As the president of a healthcare plan in Ohio, I am used to answering for the shortcomings of our industry. When neighbors vent to me at the grocery store that medical bills are driving them to the poorhouse, it never seems to matter that our plan, SummaCare, has been named one of the nations top health plans, or that our 120,000 members consistently give us high marks for service. Im painted with the same brush as the worst actors in our industry. I understand. It comes with the territory.
From the C-Suite: Policy distinctions
Medicare Advantage works for urban seniors
But when that same broad brush is applied by policymakers, the results can be counterproductive. All health plans are not created equal. A case in point is the Medicare Advantage program, which a recent cover story (April 13, p. 6) described accurately as a favorite target of both Congress and the Obama administration. At SummaCare, we believe that competitive bidding, if done right, can weed out bad actors and benefit seniors in a way that is sustainable for the Medicare program. (And by done right, I mean not like the recent CMS adventure over its new competitive bidding program for durable medical equipment, which drove 90% of small firms out of the process.)
In our view, however, it is not in anybodys interest to eliminate the program altogether. Doing so would be the ultimate example of throwing the baby out with the bath water for more than 10 million seniors. There are three reasons why:
At SummaCare, our readmission rates for hospitals are 50% better than regular Medicare. Why is this important? Because as President Barack Obama has said for more than a year: Reducing readmission rates can save taxpayers billions of dollars.
As Im often reminded at the grocery store, private health plans are an easy mark. We should welcome changeand competitive bidding will bring change. But we should resist cutting Medicare Advantage plans outright.
If it were to happen, our seniors will have just two choices: either the limited coverage of regular Medicare, or the often unaffordable coverage of supplemental insurance, all at a time when unmanaged chronic care among seniors is the primary cause of rising health costs. That would bring about a medical procedure no health plan would recommend: cutting off our nose to spite our face.
Martin Hauser is president of SummaCare, Akron, Ohio.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.