Re: “New Medicare program using AI leaves WA patients in pain” (March 18, Enterprise):
Medicare is a mutual profit program — I’ve paid into it my entire working life and rely upon it in retirement. It’s additionally probably the most environment friendly well being insurer within the nation, with administrative prices round 2%, in comparison with 18%-30% for some Medicare Benefit plans. That hole isn’t inefficiency. It’s revenue — cash skimmed from care.
Now Congress is greenlighting a pilot program — the “Wasteful and Inappropriate Service Discount” program — that fingers prior authorization selections to the identical for-profit contractors who plague Medicare Benefit. These insurers use AI to disclaim claims whereas refusing to reveal their methodologies or codes. This system’s personal title says the quiet half out loud: The objective is lowering providers, not saving lives. The expertise of Keith Magnuson, featured within the article, proves it.
Giving non-public, profit-driven actors a veto over care in Conventional Medicare — at the same time as a “pilot” — opens the door to everlasting erosion of this system. If CMS desires to chop waste, there’s a target-rich setting in Medicare Benefit. Begin there.
There isn’t any profit to Medicare individuals in WISeR. Use well being care {dollars} for well being care — not CEO bonuses.
Kate Schwarz, Coupeville
