Topic: Health (229)

Call To Action On Medicare (Dis)Advantage!

If we do not speak out NOW on the privatization of Medicare, the system will effectively be eaten alive from within.

If we do not speak out NOW on the privatization of Medicare, the system will effectively be eaten alive from within.

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• Topics: Health, Health, Health, Health,

Update 7/27/2023.  The latest call to action to stop the raiding of Medicare is from PSARA (Puget Sound Advocates for Retirement Action).  They are calling for supporters to attend a rally on Tuesday, August 1st at 11:30am in Seattle, WA. Guest speakers will be Rep Pramila Jayapal and Alex Lawson, Executive Director of Social Security Works.  Click on the poster below for more details.   

 

 

A few days ago, I was in my ophthalmologist's office. As I was waiting to be called into his exam room, a man checking in at the counter merrily exclaimed that he had new insurance. “I just signed up for Medicare Advantage!” He was pleased as punch. My heart sank. My happy thought now is that he will read this article. 

Physicians for a National Health Plan (PNHP) is calling for your assistance. NOW is the time to comment on rules cracking down on the massive misdeeds of Medicare Advantage insurers. The antics of these Advantage insurers suck hundreds of millions of dollars from the Medicare Trust Fund by overcharging for treatment and bloating the costly management structure of your Medicare service. Comments to the Center for Medicare Services (CMS) are due by Monday, March 6th. Please go to regulations.gov and enter docket number CMS-2023-0010 in the search box. From there, follow instructions to comment.

Bear this in mind as you comment.  From the site of Protect Medicare:

"The so-called “Medicare Advantage” program allows …famously wasteful companies to administer health benefits for seniors and people with disabilities. It is likely that over half of Medicare beneficiaries will be under a Medicare Advantage plan in 2023.”

By nearly any measure, Traditional Medicare is a better deal for patients, doctors, and taxpayers. Beneficiaries may pay lower premiums up-front [with Medicare Advantage plans] but they can be burdened later on with high cost-sharing, narrow provider networks, and outright denials of care—burdens that they would not have to bear if they had enrolled in Traditional Medicare."

PNHP has provided its own comments to the Center for Medicare Services. You can use it as a guide along with other references that are provided at the bottom of this article. 

The basic message to the government is:

  1. Medicare Advantage (Medicare Part C) is inherently not reparable, as it is based on a for-profit system that distorts and impedes proper medical care.
  2. By eliminating the costly Medicare Advantage program, there can be movement to a single payer system, eliminating the profit motive.
  3. All other Medicare direct contracting such as ACO Reach must be eliminated because they drain the coffers of Medicare by excessive overhead costs and refusal of services.

More information can be found at the website of the PNHP or at its spin off/sister organization, Protect Medicare. The site of PSARA (Puget Sound Advocates for Retirement Action) has newsletters online that contain good information on the Medicare Advantage legalized theft program. Previous articles on NWCitizen (found at LINKS below) will provide additional background.

Of overall importance is that you comment, “early and often,” as the old saw goes. In this case, you can comment multiple times, especially if some new idea comes to mind. Pass these links to friends and family who are on Medicare to warn them of the pitfalls of Medicare (Dis)-Advantage.  

Last day for comments is March 6th. Please take 10 minutes to invest in the future of your Medicare.  

Related Links

About Dick Conoboy

Citizen Journalist and Editor • Member since Jan 26, 2008

Comments by Readers

James Loucky

Mar 03, 2023

I am appalled at the subterfuge associated with efforts to push Medicare Advantage policies. The costs and privatization are enough to cause outrage, but also potentially to condemn unsuspecting people - especially elderly - to further financial distress.


Instead of wasteful for-profit approaches - which are commoditized, corporatized and bureaucratic - the United States needs to join other countries in offering Medicare for all as a BASIC HUMAN RIGHT.
james Loucky

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David MacLeod

Mar 03, 2023

Thank you Dick for keeping us informed on this topic, and alerting us to opportunities for action.

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M. Lynda Hanscome

Mar 06, 2023
Re your article MEDICARE DISADVANTAGE:
 
Individuals who voluntarily sign up for any of the Dis-Advantage Medicare programs do so, thinking it is a good thing.  It is not a good deal, by the way.
 
Beware to anyone who received a PeaceHealth email or letter in the past year informing them that ‘your doctor has joined a group to help manage your care’ or that ‘you are still enrolled in Traditional Medicare’ and ‘nothing has changed for you.’   If you received a notification like this, you are no longer in Traditional Medicare.  The letter is a lie.  Your readers, who are PeaceHealth patients, might want to inquire if their doctor is in this Care Alliance REACH scam.  I suspect they all are.  
 
Back in early 2022, I was secretly enrolled in the Biden Administration’s ‘pilot’ for-profit health initiative called ACO-REACH.  The PeaceHealth program is called Care Alliance or some such appealing title.  I have written to PeaceHealth and received snippy, sarcastic responses which really say ‘You are enrolled and will remain enrolled.  Have a nice day.’  I confronted my dr. a week ago when I went for my annual wellness check up.  This is what I learned during that conversation:
 
My doctor:
- admitted to joining the ‘for profit’ scam (he was probably pressured)
- said he was upset about it for 6 months
- admitted his salary increased when he signed on 
- said that Medicare is a mess and “we have to do something…”
- was SO ready for my critique and came in with all his talking points perfected
- suggested that all family practices in town are going down this money road
- said “they” were being watched carefully.  Upcoding and reduce-and delay tactics are non-existent.  He was adamant about this.  
- had no response when I asked him how this could be if the only way the third party for-profit entity can make money is off of my carcass, and there is a set amount for my age and health bracket.  They make a profit of up to 40%.  So for, example, a $1000 allotment is reduced by up to $400 leaving my ‘managed care’ availability at $600.
 
I have written to the Biden Administration twice.  The first time I got the standard PR letter about how important good health care is…etc.  The response to my second email said they were reviewing the details, etc. etc.  That was over a month ago and I have not heard anything back.  I am not holding my breath.
 
Over 2.1 million Traditional Medicare recipients have been enrolled in these REACH scams without their knowledge or consent, and the letters from providers like PeaceHealth outright lie to them.
 
I am absolutely trapped in this scam, and you can be sure that ALL of the Dis-Advantage Medicare scams are just itching to become REACH entities as well as there is just SO much money that can be made from Medicare via the totally privatized Medicare REACH scam.
 
Just my thoughts.  And anyone or group I have contacted have really been simply an arm of the insurance companies who are part of this racket so they are simply brokers for the companies.  There does not seem to be any one-on-one patient advocates who do not have some kind of financially vested interest. 
 
I fear that the plan is for ALL Medicare recipients to become entrenched in this disastrous for-profit, PRIVATIZED Medicare scheme.  I urge your readers to investigate this for themselves, especially if they are patients of PeaceHealth and THINK that they are enrolled in Traditional Medicare.  If they got the notification I referenced above, they are NOT in Traditional Medicare.
 
Lynda Hanscome, Ed.D.
Retired
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