The time has come to declare Medicare Advantage a failed experiment that not only swindles the American people but kills them.
Medicare Advantage is a swindle
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Let’s talk about a $600 billion swindle. A recent study makes a compelling case for abolishing Medicare Advantage. How much will it take for us to vote out of office anyone who supports Medicare Advantage? This program is a fraud. It is your money being taken away by a few wealthy plutocrats, giving the impression that they are doing good. For anyone who says, “Oh, I love my Medicare Advantage,” let’s be blunt: we have got to stop being selfish and gullible. Do you know why you must re-up Medicare Advantage every year while traditional Medicare is a right for getting to the ripe old age of 65? Because if they are not profiting a lot from your plan, YOU WILL BE FORCED INTO ANOTHER! Medicare Advantage was not created for you. It was created as a revenue stream for a few corporate shareholders.
Medicare Advantage may seem fine now, but as the people in your plan get sicker, that plan will eventually be priced out of the market. If Medicare Advantage were so good, you would not have to resign every year and likely change policies when the plan is no longer cost-effective, not for you or your doctor, but for the plutocrats on top—the oligarchs, the executives.
A new academic analysis published in JAMA Internal Medicine details the enormous sums privatized Medicare Advantage plans have cost taxpayers in recent years, calling for the program’s abolition. According to the nonpartisan Medicare Payment Advisory Commission, Medicare Advantage plans have overcharged the federal government by $612 billion since 2007 and $82 billion last year alone. Medicare Advantage is now used by more than half of the eligible Medicare population. These plans use a range of tactics to reap larger payments from the federal government, which provides insurers with a lump sum for each enrollee. The payment size depends on the enrollee’s health, which Medicare Advantage plans notoriously portray as worse than it is to receive heftier government payments. In other words, they cheat.
Despite these overpayments, the new study reads that Medicare Advantage plans spend 9% less on medical services than fee-for-service Medicare for comparable enrollees. If Medicare Advantage pays for less care, where do the overpayments go? Some pay for supplementary benefits, although plans do not disclose how much they spend on them. Medicare Advantage enrollees do not get significantly more dental care or incur lower out-of-pocket dental costs than those in standard Medicare. Instead, overhead and profit eat up the lion’s share. The study’s authors estimate that Medicare Advantage plans’ overhead from 2007 to 2024 was $592 billion, equivalent to 97% of taxpayers’ $612 billion overpayments.
Dr. Adam Gaffney, an assistant professor of medicine at Harvard Medical School and the lead author of the new study, stated that Medicare Advantage is a bad deal for taxpayers. Money that could be used to eliminate all co-payments or shore up Medicare’s trust fund instead lies in the insurers’ pockets. The private insurers keep Medicare Advantage enrollees from getting needed care by erecting bureaucratic hurdles like prior authorizations and payment denials.
Gaffney and co-authors Dr. Stephanie Woolhandler and Dr. David Himmelstein, co-founders of Physicians for a National Health Program, argue that the time has come to declare Medicare Advantage a failed experiment and abolish it. “Medicare Advantage plans have, in effect, stolen hundreds of billions from taxpayers,” said Himmelstein, a lecturer at Harvard Medical School and a research associate at the consumer advocate group Public Citizen. The private plan scheme also raises seniors’ Part B Medicare premiums, even if seniors who do not choose to enroll in Medicare Advantage subsidize the private plans’ profit.
The authors observe that eliminating Medicare Advantage would allow the federal government to use roughly $88 billion in estimated Medicare Advantage overpayments for the coming year to upgrade benefits for all Medicare beneficiaries. Traditional Medicare typically does not cover dental, vision, or hearing services, often leading people to choose Medicare Advantage. A smarter, thriftier way to expand benefits and lower out-of-pocket costs is possible for all Medicare beneficiaries. But first, we must eliminate Medicare Advantage and double down on traditional Medicare, covering all enrollees in an expanded and improved Medicare program. The analysis concludes that this would be a good deal for patients and taxpayers.
Think about it: not having to deal with pre-authorizations and bureaucratic hurdles. Wendell Potter, a former insurance executive turned critic of Medicare Advantage, told Common Dreams that he agrees with the study authors that Medicare Advantage should be eliminated. Medicare Advantage has never saved taxpayers a dime since its creation during the George Bush administration. Instead, it has cost us $592 billion over the last 17 years due to high administrative costs and how insurers rig the system to get paid excessively every year, said Potter, president of the Center for Health and Democracy. The program is entrenched, and the companies have so much political influence over Democrats and Republicans through campaign contributions that eliminating the program will be a heavy lift in the near term.
That means proposals to reform Medicare Advantage to address overpayments and abuses like prior authorizations are essential and important for reform advocates to support. The biggest grifters and thieves are not the poor people asking for a little assistance from the government. It is the corporations that have received big tax cuts while ripping us off by taking Medicare Advantage money and not providing the service, having pre-authorizations, and getting people killed so that they can continue to have their yachts.
We cannot tolerate this any longer. We must act. We must populate the internet with our progressive message, which most Americans want. Help us spread this truth and join the fight to abolish Medicare Advantage for a fairer, healthier America.
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