Pausing on Aetna to talk about PNHP

As I mentioned in my response to some comments, I write these health care posts to clarify some of the terminology and issues that have been tossed around over the past two years – energetically and purposefully, but not entirely accurately.

Even though NYC retirees only have a few more days to decide whether they want to opt out of the new plan immediately (it will start Sept 1 if the lawsuit against it fails), you’ll be able to move in or out of it again in November, and each year thereafter. I know some people who are waiting to see what will happen in the rollout, then jump in if major problems haven’t been reported once it’s up and running. 

One “major problem” I’m half expecting is that some doctors will not immediately accept the plan because they’ve never heard of it before. I’m also keeping my ears open for the results of prior authorizations, about which I don’t expect to hear much because Aetna must know it has to be on its best behavior with regard to these and won’t deny (m)any of them in the first half year. Time will of course tell.

But as I also mentioned in other posts, I strongly believe in changing the country’s tax structure to get universal single-payer, and this is where activism is key. Letters, contacting government officials, taking to the streets, sporting pro-Medicare-for-All messaging on self and car, and anything else you can think of will help raise awareness, and discontent.

For the armchair activists in the crowd, Physicians for a National Healthcare Program (PNHP) just sent around a brief survey, prefaced by this letter from the president:

I know what I think of Medicare Advantage (MA), the large and growing program that invites insurance corporations to manage benefits for what is now a majority of people on Medicare. Of course, these corporations use money that should be going to patient care to pad their own bottom lines. Wall Street sees this program as a financial windfall, and they’re totally right.

But policy aside . . . I’d deeply appreciate it if you took a few minutes to share your perspective . . . [and] I also hope you’ll share the survey with your friends, family members, and neighbors, so we can develop a truly broad-based understanding of the program.

Digital version here.

Print version here.

PHNP’s mission statement involves advocating for universal, comprehensive single-payer national health insurance, and joining with other groups to fight racism and advance social justice.

You don’t need to become a member to see their research materials or watch their video analyses of our profit-driven American health insurance structure, a couple of which live at these links:

Medicare Advantage: What single-payer advocates need to know

Upcoding, Medicare Advantage, and DCEs

Dr. Ed Weisbart on Direct Contracting Entities

Try 'em out. The techie ones really get into the weeds.