Bad Crow Review: Medicare For All
Links at the end.
Look Out for Health Insurance That Seems Too Good to Be True
That’s the headline from a Kaiser Health News (not to be mistaken for the giant health care company) story geared for health insurance/Medicare plan selection, the times for which are upon us. Unlike the photo above, which is of a real and fabulous moment, a lot of insurance plans are either not insurance plans or bad insurance plans.
It took nearly a year for Kelly Macauley to realize the health plan she bought while shopping for insurance coverage last October was not, in fact, insurance. Sure, red flags popped up along the way, but when she called to complain, she said, she was met with explanations that sounded reasonable enough and kept her paying her $700 monthly premiums.
She said she was told that her medical bills weren’t being paid because the hospital was submitting them incorrectly. That Jericho Share, the nonprofit that sent her a membership card reading “THIS IS NOT INSURANCE,” was just her policy’s underwriter, not the actual insurer. That she hadn’t received a policy welcome packet because the company was saving paper and passing those savings on to customers.
Then, this summer, the 62-year-old retired teacher who recently moved from the Philadelphia area to South Carolina, learned her plan had paid only $120 of the bill for her hip replacement last year, leaving her with a balance of over $40,000. She said she’d been assured the procedure would be covered when she was shopping for insurance. But it turns out that the plan she purchased wasn’t insurance at all but rather part of something called a health care sharing ministry.
Nationwide, lawmakers and regulators are taking notice of how health care plans are sold. Senate Finance Committee Chairman Ron Wyden, a Democrat from Oregon, is investigating complaints about the marketing of Medicare Advantage plans. And in May, the Centers for Medicare & Medicaid Services noted that complaints about marketing practices for Medicare Advantage and Medicare prescription drug benefit plans rose from 15,497 in 2020 to at least 39,617 in 2021.
“Scams involving health care have increased exponentially,” said Delaware Insurance Commissioner Trinidad Navarro, who also chairs the anti-fraud task force of the National Association of Insurance Commissioners.
With Medicare for All — and we’re talking the John Conyers version, or the Bernie Sanders version, both of which are fully funded by tax dollars and administered by the government, both of which include dental and vision coverage and are free at the point of service, both of which save a shit-ton of money over time — everybody gets a Medicare card. Nobody has to shop around other than for exotic insurance, such as for unnecessary body modifications. Nobody has to worry about getting sucked in by a scam.
By next year, half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers in the program have been accused in court of fraud.
Medicare for All would also eliminate Medicare Advantage plans, among which fraud and overbilling are rampant, siphoning billions from Medicare funds. Of the top 10 Medicare Advantage purveyors, eight have been found to be overbilling the government, and five have been sued or taken to court for fraud.
Everybody gets a Medicare card. Everybody gets dental and vision coverage. Insurance companies aren’t stealing billions in Medicare funds.
The health system Kaiser Permanente called doctors in during lunch and after work and urged them to add additional illnesses to the medical records of patients they hadn’t seen in weeks. Doctors who found enough new diagnoses could earn bottles of Champagne, or a bonus in their paycheck.
Anthem, a large insurer now called Elevance Health, paid more to doctors who said their patients were sicker. And executives at UnitedHealth Group, the country’s largest insurer, told their workers to mine old medical records for more illnesses — and when they couldn’t find enough, sent them back to try again.
Each of the strategies — which were described by the Justice Department in lawsuits against the companies — led to diagnoses of serious diseases that might have never existed. But the diagnoses had a lucrative side effect: They let the insurers collect more money from the federal government’s Medicare Advantage program.
Everybody gets a Medicare card. Everybody gets dental and vision coverage. Insurance companies aren’t stealing billions in Medicare funds. And the country saves a massive amount of money, as evidenced by multiple studies conducted by analysts from across the political spectrum.
The insurance companies are pirates and thieves on a scale most private equity firms can only dream of, but Congress and successive administrations still approve shoveling money at them. The same thing happens with for-profit companies managing Medicaid for state governments.
This is not to say we had no fraud before the privatization of Medicare and Medicaid set sail. Doctors and practices and hospitals and billing companies are tagged for fraud and overbilling all the time. But they aren’t being paid to do it. It’s not a standard industry-wide business practice.
One can look at this carnage and the toll it takes on people who aren’t insurance company executives or politicians raking in insurance company cash, and say man, that’s stupid. But it’s not stupid: absurd, yes; stupid, no. It’s immensely profitable for companies which give money to federal and state legislators resulting in laws and regulations which return millions on the dollar for their lobbying and campaign committee investments.
And this bribery isn't a partisan affair. Of the top 20 House and Senate recipients of insurance industry cash in 2022, eight are Democrats—including the number two recipient, who happens to be the Senate majority leader at the moment.
Before Hilary Clinton's presidential campaign flamed out, she was the leading Democratic recipient of money from the insurance and healthcare industries (second only to Rick Santorum), including money from Harry and Louise.Some of the same interests that tried to derail Mrs. Clinton’s health care overhaul are providing support for her Senate re-election bid. The Health Insurance Association of America ran the famous “Harry and Louise” commercials mocking the Clinton health care plan as impenetrably complex. Some companies that were members of that group are now donating to Mrs. Clinton.
Charles N. Kahn III, a Republican who was executive vice president of the Health Insurance Association in 1993 and 1994, now works with the senator on some issues as president of the Federation of American Hospitals, a lobby for hospital companies like HCA and Tenet. He describes his battles with the first lady as “ancient history,” and he said health care executives were contributing to her now because “she is extremely knowledgeable about health care and has become a Congressional leader on the issue.”
So it’s not stupid: insurance companies bribe and extort elected officials, who in turn pass laws and pressure regulatory agencies to favor their benefactors.
Everybody gets a Medicare card. Everybody gets dental and vision coverage. Insurance companies aren’t stealing billions in Medicare funds. Any other scheme allows insurers and politicians to rob and murder their customers and constituents, and pillage the treasury.
This isn’t to say people are stupid for choosing Medicare Advantage plans. Some of them offer tangible benefits at reasonable prices. Just do it in the knowledge that the chance your insurer is ripping off the government, hence taxpayers, hence perhaps you, for huge sums of money, is quite good.
Everybody gets a Medicare card. Everybody gets dental and vision coverage. Insurance companies aren’t stealing billions in Medicare funds.
We just got back from the grocery store. Inflation and and corporate profiteering across the supply chain have taken a chain saw to the food budget. Some people are voting on that.
The Beta Band, “Hot Shots II;” Spiritualized, “Everything Was Beautiful;”
And that, comrades, is all we got. Be well, take care.
A lot of people work in the insurance industry. Throwing them all out of work would present some political problems, no? Consider the attitudes of petroleum and coal workers and the political repercussions of putting them out of jobs. I'm not suggesting that their interest should prevail but I am suggesting that accomplishing medicare for all isn't just a matter of logic.