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The Insidious Creep of Medicare (Dis)Advantage

Crappier coverage for us, even more money for insurance companies.

Crappier coverage for us, even more money for insurance companies.

By
• Topics: USA / Global, Health,

Guest Writer Carol Kemp retired from a large, multinational technology company that forced its retirees to join a Medicare Advantage plan or lose all company health care benefits.  She chose to lose her benefits.


The Centers for Medicare and Medicaid Services (CMS) is holding a public comment period, which ends March 1.

The proposal is for a 3.7% increase in payments to Medicare Advantage plans in 2025. 

You can make your public comment at:  

www.regulations.gov/…

Here is the comment I posted:

I am writing to oppose the 3.7% increase in payments to Medicare Advantage (MA) plans in 2025.

Medicare Advantage plans are overcharging taxpayers by up to $140 billion per year by using unethical practices such as upcoding (diagnosing patients as sicker than they are). In addition, they delay and deny necessary treatment as a means to pad their profit margins.

The excess funding that MA plans receive each year would more than cover an expansion of traditional Medicare to include dental, hearing, and vision; or totally eliminate Part B premiums; or fund the Medicare Part D prescription drug program.

More than half of eligible Medicare beneficiaries are now enrolled in MA plans with projections of 70% by 2030. In addition, four insurers now control 70% of the market.

The largest company, UnitedHealth, saw revenues of $371.6 billion in 2023, an increase of almost 15% over 2022. Net earnings increased by $1 billion to $22.3 billion. Andrew Witty, CEO, made over $20 million in total compensation in 2022, 300 times the median employee pay.

Medicare Advantage programs are proving very profitable to these insurers, with gross margins at least double their other health care markets.

Medicare was established by a Democratic president to provide health insurance for older Americans. It is one of our most popular government programs and has helped millions of seniors; however, it has not kept pace with the rising costs of medical care. The cost of Part B premiums and the lack of dental, hearing, and vision coverage, as well as prescription drugs, have made it unaffordable for many.

The focus of a Democratic administration should be to strengthen and expand Medicare rather than contributing to its further erosion by rewarding MA providers with additional funding. Without aggressive action, Medicare will cease to exist for the next generation of senior citizens. Democrats should not berate the other party for its continuous threats to Medicare when they are allowing it to die in the long run.

Comments by Readers

M. Lynda Hanscome

Feb 25, 2024

As bad as Medicare (dis)Advantage programs are for seniors, the bigger thieves will soon be the expansion of the ACO-REACH scams that are far worse.  2.1 million seniors have already been secretly enrolled in the “pilot” by the Federal Government without their knowledge or consent.

I am one of those 2.1 million seniors.  This is completely privatized healthcare.  Obama began the downgrading of Traditional Medicare and Trump ushered in ACO-REACH.  The ACOs reap up to 40% for “administrative fees” right from the get-go BEFORE the patient receives treatment in most cases.  Subsequently, the upcoding and delaying and denying scam is the same as the other (dis)Advantage programs.  I strongly suspect that seniors in the near future will be enrolled in ACO-REACH programs automatically.  This puts the for-profit entity between the senior and his/her doctor.  I have asked to be removed from the ACO at PeaceHealth and they refuse.

Lynda Hanscome, 

Retired Educator

Read More...

Dick Conoboy

Feb 26, 2024

 Carol,

Thanks for posting your article.  I submitted a comment through the portal you provided.  Here is the comment in its entirety:

“How do you expect any normal citizen to comment on 186 pages of gibberish?  What the government needs to do is get rid of Medicare Advantage in its entirety and stop the theft of billions of dollars from the Medicare Trust Fund by corporate insurers.  Simplify all this crap by going to a single payer, Medicare for all and stop the grand larceny now taking place in the Medicare (Dis)Advantage program.  Shame on you for even proffering these 186 pages of nonsensical, unreadable argle-bargle.” 

Read More...

David A. Swanson

Feb 27, 2024


...The lust and the avarice, the bottomless, cavernous greed….

(from Natalie Merchant’s “Motherland.”)

Read More...

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