Readers Weigh Downsides of Medicare Advantage and Stick Up for Mary Lou Retton

Letters to the Editor is a periodic characteristic. We welcome all feedback and can publish a variety. We edit for size and readability and require full names.

In response to Sarah Jane Tribble’s report about rising enrollment in Medicare Benefit plans — and the rising issues — a senior coverage adviser on the Robert Wooden Johnson Basis weighed in on X, previously often known as Twitter:

Managed care backlash in full swing as extra customers develop into conscious of the tradeoffs concerned selecting M.A. https://t.co/7EAMZJ9YJk

— Katherine Hempstead (@khemp64) January 8, 2024

— Katherine Hempstead, Princeton, New Jersey

Medicare Benefit: To Whose Benefit?

Sarah Jane Tribble did a wonderful job reporting on Medicare Benefit plans and the main limitations inside them that go away folks principally screwed (“Older Individuals Say They Really feel Trapped in Medicare Benefit Plans,” Jan. 5).

Don’t neglect presidential hopeful Nikki Haley at one of many Republican debates said that Medicare Benefit plans are what nearly all of seniors need and needs to be expanded.

That subsequent morning, I instantly known as the South Carolina Democratic Occasion and provided that they need to be standing on their desks demonizing her as a result of they know full effectively that low-income, underserved Black folks in South Carolina rural ZIP codes wouldn’t be eligible for Benefit plans the place care is linked to ZIP code.

Disgrace on all events and candidates who by no means point out single-payer common well being care (apart from Inexperienced Occasion candidates).

Excellent news story, Ms. Tribble.

— Steve Scuderi, Chicago

A well being companies researcher within the Division of Well being Coverage at Vanderbilt College additionally praised the article on social media:

This piece is REALLY nice (thanks, @sjtribble!). We’re engaged on a grant associated to this subject now (thanks, @LLSusa!) and can’t emphasize sufficient how vital this challenge is for folks getting old into Medicare. https://t.co/lQqFsnUfp9

— Stacie Dusetzina (@DusetzinaS) January 5, 2024

— Stacie Dusetzina, Nashville, Tennessee

The founder and president of Healthcare Navigation, a consultancy, added recommendation for medical health insurance buyers on X:

Beneficiaries who initially enroll in conventional Medicare are assured to qualify for a Medigap coverage with out pricing primarily based on their medical historical past.Discover out extra right here: https://t.co/agG9VH8Hxo pic.twitter.com/pmnq9eDYAQ

— Maura Carley (@MauraCarley) January 20, 2024

— Maura Carley, Darien, Connecticut

Don’t Blame Sufferers for Unaffordable Well being Care

This op-ed (not article) by KFF Well being Information reporter Julie Appleby shames the previous Olympic athlete for her monetary misery and for being unable to handle her funds and well being — whereas unwell, injured, or chronically disabled (“Mary Lou Retton’s Rationalization of Well being Insurance coverage Takes Some Somersaults,” Jan. 12).

The writing implies that an American shopper or citizen generally is a very “profitable particular person in your different life” however “not perceive American well being care” and that monetary misery might have been prevented if solely Mary Lou Retton had been extra assertive, knowledgeable, and clever.

Appleby states that “Retton excelled in touchdown tough strikes as a gymnast, however she could have missed the bar when it got here to purchasing insurance coverage protection.”

This notion — particularly amongst well being journalists and newsrooms overlaying the well being care mannequin within the U.S. — that industrial medical health insurance ensures entry to well being care, or that the Inexpensive Care Act is inexpensive and ensures entry — is a false one. ACA plans are largely managed by personal industrial medical health insurance corporations. The trade enterprise mannequin is “Denial of Care.” That’s how insurers ship returns on funding to shareholders 12 months after 12 months, quarter after quarter, and revenue from sickness, harm, incapacity, and demise. This mannequin as of at the moment remains to be authorized. And, with PxDx software program and synthetic intelligence, corporations are actually denying medical care claims at a charge of 100 per 1.2 seconds.

To counsel paying for industrial medical health insurance guarantees medical care is editorially irresponsible. To counsel a citizen was not clever sufficient to navigate the barbaric and merciless industrial medical health insurance trade’s non-system of well being care is reprehensible and repugnant. The one one who “missed the bar” was Appleby and her misinformed editors.

KFF Well being Information has been partnering with NPR and CBS for almost seven years on the “Invoice of the Month” sequence. Throughout that point, doctor suicide has reached report highs, medical employee strikes have hit report highs, medical invoice bankruptcies have reached report highs, medical residents throughout the nation are unionizing to guard sufferers’ rights and affected person security, and but, all of the whereas, industrial medical health insurance trade earnings have reached report highs. And their monetary product divisions proceed to spend money on portfolios that don’t have anything to do with well being care.

By each measurement and metric, over the previous 40 years, the industrial medical health insurance trade has prompted preventable hurt and demise — deliberately, for revenue. And nonetheless, Appleby suggests it’s the fault of sufferers that they can’t afford medical care? What, particularly, does Appleby counsel sufferers like Retton “do higher?”

It’s time to start reporting responsibly and precisely about statewide single-payer resolutions and laws throughout the US and the nationwide (improved) Medicare for All Act of 2023-24 on the federal degree.

Industrial medical health insurance just isn’t well being care.

— Kimberly J. Soenen, government director of Some Individuals and managing editor of The Tremendous Print, Grand Marais, Minnesota

This text drew swift consideration on social media. Right here’s a sampling of readers’ posts on X, reacting each to the KFF Well being Information and NPR variations:

Retton didn’t have insurance coverage as a result of premiums have been too excessive. She has insurance coverage now; so do thousands and thousands of different Texans. That’s the story right here, not that she didn’t exactly clarify the ranking dynamics of a non-compliant setting.https://t.co/EnzjyACn2v https://t.co/SBFSzVNe4Q

— Greg Fann (Professional-compliance Well being Actuary) (@greg_fann) January 14, 2024

— Greg Fann, Temecula, California

I’m glad NPR highlighted this. Don’t know if Retton is ignorant or MAGA. Disgrace on ⁦@TODAYshow⁩ and ⁦@hodakotb⁩ for not utilizing this to tell their viewers that preexisting circumstances aren’t a problem with the #ACA. Premiums will be $0. https://t.co/Rkl4WVG5wO

— Jody Johnson (@jodywayzata) January 13, 2024

— Jody Johnson, Dallas

I do know too effectively {the marketplace} well being rip-off that leaves so many people with out insurance coverage. I’ve a set earnings of $29,000. With a bronze-level plan, meaning a $10,000 deductible, and $473 per 30 days for premiums. Are you calling this inexpensive? The very fact I’m paying $10,000 earlier than my insurance coverage kicks in, plus month-to-month premiums, it’s $15,000 out-of-pocket — a pocket I don’t have until I’m homeless. That is the rip-off.

— Brenda Frantz, Hinesville, Georgia

Yep. Mary Lou Retton’s clarification for why she did not have medical health insurance did not move the sniff check: https://t.co/AieiuAzD7n through @kffhealthnews

— Victoria Colliver (@vcolliver) January 12, 2024

— Victoria Colliver, Oakland, California

Orthopedic surgical procedures??So gymnastics is unhealthy?https://t.co/ki3qRbF7O2

— Lance Cross (@Tea4gunsSC2) January 14, 2024

— Lance Cross, Carta Valley, Texas