By Julie Pease, M.D.
Portland (Maine) Press Herald, Letters, August 1, 2023
On July 30, 1965, President Johnson signed Medicare into law, allowing millions of seniors to access health care. On the occasion of Medicareās 58th birthday, Medicare is under threat. Efforts to privatize Medicare are eroding this landmark program, allowing the greed of a few to threaten the well-being of us all.
The Medicare Advantage program is diverting billions of dollars a year to corporate profiteering. Through the process of āupcodingā (making patients look sicker than they actually are), insurance corporations have been overpaid by taxpayers to the tune ofĀ tens of billions of dollars.
Hereās how āupcodingā happens: I am 66 years old, in good health. I am enrolled in a Medicare Advantage plan. I am getting several calls each month from the insurance company, urging me to take advantage of a āfreeā health screening. The purpose of this home health visit is not to provide health care. Rather, its purpose is to āupcodeā: to add irrelevant diagnoses to my medical history just to increase the insurance companyās payout.
President Biden has taken some steps to try to rein in the practice of upcoding, but he can do more. Therefore, on the occasion of Medicareās 58th birthday, I am encouraging President Biden to take executive action to prohibit upcoding, and to stop overpayments to Medicare Advantage. The tax dollars saved can be used to improve traditional Medicare ā eliminating deductibles and expanding coverage to include dental, vision and hearing ā so that we have the freedom to just choose Medicare, not a privatized plan.