Medicare and Corporate Health – Fullerton Observer

Health insurance is big business. The insurance called Medicare Advantage is a massive business. Profit-making private corporations using that name make their money from all of us who pay into our public health care system for those 65 or older: Medicare.

The “advantage” plans are technically Medicare in that they have since 1999 “Part C.” I was rather taken aback when I discovered that. Part C was established by the Balanced Budget Act of 1997, effective January 1999. Some people object to private corporate use of the name of a Federal government program. However, they sell so well that they avoid legislative reform. Quoted in a New York Times article a year ago, Representative Lloyd Doggett, a Texas Democrat who chairs the House Ways and Means Health Subcommittee, said, “You have a powerful insurance lobby, and their lobbyists have built strong support for this in Congress.” An indication of its bigness is the amount of recruiting going on during the time that is called “open enrollment.” We taxpayers are supporting that recruiting.

Check out the number of “Medicare Q and A sessions that have been booked at our public Community Center. These were also advertised at the literature rack in City Hall at no cost to the enterprises. There were 6 “x 11” heavy stock cards on the rack advertising “Medicare annual enrollment workshop meetings.” You don’t have to enroll annually in Medicare.

These cards clearly stated, “These are sales meetings.” Four meetings were listed. There were also fliers for the sessions at the Community Center. The “Medicare” sessions–there were at least four of them –were billed as “informative.” They were hosted by insurance brokers who were advertising various insurance companies.

One broker said he paid nothing because it was an “educational” event. He passed out bags with the insurance company name and literature, pens and hand sanitizers, and his card and he had little slips for people to sign up for a session with him. The cost for a non-Fullerton business is $80 an hour. Two of the brokers were from Brea and Garden Grove. A large Fullerton organization held a four-hour-long “Medicare Expo” in the gymnasium area. The price to rent a half gym for a Fullerton business is $90 an hour. I do not know if this enterprise paid fees. There were many tables for various brokers and six for insurance companies listed as “Our Medicare Partners.” The enterprise offered packaged snacks, chapsticks, pens, water, and tissue packets advertising “Affiliated Physicians.”

One broker said he was paid $30 monthly for each person enrolled with an insurance company. He said all insurance companies paid the same to all brokers. I asked how the insurance companies made money from signing up an older person. He said they estimate your health, then tell Medicare how much they want to cover you. He quickly eyeballed this reporter and said, “..for example, $15,000 for you.” I said, “So if I don’t use that much in medical care, they keep the rest of the money?” He said that was correct. He said the big companies will send a nurse to a prospect’s home to do a medical check so they can better estimate what your care will cost per year.

As stated in the New York Times last October, “The government pays … with higher rates for sicker patients. The insurers have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits. As a result, a program devised to help lower health care spending has become substantially more costly than the traditional government program it was meant to improve.” (The government has brought lawsuits against many “Advantage” insurers for frauds of various sorts.)

Dr. Donald Berwick, a former C.M.S. administrator, quoted in the Times, said, “Even when they’re playing the game legally, we are lining the pockets of very wealthy corporations that are not improving patient care. It has been estimated that the government gives enough money to Medicare Advantage insurers for additional diagnoses to cover hearing and vision care for every American over 65.”

We also fund the numerous emails that Medicare sends out, telling us to check into enrolling in an “advantage” plan. Even my congressman, Lou Correa, sent such an email notice to me on October 21; I had sent him an email on October 5, asking that he advocate reform so that private profit-making corporations could not use the honorable name “Medicare.” I was incensed! I sent back a letter of stern rebuke.

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