This commentary is by Jack Mayer, M.D., MPH, of Middlebury, a retired pediatrician and writer who founded Rainbow Pediatrics in Middlebury in 1991. He has been a persistent critic of the private health care system in the United States.
I’ve spent my professional life as a primary care pediatrician, mostly in Vermont. Now I’m retired and the beneficiary of Medicare.
I see alarming signs that Medicare, a public good, is being privatized and abused by for-profit insurance companies. Their greed threatens the integrity and sustainability of Medicare.
Medicare Advantage plans are actively hawked on TV by aggressive private insurers who stand to gain handsomely by enrolling healthier younger seniors. Since they are paid based on each patient’s medical record, these private companies routinely “upcode” or exaggerate diagnoses to make their patients appear sicker and thus receive enhanced compensation. One can only use doctors “in network” and care is often delayed or denied by requirements of prior authorization for treatments, medications, tests and consultations. continue reading