Not only is Medicare a third-party-payor, but it is actually “single payer” for the elderly.

Lawrence Huntoon, MD, PhD explains:

Did you know that despite Section 1803 of Title 18 of the Social Security Act (Medicare), which says:

“Nothing contained in this title shall be construed to preclude any State from providing, or any individual from purchasing or otherwise securing, protection against the cost of any health services,” the government destroyed the private insurance market following implementation of Medicare. That means, that citizens 65 and over cannot purchase private insurance with better coverage than rationed Medicare, even if they wanted to, because no private plan for those 65 and over exists.

Many elderly citizens are utterly shocked to learn that past age 65, they have lost the ability to pay for care that they want, using their own money (except if they go to an opted out physician). If Medicare tells them that they cannot have a particular medical service, then they will not get it (i.e. blatant rationing of care).

Those who are 65 and older have been made totally dependent on the government’s Medicare program and they are at the mercy of unlicensed Medicare bureaucrats who make decisions about “medical necessity.”

And, the government contracts with private insurers to process Medicare claims. This creates an enormous conflict of interest since private insurers typically follow not only the Medicare fee schedule (or some percentage related to), but they also may follow local medical review policies which determine which services are covered and which are not. Thus, the more local medical review policies the insurer makes to deny payment for services based on “medical necessity,” the more the private insurer will benefit with respect to its own insured.

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