The Hidden Healthcare Question: Who Pays for “Medicare Advantage for All?”

November 27, 2019

While “Medicare for All” is an attractive politician slogan, it avoids stating the full scope of the problem. Why don’t the politicians and their supporters, for instance, make banners reading: “Medicare Advantage for All”?

I don’t think they have the courage to address the predicament of comprehensive health care for all. Let us review the situation, using the statements on the government’s own website of Medicare expirations.

https://www.medicare.gov/pubs/pdf/11474.pdf

You can get your Medicare benefits through Original Medicare, or a Medicare Advantage Plan (like an HMO or PPO). If you have Original Medicare, the government pays for Medicare benefits when you get them. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits.If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage.

“How much do Medicare Advantage Plans cost?
In addition to your Part B premium, you usually pay one monthly premium for the services included in a Medicare Advantage Plan. Each Medicare Advantage Plan has different premiums and costs for services, so it’s important to compare plans in your area and understand plan costs and benefits before you join.

Question:
If Medicare provides you with health care when you retire, why would you need an “Advantage” plan, for which you have to pay yet more money, out of your limited resources as a retired person?

Answer:
Because Medicare by itself is extremely limited in the quantity of services it provides. Signing up with an HMO gives you possible access to more services.

Question:
But doesn’t signing with a HMO through Medicare Advantage place you at the mercy of a profit-obsessed business?
Answer:
You bet it does. HMOs are in the medical business. They are designed to maximize profit. From personal experience, I can testify how an HMO operates on one principle: how little service can it provide, even if you are obviously in peril of dying, and your death can be easily prevented. From the HMO point of view, a patient is a criminal, and deserves nothing less capital punishment. The care I received when I experienced several months of severe chest pain in the summer and fall of 2010 informs that assessment. It was obvious to me that the HMO wanted only one thing: delay the necessary tests as long as possible, in hopes that I would die before any remedial action that might cost the company money (and thereby reduce profits) had to taken. Yes, HMOs are that cynical.

Question:
But wouldn’t a single-payer system eliminate the profit motive, and thereby enable the health system to focus on providing sufficient care?
Answer:
Theoretically, yes. However, I find it very hard to believe that a national government acting as a HMO for all the residents of a country would provide even the reluctant level of service currently provided by the HMO I am currently signed up with.

Question:
Why do you find it so hard to believe that a socialized HMO would respond to your health needs?
Answer:
Because politicians lie. They can’t help it. This is what they are trained to do. Yes, Bernie Sanders and Elizabeth Warren are well intentioned human beings and their supporters believe in the efficacy of their plans. But their failure to address the obvious shortfalls of “Medicare” and expand their demand to “Medicare Advantage for All” demonstrates that they cannot tell the truth about what their plan will cost, who will pay for it, and how little many of those who pay for it will receive in return.

The fact remains that I have been lied to too many times to believe any politician. The Democratic and Republican parties have produced nothing but betrayals. When people lost jobs in the 1990s, what happened to Bill Clinton’s plans for job training? Pathetic. When things were incredibly worse in 2007 through 2010, what did Obama do to increase employment immediately and provide direct relief to millions of workers? PATHETIC!

Why would the promises about health care be different? If anyone thinks, “Oh, it will be different this time!” then you don’t understand that the social environment of this nation has rapaciousness and duplicity built into its psyche to such a degree that it is incapable of compassionate action.

Campaign promises are the opiates of ideology. It’s hard to shake a drug habit unless one confronts the actual situation. No matter what Sanders and Warrant propose, health care will not improve; access will not improve.

If anything, a significant percentage of American workers will see their incomes decrease. Right now, my health coverage premium is paid for by my employer. It is part of my remuneration for the work I do.

Under “Medicare for All,” I will lose that benefit and will instead be given the pleasure of paying more taxes to receive minimal medical care.

(As for the Republican Party’s evolution into something resembling a self-serving pack of illiterate playground bullies, there is almost no possible chance of redemption. Why would they ever apologize for their facilitation of war crimes committed on several continents in the past 70 years?)

Will I vote for Warren or Sanders?

Yes.

But my support should not be mistaken for anything but hope extinguished in the very futility of the vote that engenders it.