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A recent article in The Guardian tells the sad stories of seniors who have been denied by their Medicare Advantage plans of care prescribed by their doctors. (Medicare Advantage is funded by the government but administered by private insurers, who extract a profit.) The article should be read by everyone approaching the age of 65. Seniors are discovering that their insurance isn’t there when they need it most.
The problem is fundamental: With private, for-profit health insurance, I believe that company profits and quality of care will always be in an inverse relationship. You can enhance one only by diminishing the other. If profits are down this quarter, they can be boosted by skimping on care or denying it altogether — a seemingly irresistible temptation. In their relationship with the patient, corporate directors are not constrained by a code of medical ethics. I think their sole reason for being is to maximize shareholder value, the sole determinant of executive compensation.
Traditional (original) Medicare bypasses the middleman; the government pays providers directly. With rare exceptions, it does not require prior authorizations but instead respects the judgment of the clinician, who knows the patient and their condition intimately and cares about the patient’s welfare. And it costs the government/taxpayer less per patient than Medicare Advantage. It is time to recognize the fundamental flaw in the privatization of Medicare — which has neither saved us money nor improved outcomes — and return everyone to traditional Medicare, which has served seniors well for almost 60 years.
Michael P. Bacon
Westbrook