For profit health insurance companies are the problem. Everyone on D.U. agrees.

[Grins]

5. Medicare Advantage plans are a 'money-making scam.'

Medicare Advantage plans are a 'money-making scam.' So wrote an insurance company exec.

WaPo:

Medicare Advantage plans, which are private insurance plans for seniors paid for with federal dollars, originated as a government savings strategy, on the theory that the private sector could improve on government performance at a lower cost. But over the past two decades, it has become clear that Medicare Advantage does not result in improved care for less money. Instead, ... insurers found a way to turn it into yet another profit center, while putting bureaucratic roadblocks in the way of patients.:

seniors on Medicare Advantage cost the government more than those in the traditional program, exactly the opposite of what is intended. A government advisory panel recently estimated the overpayment was $12 billion in 2020.

...This flood of money is fattening the bottom line of the health insurance giants even as they’re increasing pressure on the Medicare Hospital Insurance Trust Fund, which is projected to run out of funds in 2026. And Congress is loath to crack down, thanks to the combined power of health insurance lobbying and the program’s popularity with cash-strapped seniors.

...It’s “widespread” for Medicare Advantage plans to initially deny coverage for doctor-advised care.... Plans erect roadblocks to treatment by demanding prior authorization for services (that) traditional Medicare covers without questions. ...There are increasing complaints that private insurers rush patients out of skilled nursing and rehab facilities."

More? NY Times:

The government pays Medicare Advantage insurers a set amount for each person who enrolls, with higher rates for sicker patients. And the insurers, among the largest and most prosperous American companies, have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits.

As a result, a program devised to help lower health care spending has instead become substantially more costly than the traditional government program it was meant to improve. ...Last year, the (Justice) department’s civil division listed Medicare Advantage as one of its top areas of fraud recovery.

CBO:

The Congressional Budget Office projects that the Medicare Advantage share will grow from 54 percent of eligible Medicare beneficiaries in 2024, to about 64 percent in ten years if it continues on its current course. ...Congress’s Medicare Payment Advisory Commission (MedPAC) estimates that MA payments in 2024 were 22 percent above traditional Medicare — a difference that amounts to $83 billion in annual spending.

It started out with high promises. The insurance companies made it a scam that is costing far more than it is worth while delivering less. It, like so many other programs, is going to go broke and break us.