ORIGINAL MEDICARE VS MEDICARE ADVANTAGE

Medicare Advantage plans cost Medicare about 12% more than traditional medicare. If the original Medicare got the same funding, it would have only about a 10% deductible instead of the present 20% deductible. Medigap or Medicare Supplemental insurance could cover the rest for about half what it does if the funding was equal.

Original Medicare has no networks. Health Maintenance Networks or HMOs and  preferred provider organizations or PPOs all have them. Networks are restricting and dangerous:

  • You have to choose from lists of doctors and hospitals that are sometimes skimpy.  Having to settle for a less desirable doctor can lead to less than optimal results.

  • Your doctor or hospital could drop out.

  • You have to be careful with travel.

  •  Every year you have to go over all this for the changes.

There have been cases of operations at hospitals set up in network and an “assistant” is added who is out of network or someone else like an Anesthesiologist may be substituted who is out of network. Getting an unplanned out of network bill of $50,000-100,000 can happen.

PPOs do cover out of network providers, but cost more and are ambiguous about how much they will cover.

There are some doctors who don’t accept Medicare, but they are far less common than out of network doctors.

Medicare Advantage is gaining ground because of the advertising and hordes of sales people that the original Medicare does not have. These are paid for from the 12% extra that the Advantage plans soak up.

To get some idea of the kind of sales forces there are, note this. I went to about 3-4 web sites promising Medicare insurance quotes. They all asked for information including phone numbers. None of them provided rates for plans on the web sites as implied after the information was entered. In the next 48 hours I was called from 30 different area codes by telemarketers. Many of these called repeatedly. Luckily I only gave a land line with caller ID and not a cell phone!  I answered only a few callers. What a waste of money. Original Medicare has none of these costs.

If we expanded Medicare to cover everyone, we would eliminate the menagerie of for-profit insurance companies, Obamacare and Medicaid. Our Veterans could leave the VA if not treated properly. With proper management, the day might come where the 20% Medicare deductible could be lowered or eliminated.

This could be done through more regulation of hospitals especially in the policing of medical errors that kill between 100,000 and 400,000 per year. Hospitals make money on their errors. We pay for it directly or indirectly. They should be regulated just like the airlines and nuclear power industry. CEO’s and management should be penalized for unnecessary injuries and deaths. That will make hospitals safer and we would save billions of dollars.

We should also have price controls on drugs (we do it with electricity); ban drug advertising and find a new way for developing drugs through non-profit corporations.

Seniors and future Medicare beneficiaries are being cheated by the usual corruption in our government. The campaign contributions and speaker fees from the healthcare insurance industry are good investments for them.  Politicians from both parties feed on them.

For more detailed information on the plunder of Medicare, visit here.

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