Wendell, you and I both know that this problem extends far beyond United Healthcare and Medicare Advantage. The entire U.S. healthcare system operates for one purpose only: to reward investors. Any other consideration--like actually helping sick people get better and, lord forbid, maintain their health--takes a back seat to making sure investors' wallets are overflowing with greenbacks. And I include all the alphabet soup health related agencies in this problem, too. The FDA, CDC, NIH, etc, all behave as though their true purpose isn't public health but investor profits. It's all a sick, lethal cesspit of corruption and skewed incentives.
It's a new game of whack-a-mole. As long as there is an opportunity to profit from the health and lives of human beings, the greedy and unscrupulous will dream up new ways to steal legally. Take profit out of healthcare and cover everyone.
Brilliant article this morning ☕ Wendell. Everyone Needs to Read this essay, you've broken down all the Main Talking Points,that these so called "Advantage Plans" that have brainwashed the American people for decades !! Thank You, and will reStack ASAP 🙏💯👍
If Medicare would pay 100% instead of leaving us open to owing 20% of a possibly incredible amount, our homes could be foreclosed, and nobody would get private for-profit care for obvious reasons. Also, my teeth and eyes are part of my body and should be covered.
As my friends all approach 65, I’ve encouraged them to do their homework and seriously consider original Medicare but they are all lured in by the seemingly low cost Advantage plans. Something needs to be done to make the difference between the two options more plain and simple so folks aren’t scammed. Medicare Advantage should not be called Medicare - because it isn’t. It’s subsidized profiteering.
Wow. So this branch, which is under the big UnitedHealth Group umbrella, which includes UnitedHealthcare, makes up health conditions to bilk US taxpayers & Medicare out of money, while UnitedHealthcare denies claims for needed healthcare at an alarming rate. You can’t make this up! Welp we will not be getting healthcare reform anytime soon.
We will rescue ourselves. Do not sign your name to anything about part c (advantage) plans no matter the pressure from retirement systems, brokers and insurers. Then check with your local council on aging and consider buying a high deductible G (for good) plan. Also ask someone you trust about part D. The doughnut hole is gone and is something to consider.
If Medicare still exists by the time I’m eligible to receive it. They wanna raise the age of retirement to 70. That’s 12 years to go; 4 before I can apply for early, but will they mess with that as well? I think they’re gonna try.
Medicare exists now because the for-profit private health insurance industry dropped people as they aged. That was 1965. Also hospice care is not covered by health insurance industry.
During 2024 I along with other Medicare Advantage patients have been raising these concerns on this site because many of us have experience being denied care, overcharged and many other ethical concerns about United Healthcare, BCBN, Kaiser Permanente etc. what is needed now is the US Senate to do something to actually fix these systemic profiteering problems that make Medicare Advantage uncompetitive compared to Traditional Medicare. We patients want Action not more words and excuses. Sadly too many Members of the US Congress and Senate are in the pockets of these insurance giants NOT representing the needs of constituents. Honestly I am sick and frustrated at the inertia and outright ignorance of these Legislators who have been hoodwinked into believing that privatizing Medicare will save Money, when in fact, the opposite is true. We have a broken Healthcare system that is the world’s most expensive mediocre to failing grades for health care.
I believe my Michigan Ambetter from meridian (aca) is trying to do this, literally every week ( over 2 years) they want to schedule a home visit .I've read numerous articles how the insurance companies have made house calls to Medicare advantage enrollees and leaving w/diagnoses to report to them so government will subsidize a higher payment
This needs to be addressed and audited they are denying u care at our expense and profiting on fake diagnosis.
I do some volunteer work in senior issues (though I'm that age myself). One elderly gentleman told me he was threatened with not only cancellation of his Medicare supplemental plan (may have been an early Advantage plan) but also with completely denying him Medicare -- because he absolutely refused those incredibly intrusive "home visits." He was told that Medicare "surveills" Medicare patients to make sure they are "doing what they are supposed to do" and if they don't "do what they're supposed to do" they will have everything allegedly canceled. It was his health insurance plan rep who threatened him.
Correct me if I'm wrong, but the only fix I can see is a not-for-profit, government regulated alternative to private medical insurance, such as "Medicare for All."
Well it makes sense now why UHG doesn’t do anything about addressing morbid obesity. And everyone is labeled as morbid obesity even if they are just obese or overweight by a couple of pounds .
Our physician-owned multi-specialty clinic in small town South Dakota has, since early 1980's, annually rebuffed merging with the hospital and its mother network across the street. "We will do the billing so that you can concentrate on the care..." was the mantra blasted at us...
Up to now, the clinic physicians have always responded with: 1) our care is cheaper to our patients, insurers, Medicare, Medicaid, and the uninsured; 2) we will not give up our independence to practice medicine as we pledged in our Hippocratic Oath...
At the clinic the physicians determin the bill for any service, not an exploitive hospital coder. But time will only tell when the financial power of corporate healthcare, owning the only hospital in town, will break the solidarity of this clinic in the future...
Please provide the WSJ article in full - or at least advise that it's behind a paywall for non-WSJ subscribers. Plus: the article MISSES the alternative way Medicare Advantage insurance companies increase their profits: utilization management. MEANING: the MA company incentivizes DOCTORS to withhold care by offering the "not medically necessary" reason. So for example two of the most popular elderly medical issues needing surgery are hip replacement and cataracts; doctors are now being incentivized and bonused to simply do a cursory initial patient exam, declare that treatment is "not medically necessary" - and the Medicare Advantage company keeps MORE of its capitation money even after sharing a little with that collaborating MD. Please read the entire Dr. Solomon's Dilemma series about financial incentives, a PBS Frontline documentary.
Wendell, you and I both know that this problem extends far beyond United Healthcare and Medicare Advantage. The entire U.S. healthcare system operates for one purpose only: to reward investors. Any other consideration--like actually helping sick people get better and, lord forbid, maintain their health--takes a back seat to making sure investors' wallets are overflowing with greenbacks. And I include all the alphabet soup health related agencies in this problem, too. The FDA, CDC, NIH, etc, all behave as though their true purpose isn't public health but investor profits. It's all a sick, lethal cesspit of corruption and skewed incentives.
It's a new game of whack-a-mole. As long as there is an opportunity to profit from the health and lives of human beings, the greedy and unscrupulous will dream up new ways to steal legally. Take profit out of healthcare and cover everyone.
Brilliant article this morning ☕ Wendell. Everyone Needs to Read this essay, you've broken down all the Main Talking Points,that these so called "Advantage Plans" that have brainwashed the American people for decades !! Thank You, and will reStack ASAP 🙏💯👍
If Medicare would pay 100% instead of leaving us open to owing 20% of a possibly incredible amount, our homes could be foreclosed, and nobody would get private for-profit care for obvious reasons. Also, my teeth and eyes are part of my body and should be covered.
And ears (the scamming going on with hearing issues).
As my friends all approach 65, I’ve encouraged them to do their homework and seriously consider original Medicare but they are all lured in by the seemingly low cost Advantage plans. Something needs to be done to make the difference between the two options more plain and simple so folks aren’t scammed. Medicare Advantage should not be called Medicare - because it isn’t. It’s subsidized profiteering.
The insurance lobbyist (crooks) are probably responsible for the term advantage. YES part C plans are not Medicare.
Great article and very enlightening. Money money money United Healthcare. Interesting only advantage client have more dx.
Wow. So this branch, which is under the big UnitedHealth Group umbrella, which includes UnitedHealthcare, makes up health conditions to bilk US taxpayers & Medicare out of money, while UnitedHealthcare denies claims for needed healthcare at an alarming rate. You can’t make this up! Welp we will not be getting healthcare reform anytime soon.
We will rescue ourselves. Do not sign your name to anything about part c (advantage) plans no matter the pressure from retirement systems, brokers and insurers. Then check with your local council on aging and consider buying a high deductible G (for good) plan. Also ask someone you trust about part D. The doughnut hole is gone and is something to consider.
If Medicare still exists by the time I’m eligible to receive it. They wanna raise the age of retirement to 70. That’s 12 years to go; 4 before I can apply for early, but will they mess with that as well? I think they’re gonna try.
Medicare exists now because the for-profit private health insurance industry dropped people as they aged. That was 1965. Also hospice care is not covered by health insurance industry.
During 2024 I along with other Medicare Advantage patients have been raising these concerns on this site because many of us have experience being denied care, overcharged and many other ethical concerns about United Healthcare, BCBN, Kaiser Permanente etc. what is needed now is the US Senate to do something to actually fix these systemic profiteering problems that make Medicare Advantage uncompetitive compared to Traditional Medicare. We patients want Action not more words and excuses. Sadly too many Members of the US Congress and Senate are in the pockets of these insurance giants NOT representing the needs of constituents. Honestly I am sick and frustrated at the inertia and outright ignorance of these Legislators who have been hoodwinked into believing that privatizing Medicare will save Money, when in fact, the opposite is true. We have a broken Healthcare system that is the world’s most expensive mediocre to failing grades for health care.
I believe my Michigan Ambetter from meridian (aca) is trying to do this, literally every week ( over 2 years) they want to schedule a home visit .I've read numerous articles how the insurance companies have made house calls to Medicare advantage enrollees and leaving w/diagnoses to report to them so government will subsidize a higher payment
This needs to be addressed and audited they are denying u care at our expense and profiting on fake diagnosis.
I do some volunteer work in senior issues (though I'm that age myself). One elderly gentleman told me he was threatened with not only cancellation of his Medicare supplemental plan (may have been an early Advantage plan) but also with completely denying him Medicare -- because he absolutely refused those incredibly intrusive "home visits." He was told that Medicare "surveills" Medicare patients to make sure they are "doing what they are supposed to do" and if they don't "do what they're supposed to do" they will have everything allegedly canceled. It was his health insurance plan rep who threatened him.
Correct me if I'm wrong, but the only fix I can see is a not-for-profit, government regulated alternative to private medical insurance, such as "Medicare for All."
Thank you UnitedHealth care (cost) for leading & keeping people as sick as is profitable for health insurance industry.
Well it makes sense now why UHG doesn’t do anything about addressing morbid obesity. And everyone is labeled as morbid obesity even if they are just obese or overweight by a couple of pounds .
vive la NHS.
it's risen incorruptible
The Whole System is Theft and Fraud, yes folks the World System is part of it. As George Carlin said " It's a BIG CLUB and you aren't in it"
This world will always stand up for beings sick or injured.
🤦♀️
Our physician-owned multi-specialty clinic in small town South Dakota has, since early 1980's, annually rebuffed merging with the hospital and its mother network across the street. "We will do the billing so that you can concentrate on the care..." was the mantra blasted at us...
Up to now, the clinic physicians have always responded with: 1) our care is cheaper to our patients, insurers, Medicare, Medicaid, and the uninsured; 2) we will not give up our independence to practice medicine as we pledged in our Hippocratic Oath...
At the clinic the physicians determin the bill for any service, not an exploitive hospital coder. But time will only tell when the financial power of corporate healthcare, owning the only hospital in town, will break the solidarity of this clinic in the future...
More and more healthcare providers are breaking from corporate exploitative healthcare.
Please provide the WSJ article in full - or at least advise that it's behind a paywall for non-WSJ subscribers. Plus: the article MISSES the alternative way Medicare Advantage insurance companies increase their profits: utilization management. MEANING: the MA company incentivizes DOCTORS to withhold care by offering the "not medically necessary" reason. So for example two of the most popular elderly medical issues needing surgery are hip replacement and cataracts; doctors are now being incentivized and bonused to simply do a cursory initial patient exam, declare that treatment is "not medically necessary" - and the Medicare Advantage company keeps MORE of its capitation money even after sharing a little with that collaborating MD. Please read the entire Dr. Solomon's Dilemma series about financial incentives, a PBS Frontline documentary.
Archived version:
https://archive.is/FEPmY