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Joseph Bentivegna, M.D.August 18, 2014

Managed Care is a Scam

The recent merger between Aetna and the managed care company US Healthcare should convince the public once and for all that managed care is a scam. The multibillion dollar deal is part of the ongoing wealth transfer from the middle class to the super wealthy. The CEO for US Healthcare is taking home $1,000,000,000(Your eyes are fine. That’s one with nine zeros after it.)along with a $25,000,000 corporate jet, $10,000,000 in stock options, and another $10,000,000 in consulting fees.

Managed care has been successful because it has perfected the art of satisfying the vast majority of patients who are healthy while tormenting the sick minority with paperwork, 800 numbers, and bureaucracy to prevent them from obtaining care. Women and their infants are heaved out of the hospital 12 hours after birth. Patients with psychiatric disorders have their most intimate conversations
perused by bureaucrats. But this merger is a precursor to a huge taxpayer rip off—managed Medicare.
Medicare is the government program that cares for the elderly and disabled. It has been a huge success, increasing the quality of life for our elderly so that the United States now leads the world in life expectancy for those who are 65 and older. It will also be bankrupt in five years. Our policy leaders hope that managed Medicare will be the white knight. They are sorely mistaken. Managed Medicare is popular with healthy seniors because it is virtually free. Traditional Medicare has deductibles that must be met annually for both doctors’ visits and hospitalization. Only 80% of health-care bills are covered and this does not include dental bills, prescription medicines, eye glasses, hearing aids, and long-term nursing home care. Supplemental insurance must be purchased. In Connecticut, the cost of this insurance rose 27% last year.

Enter the managed-care conglomerates. The United States government is now forking out taxpayer money to managed-care companies that can sign up senior citizens for managed-care plans. These companies offer coverage for prescription medicines along with $5 doctor visits and free hearing aids.
If this sounds too good to be true, that’s because it is. In actuality, the managed-care companies are cherry picking the healthy seniors. Some companies deliberately schedule their promotions in areas that do not have public transportation and on the second floor of buildings that lack elevators, thus excluding seniors incapable of driving or walking up stairs. Younger seniors are the preferred customers. Eighty-five percent of 65-year-olds have no major health problems. Their knees and hips are fine. Their cataracts are minuscule and they don’t need nursing home care.

But what will happen when they reach 80 and need plenty of care? Suddenly, our managed-care companies will have problems with “capitalization.” Seniors with hip problems will be advised to take up bridge while those with large cataracts will be told to add a new pet to the household— a Seeing Eye dog. Political pressure will mount and taxpayers will be forced to pay for the care of these individuals. Meanwhile, the billionaire insurance company CEOs will be laughing from their yachts. Do not expect our politicians to stop this taxpayer rip-off. They have been bought and paid for. As pointed out in the recent report by Connectciut Secretary of the State, Myles Rappaport, 90% of political contributions come from the wealthiest 2%. Like the Savings and Loan fiasco and the Mexican Peso bail out, the roots of another taxpayer rip-off are being sown with managed Medicare. Nothing will be done until it’s too late.

As a physician, I realize that we created this mess by ignoring the increasing costs of health care and fighting attempts for reform. What is needed is single-payer catastrophic coverage for all Americans. Medicare costs can be controlled by increasing premiums on wealthier seniors and stopping useless treatments at the end of life. Instead, we are getting another scam that will benefit the wealthy and give the middle class higher taxes.

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Doctor Bentivegna is an ophthalmologist living in Connecticut. He has written numerous op-ed pieces for The Hartford Courant and The New York Times regarding health care, tort reform, and the political situation in Haiti.

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