Letter: Hands off my Medicare | Letters to the Editor
Most retired physicians, like most retired Americans, choose traditional Medicare over a Medicare Advantage program during open enrollment. We prefer it because it gives us free choice of providers and hospitals, allows our providers to recommend tests and treatments without authorization from an insurance company, and is less expensive to taxpayers.
Our freedom of choice for traditional Medicare could soon change, however. There is a move by the Center for Medicare and Medicaid Innovation to privatize Medicare completely by 2030. The “Direct Contracting Entities” pilot program can automatically assign seniors to a commercial for-profit group without their consent. Medicare will search two years’ worth of a senior’s claims history to find any visits with a physician who is affiliated with a DCE, then assign them to that DCE. To opt-out of the DCE, you would need to change physicians.
I am fortunate to have minimal healthcare needs right now, so my annual cost to Medicare is under $1,000 a year. If I had a commercial Medicare Advantage plan, the government would be paying more for my care, maybe much more. According to an OIG report Advantage insurers overcharged the government $16 billion in 2019 by exaggerating the severity of patients’ medical conditions. Paying a middleman to “manage care” has never resulted in savings to Medicare, and carries a risk of undertreatment to us as patients. An Advantage program in Texas denied a relative of mine an MRI that was recommended by his plan’s urologist. He would have received it under traditional Medicare (which he has now).
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DCEs can spend as little as 60% of the Medicare money they receive on healthcare and are allowed to keep the rest for overhead and profit. Traditional Medicare spends 98% of its funds on healthcare and only 2% on overhead. If using middlemen to save money actually worked, we wouldn’t have the most expensive healthcare system in the world.
The DCE program is currently not subject to oversight by Congress, and many of our legislators are just becoming aware of it. Please ask Rep. Mike Thompson to intercede and stop the pilot DCE program before it becomes entrenched and Medicare is fully privatized. Wall Street wins, seniors lose. Appeal to Health and Human Services Secretary Xavier Becerra to stop this program. And read correspondence about your Medicare benefits carefully. It may give you your only opportunity to opt-out of a DCE before you are “aligned” without your consent.
Let’s improve our traditional Medicare benefits by negotiating drug prices and by covering vision, hearing, and dental services. We need to maintain the integrity of this valuable program, not hand it off to for-profit middlemen.
Financially rewarding corporations for cutting the cost of my healthcare is a perverse incentive and risks rationing healthcare based on cost alone. DCEs are a…
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