Incredibly important article - I just discussed it with my father and sent it to Wendell a few weeks ago. As a patient advocate and a medical writer with physicians as clients, I am hopeful Arends' article is just the beginning.
I will do everything I can to shout this from the mountaintops - super important and glad to hear that Brett's story is getting attention. Boiling it down to the fact that our tax dollars are subsidizing profits for commercial insurers SICKENS me. How bout this idea - get rid of MA, and take the money that HAD been going to commercial insurers (use 10% of the 22% they've been overpaying) and use it to cover the large deductibles (which is why people get MA plans to begin with!). Congress needs to wake the hell up!
As a physician, my firm belief is that this represents Medicare Fraud and Abuse. The very thing that physicians get in trouble for is how these insurance companies are making record profits. Doctors need to be talking about this, patients/consumers need to be talking about this. We need a full reform of our medical system. I refuse to be in any insurance system because of this. I am cash only and I work for the patients, with the patients. I provide excellet care and my patients are happy and they do very well.
We would have had a single payer system long ago had it not been for the Health Insurance industry's lobbying efforts to Congress to keep their profits coming in. We need "a publicly financed, non-profit single-payer national health program that should fully cover medical care for all Americans". It's time we realign our priorities. PNHP contributed to this comment as quoted.
Spot on, Cheryl! It angers me how short sighted the mentality of our Establishment Parties both GOP and Democrats. They do not listen to the voice of their respective Constituents other than the Special Interest Lobbies. Follow the money trail. Will we ever learn or will this Nation have to experience real Authoritarian rule? I certainly hope not. Time to start looking for places to live in exile outside the USA…. It would be sad, but in my family there were Holocaust escapees and victims. Why we don’t learn from the past is simply despicable and dangerous.
What concerns me about this article and the discussion is the predominance of cost overruns and charges to the Medicare Trust Fund at the expense of the damage and deaths of actual Medicare (dis) Advantage
“What about the expense (actual) costs to Medicare (dis) Advantage patients/Senior citizens who have been sold a package of lies about coverage under this so called “competitive(?)”, privatized health insurance policy? SilverEarings is 100% correct. When are we going to stop subsidizing M(dis)A and move patients back into traditional Medicare policies? I am outraged just how slow the Legislative process is recognizing and admitting how flawed and irreparably damaging the M(dis)A is to the welfare of US citizens and legal residents mmm. Inertia breeds distrust in Government and just the allegations of corruption by Members of the US Senate. It is time to properly regulate Medicare DisAdvantage once and for all. My patience has run out!!?
We keep on subsidizing “losing” ventures such as the manufacturing of “High Fructose Corn Syrup” that is actually more expensive and is implicated in obesity levels over the past 10-15 years because HFCS is sweeter than sugar as well as addictive. The FDA okayed it and 60% of Americans are now obese. Another losing venture is the cost-overruns of our defense industrial complex of private corporations that has a flawed competitive bidding process? Furthermore, what about our national Security outsourcing of our intelligence assets and mercenary forces, not to forget the abuses of human rights violations and lack of care at privatized Correctional facilities? Each and every one of these business sectors are either irreparably flawed or haven proven themselves to be uncompetitive compared to being run and operated by the responsible government agencies that at lower costs and greater efficiency.
We keep on making the same ridiculous mistake that clearly must add to our national debt and deficit. It is not rocket science to correlate these disastrous policies.
I’m a retired CEO and founder of three international manufacturing companies, all still profitable.
We have gone hpast end stage capitalism. We are well into end stage democracy. If fortunes over $100m are not confiscated or otherwise “addressed,” we will be niether capitalist nor a democracy.
I've been a medical biller since ~1996 with no gaps until the plandemic. A Lead HMO Claims Auditor is on my resume. With that https://www.iceforhealth.org/home.asp is the website all Medicare Managed Care "claim shops" are all familiar with. The site is practically considered the bible on all things Managed Care and standardization. Everybody is pretty familiar with the acronyms IPA & HMO, but most don't know about MSO's? For instance Excel MSO is San Jose, CA (aka Physician's Medical Group of San Jose) is also a MSO (claims shop) entrusted to process incoming insurance claims for many Medicare Managed Care products in the Bay Area of Northern California. MSO's are kept under close scrutiny by big health Insurance auditor's. These insurance auditors, auditing the MSO's in California coincidentally seem to live in Central California (Fresno/Bakersfield). I assume it's a strategic location to visit the Bay Area and Los Angeles which is where all the claim shops (MSO) are located. Managed Care Plans (Medicare Part C) is allowed to milk the Medicare coffers starting at the Utilization Management (UM-Authorizations). You know everything is driven off prior authorization. I think it's a combination of driving authorizations to the latest and greatest most expensive treatment, therapies, and procedures like the Interocular injections of monoclonal antibodies for macular degeneration these new vaccines are causing as just one small/large example. Now many of these MSO's farm out much of the billing grunt work to India. Now many major clearing houses like ChangeHealthCare (formally RelayHealthCare) offer medical billing services who also farm out to India. It would be interesting to read about MSO's, Clearinghouses, India and how they are all interictally connected back to the major insurances running the managed care scam. PMG of SJ farms out to India. I know this because I helped set it up at the time, not seeing the bigger picture. God Bless
When we started on Medicare we also had the G plan to go with. But the insurance co. raised my husband’s policy twice a year, and mine 1x a year even though I never used it the first 3 yrs I was on it. We had to buy a prescription plan, and I never used it, because I am not on any drugs! What a waste of money! I liked the G plan, but they priced us right out of it. Something really needs to be done with insurance co. I think it is a matter of time before we all lose Medicare because , they are pretty much bankrupt along with Social Security. Sad future for a seniors!
Incredibly important article - I just discussed it with my father and sent it to Wendell a few weeks ago. As a patient advocate and a medical writer with physicians as clients, I am hopeful Arends' article is just the beginning.
I will do everything I can to shout this from the mountaintops - super important and glad to hear that Brett's story is getting attention. Boiling it down to the fact that our tax dollars are subsidizing profits for commercial insurers SICKENS me. How bout this idea - get rid of MA, and take the money that HAD been going to commercial insurers (use 10% of the 22% they've been overpaying) and use it to cover the large deductibles (which is why people get MA plans to begin with!). Congress needs to wake the hell up!
As a physician, my firm belief is that this represents Medicare Fraud and Abuse. The very thing that physicians get in trouble for is how these insurance companies are making record profits. Doctors need to be talking about this, patients/consumers need to be talking about this. We need a full reform of our medical system. I refuse to be in any insurance system because of this. I am cash only and I work for the patients, with the patients. I provide excellet care and my patients are happy and they do very well.
We would have had a single payer system long ago had it not been for the Health Insurance industry's lobbying efforts to Congress to keep their profits coming in. We need "a publicly financed, non-profit single-payer national health program that should fully cover medical care for all Americans". It's time we realign our priorities. PNHP contributed to this comment as quoted.
Spot on, Cheryl! It angers me how short sighted the mentality of our Establishment Parties both GOP and Democrats. They do not listen to the voice of their respective Constituents other than the Special Interest Lobbies. Follow the money trail. Will we ever learn or will this Nation have to experience real Authoritarian rule? I certainly hope not. Time to start looking for places to live in exile outside the USA…. It would be sad, but in my family there were Holocaust escapees and victims. Why we don’t learn from the past is simply despicable and dangerous.
What concerns me about this article and the discussion is the predominance of cost overruns and charges to the Medicare Trust Fund at the expense of the damage and deaths of actual Medicare (dis) Advantage
Continuation since I couldn’t edit.
“What about the expense (actual) costs to Medicare (dis) Advantage patients/Senior citizens who have been sold a package of lies about coverage under this so called “competitive(?)”, privatized health insurance policy? SilverEarings is 100% correct. When are we going to stop subsidizing M(dis)A and move patients back into traditional Medicare policies? I am outraged just how slow the Legislative process is recognizing and admitting how flawed and irreparably damaging the M(dis)A is to the welfare of US citizens and legal residents mmm. Inertia breeds distrust in Government and just the allegations of corruption by Members of the US Senate. It is time to properly regulate Medicare DisAdvantage once and for all. My patience has run out!!?
We keep on subsidizing “losing” ventures such as the manufacturing of “High Fructose Corn Syrup” that is actually more expensive and is implicated in obesity levels over the past 10-15 years because HFCS is sweeter than sugar as well as addictive. The FDA okayed it and 60% of Americans are now obese. Another losing venture is the cost-overruns of our defense industrial complex of private corporations that has a flawed competitive bidding process? Furthermore, what about our national Security outsourcing of our intelligence assets and mercenary forces, not to forget the abuses of human rights violations and lack of care at privatized Correctional facilities? Each and every one of these business sectors are either irreparably flawed or haven proven themselves to be uncompetitive compared to being run and operated by the responsible government agencies that at lower costs and greater efficiency.
We keep on making the same ridiculous mistake that clearly must add to our national debt and deficit. It is not rocket science to correlate these disastrous policies.
I’m a retired CEO and founder of three international manufacturing companies, all still profitable.
We have gone hpast end stage capitalism. We are well into end stage democracy. If fortunes over $100m are not confiscated or otherwise “addressed,” we will be niether capitalist nor a democracy.
I've been a medical biller since ~1996 with no gaps until the plandemic. A Lead HMO Claims Auditor is on my resume. With that https://www.iceforhealth.org/home.asp is the website all Medicare Managed Care "claim shops" are all familiar with. The site is practically considered the bible on all things Managed Care and standardization. Everybody is pretty familiar with the acronyms IPA & HMO, but most don't know about MSO's? For instance Excel MSO is San Jose, CA (aka Physician's Medical Group of San Jose) is also a MSO (claims shop) entrusted to process incoming insurance claims for many Medicare Managed Care products in the Bay Area of Northern California. MSO's are kept under close scrutiny by big health Insurance auditor's. These insurance auditors, auditing the MSO's in California coincidentally seem to live in Central California (Fresno/Bakersfield). I assume it's a strategic location to visit the Bay Area and Los Angeles which is where all the claim shops (MSO) are located. Managed Care Plans (Medicare Part C) is allowed to milk the Medicare coffers starting at the Utilization Management (UM-Authorizations). You know everything is driven off prior authorization. I think it's a combination of driving authorizations to the latest and greatest most expensive treatment, therapies, and procedures like the Interocular injections of monoclonal antibodies for macular degeneration these new vaccines are causing as just one small/large example. Now many of these MSO's farm out much of the billing grunt work to India. Now many major clearing houses like ChangeHealthCare (formally RelayHealthCare) offer medical billing services who also farm out to India. It would be interesting to read about MSO's, Clearinghouses, India and how they are all interictally connected back to the major insurances running the managed care scam. PMG of SJ farms out to India. I know this because I helped set it up at the time, not seeing the bigger picture. God Bless
When we started on Medicare we also had the G plan to go with. But the insurance co. raised my husband’s policy twice a year, and mine 1x a year even though I never used it the first 3 yrs I was on it. We had to buy a prescription plan, and I never used it, because I am not on any drugs! What a waste of money! I liked the G plan, but they priced us right out of it. Something really needs to be done with insurance co. I think it is a matter of time before we all lose Medicare because , they are pretty much bankrupt along with Social Security. Sad future for a seniors!