MEDICARE: Delays, Denials, Growing Privatization Leading to Harmful Outcomes in Healthcare

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'Delays, denials, debt and the growing privatization of Medicare,' The Guardian, June 3, 2024. - Medicare Advantage enrollees report treatment denials and delays in payment, leading to harmful outcomes in healthcare 🥼
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Jenn Coffey was sick, on several medications, and in and out of the hospital around 2016 when she made a decision that she has come to regret. Having fought off breast cancer, the former emergency medical technician faced numerous complications, and was diagnosed with two rare diseases: complex regional pain syndrome and small fiber neuropathy. “I was terrified,” she said.

“I went into the hospital as a fully functional EMT and came out in a wheelchair, to go on disability income, and I lost everything. I lost my house, I lost everything.”

Coffey, 52, had been selling her belongings and raising money on GoFundMe to cover her medical care. To make things cheaper, she shifted her disability plan from traditional Medicare – a government-run health insurance program for older and disabled people – to Medicare Advantage, a program under which private health insurers contract with the Medicare program to provide health benefits.

With monthly premiums of $18.50 per month on average, Medicare Advantage often looks like a frugal alternative.

However, private insurers keep premiums low by limiting providers and using byzantine cost containment tools such as prior authorization. For Coffey, switching proved more expensive, as her Medicare Advantage provider, UnitedHealthcare, denied requests to cover treatments, medications and infusions she required.

Coffey used to be a Republican state representative in New Hampshire. “I changed a lot over these years,” she said. “I used to think we could fix healthcare.” Her experience with Medicare Advantage is not unusual. Private insurers now cover roughly half of the nation’s 68 million Medicare beneficiaries. Their dominance of this space has grown rapidly over the past two decades – at the expense of patient care, according to healthcare activists and patients, as corporations often deny medical care directed by doctors...
https://www.theguardian.com/us-news/article/2024/jun/03/medicare-advantage-privatization
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Also: Reagan, Deregulation & America's Exceptional Rise in Health Care Costs: NYT
https://www.democraticunderground.com/1016377845