Medicare Disadvantage Plans suck money out of the system from 3 different sides.
(1) They cost the government more money per patient than real Medicare
(2) They falsely denied 18% of valid claims according to Medicare’s Inspector General. They also screw customers by denying people specialists , requiring prior approvals etc.
(3) They cost providers more money by increasing the manpower they need to get their payments by throwing up hassles.
“Medicare Brokers” get gigantic commissions (not just the first year but EVERY year someone is on the same plan) to push Medicare Disadvantage Plans on people who don’t know any better.
There is a also a SECOND medicare scam from the GOP for people who wisely avoid Medicare Disadvantage called “Accountable Care Organizations”. The bottom line is that you cannot trust your primary doctor’s advice on when to seek a specialist because they pay doctors to discourage you from seeking a specialist when you need one. They don’t give you a choice about belonging to an ACO but they do have to notify you when they stick you in an ACO, so at least you know when your primary doctor has a financial incentive to discourage you from getting treatment.
https://surgerycenterok.com/blog/scam-series-pay-for-performance/
There is a solution. Tax ultramillionaires and billionaires and corporations at 1950’s 93% rate, fully fund comprehensive health, no co-payment, no deductible, including at least annual preventative visits.
You don’t really even need to fund single payer healthcare. The U.S. spends twice as much on healthcare as other developed countries already. You just have to nationalize the insurance companies, which can cost as much as you’d like. There a no law of physics preventing it.
You still have to allocate the money.
We very specifically need single-payer universal healthcare. One of the biggies issues with healthcare is the sheer number of different insurers. Knock it down to just Medicare and give it to literally everyone. Period.
Yes, and fully funded is also key, because Medicare rates are ridiculously low.
It’s appalling how much we have to alter treatment plans based on Medicare rates. If someone doesn’t have a supplement plan, they probably won’t be able to afford the new medications that are MASSIVE improvements on the old ones. It’s so frustrating to have to try to cobble together a treatment regimen for congestive heart failure or type 2 diabetes without being able to use the new medications because Medicare doesn’t cover enough of the cost for the patient to be able to afford it. It also affects how long a patient can be hospitalized and figuring out the requirements to make sure they qualify for rehab after hospitalization is aneurysm-inducing.
Yes. It’s frustrating for everyone involved except those who profit from such s a convoluted system. I’m sure handing a terminally ill patient a Medicare waiver is absolutely heart-wrenching. When I worked ICU hall in the nursing home, back when two CNAs were actually required per fifty patients, and worked in teams, I can’t tell you how many were quickly burned out from being disheartened by having five minutes or less to dress immobile patients, or from having to restrain patients to keep them from scratching shingles outbreaks, or being unable to find a nurse available to suction patients with death-rattle.
I just finished my second family medicine rotation and it’s just so ass-backwards because if we could give them the medication they need, they won’t end up in hospitals/ICUs/long term care facilities/etc. The new medications are incredible drugs and can vastly improve the quality and quantity of life for patients with diseases like diabetes, heart failure, renal failure, and more…if the patients can afford them, which they frequently cannot.
Oh so you’ve got a double dose of burnout, from overwork and trying to navigate the system. I’m sorry. What general region are you in? Wondering if we can somehow work together on getting universal passed?
I’m a third year medical student in the Midwest. I’m aiming to do my residency in Minnesota, either Emergency Med or Family Med because apparently I like doing social work and hate my sanity or something.
These companies thus make much of their profit by routinely denying claims — 1.5 million, or 18 percent of all claims, were turned down in one year alone
they profit when human beings literally suffer, and we have all collectively decided this is ok for some reason
Which continued with every president since Bush and will continue with whoever the next president is.
Congress controls the budget
At the request of the president
No, it’s in the Constitution that Congress has control of the budget.
Uh, sure
Just one?
Pretty sure the federal budget is a little over $6 trillion
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