Latest news with #MedPac
Yahoo
4 days ago
- Business
- Yahoo
U.S. could have best health care. But not if profit-driven private sector keeps control.
Kay Tillow, with Kentuckians for Single Payer Health Care, led a rally against Medicare Advantage plans Oct. 11, 2023 outside the Humana headquarters in Louisville. (Photo by Deborah Yetter) Ours is the only nation in the industrialized world that has turned health care over to the private sector, subjecting all of us to life expectancy five years below the norm in other wealthy countries. More of our babies die in the first year of life and more of our moms die in childbirth than in any other industrialized country. We spend twice as much per person on health care in the United States as peer countries, yet we have the highest rates of death for conditions that are treatable. On the congressional agenda are cuts to Medicaid of more than $600 billion over 10 years. Hundreds of thousands Kentuckians are among those in the line of fire. The results will be deadly. Administration officials are determined to offset the tax cuts that will benefit the wealthiest even though it means loss of health care for millions of Americans. People are in the streets to stop the catastrophic damage to Medicaid. The Congressional Budget Office estimates that 10.3 million people would lose their Medicaid coverage by 2034 under the GOP bill. Med Pac, the independent agency that advises Congress, predicts the projected cuts will throw 8 million onto the uninsured rolls. Med Pac has also informed Congress that the privatized Medicare plans, misnamed Medicare Advantage, that were supposed to save money are instead costing us $84 billion a year more than if those patients were in traditional Medicare. So this looks like an easy fix. Leave Medicaid alone. Cut out the Medicare Advantage plans, placing those patients onto the better coverage of traditional Medicare, saving more than enough money over 10 years than is needed to offset the tax cuts. Problem solved! But in health care things are seldom simple. The Medicare Advantage patients who gained access to traditional Medicare would find themselves faced with unaffordable monthly premiums for the prescription drugs and supplemental coverage they would need. The Medicaid patients who were rescued from the firing squad will continue to suffer at the hands of the private Medicaid managed care companies that regularly deny 12% of claims, a rate double the awful rate in Medicare Advantage. Medicaid patients would still have a hard time finding specialists. Their rural hospitals would continue to close as the Medicaid payments are insufficient to maintain the necessary infrastructure. Billions of the public funds provided for Medicaid patients would be siphoned into the coffers of the insurance companies as care, by law, is secondary to profit, in this privatized Medicaid system. Those fortunate enough to have health care through their employers will continue to find the premiums, deductibles and co-pays beyond their means. The average family plan is now over $25,000 a year. The 15 years since the passage of health care reform have left 100 million of us in medical debt in what the Commonwealth Fund accurately calls a failing health care system. Over 130 national and local organizations have called for a national day of action on Sat., May 31, to 'Demand Health Not Profit: Put Single Payer on the Nation's Agenda.' On that day in 25 cities from Detroit to Houston and Seattle to Charlotte, people will gather to advocate against cuts in an already failing system and in favor of enhanced Medicare for all. The protesters are demanding passage of a publicly financed, national single-payer program that would provide comprehensive coverage to everyone. In Kentucky, the Rally for Health Not Profit will be at noon Saturday at the Mazzoli Federal Building in Louisville. The people there will be fighting for all of those on the firing lines and insisting that, this time around, we can remove the profits from health care and enact a plan that cares for all of us. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
29-03-2025
- Business
- Yahoo
Elon Musk's ‘DOGE' should target this $84 billion boondoggle — but will it?
As the Trump administration and its chainsaw-wielding budget cutter, Elon Musk, hunt for ways to slash federal spending, a massive opportunity has just fallen into their lap. Whether they'll be able — or willing — to take it is another matter. 'He gave me a week to get out': My son and I bought a house — now I'm homeless and living in a car. Can I sue him? 'He was my dad too': My father died. I rarely speak to my 90-year-old stepmother. Should I ask if I'm in her will? I met a friend for lunch. When the check arrived, she said, 'Thank you so much for paying!' Was I taken for a fool? If you love dividend stocks, check out these 11 companies with room to boost their hefty payouts 'I'm being held hostage': I bought my parents' house and added my brother to the deed. He won't pay the mortgage. What now? The partially privatized Medicare Advantage program is costing U.S. taxpayers an extra $84 billion a year in waste, fraud or abuse, the Medicare Payment Advisory Commission has just confirmed in a new report to Congress. And that gigantic figure, equivalent to about $2,600 a year for every U.S. household, is persistent: The latest estimate confirms the figure MedPac reached last year. The Medicare Payment Advisory Commission is a nonpartisan body of independent experts that advises Congress on the Medicare program, which pays for medical care for people 65 and over and costs U.S. taxpayers $1 trillion a year. 'In 2025, we estimate that Medicare will spend about 20 percent more for MA enrollees than it would spend if those beneficiaries were enrolled in FFS Medicare, a difference that translates into a projected $84 billion,' MedPac reports in its latest annual report to Congress. MA refers to Medicare Advantage, the program whereby Medicare insures beneficiaries through private health-insurance companies, and FFS refers to 'fee for service,' or traditional, Medicare, which cuts out the middleman and insures beneficiaries directly. 'The relatively higher payments to MA plans are financed by the taxpayers and beneficiaries who fund the Medicare program,' MedPac adds. And it estimates that the extra payments — only some of which Medicare Advantage health-insurance companies then shared with actual beneficiaries — drive up Medicare premiums for all beneficiaries, including those with traditional Medicare, adding about $198 a year to Part B premiums. Medicare Advantage traces its roots back to the early 1970s, when Congress first introduced private health-insurance options into the Medicare program to compete with the basic or traditional government insurance program. In recent years, it has overtaken the traditional program, covering more than half of all Medicare beneficiaries. The original idea was that private insurers would provide government-run health insurance with some needed competition and would thus help drive down healthcare costs. But MedPac says Medicare Advantage now costs more — much more — than the basic alternative. The estimated excess payments to the private insurers is equivalent to about 20% of the $500 billion that taxpayers paid to Medicare Advantage providers last year. MedPac says the private insurance companies cherry-pick the healthiest senior citizens to insure, leaving those with much higher healthcare costs to be insured by the taxpayers. It says those companies also game the system through a technique known as 'coding intensity,' whereby they make each insured person seem as sick as they possibly can, regardless of any symptoms, knowing that they can bill the taxpayers extra for each condition. Such practices, so long as they are conducted within legal boundaries, do not constitute fraud. Private insurers spend a small amount of these extra payments on beneficiaries themselves, often by subsidizing or eliminating monthly premiums, offering absolute annual limits on out-of-pocket costs and providing add-on benefits like dental checkups, eyeglasses and gym memberships. But most of the money goes to the insurance companies themselves. You'd think an $84 billion boondoggle would be an easy target for people like Musk, who has set himself the goal of finding '$1 trillion' in budget savings, but it's not that simple. Medicare Advantage, for obvious reasons, is popular with health-insurance companies, their stockholders and their lobbyists. It is also popular with many of its 34 million members, who get at least some extra benefits at the expense of taxpayers. President Donald Trump may find himself politically trapped by his previous promise not to cut Medicare: Any attempt to claw back this huge amount of money would be bound to generate a backlash. Medicare Advantage is also hard to touch for political reasons: Because it involves private insurance in competition with government insurance, it is deeply popular with small-government conservatives, even though it increases government spending and costs the taxpayers more. Project 2025, the program outlined by the ultraconservative Heritage Foundation that has helped inspire this second Trump administration's approach, simultaneously calls for deep cuts to federal spending and a major expansion of Medicare Advantage. What will Trump, Musk and the Republican Party do? Stay tuned. All the ways Friday's PCE inflation and spending data may discourage investors 'I'm considering marriage in my mid-60s': Am I responsible for my spouse's medical debt? 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