[rad-green] Wake Up AARP! A Message to Seniors: Medicare "Disadvantage" Is a Corporate Trap

*https://www.commondreams.org/views/2019/11/22/wake-aarp-message-seniors-medicare-disadvantage-corporate-trap
<https://www.commondreams.org/views/2019/11/22/wake-aarp-message-seniors-medicare-disadvantage-corporate-trap>Common
Dreams          November 22, 2019*





*Wake Up AARP! A Message to Seniors: Medicare "Disadvantage" Is a Corporate
TrapMedical Disadvantage would be a more accurate name for the
quasi-private programs referred to as Medicare Advantage, as insurance
companies push to corporatize all of Medicare, yet keep the name for the
purposes of marketing, deception, and confusion.by Ralph Nader*

[image: "AARP reportedly receives a commission of 4.95% for new enrollees
on top of the premiums the elderly pay for the Medigap policy from United
Healthcare," writes Nader. "This money—about seven hundred million dollars
a year—is a significant portion of AARP’s overall budget." (Illustration:
AARP advertisement with overlay)]

*"AARP reportedly receives a commission
<https://www.courthousenews.com/class-claims-aarp-bilking-seniors-through-insurance-commissions/>
of
4.95% for new enrollees on top of the premiums the elderly pay for the
Medigap policy from United Healthcare," writes Nader. "This money—about
seven hundred million dollars a year—is a significant portion of AARP’s
overall budget." (Illustration: AARP advertisement with overlay)*

While the Democratic presidential candidates are debating full Medicare for
All, giant insurance companies like UnitedHealthcare are advertising to the
elderly in an attempt to lure them from Traditional Medicare (TM) to the
so-called Medicare Advantage (MA)—a corporate plan that UnitedHealthcare
promotes to turn a profit at the expense of enrollees.

Almost one third of all elderly over 65 are enrolled in these numerous,
complex MA policies the government pays so much for monthly. The health
insurance industry wants more enrollees as they continue to press Congress
for more advantages.

Medical Disadvantage would be a more accurate name for the programs, as
insurance companies push to corporatize all of Medicare, yet keep the name
for the purposes of marketing, deception, and confusion.

"All this anxiety, dread, and fear, all these arbitrary denials of
care—prompted by a pay-or-die commercial profit motive—all these
restrictions of what doctors or hospitals you can go to, do not exist in
Canada."

Elderly people enrolled in MA will experience its often merciless denials
when they get sick. As hospital expert—attorney, physician, Dr. Fred Hyde
put it: “It’s not just what you pay, it’s what you get.”

Start with the cross-subsidy of MA from TM. In 2009, the Congressional
Budget Office estimated these overpayments would cost the federal
government $157 billion over the coming decade. Obama’s Affordable Care Act
started to reduce these subsidies to the giant insurers, but they still
amount to many billions of dollars per year.

Add that with Medicare Disadvantage you are restricted to networks of
vendors. That restricts your choice for competence and skills, and
sometimes, requires you to travel longer distances for treatment. This
could mean fewer enrollees will utilize their healthcare and more profits
for the insurance companies.

Under Medicare Disadvantage you are subject to all kinds of differing
plans, maddening trapdoor fine print, and unclear meaning to the insurers
arguing no “medical necessity” when you’re denied care.

The advertisements for Medicare Disadvantage stress that you can sometimes
get perks—gym memberships, hearing aids, and eyeglasses, as enticements,
but they avoid telling you they are not so ready to cover serious needs
like skilled nursing care for critically ill patients.

Under Medicare Disadvantage, there is no Medigap coverage as there is for
TM. Co-pays and deductibles can be large. Under a recent Humana Medicare
Advantage Plan in Florida, your co-pay for an ambulance is up to $300, up
to $100 co-pay for lab services, and another $100 for outpatient x-rays.

A few years ago, UnitedHealthcare corporations dismissed thousands of
physicians from their MA networks, sometimes immediately, sometimes telling
their patients before telling their physicians.

Dr. Arthur Vogelman, a gastroenterologist, said he received a termination
letter in 2013 from UnitedHealthcare. He appealed, documenting his
successful treatment of many patients. The company denied his appeal, with
no reason, as it had for thousands of network physicians.

Dr. Vogelman called it “an outrage. I have patients in their 80s and 90s
who have been with me 20 years, and I’m having to tell them that their
insurer won’t pay for them to see me anymore. The worst thing is I can’t
even tell them why.” Except that the company wanted more profits.

After a lengthy protest by national and state medical societies in 2013,
UnitedHealthcare began to be less aggressively dismissive.

Studies show the main reason MA enrollees return to TM is how badly the
corporate insurers treated them when they became sick.

Medicare itself is getting overly complex. But nothing like the ever
changing corporate rules, offerings, and restrictions of Medicare Disadvantage.
How strange it is that AARP, with its Medigap insurance business run by
UnitedHealthcare, doesn’t advise its members to go with the obviously
superior Traditional Medicare. AARP reportedly receives a commission
<https://www.courthousenews.com/class-claims-aarp-bilking-seniors-through-insurance-commissions/>
of
4.95% for new enrollees on top of the premiums the elderly pay for the
Medigap policy from United Healthcare. This money—about seven hundred
million dollars a year—is a significant portion of AARP’s overall budget.

AARP responded to my inquiries into their Medicare Advantage policy saying
that it does not recommend one plan over another, leaving it to the
uninformed or misinformed consumer*. *That’s one of AARP’s biggest
cop-outs—they know the difference.

There is no space here to cover all the bewildering ins and outs of what
corporations have done to so-called managed Medicare and managed Medicaid.
That task is for full-time reporters. The government does estimate a
staggering $60 billion
<https://abcnews.go.com/Politics/medicare-funds-totaling-60-billion-improperly-paid-report/story?id=32604330>
in
billing fraud annually just on Medicare—manipulating codes, phantom
billing, etc. You need the equivalent of a college-level course just to
start figuring out all the supposed offerings and gaps.

Suffice it to say that, in the words of Eleanor Laise
<https://www.kiplinger.com/article/retirement/T039-C000-S004-medicare-vs-medicare-advantage-ill-health-switch.html>,
senior editor of Kiplinger’s Retirement Report, “the evidence on health
care access and quality decidedly favors original Medicare over Medicare
Advantage, according to a Kaiser Family Foundation review of 40 studies
published between 2000 and 2014.”

All this anxiety, dread, and fear, all these arbitrary denials of
care—prompted by a pay-or-die commercial profit motive—all these
restrictions of what doctors or hospitals you can go to, do not exist in
Canada. All Canadians have a Medicare card from birth; they have free
choice of health care vendors. There are few American-style horror stories
there; patients have better outcomes, and almost never even see a bill. The
whole universal system costs half *per capita* of that in the U.S., where
over 80 million people are uninsured or underinsured—still! (See
singlepayeraction.org
<https://www.commondreams.org/views/2019/11/22/singlepayeraction.org>, for
civic action to rid Americans of this perverse chaos).

Ralph Nader <http://www.commondreams.org/author/ralph-nader> is a consumer
advocate, lawyer, and author. His latest books include: *To the Ramparts:
How Bush and Obama Paved the Way for the Trump Presidency, and Why It Isn’t
Too Late to Reverse Course <https://nader.org/books/to-the-ramparts>, **How
the Rats Re-Formed the Congress*
<https://nader.org/books/how-the-rats-re-formed-the-congress/>, *Breaking
Through Power: It's easier than we think <https://nader.org/latest-book/>,
and Animal Envy: A Fable <https://nader.org/books/animal-envy/>*

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