Proponents of private plans say they are indisputably good for many older Americans because they coordinate care and may offer extra benefits, like discounts on eyeglasses, hearing aids and dental care.
But federal officials said that the fastest-growing type of Medicare Advantage plan generally does not coordinate care, does not save money for Medicare and has been at the center of marketing abuses.These “private fee-for-service plans” allow patients to go to any doctor or hospital that will provide care on terms set by the insurer. In most cases, no one manages the care. And some patients have found that they have less access to care, because their doctors refuse to take patients in private fee-for-service plans.
Moreover, those plans may be more expensive than traditional Medicare for some patients, because the co-payments for some services may be higher. The Medicare Payment Advisory Commission says that the cost to the government is also higher because it pays the private fee-for-service plans, on average, 19 percent more than the cost of traditional Medicare.
Richard S. Foster, chief actuary for the Medicare program, said “the additional payments to Medicare Advantage plans, above and beyond the costs” of traditional Medicare, were causing higher premiums for all beneficiaries and speeding the depletion of the Hospital Insurance Trust Fund for Medicare.
The Republican idea of Medicare reform was to add an unnecessary middle-man, driving up costs and increasing levels of abuse. Here's Kevin Drum's interpretation:
Private insurance carriers charge more than Medicare to provide medical services because, duh, they're a middleman and they have to make a profit. But private carriers, by movement conservative definition, must be better than any government program, so we have to find a way to get them involved. How? By paying them 19% more! So they can provide poorer service! And rip off vulnerable elderly patients (read the story for details)! And deplete the Medicare trust fund even faster than before!
Remember, these are the people who supposedly came to DC to reduce the level of government involvement in the economy. I can't wait until they try to use the whole "tax and spend" liberal thing again.
More from Hilzoy here.
UPDATE: Hilzoy gives us a two-fer with this examination of waste, fraud, and corruption in the Education Dept. This one is obviously quite personal for me.
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