'End the Scam': Democrats Unveil Bill to Change Name of Medicare Advantage

[Northeast Agent]

[EXTERNAL LINK] - 'End the Scam': Democrats Unveil Bill to Change Name of Medicare Advantage

The bill, which faces long odds in the Republican-controlled House, was introduced as GOP lawmakers push for cuts to traditional Medicare as part of their broader austerity campaign.

It also comes as the Biden administration is moving ahead with a Medicare privatization scheme known as ACO REACH, a pilot program that critics warn could fully engulf traditional Medicare in a matter of years.

The Democratic trio's legislation does not specifically address ACO REACH, opting to zero in on Medicare Advantage plans that are notorious for denying necessary care to vulnerable seniors and overbilling the federal government.

 

[adjusterjack]

Sure, change the name, but don't punish the abuses.

Good move Democrats.

 

[somarco]

More info on the ACO reach which is flying under the radar . . .


Now known as the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the experiment inserts a for-profit entity between traditional Medicare beneficiaries and healthcare providers. The federal government pays the ACO REACH middlemen to cover patients' care while allowing them to pocket a significant chunk of the fee as profit.

The rebranded pilot program, which was launched without congressional approval and is set to run through at least 2026, officially began this month, and progressive healthcare advocates fear the experiment could be allowed to engulf traditional Medicare.

In a Tuesday letter to Health and Human Services Secretary Xavier Becerra and Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure, Physicians for a National Health Program (PNHP) argued that ACO REACH "presents a threat to the integrity of traditional Medicare, and an opportunity for corporations to take money from taxpayers while denying care to beneficiaries."

[EXTERNAL LINK] - 'Cancel This Failed Experiment': Physicians Tell Biden HHS to End Medicare Privatization Pilot

The Obamacare era ACO model burned through millions of taxpayer dollars as part of a failed program that allowed grifters to get federal funds and create an "HMO-like" managed care program.

“Accountable care organizations” is the health wonk phrase du jour. Obamacare’s advocates point to its support for ACOs as one of the important cost-control initiatives in the law. Except that, like nearly everything about Obamacare, the truth isn’t so simple. It turns out that the government’s idea of an accountable care organization is completely unworkable, to the point where nearly all leading health providers have declared it dead on arrival.

[EXTERNAL LINK] - How Obamacare is Destroying Accountable Care Organizations



Why did accountable care organizations fail?
We see two main reasons for the failure of accountable care organizations: The diagnosis was wrong and the prescription was wrong.

The key assumption underlying the nation’s managed care experiment is that U.S. health care costs are high because Americans get too many medical services, and this overuse is caused by the fee-for-service method of paying doctors. Fee for service creates a financial incentive for doctors to order more tests and do more procedures, something doctors allegedly cave in to. That, anyway, was the diagnosis promoted in the early 1970s by proponents of health maintenance organizations, an early form of managed care, and it is the diagnosis offered today by ACO proponents.
[EXTERNAL LINK] - Accountable care organizations don't cut costs. It's time to stop the managed care experiment

 

[gregj]

stuff labeled health care accounts for 18-20% of US GDP. High prices account for much of it (rather than, for instance, rampant overuse). But pricey rescue care also accounts for a worrisomely high fraction; our "system's" habits (clinician/care provider incentives, etc) are not oriented toward preventive or 'maintenance' care.

One result; we get less "health" for what we spend. To me, that's a bigger issue than how much is spent, or what share of GDP health stuff accounts for.

My personal delusion is that collection/digestion/dissemination of more actionable information would help some with that. Not "price transparency" & other tactical window-dressing -- more like "health wisdom", whatever that might be (what, you expect ME to know? )

 

[Newby]

There those Dems go again trying to take away everyone’s Medicare.

 

[gregj]

“Accountable care organizations” is the health wonk phrase du jour.

lol

they've been around for more than a decade, & on drawing boards longer than that...

 

[somarco]

lol

they've been around for more than a decade, & on drawing boards longer than that...

Too bad you missed the tongue in cheek reference regarding ACO's . . .

The definition of insanity is doing the same thing over and expecting different results. ACO's have been around since 2006 and are a complete failure . . . yet the bozo's in DC think they will work this time.

GARBAGE!

Why did accountable care organizations fail?
We see two main reasons for the failure of accountable care organizations: The diagnosis was wrong and the prescription was wrong.

People who lack reading comprehension skills have a similar challenge.