Biden Admin May Be Setting Stage for Medicare Cuts

Healthcare, as much as the left hates to admit it, is a market item, like any other good or service. Until the mid-20th century, the provision of healthcare was like any other business; you went to the doctor, you paid him, and that was that. Granted, now modern, high-tech medicine is more expensive, and there is therefore a market for health insurance to spread that cost out. That, too, is a market item.

When the government meddles in markets, they almost always screw it up. The Biden administration has never and will never learn this lesson; now, in the latest episode, they propose messing again with Medicare Advantage. A lot of healthcare providers are unhappy about the details.

Physicians and other health care providers contend the Biden administration's proposed update to Medicare Advantage payment policies could wind up hurting their practices and patients.
Why it matters: With providers joining insurers against the proposed changes, the Biden administration is left with few allies.
CMS still could reverse course or delay the changes — an outcome that looks increasingly likely as more industry groups voice their discontent.
Driving the news: The Centers for Medicare and Medicaid Services last month proposed an average 1.03% revenue increase for private Medicare plans in 2024.
But insurers say changes to the MA risk adjustment model, which tweaks plan payment based on enrollees' health and demographic statuses, would result in a net cut next year.
Insurers and many consumer advocates came out strongly against the policy, and Republican lawmakers accused the Biden administration of effectively cutting Medicare with the proposal.
Meanwhile, smaller non-profit plans like the idea, and Humana CEO Bruce Broussard said during a conference on Tuesday that the rate notice could actually benefit the insurer, Modern Healthcare reported.

Government involvement in health care in recent years has been, shall we say, problematic.

Rand Paul Eviscerates Tony Fauci, 'For His Dishonesty, Frankly, He Should Go to Prison'

Dr. Brian Miller, MD, who works with the Medicare Payment Advisory Commission (MedPAC), was not sanguine about the changes.

Brian Miller, an assistant professor of medicine at John's Hopkins University, was at the center of complaints toward the status report compiled by policy analysts, arguing that the report only highlighted the negatives of the program and that past suggestions of his have not been taken into consideration.
Because Miller believed the report was decidedly anti-Medicare Advantage, he challenged the analysts to name three positive things about the program, calling into question the objectivity of the report. They responded that they strive for balance, and the commission, which is a nonpartisan independent agency that advises Congress on Medicare, has a long history of supporting private plans in the Medicare program. When chair Michael Chernew, professor of healthcare policy at Harvard, attempted to move along the conversation to the next commission member, Miller persisted.
"I think this is important for the public record because it gets to how balanced we are and how we approach programs, and this didn't really feel very balanced," he said. "There are plenty of bad things definitely that need to be improved ... I think it's really important again that it's a neutral thoughtful policy analysis."

It would be interesting to see, precisely, how the tweaks to plan payment based on enrollee's health and demographic statuses are supposed to work. Granted, health insurance and life insurance plans generally take an enrollee's health into account. Insurance plans, be they for health care or anything else, are a mechanism to spread risk among a larger group of people and so spread the cost of events; auto insurance, for example, requires one to pay a periodic premium to avoid any sudden and possibly catastrophic cost due to an accident; doing so spreads the financial risk among the insured.

But what about the "demographic statuses?" What does that mean? Is this some new attempt at government-demanded "equity," or is it based on science? For instance, black Americans are more prone to sickle-cell anemia than people of European descent, and such genetic matters are part of the risk evaluation. But given the track record of the Biden administration and, indeed, the federal government in general, in dealing with anything demographic, one is justified in immediate suspicion.

At the core, this is a market issue, and honestly, the government has no constitutional justification to be involved in this at all. When left alone, markets usually get things right in the end. But politicians just can't seem to resist sticking their fingers in.