Donald Trump promises he will
“not cut one penny” of Medicare,
but like most elected Republicans he’s a strong proponent of #Medicare #privatization.

During his first administration, Trump issued an executive order that said #Medicare #Advantage,
the privatized version of Medicare,
“delivers efficient and value-based care through choice and private competition.”

#Mehmet #Oz, the TV doctor Trump nominated to run the Centers for Medicare and Medicaid Services,
disparages traditional Medicare and has called for massive expansion of Medicare Advantage.
By remarkable coincidence, as of 2022 Oz owned a reported stake of $550,000 in UnitedHealth, Medicare Advantage’s largest participant.

There are many things the private sector does better than the federal government, -- among them enriching shareholders like Oz.
But the private sector does not provide health care more efficiently than the public sector.
That’s been demonstrated over and over, yet nobody wants to believe it.

A reportpublished Wednesday by The Wall Street Journal
summarizing a year’s worth of its investigations
indicates that where Medicare Advantage really excels is in the filing of #fraudulent #claims.

Congress created Medicare Advantage in 1997
to demonstrate for good and all, damn it, that the market economy could be more cost-effective at delivering doctor and hospital care.
The privatization program succeeded in winning over the public:
54 percent of the Medicare-eligible population chooses Medicare Advantage.
Medicare Advantage looks to people over 65 like a better deal because it covers things traditional Medicare doesn’t,
such as visits to the dentist or the eye doctor. Some plans even cover acupuncture.
But if you get seriously ill and need to be referred to a specialist, Medicare Advantage isn’t so great.
An April 2022 study by the Health and Human Services Department’s inspector general found that
13 percent of the referrals denied under Medicare Advantage would have been approved under traditional Medicare.

Medicare Advantage also shows that health care privatization is a lousy deal for taxpayers.
Medicare Advantage costs the federal government 7 percent more per enrollee than traditional Medicare, according to an August 2024 study by the fiscally conservative Peter G. Peterson Foundation.
For enrollees with similar health profiles, Medicare Advantage costs 22 percent more, according to the Medicare Payment Advisory Commission.

Perhaps that’s because, as the Journal’s investigations found, Medicare Advantage insurers routinely
pad their government reimbursement requests with #spurious #diagnoses.
For example, an astounding 66,000 Medicare Advantage patients were diagnosed with diabetic cataracts
even after these patients had surgery to correct them,
making that diagnosis, in the Journal’s words, “anatomically impossible.”
In other instances, patients whom Medicare Advantage insurers reported as HIV positive received none of the recommended treatments.
If a doctor failed to furnish a desired diagnosis, insurers dispatched a nurse to the patient’s home to find one.
Medicare Advantage insurers also conned veterans into enrolling in the program even though they were already covered adequately by the Veterans Administration health system, which has repeatedly been demonstrated to be superior to private hospital care (something else the public is reluctant to believe).

UnitedHealth, the parent company of United Healthcare, whose chief executive, Brian Thompson, was assassinated last month, is, according to the Journal, a particular offender,
furnishing doctors with checklists of possible diagnoses.
Looking at Medicare data between 2019 and 2022, the Journal found that patients who moved from traditional Medicare to UnitedHealth’s Medicare Advantage plans
“got 55 percent sicker, on paper” during their first year in Medicare Advantage.
(UnitedHealth replied in a written statement that it provided “more accurate diagnoses” and alleged, without providing evidence, that the Journal’s reporting method was flawed)

https://newrepublic.com/article/189804/privatizing-medicare-advantage-scam-claims-fraudulent?utm_medium=social&utm_campaign=SF_TNR&utm_source=Twitter

Declaring in its 
Mandate for Leadership that “unaccountable federal spending is the secret lifeblood of the Great Awokening” (really!),
#project2025 focuses heavily on reversing social progress on the rights of racial and sexual minorities.

It also promises to decimate the most popular benefits programs in the U.S.: #Medicare and #Medicaid.

In a section dedicated to the Department of Health and Human Services, Project 2025 declares that
“HHS is home to Medicare and Medicaid,
the principal drivers of our $31 trillion national debt.”

This is a popular conservative framing used to justify ending social programs.

In fact, per person Medicare spending has plateaued for more than a decade
and represents one of the greatest reductions to the federal debt.

While admitting that Medicare and Medicaid “help many,”
the authors of Project 2025 nonetheless declare that the programs
“operate as runaway entitlements that stifle medical innovation, encourage fraud, and impede cost containment, in addition to which their fiscal future is in peril.”

To solve these imaginary problems, they suggest makin
“#Medicare #Advantage the default enrollment option”
rather than traditional Medicare.

But Medicare Advantage ( #MA ) is not a government-run healthcare program.

It’s merely a way to turn #tax dollars into #profits for private health insurers.

The more that MA providers deny coverage, the more money their shareholders make.

There is no incentive for them to cover the health care needs of seniors.

There is plenty of evidence that MA programs not only fleece taxpayers by submitting inflated reimbursement bills to the government
but also routinely deny necessary medical coverage.

In other words, they’re drinking out of both sides of the government trough.

The Center for Economic and Policy Research pointed out in a March 2024 paper that the
“insurance companies that run these MA plans spend significant sums of money to blanket seniors with marketing”
while relying on
“heavily restricted networks that damage one’s choice of provider along with dangerous delays and denials of necessary care.”

But Project 2025 claims, without evidence, that
“the MA program has been registering consistently high marks for superior performance in delivering high-quality care.”

#Medicaid, the government program that covers health care for the lowest-income Americans,
including millions of children,
is also a major target of the conservative authors.

They want to add work requirements to the benefit,
adopting the familiar conservative trope of low-income Americans living off tax dollars because they’re too lazy to work.

And like the MA programs, they want to allow private insurers to get in on the game.

Calling Medicaid a “cumbersome, complicated, and unaffordable burden on nearly every state,”

Project 2025 complains about the program’s increased eligibility while at the same time claiming to care about how it impacts “those who are most in need.”

But a June 2024 report by the Center on Budget and Policy Priorities concludes that
Medicaid’s expanded eligibility rules have helped insure millions of Americans who would otherwise be uninsured and saved money in state budgets.

Most encouragingly, “the people who gained coverage have grown
️healthier and more financially secure, while long-standing racial inequities in health outcomes, coverage, and access to care have shrunk.”

Project 2025 claims to have the underlying ideology to
“incentivize personal responsibility,”
as if its authors simply want Americans to begin acting like responsible grownups.

But they mysteriously don’t apply this same standard to wealthy elites
— perhaps because that’s precisely who they are.
https://www.counterpunch.org/2024/07/19/project-2025s-plan-to-gut-medicare-and-medicaid/