Dr. Turner warns seniors to be wary of Medicare Advantage Plans: Letters

·8 min read

Jan. 17 -- To the Editor:

Until recently I did not understand the reason for the explosion of ads for Medicare Advantage plans on television. My understanding changed after I received communication from the Physicians for a National Health Plan organization.

Medicare Advantage plans function like HMO’s: they receive a set payment from Medicare for each enrollee and then manage how those funds are used to pay for the enrollee’s health care. The patient’s health care options are often restricted or limited to a selected panel of providers. The plans often encourage over coding which increases the cost of the Medicare Advantage plans compared to traditional Medicare.

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Late during the Trump administration an even more insidious effort was made to privatize Medicare. That program established Direct Contracting Entities (DCE), which like Medicare Advantage plans, receive direct monthly payments from the Medicare fund for each enrollee. With DCE plans, seniors can even be automatically enrolled into a DCE without their full knowledge or consent. These DCE plans can spend as little as 60% of the funds that they receive from Medicare for health care services and then keep up to 40% of those revenues as profit! Studies have also shown the DCE’s and Medicare Advantage plans encourage over-coding and the use of medically questionable studies or intervention to further maximize their profits.

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As of April 2021 there were 53 DCE’s operating in 43 states and DC. Twenty eight of these plans are investor owned and six more are managed by insurers. Traditional Medicare spends ~98% of its budget on direct patient care while, as mentioned above, DCE’s can retain up to 40% of their revenues as profit. This arrangement provides an incentive for these DCE’s to restrict patient care. In 2019 Medicare spending was $330 billion but by 2025 it is projected that Medicare DCE’s could potentially collect $660 billion from the Medicare Trust Fund.

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I would urge seniors to be very wary of signing up for Medicare Advantage Plans since like DCE’s, those plans are designed to improve financial outcomes, not clinical outcomes. Also I would urge everyone to call their Senators and Representative to encourage them to stop the dangerous DCE program. One could also contact Xavier Becerra—the Secretary of Health & Human Services.

H. Dixon Turner, MD

Portsmouth

Abortion fight encompasses every aspect of women's lives

Jan. 17 -- To the Editor:

I remember when my mother, now 89, went to work for the state of New Hampshire's first Family Planning office back in the early '70s. It was a time when Meldrim Thomson was Governor and William Loeb ran the Union Leader, and when 'Live Free or Die' began to be stamped on our license plates. I was just a kid, but I remember her explaining that Family Planning helped provide health care services to women and families.

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In college, I took a Women in Law course and studied the Roe v Wade case in detail. I remember learning, at age 20, that Roe was not guaranteed, and that we needed to be vigilant about protecting women's rights, particularly at the state level where anti-abortion laws remained on the books, which would go back into effect if Roe were ever overturned. That seemed unlikely to me, even during the Reagan era, but I tried not to take for granted the legal and social progress that had been fought for and won by all the women before me.

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Decades later, here we are. I'm now past child-bearing age, but am angry that my two kids, now in their 20s, face the prospect of navigating their reproductive years knowing that an unplanned pregnancy could derail their lives, or worse, result in medical and / or psychological trauma.

This fight is not and never has been just about abortion, it's about control over women's lives. It's about punishing us for getting pregnant by forcing us into roles that may not be right for us emotionally, physically, or financially. It’s about women having job security, being able to pursue and complete a degree, about women getting to decide whether to take on the very real medical risks that pregnancy and childbirth pose. And it's about women being able to say 'no' to a stifling (or worse) relationship with a man, rather than becoming dependent on him and his income to help her raise a child she does not want to have (and that he probably doesn't want to have, either). In other words, this fight is about every aspect of women's lives.

Two bills are up for consideration in the State Senate this week that move in the direction of promoting women's right to self-determination. SB 399 and SB 436 should be supported by every freedom loving Senator.

Mary Downes

Madbury

Mandating vaccines is insanity

Jan. 9 -- To the Editor:

We are still in the midst of a deadly pandemic and nurses are being fired by the thousands. Why? To satisfy a possibly unconstitutional presidential mandate for vaccinations by employees of any company or organization with more than 100 employees. To me this is insanity! I am asking anyone to defend this logic or decision. The President took an oath to defend the Constitution: “…to insure domestic tranquility…and promote the general welfare”. Does any reader think our President has upheld his oath with this directive?

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What will it take to allow citizens to have and exercise freedom of religion and personal beliefs?

What happened to the rule of law? We are a representative democracy; a country of laws: debated and enacted by the will of a majority, not by a single person’s dictum. Today we have laws that require certain vaccinations to attend school. The problem is a law that requires a vaccination to hold a job may not hold up as constitutional.

It all comes back to moral suasion. Changing standards of wearing masks, remote learning and covid infections despite vaccination do not provide convincing arguments. So, to maintain our sanity we must be tolerant – to be able to: “Live Free or Die”.

I have received all vaccinations because it was my choice near the end of my life. I most certainly respect those who choose not to, uncertain of its long-term effects or personal beliefs.

Rick Stanton

North Hampton

Trump lost election legal challenges because they were ludicrous

Jan. 17 -- To the Editor:

I am writing in response to the dangerous falsehoods promoted by Sue Polidura in a recent letter to the editor. She clearly subscribes to the Big Lie wing of the Republican Party. Polidura says about the 2020 presidential election, "The fact is that nearly all of the challenges brought to the courts were dismissed, not due to lack of evidence but rather a lack of judicial courage...." Trump lost the electoral college by 74 votes and the popular count by 7 million votes. He lost all of his ludicrous challenges in court because his crack legal team could not produce a shred of evidence of any significant voter fraud.

A tragically large number of Americans now doubt the reality of the last election because of the traitorous lies of countless elected members of the Republican Party, many of whom, by the way, also supported the attempted coup d'etat on January 6.

Michael Behrendt

Durham

Election was a referendum on Trump and Trump lost the election

Jan. 17 -- To the Editor:

Sue Polidura’s recent opinion piece is another sad commentary that most of the informed readers already know: you can not inform or educate the GOP true believers to a different point of view. Her quotation of an opinion sampling Rassmusen data only demonstrates that the GOP faithful are swayed by their wishes and beliefs not the evidence. It was only an opinion sample. The evidence and nearly unanimous court rejection of election fraud is dismissed as merely a lack of courage, especially by Trump selected judges and numerous hand recounts of votes found only small voter irregularities of both Democrat and Republican votes.

It is a sad realization that Ms. Polidra, Mr. Forbes and the various other GOP faithful who write to this paper will never, ever accept that the election was a referendum on Trump. He lost! January 6 was an insurrection, the election was not rigged, covid is real, vaccinations work, and, if you watch anything other than Fox entertainment news you would know these things. But, Sadly, that won’t happen.

Steve Little

Portsmouth

This article originally appeared on Portsmouth Herald: Dr. Turner warns seniors to be wary of Medicare Advantage Plans: Letters

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