Medicare Advantage Plans To Be Squeezed Next Year, Reduce Benefits

[InsuranceGuy29]

Paper facts and real world results are two different things.

I have been a business owner for 19 years.

I have sold health insurance (and many other lines) for a decade longer than you have. And it's clear you do not understand some basic concepts of the situation and it's real world impact.

I support private enterprise, even within healthcare.

I no longer support for profit health insurance entities for primary care coverage. Despite still being active in the group market. This is due to almost 20 years of experience in the health market.

I support the free market. (which our healthcare and health insurance system has not been for the past 30 years)

Read to understand, not to argue. That is the first step.

That's phenomenal. There's a lot of clueless people that have been business owners for a long time and in the healthcare industry a long time. It's clear to me you don't even understand the basics of MA or what is actually going on.

 

[InsuranceGuy29]

Thats the funniest thing Im going to hear all year

I mean, your posts are the funniest thing I've seen in years. LOL

 

[scagnt83]

I mean, your posts are the funniest thing I've seen in years. LOL

Glad you appreciate my humor.

 

[scagnt83]

Insurers don't want their people sicker because sicker people cost a lot of money. This is where you're especially confused. You honestly think insurers want people that are sicker? They want their beneficiaries to be the opposite of this.

I never said that.

Reading comprehension, friend.

I cant say it in more simple terms than I already have.

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[InsuranceGuy29]

"Fixed profit margin, forced by shareholders to increase profits.... inability to create more sick people.... the only option is to increase the price of being sick."

I went ahead and put it in bold, italicized it, and underlined it, as well. I try to make things easy for those that just aren't getting it.

 

[DonP]

Here lies the problem with all health insurance the last 50 plus yrs .When the govt runs ( orginal medicare ) you have massive fraud by drs , hospitals and vendors . Theres no checks and balances thus massive fraud doing tons of unneeded stuff . It’s like robbing a bank with the vault open . Medicare advantage the fraudsters are the private carriers who have big incentive to cut healthcare costs for their own profit . So the drs and hospitals hate them because they’re like the mafia that wants part of the profits . The private carriers are cutting in on there game of the govt paying them basically for everything they bill . Another reason the medical community hates mapd is all the unpaid copays and moop not paid by patients . I bet you 50% of bills from mapd plans not paid . People since the 1960’s have been trying to fix the healthcare system . Nobody had the answer then and nobody has it now . You have competing forces of profit ( carriers , Dr’s , hospitals ,rx ) against payers ( govt and individuals ) .

 

[Millwood]

Here lies the problem with all health insurance the last 50 plus yrs .When the govt runs ( orginal medicare ) you have massive fraud by drs , hospitals and vendors . Theres no checks and balances thus massive fraud doing tons of unneeded stuff . It’s like robbing a bank with the vault open . Medicare advantage the fraudsters are the private carriers who have big incentive to cut healthcare costs for their own profit . So the drs and hospitals hate them because they’re like the mafia that wants part of the profits . The private carriers are cutting in on there game of the govt paying them basically for everything they bill . Another reason the medical community hates mapd is all the unpaid copays and moop not paid by patients . I bet you 50% of bills from mapd plans not paid . People since the 1960’s have been trying to fix the healthcare system . Nobody had the answer then and nobody has it now . You have competing forces of profit ( carriers , Dr’s , hospitals ,rx ) against payers ( govt and individuals ) .

Well the Doctors are taking a plastic knife to a gun fight and the hospitals are taking a butter knife to the same fight.

 

[somarco]

CMS and carriers believe they control the health care market and many agents are clueless.

Truth is, the PROVIDERS control health care. They decide which insurance plans they will accept and the ones they will not. They play by the rules up to a point, but most practice the Hippocratic oath and do what is best for the patient. When they get fed up with jumping through hoops they will not hesitate fire carriers or refuse to accept certain plans.

There are a number of daggers pointed at them, including the licensing board and malpractice attorneys. They are not business people but are aware of cash flow even if they don't know all the intricacies of ledgers and balance sheets.

When you or a family member has a serious health issue you better hope the best practitioners will accept your plan and the skills of the provider matches their "Yelp" ratings.

I know I do . . .