Thanks for this, Thom. From painful experience we heartily endorse especially your last paragraph. We were suckered into switching to a United Healthcare Advantage plan when we moved to Portland from Washington state, and now we're well and truly screwed. Moving to Corvallis a couple of years later, we could switch to Samaritan Advantage, but to return to regular Medicare is prohibitively expensive. At least we're dealing with a local scammer now, not the national vulture United Health. Meanwhile, a great pleasure just now posting your piece on Facebook, with a caveat in CAPITAL LETTERS.
I learned in Insurance 101 that insurance has premiums actuarially related to risk or probabilities of unaffordable events. Medicare is an entitlement, not insurance, since the taxes paid are not statistically tied to the promise of event-driven claims. When Medicare sells the risk to a third-party, I think it is still an entitlement transaction rather than insurance. The euphemism of insurance conveys an entailment that I have no control over my health, since we only insure events over which we do not have control or moral hazard. Also, insurance is always for a loss, never for a gain such as health as a goal. The insurance framework of finance keeps the medical industry focused on disease rather than health. The system is designed to not be transparent, witness all the funny numbers on any E.O.B. and the difficulty of getting comparable costs for consumers to make any decisions. (Actually, I'm the product, not the consumer.) How do my annual Medicare Advantage "claims" compare to what the plan is paid by Medicare? The underlying problem is that it is hard to define in a policy and administer objectively the legal obligation of a goal-oriented claim. It is not like life insurance where there is general agreement on whether a person is alive or dead.
Having worked in corporate buying of medical and health services, the complaints of specific Medicare Advantage companies is not a surprise. Reputations persist for years. The consumer needs to do some digging as to the fiduciary credibility of specific companies.
This is miserable for people that have not paid attention to insurance all their life. I had a job where I needed to explain our insurance options to our employees; that put me well ahead of the "game".
Once again this takes advantage (pardon the pun) of clueless folks and the ones that are too poor to pick anything else. JJ Walker is out there telling people that they can stop paying for Part B and SOMETIMES that is true, but just as you said there is no free lunch. When it's time to depend on them, they will force their docs and nursing homes on you.
All of this advertising they do is built on the backs of these poor people struggling to have a little more monthly income. Our insurance and health care provision in America is a crime in progress. They are stealing from the poor to give to the rich.
I wanted to throw-up watching that thief Rick Scott at the recent hearings Bernie did on Social Security! Keep preachin', Brother Thom.
So how do I change an Advantage Plan in Kaiser Permanente when I have complex and expensive pre-existing health challenges such as bone marrow cancer (multiple myeloma), osteoporosis and a pacemaker plus other heart-related problems?
Thanks for this, Thom. From painful experience we heartily endorse especially your last paragraph. We were suckered into switching to a United Healthcare Advantage plan when we moved to Portland from Washington state, and now we're well and truly screwed. Moving to Corvallis a couple of years later, we could switch to Samaritan Advantage, but to return to regular Medicare is prohibitively expensive. At least we're dealing with a local scammer now, not the national vulture United Health. Meanwhile, a great pleasure just now posting your piece on Facebook, with a caveat in CAPITAL LETTERS.
I learned in Insurance 101 that insurance has premiums actuarially related to risk or probabilities of unaffordable events. Medicare is an entitlement, not insurance, since the taxes paid are not statistically tied to the promise of event-driven claims. When Medicare sells the risk to a third-party, I think it is still an entitlement transaction rather than insurance. The euphemism of insurance conveys an entailment that I have no control over my health, since we only insure events over which we do not have control or moral hazard. Also, insurance is always for a loss, never for a gain such as health as a goal. The insurance framework of finance keeps the medical industry focused on disease rather than health. The system is designed to not be transparent, witness all the funny numbers on any E.O.B. and the difficulty of getting comparable costs for consumers to make any decisions. (Actually, I'm the product, not the consumer.) How do my annual Medicare Advantage "claims" compare to what the plan is paid by Medicare? The underlying problem is that it is hard to define in a policy and administer objectively the legal obligation of a goal-oriented claim. It is not like life insurance where there is general agreement on whether a person is alive or dead.
Having worked in corporate buying of medical and health services, the complaints of specific Medicare Advantage companies is not a surprise. Reputations persist for years. The consumer needs to do some digging as to the fiduciary credibility of specific companies.
Sorry to be late with this. I heard part of a report on NPR this morning about this study. I found it on INSIDER
Ayelet Sheffey 3/10/22
3 Million Americans have more than $10,000 in medical debt, and they’re skipping doctor’s appointments because of it
It confirms what Thom has been saying with shocking new stats.
This is miserable for people that have not paid attention to insurance all their life. I had a job where I needed to explain our insurance options to our employees; that put me well ahead of the "game".
Once again this takes advantage (pardon the pun) of clueless folks and the ones that are too poor to pick anything else. JJ Walker is out there telling people that they can stop paying for Part B and SOMETIMES that is true, but just as you said there is no free lunch. When it's time to depend on them, they will force their docs and nursing homes on you.
All of this advertising they do is built on the backs of these poor people struggling to have a little more monthly income. Our insurance and health care provision in America is a crime in progress. They are stealing from the poor to give to the rich.
I wanted to throw-up watching that thief Rick Scott at the recent hearings Bernie did on Social Security! Keep preachin', Brother Thom.
So how do I change an Advantage Plan in Kaiser Permanente when I have complex and expensive pre-existing health challenges such as bone marrow cancer (multiple myeloma), osteoporosis and a pacemaker plus other heart-related problems?
Another need-to-know article. Thanks for the forewarning Thom.