IBM Medicare Via Benefits the Disadvantage of Medicare Advantage Plans

There are two ways for the government to get rid of Medicare.  The obvious way is to repeal the law enacting Medicare that was passed in 1965.  That would be political suicide.  The subtle way is to privatize it and then turn it into a voucher system.  That effort has been in play since the mid 1980s and the process is accelerating in sneaky, stealth, legislative and non-legislative actions (by Health and Human Services).
   
The legislative actions to affect Medicare rarely come as direct "Medicare Legislation".   The actions are buried in bills that have no hint of  having anything to do with Medicare.  The actions are buried in crazy places, like a farm bill or a budget bill.  For example, in the Budget Act of 2018 (H.R.1892) bill there was a significant increase for higher income Medicare recipients' part B premium "tax", (but don't call it a "tax" call it something incomprehensible like IRMAA to disguise it). It's a sneaky way of attacking Medicare. Sometimes, journalists pick up on these changes and citizens are able to push back on the proposed actions.  Mostly, it doesn't happen.  Ergo, medigap plan F will no longer be available in 2020 even though it is a popular plan, because the legislative body decided people who have it go to the doctor too much. WHAT?  Seriously, that is the reason.
 
The non-legislative actions are just plain stealth.  They are harder still to find, follow and understand.  These slow motion actions are also sinister because no journalist will have the tenacity to investigate and do ongoing reporting of the impact of  negative changes dribbling out over years. The biggest changes that are not obvious are the elimination of many services like the closing of local Social Security offices making it more difficult for people to resolve problems when they sign up for Medicare or the reduced staffing and increasing turnover of 1-800-MEDICARE client service representatives because of low bid contracts, making the help available for complex problem resolution worthless.  Even the website is deteriorating and has not been updated in 18 months because the contract to do any upgrades has been "held up" in the HHS bidding process.
   
The biggest non-legislative actions happen because insurance company lobbyists push legislators who in turn push HHS to expand the options available in Medicare Advantage Plans. There is currently a plan to expand those fringe options, such as adding acupuncture. There are already services included in Medicare Advantage Plans, such as dental coverage, that are not included in original Medicare even though the government is subsidizing both ways of getting coverage.  Why add more?

If  Medicare eligible recipients move to Medicare Advantage (MA) Plans then the government can get out of the insurance pool business. That is, get rid of original Medicare.  The next step will then be to provide a fixed amount of money (aka vouchers) to Medicare recipients to buy MA policies and further disengage by gradually removing government oversight and pushing complaints back to the insurer to resolve.  Better still, the voucher money will never increase (think IBM HRA), making the cost burden of Medicare shift back to the recipients and off of general tax payers. It thereby ends Medicare.

Maybe that's the most dire scenario.  The less dire scenario is the government just pushes everyone onto Medicare Advantage Plans and kills original Medicare with a medigap. What's the big deal?  Well, Medicare Advantage Plans are MANAGED CARE policies.
   
As some of you know, I do Medicare counseling.  In the last month, I tried to help two people who were locked into Medicare Advantage plans. Neither could go to an advanced cancer treatment center, like City of Hope in California, to get treatment for rare forms of cancer.  One policy holder had an HMO policy that did not allow out-of-network coverage, another had PPO coverage but could not afford the co-pays of out-of-network services.

Reminder, Medicare recipients who have original Medicare can go to any Medicare doctor or clinic anywhere in the country.  Beware shiny objects being flashed by Medicare Advantage Plans.  Having Silver Sneakers won't help you if you need to remedy a potentially life ending health crisis which requires treatment from a top notch specialist.