If you want to understand why Aetna, Independence Blue Cross (Keystone), and other insurance companies are dropping some, though not all, of their Medicare Advantage policies, you have to understand the way these plans have been tainted by President Obama and the Democratic proposals for Obamacare in its various forms. Their proposals, not yet enacted, will destroy the greatest health care delivery system in the world if enacted. But what they have already done has started to do serious damage to our system, as exemplified by what is going on with Medicare Advantage. Medicare Advantage plans are popular and have many advantages for senior citizens. So, naturally, Mr. Obama wants to kill them.The trade association America's Health Insurance Plans (AHIP) describes Medicare Advantage plans as follows: "An increasing number of Medicare beneficiaries are choosing Medicare Advantage (MA) plans. Medicare Advantage plans offer a different approach to health care delivery than beneficiaries experience under fee-for-service Medicare. Instead of focusing almost exclusively on treating beneficiaries when they are sick, these plans also place a strong emphasis on preventive health care services that help to keep beneficiaries healthy, detect diseases at an early stage and avoid preventable illnesses. In addition, MA plans help reduce beneficiaries' out-of-pocket costs by providing additional benefits not covered in the Medicare program and reducing cost-sharing for Medicare-covered benefits." AHIP says about 10 million people are now enrolled in Medicare Advantage plans, accounting for 25 percent of the market.
Mr. Obama has proposed cutting the heart out of Medicare in general and Medicare Advantage plans in particular by trying to save about a half a trillion dollars to finance his government takeover of our health delivery system. This Obama proposal and its reasons are, of course, as phony as a three-and-a-half dollar bill, as everyone knows those savings have been talked about for decades, but never achieved. They are virtually inherent in a government system of health delivery and the fraud, waste, inefficiency and abuse it produces. If those savings from eliminating fraud, etc. are there, why haven't they already realized them?
But the Obama Medicare and Medicare Advantage savings ploy is not only a phony idea, but also an immediately damaging one. Mr. Obama has demonized Medicare Advantage, virtually painting it as a fraud, involving government payments for no good purpose. This has probably raised concerns in the minds of Medicare Advantage providers, who may wonder about the future of this form of coverage. But there's more. When you see the disgraceful performance of Mr. Obama and his leftist radical Congress who are in the process of acting more like junior dictators than legislators, you wonder why anyone would even want to be in the business of selling health insurance. Consider what Congress is doing:
- The Democratic Congress has been passing bills of astronomical cost and complexity without reading them
- The legislative process has frozen out the Republicans, so what should be a bipartisan process, as promised by Obama, is turning out to be hyper partisanship at its worst, Obama style
- These same Democrats have voted against giving the public 72 hours before a vote to read the bills. You'd think if Congress doesn't want to read the bills, at least it would allow the public the right to do so, given Mr. Obama's promise of transparency
- Then there's the U.S. Senate Finance Committee, which just passed not a bill with legislative language, but a bill with "concepts." This means no one knows what the bill will cost or what it will really mean once it is translated into legislative language. The Democratic Senate is, in a real sense, flying blind and is about to crash not only our health care delivery system, but our economy as well
- Finally, Mr. Obama and Congress are willing to ignore the Town Hall meetings, the Tea Parties and public opinion, which concertedly, repetitiously and loudly say, "Read the bills, let us read the bills and don't wreck our present health care delivery system."
What makes this view bizarre is that Mr. Obama has been singing the praises of prevention and even claiming huge savings because he plans on introducing more prevention into the health care delivery system. Yet, the Medicare Advantage Plans already stresses prevention and the kind of case management of chronic illnesses that generates prevention of complications and disease. Medicare Advantage Plans have built in features that encourage preventive medicine. For example, they may feature comprehensive disease management for such medical problems as asthma, diabetes, and congestive heart failure. A spokesman of Aetna, Inc., Walt Cherniak, told me their plans may provide online tools for managing disease, access to nurses for medical management, and the monitoring of cases to make sure each patient gets the care they need. The Medicare Advantage plans also feature first dollar coverage so policyholders have no incentive to skip routine tests and monitoring. Like Aetna, Independence Blue Cross also has an impressive list of features to promote prevention.