Best Healthcare System in the World

What a surprise, for-profit Medicare Advantage plans are aggressively pushing seniors out of those plans, leaving them to go to traditional Medicare, boosting their profits and increasing the costs to taxpayer and to the Medicare trust fund.

It's almost like Medicare Advantage plans are s tactic to destroy Medicare and encourage looting.

Oh ……… Right ……… That was the plan all along.

Patricia Greene had spent a month recovering from a devastating stroke when her Medicare Advantage insurer, a unit of UnitedHealth Group, decided to stop paying for her nursing home.

The 85-year-old was so weak and fragile, her son said, that she couldn’t even get herself out of bed. Her family felt she wasn’t ready to leave the facility in New York City’s Queens borough.

So she dropped her UnitedHealth coverage and enrolled in the traditional version of Medicare run directly by the federal government.

That decision saved UnitedHealth tens of thousands of dollars in the months that followed, billing records show, and shifted onto taxpayers the cost of later hospital and nursing home care in what turned out to be the final months of her life. 

A Wall Street Journal analysis of Medicare data found a pattern of Medicare Advantage’s sickest patients dropping their privately run coverage just as their health needs soared. Many, like Greene, made the switch after running into problems getting their care covered. 

………

Medicare Advantage insurers collectively avoided $10 billion in medical costs incurred by the dropouts during that period, the analysis found. If those beneficiaries had stayed in their plans, the government would have paid the insurers about $3.5 billion in premiums, meaning the companies netted more than $6 billion in savings during that period. 

………

Medicare Advantage grew out of the idea that the private sector could make the sprawling Medicare program more economical, and private insurers now oversee benefits for more than half of Medicare recipients.

The insurers use some of the same money-saving tactics they use with their non-Medicare customers, such as requiring referrals from primary-care doctors or approvals from insurers for many services, and including only certain hospitals and doctors in their networks. In 2022, Medicare Advantage insurers denied 3.4 million requests for services, according to an analysis by the health-policy nonprofit KFF.

This is really simple.  If you bring in private insurance, you get private insurance rat-f%$#ery.