Privatization of Medicare?

Guys, it's happening already.

And, I'm completely OK with that.

Here's what's happening:

• You get Part A - the government picks up all the cost of that
• you get Part B - the government picks up all, or most (except for $134 for most recipients) of that 
• You choose your Part C - THAT'S where the privatization comes in.

The Part C - you pay a small amount (if that - my monthly this next year will be ZERO). The federal government picks up the rest.

The government then pays these private companies to run the claims for all of the recipients in their plan. If it costs them MORE than the amount budgeted, the company takes the hit. If it costs them LESS than the amount budgeted, the company takes the profit.

There is a huge financial incentive in these companies to get, and keep, you healthy. To that purpose, most have agreed to pick up fitness memberships, which should improve the overall health of the Medicare recipient.

Could they just deny most, if not all claims, to improve their bottom line? Well, technically, they could, but then those people would just select another plan the next time they had Open Enrollment.

Are some companies denying care, such as proton therapy for some cancers? That happens even with non-Medicare plans. And, to be fair, proton therapy is not always the best choice for all cancers.

But, generally, such therapy is easier to get through the system than other therapies - proton therapy is much less destructive of nearby tissues, and has a better recuperation rate.

Might they not pay for transplants? VERY FEW plans pay for those over 65 - they're a high risk, low good outcome group.

So - why is this BETTER than the old way of handling Medicare?

Fraud. 

Unlike the government employees, who have little to gain by questioning billing, the private industry looks askance at inflated/erroneous bills, and will generally snoop out those Medicare Mills that churn patients through to generate multi-million dollar incomes.

Since a very large part of the cost of Medicare is the fraud involved in it (according to then-Attorney General Holder, approximately 60 BILLION a year), this is one method of reducing costs that might have a better outcome than many other measures.

The overall cost of Medicare to taxpayers was $672.1 billion in 2016. So, the fraud amounts to about 10%.

That could pay for a LOT of services and medications for seniors.

For now, this may be the best solution. I'll report back next year, and see if I still think so.

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