Groups pushing Medicare reform will weaken system
Sau Friedman
Newsday
July 21, 2007
Beware the front groups that claim they would help save Medicare or promote health care reform. More than likely they’re saving or promoting themselves - at the expense of Medicare and your health.
The “front group,” invented by the late father of public relations, Edward Bernays, is the quintessential tool of deceptive propaganda, says the Center for Media and Democracy, a nonprofit public-interest organization, for it is “an organization that purports to represent one agenda while in reality it serves some other party or interest.”
One prominent example is the Coalition for Medicare Choices, which said in a May press release it enlisted “more than 100,000 seniors … to urge Congress to protect the benefits they receive though Medicare Advantage plans. With the recent surge in membership, the Coalition now totals more than 350,000 members.”
The Coalition’s sponsorship is not hidden, but it may not be well known, among the unions and predominantly African-American organizations it lists as supporters, that it was organized in 1999 and is wholly financed by America’s Health Insurance Plans. That group has opposed the expansion of publicly supported health care and most measures to strengthen Medicare. It, as well as drug lobbies, wrote the 2003 legislation that gave administration of the new Part D drug benefit to insurers instead of Medicare and prohibited the government from negotiating prices with drug manufacturers.
Medicare Advantage (HMOs and PPOs) is private managed care that seeks to take the place of traditional Medicare. And for weeks the Coalition has been bombarding lawmakers and unsuspecting editors with letters, messages and press releases sounding alarms over Democratic proposals to slash the government subsidies paid to insurance companies to offer these plans. Letters to editors have listed how many beneficiaries in various states stand to lose their Medicare Advantage coverage if the proposals pass.
As I’ve reported, the government pays the insurers on average 12 percent more per beneficiary on a Medicare Advantage plan than it pays for an enrollee on traditional Medicare. That’s one reason insurance companies have been able to promise subscribers extra benefits and lure 19 percent of the 43 million Medicare beneficiaries away from traditional Medicare. But, as we reported on March 24, subscribers have complained that the insurers’ salespeople have been using deceptive practices and advertising to sell unwary Medicare beneficiaries on Advantage plans that may not serve them well.
Medicare Advantage insurers may refuse to pay for out-of-network services or deny coverage for some procedures. Drug benefits may be uncertain. Its policies require written referrals for specialists or lab work and frequent co-payments. Last month, America’s Health Insurance Plans president Karen Ignani announced that seven leading insurers have voluntarily suspended selling Medicare Advantage plans. She’s also the spokesperson for the Coalition for Health Care Choices, which has chosen to remain silent on the issue.
The official Medicare Payment Advisory Commission (MedPAC), the American Medical Association and most Medicare advocates have told members of Congress that the subsidies for the Medicare Advantage plans are not needed. The Congressional Budget Office estimated that cutting them would save Medicare more than $50 billion over five years - money that could be spent on the State Children’s Health Insurance Program and Medicare.
But Congressional Budget Office director Peter Orszag told the Senate Budget Committee that, if Medicare Advantage plans grow, they will strain the Medicare budget. Worse, he said, “I think the result would be a fundamental change in the nature of the Medicare system that may be hard to reverse.” The Centers for Medicare and Medicaid Services has acknowledged abuses in the sale of Medicare Advantage plans but has taken no position on the legislation.
The Coalition for Health Care Choices and America’s Health Insurance Plans maintain that, without the subsidy, insurers may have to abandon the Medicare Advantage business, as they did five years ago when they quit offering Medicare Plus Choice (HMO) plans because profits weren’t high enough. These are scare tactics, to be sure, but Medicare Advantage beneficiaries should be warned that they may, indeed, lose their coverage and have to switch to traditional Medicare, if Congress ends the insurers’ gravy train. The good news, however, is that traditional Medicare will be strengthened.
Another couple of front groups have formed to fight against government-sponsored universal health care, including Medicare. Health Care America, based in Washington, D.C., gets support from the drug industry, according to its Web site. More prominent is the recently formed Coalition to Advance Healthcare Reform, which describes itself on its Web site as group of “business leaders, employers and other like-minded leaders committed to healthcare reform” through “meaningful, market-based solutions to our health care crisis.”
Much of the reason for the crisis is the current market-based system. Nevertheless, the new coalition says its “core principles” include “a market-based” system, and “universal coverage with individual responsibility,” meaning requiring individuals and/or employers to buy insurance, perhaps with help from government.
This coalition includes more than 40 of the nation’s largest corporations, many of which helped make the American health care system what it is today, while profiting from it: Aetna, Cigna Health Care, Eli Lilly, CVS Caremark, GlaxoSmithKline, McKesson Corp., Kaiser Permanente, plus General Mills, The Kroger Co., Safeway and PepsiCo.
The coalition’s statement of purpose says business wants a “place at the table,” if and when the nation chooses a health care system, to make sure it’s based on private insurance. In a coming column, I’ll write about whether we need private insurance.
WRITE TO Saul Friedman, Newsday, 235 Pinelawn Rd., Melville, NY, 11747-4250, or by e-mail at saulfriedman@comcast.net