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Beware of Medicare Advantage for All

June 25, 2019

Topics: Quote of the Day

By Paige Minemyer
Fierce Healthcare, June 19, 2019

Cigna chief David Cordani said it’s time to pump the brakes on calls for a healthcare system overhaul like “Medicare for All.”

Cordani, speaking at the AHIP Institute & Expo Wednesday, said insurers should hear the underlying message from consumers that their care is often too costly. And while reform on the scale of transitioning to a single-payer system may not be necessary, consumers’ frustration with healthcare costs does speak to the need for real, substantial change, he said.

“There’s a real call from a societal standpoint for more value and more peace of mind to be delivered to individuals,” Cordani said.

Instead, Cordani said the solution is for insurers like Cigna to strengthen the public-private partnerships they operate today—Medicare Advantage and Medicaid managed care being the two prime examples—and pivot toward work that keeps people healthy in the first place.

https://www.fiercehealthcare.com…


Q&A: ‘We have had a maniacal focus on the patient’

Modern Healthcare, June 22, 2019

Dr. William Shrank had some big shoes to fill. In April he succeeded now-retired Dr. Roy Beveridge as chief medical officer at Humana. Shrank was previously CMO at UPMC. Shrank recently met with Modern Healthcare’s editorial board to discuss his goals at the large insurer.

MH: How will you apply some of what you learned at UPMC to your new role at Humana?

Shrank: We’re focused on the elderly population; we’re focused on Medicare Advantage. We have been putting a whole host of assets and tools together that we can wrap around and meet patients in the community.

MH: Recently it was reported that Humana CEO Bruce Broussard came out against proposals to adopt a Medicare for All type of proposal. What would you see as some of the drawbacks of such a plan?

Shrank: We should be really precise about some of the terms here. Everyone agrees that expanding healthcare coverage is a good thing. That’s not in question. The response was very specific about a very specific part of a proposal that said that there would be no private insurance, there would be no Medicare Advantage. We believe very firmly that Medicare Advantage is an important part of the solution set for our seniors for a variety of reasons. We know that Medicare Advantage allows us to offer a broader set of benefits that we know are not covered in traditional Medicare—vision, hearing aids, a variety of things that are not available in traditional Medicare.

We know that Medicare Advantage offers protection against financial catastrophe with maximum out-of-pocket costs. We know, most importantly, that Medicare Advantage is the most rapid way to transform healthcare to a value-based system.

https://www.modernhealthcare.com…


Former Aetna CEO Mark Bertolini on ‘Medicare for All’: No one can explain to me what it is

Medicare Supplement News, March 28, 2019

Squawk Box: How do you deal with things like Medicare for All?

Mark Bertolini: Well, let’s talk about Medicare for All. Medicare for All, single payer – great populist term to throw out to the public. What is it? Nobody can tell me… Tell me a country that has a program like that. Most people say Canada or the UK. Those are not Medicare for All or single payer systems. Those are socialized systems…

SB: Wouldn’t single payer here mean that it’s a public option and there aren’t private options any more?

MB: So that’s the second question I ask. Who runs all of our public programs today… The private insurers… The health care insurance companies are the intermediaries for Medicare and Medicaid. We run it for the government. They give us the specs. We build it out…

SB: There’s a lot of things in Medicare, a lot of waste, a lot of fraud.

MB: There sure is in Medicare fee for service, not in Medicare Advantage which is what we run more tightly…

SB: Didn’t we try to drive a stake into Medicare Advantage?

MB: It’s too big to kill; it’s over 20 million lives… Back to the ACA, if we had allowed Medicaid expansion to happen and we would have means tested people down to age 50 for Medicare – Medicare Advantage – so 50 to 65, we would have covered more people than the ACA did at far less cost…

http://medsuppnews.com…


As Democrats Talk Single Payer, Private Medicare Advantage Soars

By Bruce Japsen
Forbes, February 3, 2019

Health insurers are reporting unprecedented growth in the number of seniors flocking to private Medicare Advantage plans amid talk of a single payer government-run approach that could uproot such coverage.

https://www.forbes.com…


How About Medicare Advantage for All?

By Froma Harrop
Real Clear Politics, September 13, 2018

Let’s be blunt. The government must limit its spending by fiat. Then we can let the market step in and sort out the details. Under Medicare Advantage for all, the insurers would become, in effect, regulated utilities.

https://www.realclearpolitics.com…


One Proven Way to Improve U.S. Health Care: Expand Medicare Advantage

By John S. Toussaint
Harvard Business Review, February 14, 2018

It’s time for a better idea that addresses both cost and quality. That better idea is expanding the successful Medicare Advantage program to both Medicaid and employer-covered populations.

https://hbr.org…


Comment:

By Don McCanne, M.D.

The single payer model of Medicare for All would eliminate private health insurance plans (except for supplemental plans for nonessential services), but nobody should expect the insurance industry to sit back and accept this fate. In fact, the private Medicare Advantage plans have already been very successful in displacing about 40 percent of the traditional Medicare program. It appears that they are ready to take advantage of the popularity of the Medicare for All concept by usurping it as an even better Medicare for All by offering competing private plans supposedly with higher quality and lower costs: Medicare Advantage for All.

As the private insurers continue to integrate themselves into the health care delivery system, it will be much more difficult to displace them with a single, publicly-administered Medicare for All insurance program. Two decades of delay have allowed them to become thoroughly entrenched in the Medicare and Medicaid programs. Experimenting with a public option model of Medicare for some will just give them that much more time to implement their irreversible innovations. How do you get rid of the large private insurers when they have become the health care delivery system?

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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