You are either at the table or on the menu according to lobbyists in Washington when it comes to health care. All of the major media have reported that earlier this month, Humana sent a one-page letter to its customers enrolled in its Medicare Advantage plans, which offer private options to Medicare beneficiaries. Humana noted that, because of spending cuts proposed by Democrats, "millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so valuable." The company also urged its customers to contact their Representatives. Fairly tame you would think right? Not to Max Baucus.
Mr. Baucus took it as a declaration of war, and complained to the Centers for Medicare and Medicaid Services, which ordered Humana to cease and desist. CMS claimed the mailer was "misleading and confusing" and told the company it has opened an official probe as to whether the mailer violated laws about how the insurers that manage Advantage plans are allowed to communicate with their customers, as well as other federal statutes.
"Please be advised that we take this matter very seriously and, based upon the findings of our investigation, will pursue compliance and enforcement actions," CMS concluded, ominously. Humana could be fined or booted from Medicare Advantage altogether.
"It is wholly inappropriate for insurance companies to mislead seniors regarding any subject—particularly on a subject as important to them, and to the nation, as health-care reform," Mr. Baucus said in a statement yesterday, playing the role of Congressional censor. "The health-care reform bill we released last week strengthens Medicare and does not cut benefits covered under the Medicare program—and seniors need to know that."
In fact, the Baucus draft legislation slashes $123 billion over the next decade from Medicare Advantage, which Democrats hate despite the fact that almost one-fourth of beneficiaries have chosen it over traditional fee-for-service Medicare. One reason seniors like it is because private insurers focus on quality and preventive care and try to manage benefits, as opposed to simply paying bills.
A new study from America's Health Insurance Plans, the industry trade group, finds that seniors on Advantage in California spent 30% fewer days in hospitals over fee-for-service patients, based on federal data. These cuts—as Humana correctly noted— could mean that seniors may lose this coverage.
Mr. Baucus doesn't want seniors to be educated about these facts, and obviously he's willing to use his enormous power to punish any private company that doesn't his version of reality. Yesterday, the agency barred all Advantage insurers from providing similar information to their beneficiaries.
This episode neatly shows how all U.S. health care will operate if Mr. Baucus's bill becomes law. They'll have no choice but to support administration policies or the political class will pull out the tire irons and dump their bleeding bodies in the Chicago River.
Humana made the mistake of trying to tell seniors the truth about what will happen to their coverage, after months of supporting health care reform in the hopes they would stay at the table when all those new bodies came in to the insurance market and now they better hire a good team of lawyers. Mr. Baucus and the Obama Administration are out to make Humana an object lesson to the rest of the business class, and that means they won't stop until Humana cries uncle or is ruined.
Wednesday, September 23, 2009
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