To the editor:
(re: “Biaggi makes single-payer case during seniors visit,” Feb. 14)
In her recent story, Simone Johnson captures the growing popularity of the single-payer New York Health Act and the enthusiasm of supporters like Sen. Alessandra Biaggi.
However, it leaves the impression that older adults with Medicare Advantage plans, like Ms. Yona Bello quoted in the story, are doing just fine. The fact that the commercial insurance companies find them enormously profitable should make one suspicious.
Most don’t know that tax dollars are used to provide special subsidies to MA insurers so they can offer extra services, like optical and dental, with the aim of privatizing Medicare. And most aren’t aware that insurers market these plans primarily to healthier seniors with numerous disincentives for those with chronic and complex conditions, including restricted choice of primary care providers and poor access to specialists.
There also are limits on expensive treatments and steeper cost sharing.
A 2017 government study showed that this forced a disproportionate number of sicker patients to switch from MA to traditional Medicare. A 2017 Kaiser Family Foundation report found that MA plans with broader networks had much higher premiums.
MA insurers also are prone to deny coverage in borderline cases, even though almost 80 percent of challenged denials are reversed. Insurers know that large numbers of denials are never contested. They are also paid per capita fees by the government, which include a factor based on how sick patients are.
This leads to unscrupulous “upcoding” to make patients look sicker than they are. Investigations by the Center for Public Integrity found extensive evidence of upcoding. Some insurance companies have even been fined.
Older adults have become pawns in Republican plans to privatize Medicare, and are being seduced by plans offering more benefits. By ridding our health care system of profiteering and waste, the New York Health Act would offer even better benefits, including long-term care, and without Part B and Medi-gap premiums, deductibles, copays, co-insurance, drug doughnut holes, or restricted networks.
Any tax obligation will be far lower than current out-of-pocket costs for the vast majority of seniors.
The author is on the board of the New York Metro Chapter of Physicians for a National Health Program.