In the near future, the new Medicare rules may prove increasingly more onerous than the private ones. It could yield another hit to Medicare’s fee for service scheme. Doctors may well choose to see Medicare patients only under the auspices of an Advantage plan – preferring to deal with the rules imposed by one or a few insurers, rather than the increasingly more byzantine rules imposed by Washington.
The political irony is that there’s a class of progressive policy wonks who decry the growth of Medicare Advantage, fearful that the rise of these plans represents the slow privatization of how the Medicare benefit gets delivered. They favor, instead, a single payer scheme administered by Washington. Yet we already have a single payer scheme – it’s Medicare’s traditional fee for service program.
The same political class that targets the Advantage plans has presided over successive waves of new regulations on providers, and repeated failures to improve how Medicare pays doctors. That failure to maintain a workable alternative is one of the single biggest factors in the burgeoning success of Medicare Advantage.