Privatizing Medicare, Medicare Advantage and the crooked insurance industry.

A report in the New York Times shows how bad it is.

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About a month ago the state of Illinois informed those of us who are retired teachers that our state Medicare Advantage coverage was being switched from United Healthcare to CVS owned Aetna.

We were assured that nothing about our coverage or networks would change and that our premiums would actually be lower.

Many retirees I know expressed skepticism. I suppose we will see.

Most of us chose Medicare Advantage because we paid into a subsidy that the state offered if we joined their Medicare Advantage plan.

Those who elected to stay with Original Medicare are denied the state subsidy.

The entire situation is concerning to those of us who suspect that there is a bipartisan plan to privatize Medicare and who view the growth of Medicare Advantage plans as the pathway to privatization.

The Biden administration has already announced it wants to move everyone to Medicare Advantage type plans, with their consent of not, by the end of the decade.

This morning’s New York Times contains a scathing report on the ways in which the private insurance industry has used Medicare Advantage plans to scam, rob and steal from the government.

The privatization of senior healthcare through Medicare Advantage programs has grown at an alarming rate and doesn’t advantage either the patient or the taxpayer.

The Kaiser Family Foundation (unaffiliated with Kaiser Permanente) reports:

Since 2006, the role of Medicare Advantage, the private plan alternative to traditional Medicare, has steadily grown. In 2022, more than 28 million people are enrolled in a Medicare Advantage plan, accounting for nearly half or 48 percent of the eligible Medicare population, and $427 billion (or 55%) of total federal Medicare spending (net of premiums). The average Medicare beneficiary in 2022 has access to 39 Medicare Advantage plans, the largest number of options available in more than a decade.

Current insurance industry practices such as systematic over billing of the government for both real and imaginary illness provide a window on what the move to privatize Medicare will look like.

New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars.

The government pays Medicare Advantage insurers a set amount for each person who enrolls, with higher rates for sicker patients. And the insurers, among the largest and most prosperous American companies, have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits.

As a result, a program devised to help lower health care spending has instead become substantially more costly than the traditional government program it was meant to improve.

Eight of the 10 biggest Medicare Advantage insurers — representing more than two-thirds of the market — have submitted inflated bills, according to the federal audits. And four of the five largest players — UnitedHealth, Humana, Elevance and Kaiser — have faced federal lawsuits alleging that efforts to overdiagnose their customers crossed the line into fraud.