Thursday, January 18, 2018

Is "Health Insurance Fraud" an Oxymoron?

‘As the US demonstrates, when the profit motive is introduced into a health delivery system, ways of gaming the system and outright fraud schemes are easier to devise, and they are a far more profitable business to engage in than treating patients.’
David Lindorff

This article in the London Review of Books details conventional fraud, but the fraud behind the system is the system itself: healthcare for profit.

Obamacare was a necessary set of innovations to protect more Americans, and its reliance on private insurance was politically inevitable.  But the system is still a massive fraud.

Or maybe I'm just a little ticked as I survey my past year's expenses and look forward to the next.

For example, for 2018 Social Security granted a 2% cost of living adjustment, after several years of pretending that the real cost of actually living as a senior hadn't gone up at all, gosh, weren't we lucky.  All the price rises on food, clothing etc. must have been senior moment delusions.

Unfortunately also for 2018 Medicare Part B increased its rates to those same seniors (including me), cutting the adjustment roughly in half.  It's a common assumption that Medicare is free.  Well, it ain't.

Only Medicare Part A, which covers hospital costs (though of course not all of them) doesn't charge a monthly premium.  Medicare B (doctors costs, but not all of them, oh no) is deducted from the Social Security check.  Not to mention Medicare C and D plans (if you can afford them) which cover other stuff, and are run by private insurance companies.

Then there are the so-called Medigap private insurance plans that cover what Medicare A and B don't cover.  Though still not all, oh no.  My AARP plan told me my premium for them is also going up in 2018, so forget the cost of living increase.  The cost of living increased beyond it, before I got out of the insurance category.

(AARP also told me that the monthly premium I'm paying is not the actual monthly premium, oh no, it includes a discount.  "Discount" is not a word I've heard from them before.  But apparently this is going to keep going up every year.)

In the past year, the AARP plan paid for--what a surprise--virtually nothing.  It just paid their executives, lobbyists and their fraud insurance.  So here's my 2017: practically all medical goods (prescriptions) and services (including dentist and eye doctor) I paid for entirely out of pocket, plus some doctor bills Medicare and AARP wouldn't pay for, plus copays.

 Meanwhile I paid thousands of dollars in the semi-private Medicare Part B insurance and the private Medigap insurance, for which I got pretty much nothing but pieces of paper telling me why I was getting nothing.

Fraud may be more profitable than treating patients.  But insurance must certainly be.

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