Surveys tell us that many Americans are upset with the cost of healthcare. Democrats in particular are using this dissatisfaction in their campaigns to convince people to vote Democratic. They’re also complaining about “affordability” and blaming the problem on the Trump administration. There’s a common theme in both of these issues.
You wouldn’t call an arsonist to put out a fire – but both of the above problems were created by the arsonists – the Democratic Party! Inflation got out of control during the Biden administration and the cost of healthcare is directly related to the passage of ObamaCare during the Obama administration. While Republicans have failed to correct these problems to the satisfaction of the American people, they can’t expect Democrats to have the solutions when they caused the problems in the first place!
Further evidence that Democrats can’t solve these problems is a recent bill introduced in the Congress by Rep. Lloyd Doggett (D- Texas) and co-sponsored by more than 40 House Democrats that would sharply reduce government payments to Medicare Advantage plans. Medicare Advantage plans are privately managed policies for Medicare enrollees. They are extremely popular since they provide greater benefits at lower costs than traditional Medicare.
But Mr. Doggett introduced the bill because he said it would “level the playing field” between traditional Medicare and Medicare Advantage plans. In other words, they want to make these plans less attractive and more costly! Why would they want to do something that would make healthcare more expensive?
John C. Goodman, writing for The Wall Street Journal, gives us the explanation.
“It is no secret that many congressional Democrats dislike private health insurance even though private insurers were heavily involved in designing ObamaCare. Politicians on the left often speak about the desirability of a “public option.” But Medicare has already had a competing public option for more than two decades. It’s called traditional Medicare, and it has been losing the competition. More than half of all Medicare enrollees are in private plans. For all its faults, Medicare Advantage is arguably the best healthcare program we have. It’s much better than the ObamaCare exchange plans and most employer plans. Mr. Doggett is attacking this overall well-functioning program while ignoring our nation’s worst program: Medicaid.
Goodman goes on to explain that one of the great ironies in U.S. healthcare is that the private insurance industry is largely responsible for administering both the best and worst health insurance programs we have. What Mr. Doggett calls the “giant private insurance companies that profiteer off Medicare” are mostly the same companies that are administering Medicaid.
If private companies run both programs, why is one so much better? Goodman says the answer lies in how the program is structured. Medicare Advantage gets four things right:
First, it is the only program in our entire healthcare system in which a doctor who discovers a patient’s previously unknown health problem can send that information to the insurer (in this case Medicare). This results in a higher premium payment for the health plan to cover the higher expected cost of care.
Second, because of a sophisticated risk-adjustment program, Medicare Advantage plans are the only plans in our healthcare system that actually want sick people as enrollees. No employer, commercial insurer or ObamaCare marketplace plan wants a sick enrollee.
Mr. Doggett insists that Medicare Advantage plans seek to enroll only the healthy, but the reverse is true. Significantly more low-income beneficiaries were enrolled in Medicare Advantage plans (68% vs. 32%) in 2023. In 2021, such plans were also the preferred choice of black (59%) and Hispanic (67%) enrollees relative to whites (43%). These minorities are known to have above-average medical needs.
Third, Medicare Advantage is the only program in our healthcare system in which health plans can specialize in the treatment of specific conditions such as diabetes, congestive heart failure or HIV. This allows them to create focused factories that are increasingly skilled at providing care. By contrast, in the ObamaCare marketplace, health plans are forced to be all things to all people.
Finally, Medicare Advantage plans make money by keeping people healthy. Long before the price of insulin became a political issue, some plans were discounting the out-of-pocket cost to diabetics. While the political focus today is on $35 insulin, some Medicare Advantage plans make insulin available free in special-needs plans for diabetics. Keeping diabetics out of emergency rooms is cost-effective medicine.
Yet, Democrats want to destroy this popular, cost-effective, healthcare program by making it more like traditional, more-costly and less popular traditional Medicare. Remember, these are the same people who sold us on the concept of ObamaCare with the promise it would lower healthcare costs for every family and guarantee “if you like your doctor, you can keep your doctor” in the immortal words of President Obama.
You can’t expect the same people who created the problem to fix it. There’s an old saying that applies here: “Fool me once, shame on you, fool me twice, shame on me.”
