In previous posts (Danger, Will Robinson, Danger!!! 11/30/2021 and Medicare is the new cash cow for insurers 4/23/2022) I described how Medicare is under attack by the privatizers. At a time when it should be obvious that public health measures are critical to protecting ALL of us, our state and federal governments are giving control over more and more of the “system” (and taxpayer dollars) to private corporations. Their logic is that private business is more efficient and will save money. Oh, and the advocates of privatizing everything throw in some BS about competition, even though they know that the health insurance industry is monopolized by two or three of the biggest insurers, but it makes for a good sound bite.
The history of Medicare and a comparison of where it allocates its money, should clearly demonstrate this is not true. By some accounts, as much as 25% of the money paid into the coffers of private insurers goes to administrative costs and profit. This compares to administrative costs for Medicare of somewhere between 2% and 5% and of course there is no profit cost in Medicare. Thus, Medicare is much MORE efficient than private insurance in paying for its enrollee’s health care bills, which is supposed to be the purpose of insurance.
But that’s not the purpose the private health care insurance industry. Their overarching purpose is NOT to provide for the health care of their enrollees, but to make a profit for their shareholders. And the way they make that profit is to DENY health care claims. Now comes a New Your Times article on the recently released federal report on Medicare Advantage, up until now the principal scheme to privatize Medicare.
Corporate marketing campaign make Medicare Advantage seem like a good deal, but these plans profoundly alter Medicare’s promise. Instead of a patient and their doctor choosing the course of care, the decision rests with the for-profit insurer, whose motivation is to deny coverage, by any means possible. Every dollar they pay out is a dollar less in profit. Medicare Advantage’s big selling point, avoiding the cost of Medigap insurance, makes it the perfect insurance – if you don’t get sick. But isn’t the purpose of health care insurance to protect you if you do get sick?
The Times reports that Medicare Advantage insurers routinely deny coverage for care that is covered under traditional Medicare. The report estimated that as many of 85,000 beneficiary requests for prior authorization were improperly denied in 2019 alone. And very few people go through the complicated process of appeal; instead, they forego needed care. In some cases, the Medicare Advantage insurers even refused to pay up for claims that had received prior authorization. At the same time the big private insurers are now demanding and getting more $$$ from the Medicare Trust Fund to provide coverage for their enrollees. Like big Pharma, their greed knows no bounds.
And the corporate greed of the for-profit insurers is driving up the premiums for everyone on Medicare, even those of us who are enrolled in traditional Medicare. This then allows the privatizers to argue that Medicare is too expensive and needs to be replaced with a totally privatized system, the very system which has made Medicare more expensive. Heads they win, tails we lose.
Medicare is not the only part of the medical system that is rapidly falling under corporate control. Many states have privatized various aspect of Medicaid, from delivery of services to administration of caseloads, including the power to deny treatments. These companies not only deny benefits, they constantly cut corners which endanger patients. Any transparency goes out the window; medical personnel who become whistleblowers are simply fired. For more details on the effects of privatization at hospitals, check out Diane Archer’s article Patient safety at risk in private-equity controlled emergency rooms at Jus+Care (https://justcareusa.org/).
Privatized health care is only good for one group, corporate healthcare and their private equity backers. What’s the alternative to provide coverage for all of us? Improved Medicare for All would guarantee the right of all Americans to obtain the care that they need AND would cost LESS that our current system, when all is said and done.
Let me repeat: Improved Medicare
for All would provide MORE benefits for MORE people for LESS money. Any
attempt to say otherwise ranks right up there with Trump’s claim that the 2020
election was stolen.
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