This is Eve. For those of you who aren’t elderly, it may seem a bit parochial to spend so much time discussing Medicare. But aside from the fact that it’s a large and popular program, its evolution is also a case study in how privateering has been thwarted, at least to a significant extent, by activists and the general public.
So even skeptics who think the idea that we can strengthen the Social Security net are naive should consider that demanding it early and often will make it harder for neoliberal plunder to proceed as quickly as it might otherwise.It is important to emphasize here that in the case of Medicare, Medicare Advantage has been successful only in terms of enriching the private sector.No one in the private sector would admit that, beyond duping seniors with misleading advertising, they had another objective in creating a two-tiered Medicare system: fee-free Medicare Advantage plans and thin coverage for the relatively poor.
Author: Ed Weisbard, MD, a retired family physician in Olivet, Missouri, and president of the Physicians for National Health Programs. A common dream
Fifty-nine years ago today, President Lyndon Johnson signed Medicare into law, the culmination of a fight for universal health care that began decades earlier and continues to this day.
Since Medicare became law, it has been a shining example of what’s possible in American health care: a truly public, truly universal program that has saved countless lives and prevented enormous financial ruin for America’s elderly. But alongside this success, corporate health care interests have grown immeasurably powerful. Insurance companies like UnitedHealthcare and Blue Cross Blue Shield have erected brutal barriers to care and are laughing to the bank.
If we want to deliver on the promise of Medicare and get the best possible Medicare for All, we need to confront the power of corporate health insurance head-on. And that starts by tackling so-called “Medicare Advantage” programs.
Strategic importance Medicare Advantage
Single-payer advocates understand that there can be no “Medicare for All” without “Medicare.” And Medicare Advantage (MA) does not count as Medicare. The health insurance companies that run these plans are business-mandated to prioritize profits above all else. This is anathema to any public health program.
The National Health Program Physicians Association (PNHP) Overwhelming Evidence MA insurers harm patients, doctors, and hospitals by delaying or denying treatment — harms rarely seen under traditional Medicare. And this cruelty isn’t even a trade-off for lower health care costs. In fact, these insurers receive payments far higher than traditional Medicare would pay similar patients. $140 billion annually, or up to 35% above traditional Medicare funding levels.
There is no path to achieving Medicare for All that ignores this existential threat.
Thankfully, the voices in support of eliminating overpayments for MA go far beyond those already working for single-payer. This fight strengthens our movement by mobilizing a broad range of people who understand or can be educated about the harm that insurance companies are inflicting on patients. Where we find common ground, we should walk together.
That’s why PNHP is exposing MA overpayments and calling for a more fiscally responsible approach from policymakers. We are working closely with several organizations to help change the national conversation and provide a much-needed counterweight to the lobbying power of big insurance companies.
When MA was created in 2003, commercial insurers promised to reduce health care costs through care coordination and improved health outcomes. A healthier population would be cheaper, they argued. We should demand that MA companies deliver on these lofty promises. Without it Billions of dollars in overpayments.
I’d love to see them take on the challenge.
Improved Medicare…for All
Recovering $140 billion a year in overpayments raises an interesting question: How could that money be used to improve Medicare for all seniors?
In lieu of the meager benefits offered by MA plans, these funds would help add robust hearing, vision and dental benefits, eliminate Medicare Part B premiums entirely, and include prescription drug benefits in Medicare Part D. Imagine the peace of mind seniors on Medicare Advantage would feel when they enroll in this plan. Actually cover It offers a full range of dental care while freeing you from the narrow provider networks and pre-authorization requirements imposed by MA plans.
Most importantly, Medicare out-of-pocket limits must be set low. Insurance companies lure seniors and people with disabilities into the Medicare trap by offering low upfront costs, while hiding huge barriers to accessing care. It’s a classic bait-and-switch tactic. Eliminating the requirement to buy Medigap would create a level playing field and everyone Stay with traditional Medicare.
Well, not everyone, but that is our ultimate goal. PNHP advocates for a national single-payer health insurance system, but what better way to get there than an improved version of the Medicare system we already have?
If there are middlemen between patients and the care they need, they should be removed. If your provider network is limited, expand it. If you have piles of prior authorization paperwork, throw them out.
We should also expand benefits to cover all medically necessary care, and finally eliminate the copayments that stop people from seeing a doctor. With these improvements in place, we will have a program worthy of the name Medicare for All.
Advocacy efforts around these priorities – eliminating MA overpayments, improving traditional Medicare, and realizing the vision for single payer – overlap and reinforce each other.
Let’s work to build a movement of seniors, doctors, students, people with disabilities, and everyone who cares about Medicare. Together, we can take on the corporate insurance companies that are causing so much disruption to our lives and lay the foundation to win a single-payer system. everyone And leaves Nobody is here.
