Wednesday, August 15, 2012

Medicare"Advantage" and the Insurance Companies

Once again I feel the need to repost to remind you that you do not need to listen to the insurance companies or their shill AARP when it comes to "Medicare Advantage Plans." Please listen to me. There is no "advantage" when it comes to "Advantage Plans."

Dear Insurance Companies,
There is no place for you in our well-functioning Medicare program. Medicare is the public option we want to give the rest of the populace, since you have so horribly abused them with your sky high monthly premiums and your policy of questioning every doctor visit, test, referral to a specialist, or procedure. And who makes these decisions to question every possible charge? Low-level phone-bank bean-counters make these decisions to get between the consumers and their doctors at your direction. How is this better than Medicare? Medicare has never questioned a single decision my doctors and I have made together to manage my healthcare needs. When I had private insurance every decision made by my doctors and me was at first denied, and then had to be negotiated by functionaries with no medical credentials or expertise at the big impersonal insurance company and my doctors office, driving up costs by requiring the hiring of new staff to deal with all the denials of coverage or medicine or referral or procedure or hospitalization. My doctors hate you bastards. So do I. We want you out of the only public option we have. And we are confused about how the hell you insinuated yourself into Medicare in the first place. You are now, once again, driving up costs for all of us. And we are, so far, just the low-income elderly and the disabled. You are everything that is wrong with our economy. Your greed knows no bounds. Your disregard for our well-being is nothing short of criminal negligence. You must be expelled from Medicare before you take it over completely and there isn't even a public option for the neediest and most at-risk disabled among us. You represent a cancer in the system. We need to cut you out before you turn this country into a poor third-world nation with no health care coverage for anyone but the wealthiest few.

I have had a long and detailed conversation with my medicare information personnel and I have been assured that there is no "advantage" in your "Medicare Advantage programs." We do not need you at all. But your dishonest advertising makes most of our citizens believe that they do need one of the "Medicare Advantage" programs being so aggressively pushed on us from every source. You have the money to push this program. The government run medicare program does not advertise. That would raise costs to all of us. The government run medicare program does not solicit over the phone or in mailings. That would raise costs to all of us. Why do you have the money to push your "Medicare Advantage" plans? Because you, in the private sector, have raised rates every few months just because you can. Because you have denied coverage for "pre-existing conditions." Because you have doubled premiums in a single month once a diagnosis has been made that will require surgery and ongoing treatment. You are bloodsuckers at best. Get out of Medicare. You offer no "Advantage" and cost all of us a great deal more than our modest public option does.

185 comments:

susan said...

Plan 65 has 65 reasons not to allow certain specialists or go to particular hospitals for treatment and if they tell you it's a Choice Plus plan.. Look out!

Utah Savage said...

I hope to get more comments like yours with specifics to warn the unsuspecting that there is a worse plan and that the only plan that really works for your health care is just plain old Medicare.

susan said...

I've found the state medicaid HMO's are pretty good when combined care is needed, ie drugs, wheelchairs and the like. Sometimes I have problems with code pairing (diagnosis - icd9 and procedure - cpt) but since I'm working with public service nurses we can usually get the kinks worked out before the patient even knows there might have been a problem with their treatment plan.

Beach Bum said...
This comment has been removed by the author.
Beach Bum said...

I find it terribly funny to the extreme, in sick black comedy sort of way, that the various puppets in both the congress and media can still talk about how the "private sector" would do much better in running an universal health care plan for this country.

Making things even crazier are the proles who fret and whine over the perceived fears about having some government bureaucrat make health care decisions for them.

Why I do it I don't know but I will sometimes ask one of these people how is a government bureaucrat any worse than the corporate bean counter denying you care over a pre-existing condition or any other reason.

When I do get an answer it usually involves the fact that those types of people have yet to run into a situation were they, are a member of their family, was denied care by some corporate bureaucrat and have no direct idea such things happen. They are just parroting the propaganda fed to them by the congressional and media puppets.

A single payer plan would in no way be perfect but I would prefer it to the current situation that only makes the insurance companies richer at the expense of the middle and working classes. I know, I'm a socialist but screw it.

Utah Savage said...

Beach, I'm a socialist too. No really. Not kidding. But even I the old socialist would give the private sector the opportunity to compete on an equal footing with the public sector. Let's see how it goes, if their coverage is so much better and cheaper then it should do quite will in a head to head with Medicare.

Dr. Zaius said...

I am for any health plan that offers free lobotomies.

Utah Savage said...

Dr. Z that would be plan 69, the CEO's plan unless you're a poor sucker. Then you get plan 65. See Susan's comment for plans 65. Neither comes with ice cream and cake, but if you get that lobotomy you won't know what you're eating anyway.

Fran said...

I sat through a long Aflack supplemental insurance presentation @ work. In the end they announced- they do not cover anyone with diabetes or heart problems.
Wholesale. Right off the bat.

They sure don't tout THAT in their quacking duck commercials.

I've not hit the medicare grid yet, but have heard the boatload of "options" are confusing & convoluted as all get out.

Hell, I'll be lucky if the program or Social Security even exist by the time I get there.

Utah Savage said...

Fran the only confusing thing about Medicare is what the insurance companies call "Medicare Advantage" plans. Medicare is complete coverage with no exclusions. The "advantage" plans do nothing but muck up the works with all kinds of conditions and exclusions. Just like they do in the younger population. So long as you never use your insurance you'll like your insurance. But the first time you have a medical problem that turns expensive your experience with your private insurer will turn ugly.

Comrade Kevin said...

Amen! Medicaid, which is what I have to rely on right now, is a nightmare and a half.

Comrade Kevin said...

Now they've discovered that certain insurance companies consider domestic violence a pre-existing condition.

susan said...

One good reason for extending Medicare to all who want it would be to allow people with seniority but no further interest in working to retire and make room. Paying the rent and buying food isn't the biggest problem most of us face when looking at retirement.

Medicare supplement policies are often bad news but many simply follow Medicare guidelines and are acceptable.

Kulkuri said...

The insurance companies created this mess, so how in the hell are they going to fix it????

As for the 'free lobotomies', we have too many FuckingRepublicans already!!!

the WIZARD, fkap said...

Utah, I just wanted you to know I stop by from time to time and always find your writing compelling and thought provoking. I've certainly enjoyed chatting with you on Twitter.

Thankfully, I'm just a mere lad of 60 and won't cross over to the Medicare Land for a few years. The joys of youth.

My mother, however, is 83 and has selected a Medicare Advantage Insurance Program. Thankfully she has encountered none of the problems you and your contributors have enumerated here. She has needed several complicated medical proceedures (MRI's CT Scans and even worse) and a complicated double surgery with both urinary and abdominal intestinal work, all caused by complications of colon cancer she had over 25 years ago. Thankfully, her Advantage insurance covered it all without a single denial, question or payment problem. And virtually no co-pays of any significance.

I do understand that Advantage programs are likely to be eliminated regardless of which new health care program ultimately passes (unless they all are blocked).

Will "take no prisoners" Hart said...

Medicare, unfortunately ISN'T a well run program. It's ripe with fraud, has very little in the way of cost contriols, and continues to squeeze doctors (many of whom are threatening to not even take it any more if the propsed cuts go through). And it's very lousy insurance. It only pays at 80% (50% overall when you figure in all of the other things it doesn't cover). And, really, if the Advantage option is so incredibly lousy, why are people always flocking to it? This whole thing is far more complicated than the left is selling.

Will "take no prisoners" Hart said...

And get this, Utah. Not only does Medicare deny claims, they deny them at a higher rate than do private companies. According to the AMA's own insurance report card, Medicare denies claims at a rate of 6.85%, Health Net 3.88%, Humana 2.90%, UHC 2.68%, Cigna 3.44%, and Anthem 4.62%. Now, clearly, the health insurance companies AREN'T perfect, and, yes, we DO need significant reform, but to totally eliminate (which I am NOT accusing congressional legislation of doing, btw) an entire industry/ridiculously inflate the size of government EVEN MORE, I just can't see that working. But, as usual, I could be wrong.

Jack Jodell said...

As far as I'm concerned, there's no place for ripoff insurance companies ANYWHERE!

JUDI M. said...

The Repubs have done a great job of mixing MDCR Advantage, Medicare, and Medicaid into one big ball of "entitlement' and selling it to their believers. These people do not have a clue about any of them. Medicare we have already paid for a stake in. Advantage is an insurance rip off. Medicaid is almost a "loan" from the government, and must be paid back, in a sense. As you said, plain ol' Medicare for everybody.

Having worked in OB/GYN offices 20+ yrs, I know that ins. comp. are not your friend.

BoJoFlo said...

Utah -- Just wondering if you have actually sent this great letter to 'Medicare Advantage'?

I receive in the mail, EVERY single day, one of their flyers, letters, etc., letting me know this is my 'Last Chance' to take advantage of their wonderful offer - before time runs out!! I usually just shred all mail from them, as soon as I walk back in the house.

I would like -- with your permission -- to copy your letter (or something similar), and send it off to them each time I hear from them.

It Would probably do no good, but it would make me feel good, just doing that. :o)

Always enjoy your blogs and all you do. Thanks so much.

Have a good one.

no_slappz said...

Medicaid -- the other government medical program -- is getting a lot more expensive. Here in NY the state is spending $53 billion on Medicaid this year.

That's $13,000 per person. Or about $1,100 per month.

That's what taxpayers are getting billed. Therefore, based on the example of NY, we know where the cost of government healthcare is headed. Moreover, no one has ever said Medicaid coverage is good. Adequate, perhaps, but not great or even good.

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