By Ken Dolkart, M.D.
Valley News (Lebanon, N.H.), Letters, February 9, 2024
Traditional Medicare excels in administrative efficiency. The privatization of Medicare via contracts with intermediary Medicare Advantage (MA) megaliths has required subsidies of $613 billion to reduce premiums for subscribers. Many seniors welcome those negligible premiums offered by MA and the modest-costing additional ābells and whistlesā that are so heavily marketed. However, denial and increasing restriction of services, subtle ālemon-droppingā of sicker patients into traditional Medicare, not so subtle coding fraud and the need for added subsidies to assure private profit threatens the financial integrity of Medicare. Patients are starting to share horror stories of denial of specialist care, not to mention the administrative burden on clinicians in trying to get approval for that care. We are recapitulating the 1990s, prior to the ACA, when public disgust arose due to denial of care and rising costs of the deregulated, interstate managed-care industry.
As a subscriber to traditional Medicare, I recently learned that my traditional Medicare premiums have been raised to pay for those subsidies that enable profit by MA plans! MAās profitized inefficiencies should not require raising premiums on subscribers of traditional Medicare. Those subsidies would be better spent expanding the services of traditional Medicare. Our must trusted form of āuniversal careā for American seniors is being scavenged by those who turn Reaganesque, anti-regulatory fervor into ways to creatively siphon money off public health dollars.
Promotion of the financial interests of the publicly traded, for-profit medical industry seems to be the chief concern of Health & Human Services, CMS and Congress. We must ask our representatives to develop a coordinated, regulated, care-directed program that integrates clinicians, hospitals, community services and payment programs.