MAY 2023 - Meeting Wednesday, May 10th 6:30 -7:30 pm - Zoom Invitation

 Information About Medicare Abuses and Actions to Help Save It

Information - A brief overview of the problem

Articles to read:

 https://prospect.org/health/2023-04-11-insurance-lobbyists-medicare-advantage/

 https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html.

 https://prospect.org/health/dark-history-of-medicare-privatization/

Take action:

Help us widen the coalition. Think of a group, preferably one you already belong to, that might be able to join our fight to save Medicare, and help us form a coalition with them. Coalitions with groups in other states are also welcome so please think far and wide! You can do that yourself or you can send us the contact information so that we can invite them to join in the effort.

Historical look at the medicare problem

In 1997, as part of a budget reconciliation act, lobbyists were able to get the federal government to adopt a novel new way for Medicare to pay for health care. Rather than Medicare paying doctors for seniors’ care, people could sign up for plans with private for-profit insurers and Medicare would give a per patient amount directly to those insurers that would “manage” their care. The insurer would make a profit off of the money that was “saved” by not spending it on your health care. This program was eventually named “Medicare Advantage.” It was sold as a way to save Medicare money. The reverse happened.

By 2008, an analysis showed that over the five-year period 2004–2008, extra payments to Medicare Advantage plans (over what would have been paid under traditional Medicare) was estimated to have totaled nearly $33 billion. This extra $33 Billion did not go into more or better health care. It went into the coffers of those private insurers. (News reports about how Medicare Advantage plans provide worse health care are many.) Those corporations took a portion of their windfall (or you might say theft as much of it was obtained through dubious billing of Medicare) and bought a barrage of advertising and lobbyists to convince people that Medicare Advantage was a good deal for both seniors and taxpayers.

The situation since 2008 has only gotten worse. Much worse. The profits that these corporations are currently making by gaming the Medicare rules have become unbelievably lucrative -- they are earning TWO TIMES the profits by selling Medicare Advantage plans than they make on their non-Medicare Advantage health insurance policies. Even with proposed changes to rein in some of their fraud and abuse, over the next 8 years, Medicare Advantage plans will be paid almost $1 trillion more than Medicare would pay if beneficiaries remained in Traditional Medicare.

This enormous amount of our taxpayer money flowing out of Medicare into the coffers of these private insurers has, of course, not gone completely unnoticed. Almost from its inception, the agency that runs Medicare has tried to tweak the rules to rein in the fraud and abuse by these private insurers, but it has so far not succeeded in the hemorrhaging of our tax dollars. Today, so much money is being siphoned off of Medicare by these Medicare Advantage plans sold by corporations like UnitedHealthcare, Aetna, Humana, and others, that without big changes Medicare will not have enough money to cover the health care of seniors no matter whether they are in traditional or Medicare Advantage.

A few weeks ago, President Biden had proposed changes to Medicare to curtail the amount these insurers can skim off of Medicare but he and those who supported him were hit with a lobbying and marketing blitz. You may have seen the Super bowl ad where two bowlers talk about how people in Washington were planning to make “cuts” to Medicare Advantage and urged viewers to call the White House. That ad was paid for by UnitedHealthcare, Aetna, and Humana. The lobbying worked. Biden backed down and agreed to phase in changes over three years.

The UnitedHealthcares, Aetnas, and Humanas of the world have a lot of money to convince people to pressure politicians not to touch their profits. But we have the numbers on our side. If we ALL speak out, we can win this.

ACTION - ACTION - ACTION

The actions below are to tell your representatives that they need to act now, to stop the siphoning of money by these private insurers that are bankrupting Medicare and stealing our tax dollars. And we need to start spreading the word and get everyone we know to do the same. It looks dire today but the outrageous and well documented excesses of these insurers over the past 26 years has also given us a golden opportunity to demand changes that will assure health care for you and generations to come and save all of us taxpayers money.

One last thing. During the Trump administration, another Medicare “innovation” (similar to Medicare Advantage) was introduced, which Biden allowed to continue, and it goes by the acronym ACO-REACH. This new innovation permits investors to buy up medical practices. Seniors who saw providers at those practices and that were on traditional Medicare are then automatically dumped into the ACO-REACH plan which operates the same way as Medicare Advantage but with an even bigger potential profit margin for the investors. The action below addresses this new and growing threat to Medicare.

ACTION #1:

Call your Representative and Senators (www.congress.gov/members/find-your-member)

1. Ask them to make a public statement that the abuses by insurance companies providing Medicare Advantage — including fraud, denial of service and obscene profits (2x any other insurance product) — must end now.

2. Tell them to send a letter to Health and Human Services Secretary Becerra and President Biden to rein in the abuse of Medicare Advantage and end ACO REACH now.

ACTION #2:

Contact the White House /www.whitehouse.gov/get-involved/write-or-call/) and tell Pres. Biden to end the obscene Medicare Advantage fraud and abuse and to end ACO REACH now.

ACTION #3:

It is going to take all of us. Help spread the word that individual actions are needed. Any or all of these actions help: share my email or write your own to others who care and want to help, write a Letter to the Editor of your local paper, share this issue with an organization you are a member of that would like to help, if you on social media share these important articles (link to a google doc).

2) Help us widen the coalition. Think of a group, preferably one you already belong to, that might be able to join our fight to save Medicare, and help us form a coalition with them. Coalitions with groups in other states are also welcome so please think far and wide! You can do that yourself or you can send us the contact information so that we can invite them to join in the effort.