Medicare Advantage is a prime example of how the insurance industry's insatiable greed is ruining the American healthcare system. It takes advantage of vulnerable patients by diverting funds away from life-saving medicine and treatments.
I take great pride in being the only family doctor in the country running for Congress to pass universal healthcare. The US needs a publicly-funded, non-profit national health insurance program that fully covers all medical expenses for every American citizen.
Medicare Advantage takes us further away from that goal.
How it Works
The Medicare Advantage, also known as MA or Medicare Part C, is primarily a for-profit, privately administered insurance program created in 2003 that gets a fixed dollar amount every year for each person enrolled in their program to manage their care, regardless of how much they spend on each customer. A corporation's sole purpose for even being involved is for profit.
How do they make a profit?
Over-payments from Medicare that have no health benefit
Low reimbursements
Hassles and burdensome administration issues
Denying or delaying care
The waste could pay for comprehensive vision, dental, and hearing benefits to all Medicare recipients and reduce Medicare Part B premiums.
Furthermore, when individuals realize that Medicare Advantage has deceived them and attempt to switch back to traditional Medicare, they may face difficulties returning to the program as insurance companies often decline to provide Medigap plans that cover the 20% gap in Medicare. The pursuit of profit by healthcare companies is a disservice to the American people.
Corporations cannot provide better Medicare.
The Medicare Advantage scam allows for-profit corporations to make as much as 20% in pure profit, compared to Medicare's 2% administrative cost without profit. Advantage plans refused to pay legitimate claims. MA denies 18% of claims despite meeting Medicare coverage criteria.
This amounts to $140 billion yearly of money that for-profit insurance companies effectively steal from patients, an amount that could cut Medicare premiums to almost nothing.
We have a choice. Because it saves taxpayer money with only a 2% administrative cost, we must demand Medicare for All and eliminate Medicare for profit.
Medicare for All
Healthcare is not a privilege. It is an American right.
Medicare for All is a single-payer healthcare program covering all Americans, replacing almost all other existing public and private plans.
No, it is not socialism. Socialized medicine is a healthcare system in which the government owns, operates, employs, and pays for all healthcare services (e.g., the VA). Medicare for All is not owned, operated, or employed at all. It's a payment system. There would be one insurance plan for the American people with one single payer.
There are many versions of how the US can get this done. Current legislation covers medical, dental, hearing, vision, and long-term care with no deductibles or copayments.
Healthcare in 2024 will cost taxpayers $4.7 trillion, or $13,000-$14,000 per person.
The American people are already paying for healthcare at a cost that far exceeds Medicare for All. Congress still needs to develop precise details on how to fund the system. However, Americans already pay exorbitant premiums, deductibles, co-pay fees, and administrative expenses that benefit for-profit corporations.
Instead, we can find a way to pay for it through revenue. Many predict Medicare for All will save $500 billion annually, with savings per patient near 20%.
References:
Congressional Budget Office Scores Medicare-For-All: Universal Coverage For Less Spending: drbob.me/CBOM4A
Overview of the Medicare for All Act: drbob.me/M4A
Here are some of the significant problems that Medicare for All can address that private insurance can't:
Everybody is covered, and nobody is left out from birth to death.
You have peace of mind knowing you can receive healthcare whenever needed, regardless of your circumstances—no more surprise bills, out-of-network concerns, or staying in an undesired job just for the benefits.
Health care justice for the entire nation, meaning no one will be uninsured or underinsured.
Patients have the ultimate freedom to choose their medical provider, clinic, or hospital without worrying about out-of-network concerns.
It will cost less than our current system, end medical debt and bankruptcies, and reduce administrative waste by $500 billion annually.
Businesses will be able to provide insurance to their employees and can focus on their core mission. Lower health costs make businesses more competitive and make it easier to start new companies without the complications, expenses, and worries of obtaining employee insurance benefits.
Corporations will no longer profit off the sick, and pharmaceutical companies will no longer be able to price gouge.
Healthcare professionals will no longer incur the cost of dealing with many plans, rules, and forms.
Power to negotiate pricing for medications,
Preventive care and timely intervention can keep health problems from developing or worsening, making the need for expensive treatment less likely.
Provide access to home and community-based care for all who need it.
Guarantee coverage for dental, vision, and hearing services.
Eliminate copayments, deductibles, and premiums.
Cover long-term care.
Increase payments to medical providers.
Save rural hospitals.
For healthcare reform, we need a doctor in the House who strongly supports Medicare for All and legislation that expands affordable and accessible coverage. If honored to serve in Congress, I will lead on this issue.
Unaffordable, uncovered or undercovered healthcare and for-profit healthcare are detrimental to our well-being and financial stability. Access to healthcare — including optical, dental, mental health, long-term care, home care, and palliative care — is a fundamental American right.
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Dr. Bob Lorinser, MD, MSW, MPH, a family doctor with extensive medical and administrative experience, has served at various healthcare facilities, including the VA, the Indian Health Service, an Air Force base, and non-profit, rural clinics.
After almost three decades of medical practice in Michigan's Upper Peninsula, Lorinser worked as a diplomat for the State Department and currently serves as the Marquette County Health Department Medical Director.
Lorinser is running for US Congress in Michigan's 1st district. For more information, visit VoteDrBob.com.