- 1,953
Medicare Advantage Disadvantage.
- Thread starter Cornelius
- Start date
This article was written by a far left, socialist magazine. Its own founder, Bhaskar Sunkara, describes Jacobin as "...a radical publication being 'largely the product of a younger generation not quite as tied to the Cold War paradigms that sustained the old leftist intellectual milieux like Dissent or New Politics, but still eager to confront, rather than table, the questions that arose from the experience of the left in the 20th century'".
Go check Jacobin out on Wikipedia for a better idea on their agenda. They work closely with far-leftist groups and are pushing hard for Medicare-for-All. Don't believe everything you read, see or hear, particularly when you don't know the source or the agenda.
This slam from Jacobin on Medicare Advantage is largely anecdotal. Although nobody will deny Medicare Advantage has its flaws and it is not for everyone, it is actually working as well or better than fee-for-service in many ways. For example, a 2017 study concluded "Using recent data from three large states, we found that MA outperformed FFS on nearly all clinical quality and most patient experience measures" (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682140/).
I have hundreds of clients on both programs. I generally find my Medicare Advantage clients to be very content with their program and carrier. The same is true for my Original Medicare clients. The truth is that one of the reasons I have a job in this industry is because beneficiaries do have differences in needs, budgets, preferences, treatment approaches and so on, and it does take some experience and insight to know which program offers a better fit for each client.
Go check Jacobin out on Wikipedia for a better idea on their agenda. They work closely with far-leftist groups and are pushing hard for Medicare-for-All. Don't believe everything you read, see or hear, particularly when you don't know the source or the agenda.
This slam from Jacobin on Medicare Advantage is largely anecdotal. Although nobody will deny Medicare Advantage has its flaws and it is not for everyone, it is actually working as well or better than fee-for-service in many ways. For example, a 2017 study concluded "Using recent data from three large states, we found that MA outperformed FFS on nearly all clinical quality and most patient experience measures" (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682140/).
I have hundreds of clients on both programs. I generally find my Medicare Advantage clients to be very content with their program and carrier. The same is true for my Original Medicare clients. The truth is that one of the reasons I have a job in this industry is because beneficiaries do have differences in needs, budgets, preferences, treatment approaches and so on, and it does take some experience and insight to know which program offers a better fit for each client.
Some people don't want or need expensive first dollar coverage. Medicare Advantage is not free and is the right choice for many beneficiaries. The author is a far left-wing socialist, promoting Medicare-for-All, not Original Medicare.
InsuranceGuy29
Guru
- 405
Exactly this. Both of your posts were very well-written and excellent. They also say they want “MediCARE For All,” but what they really want, and the system they describe, is actually “MedicAID-For-All,” and we all know what a sh!tshow MedicAID is.
They just know saying “MedicAID” won’t be popular among the general population. It’s all branding and propaganda.
For those that don’t know, MediCARE is a system that people have paid into for their entire lives, and then continue to pay a little bit into when they go on it. That’s what separates it from completely-taxpayer-funded MedicAID.
This, and the supplement and Medicare Advantage money they involve, are the reason the networks are so huge and so many doctors and hospitals take MediCARE. Because MediCARE (with the extra money insurance companies have via their supplements and Medicare Advantage plans) can reimburse them a much higher and respectable rate for their service.
MedicAID networks are pin thin and they cannot reimburse like this. Why? Because it’s solely funded by taxpayers and the money isn’t there at all, because no one has been contributing to any sort of fund for it.
An example….doctors usually bill around $150 for a visit. MedicAID might reimburse them $8 for that visit, and they’ll get paid a year later….if they’re “lucky.”
MedicAID puts anyone on it at risk of unbelievably substandard care from substandard doctors. There’s a reason a lot of them have to accept MedicAID, because they’re likely not the best. Not saying there aren’t some good ones, but they usually have a wait list to see them that’s 6 months out.
I know this first-hand from dealing with it.
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I've seen the fee schedules for Medicaid and (at least in NC) and it's nowhere close to $8 - it's much higher some office consults over $130.
But I get your overall point - medicaid and low reimbursements and no skin in the game from the patient is not a good recipe.
InsuranceGuy29
Guru
- 405
Admittedly, I pulled that $8 figure out of my rear end, but I’m in Illinois (super low MedicAID reimbursement state) and know a few doctors that have taken Medicaid. From what they told me, when all is said and done and it all averages out, it’s basically minimum wage. My one buddy said some of the doctors even had to band together to sue the state because they went YEARS without getting reimbursed. It’s insane. Not gonna have very good and dedicated doctors if they’re not getting paid a respectable rate. These doctors also don’t take Medicaid anymore. No surprise there.
