Think-Tanks (even the best) Miss the Mark

No One Disputes The Commonwealth Fund’s Contribution

For me, The Commonwealth Fund, the quality of the information, the background of the people that are writing for the Fund, as a whole, represent the absolute top-tier of those that exist (Kaiser Family Foundation probably shares this).

“On Medicare But At Risk” is a new article posted here. I am not going to even start to debate the data on which it was written. Let’s presume they have the resources and brainpower to calculate correctly (true).

“Toplines” are Very Incomplete, and Wrongly Framed

These are the Twitter takeaways from the article.

  • By not limiting out-of-pocket cost & excluding benefits, Medicare leaves some with high costs
  • Lower-income Medicare beneficiaries are the most at risk for being underinsured

My Suggestions for the Toplines

  • Lower-income Medicare beneficiaries are the most at risk for being underinsured (unchanged)
  • Lower-income Medicare beneficiaries are under-enrolled in plans that are widely available in every state, that would put an annual out-of-pocket limit on total costs.

They Are WAY Different from Each Other

The tilt of the Toplines, as presented, points out that it is Medicare that is the culprit. It’s Medicare’s fault. It completely ignores that there are no-premium options available in every state, that would put a limit on the total out-of-pocket costs.  It ignores the fact that “the consumer is ultimately responsible for not having the information that these options exist.”

The fact that my “Toplines” weren’t the ones used should evoke the question: why? It is unclear. Let’s think a second. Maybe it was because the article’s implied message is that Medicare is flawed by not having an out-of-pocket maximum on Part A and Part B. The counterpoint: how much would it cost, and who is going to pay for that cost? The second potential answer is that the research didn’t consider the fact that no-premium plans exist. Is either of these two reasons acceptable? Not really, and all that is left is the tilt of the article, leaving the reader with the conclusion that it’s Medicare’s fault.

Let’s say you have read the Toplines as is, and not read this blog post. Were you likely to consider these facts? Maybe, maybe not. Were you likely to simply accept the conclusions from a high-quality source? Very, very likely. And your likely response: it’s their problem, there is little that can be done about it. Our response to that is, simply stated, no and no.

It Gets Worse, not Better

Healthcare costs are like the neighborhood foreclosure problem. You can make your payments, every month. Your neighbor defaults. What has happened to the value of your house? Up? Nope. Down? Yep.

When someone on Medicare does not have the proper coverage, someone is losing money. Guess who absorbs it? The provider (doctor, hospital, clinic)? No question, the provider gets hurt (more on that in the future). Who else? YOU get hurt, because those losses are shared via higher costs due to previous losses suffered by the provider. This is the way that every other business works, you could be selling corn and the conclusion would be the same.

Now you can understand the point to answer the question: why do we spend this much time and effort trying to communicate the message of Maximize Your Medicare? It is simply because we are asking you to pass the information to someone you know, who we know doesn’t have the correct information, as they should. There is the cost to them, and you. Very simple.


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