{{ Yet people are trusting these brokers for Medicare advice. About 30% of seniors have said that they used a broker to help choose their Medicare coverage, Jacobson says.
It speaks volumes that when the Commonwealth Fund conducted focus groups with Medicare brokers in 2023, two things emerged. First, the brokers confirmed that they earned bigger commissions for persuading people to go for a Medicare Advantage plan instead of traditional Medicare. Second, reports Commonwealth, “Most brokers and agents said they personally would choose traditional Medicare with Medigap, believing that combination offers better coverage and choices than Medicare Advantage, particularly as people age.”
You can’t make it up. Medicare Advantage for thee — but not for me! }}
We have had many discussions of Medicare Advantage here. Members are well aware that advantage plans are higher risk especially as your medical needs increase.
Their premiums are lower and they offer extras like gym membership, dental, eye care, hearing aids, etc. And they focus on keeping participants healthy.
They say Congress is cutting resources for advantage plans forcing them to trim services and/or raise copays etc.
In my area they recently dropped the best trauma hospital from their network. (Anthem Blue Cross drops Mercy Hospital in St Louis.)
We shall see how far the cost cutting goes. And will it impact quality of care.
RS changed it’s employee health insurance in the late 80s, when the company went into pay cutting mode. I was working in Kalamazoo. The nearest “in network” GP for the new plan was in Grand Rapids, fifty miles away. Fortunately, I never needed to use that insurance.
The ultimate cost cutting measure for health insurance: don’t have any “in network” providers.
I learned about the risks of Medicare Advantage from a standing-room-only public lecture about Medicare by a local insurance broker. Not all brokers are the same.
I am in a medical-care superstore (I guess). All kinds of medical care here in the Twin Cities (MN) and suburbia. UHC HQ is here, for example. U of MN teaching hospital, children’s hospitals, and so on. Most insurers (for Medicare) have 94+% of local doctors/facilities “in network”. I am within 2-10 miles of the ones I see. My clinic is 5-6 blocks away.
Sure, but probably the same problems in rural Minnesota. Patients must travel sometimes over 100 miles for in network service.
And small hospitals are often reluctant to join network. Perhaps find contract prices unprofitable. But then patients go elsewhere for in network care.
Large national network is also important if healthcare incident happens while you travel etc.
The state is trying to create more doctors who want to serve rural areas. Problem is basic: Not enough patients to support a doctor and the needed infrastructure. IMO, they need to move to an “island” model, where there is a doctor/practice with full support from state who serves an area around the practice location. Maybe have the “island” with senior care, etc–as impractical for them (as a group) to drive anywhere safely. This then frees up farmland for young farmers (who can rent the farm from the seniors so they can pay for care).
I see that all the time. However, that is with practices with enough doctors to justify the added costs of multiple locations. One of those practices has hundreds of doctors over a large number of sites and covering a wide range of medical care/specialties, including having their own MRI machine(s) and outpatient surgical center(s).
That’s great! You found the one honest Medicare insurance broker.
A few months before I turned age 65, I attended one of those SHIP seminars. The presenter said that they were prohibited from giving you a specific recommendation for one company or another (no doubt due to lobbying from Medicare Advantage brokers), but emphasized several times during the program that “after you’ve spent 1 year with Medicare Advantage, you can’t switch back to regular Medicare and get a Medigap plan without subjecting yourself to medical underwriting”.
I prayed that the other attendees understood the implications of that.
{ Restrictions on physician supply
edit
The AMA has at various points in history advocated for restricting the supply of physicians. In the early 20th century, the AMA lobbied lawmakers to shut down medical schools on grounds that they were substandard, which in turn reduced the supply of doctors.[73] The AMA lobbied for reductions in physician supply during the Great Depression.[10] In 1997, the AMA lobbied Congress to restrict the number of doctors that could be trained in the United States, claiming that, “The United States is on the verge of a serious oversupply of physicians.”[12] The AMA successfully lobbied Congress to cap how much Medicare could reimburse hospitals for resident physicians, which reduced residency training.[11]
In the decades following these restrictions on physician supply, the United States has a shortage of doctors.[11] The United States was forecasted to have a shortage of 46,900 to 121,900 physicians by 2032.[11] As a consequence of the restrictions on medical training in the United States, a quarter of physicians in the United States were trained abroad by 2022.[8]. }
Protected free speech?
I’m having to wait 8 months for a dermatologist appointment. I’ve called to see if a cancellation offers a sooner appointment, only to be told I have the earliest appointment available.
That’s for 41 dermatologists within an hour drive of my home.
I’ve a friend whose dermatologist appointment has been canceled by the provider, two times now. She’s been waiting over 1.5 years.
I’ve heard other local stories about “long waits”.
My appointment is a “spot check” to see if o need some MOHS attention.
In the Netherlands they have an i-Phone app where you take a photo of a suspicious spot on you body, send it to the company, and they tell you whether you need treatment. It’s more accurate in diagnosis than all but the most senior dermatologists.
…and the AMA, at the turn of the last century, saw nurses undercutting their profits and power, and got laws passed to stop nurses, including professionally trained social activists in such things as epidemiology in urban slums, from providing treatment…
I have a trick I’ve used periodically. I call the office and ask if they have any cancellations. The answer is always “no”. However, I then tell them that if they have any cancellation in the coming weeks, to simply call me or text me, and I can get there in about half an hour. Sometimes it takes 2 or 3 such calls, but usually within a month or two I get a call and I get my appointment.
I’ve had MOHS 5 times so far, most of the time for small areas that heal in a few weeks, but once I had a huge one. Doc did the MOHS in the morning, then sent me to a plastic surgeon to close it all up in the afternoon. Healing took many months. It was terrible.
