting subsidies for Medicare Advantage. They are defenders of corporate welfare, not your health.

While I was writing this, I got a phone call from a volunteer from the activist group I mentioned above. She urged me to attend the benefit featuring the appearance of our new Representative. On the phone, I conveyed to her a summary of what I've been writing now, and she said, "I work in a doctor's office, so you don't have to tell me about Medicare Advantage: they're horrible, horrible! Sometimes they even deny needed care!" 

She urged me to attend the benefit and confront the Representative with my thoughts. I replied that I wouldn't mind embarrassing the man, but that I wouldn't want to embarrass the activist group, which has done good work around here. Indeed, the Representative himself may also do good work in the future -- it's just too early to tell, yet.

I've come away with the impression that so long as you don't need any serious medical interventions, Medicare Advantage might suit you. But, Heaven forbid, if you should need extensive, and expensive care, the wolf will remove his sheep's clothing and reveal himself as the bloodthirsty beast he is.  And if the enemies of traditional Medicare -- and there are many -- get their way so that a senior's only option becomes Medicare "Advantage,"  there'll be no more sheep's clothing -- only the wolves.

Dio

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PPS: We know that there are plenty out there who have stories to tell -- stories of your trying to cope with our dysfunctional healthcare system. Trouble is, we don't know what these stories are! That's where you come in. If you have a story to tell, you can email me at indivisible12401@gmail.com. You can be as anonymous as you like. Thanks!

MEDICARE ADVANTAGE FOR ALL?

On December 29, there appeared in the New York Times an article by Robert Pears titled: 'Medicare for All' Gains Favor with Democrats Looking ahead to 2020. The link, below, is worth looking at.

Medicare For All Finds Favor with Democrats

It begins with the familiar -- that increasingly, many Democrats are in favor of a government run single-payer program, But then it throws us a curve: "More than one-third of Medicare beneficiaries," it says, "are in Medicare Advantage plans, run not by the government but by private insurers."  So whether to allow younger Americans to enroll in such private plans is becoming "a hotly debated political question."

It's not hard to see why: Private insurance companies have been viewed by many progressives as the problem, not the solution. Progressives find it hard to believe that any entity making money by denying people care is going to change its stripes simply because their "new" product is termed "Medicare for All." For example,  Pears quotes a Democrat who says

“There are a lot of insurance companies and medical companies that are advocating for their own best interests, and those best interests are usually money, and not people’s health,” Representative-elect Deb Haaland, Democrat of New Mexico and a supporter of Medicare for all, said in an interview. “We need a national public health care system, which would be more affordable in the long run, and the outcomes might be better.”

But there are those -- even Democrats -- who believe that the Advantage plans ought to be considered. They ask, why take away from people the plan that they're satisfied with? And some go so far as to propose that Private Insurers run the whole thing:

“Medicare Advantage for all — that would be a much more politically feasible and a uniquely American spin on single payer,” said John K. Gorman, a former Medicare official who is a consultant to many insurers. “It would be Medicare paying all the bills, but it would be privately administered by heavily regulated plans that would effectively serve as utilities.”

"Uniquely American," eh? I suppose that if the large scale perpetrating of fraud in the name of profit is uniquely American -- which it well may be -- then this is one case where it would be best to stay away from what's uniquely American. For the truth is, as Don McCanne says,

It is clear that the private insurance industry is going to continue to do all it can to capture the present and future versions of the Medicare program, and they are doing it with the help not only of the conservatives but also the neoliberals who have infiltrated the progressive camp. We will likely be hearing much more about Medicare Advantage for All.

I fear that I may have met one of those "neoliberals" who has been newly elected to the House. But I didn't think of  him as a "neoliberal" (I hadn't heard the term before). I thought of  him simply as "Corporate." I hope he proves me wrong. But whatever he is, I have vowed to watch every vote he makes, and let him know that when he votes for the status quo, or anything like it, he's not representing me. 

I hope you'll do the same.

Dio






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CreditTom Brenner/The New York Times

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