Corporate Influence in Healthcare: How to Keep Your Medicare Care Independent

A few years ago, a good friend of mine—I’ll call her “Tricianne”—faced a frustrating ordeal with her health insurance. 

After her cancer diagnosis, the doctor recommended a promising but costly treatment. Her insurer initially denied coverage, proposing a cheaper alternative, but finally approved it after multiple appeals and hours of calls.

Today, Tricianne is in remission, but the experience highlighted a troubling reality for Medicare beneficiaries: corporate interests often prioritize profit over patient well-being. 

Tricianne’s success came because she is well-versed in navigating the healthcare system and had a doctor who took the time to advocate for her. Unfortunately, many Medicare beneficiaries don’t have the same advantages.

This scenario is all too common, especially in Medicare Advantage (MA) plans, which are managed care plans that are built on a restrictive network of authorized providers who are willing to offer discounts.

These plans often deny or delay care to reduce costs, creating unnecessary obstacles for beneficiaries. While Medicare Advantage can offer extra benefits, it is important to be aware of the potential downsides, including restricted networks and limited access to treatments.

Corporate Influence in Medicare Advantage

Corporate influence in healthcare—especially through Medicare Advantage—often manifests in efforts to cut costs.

Private insurers running these plans may deny claims, limit coverage, or steer patients toward cheaper, less effective treatments. They sometimes prioritize profit over patient care, which can lead to delays in treatment, denials of necessary services, and a lack of transparency.

Moreover, pharmaceutical companies also play a role, influencing doctors’ prescriptions through financial incentives. This can lead to patients being prescribed more expensive drugs that may not be the most effective for their condition.

A more troubling trend is medical censorship, where insurers and healthcare systems limit what doctors can discuss with their patients. During the pandemic, some doctors were penalized for recommending non-standard treatments, a sign of how both government and corporate interests can restrict patient care.

Narrow Networks and Limited Options

One of the biggest drawbacks of Medicare Advantage plans is their narrow networks, which restrict beneficiaries to a limited number of in-network providers. 

If your doctor is out-of-network, you may face high out-of-pocket costs or be forced to switch to a provider with whom you’re less familiar. In contrast, those on traditional Medicare have the freedom to choose any doctor who accepts Medicare, offering far greater flexibility and control over their healthcare.

This is not to trash Medicare Advantage plans in general—they have many advantages, such as low or no premiums, built-in prescription drug benefits, supplemental benefits, and the availability of special needs plans. However, the restricted network is a significant tradeoff that everyone should be aware of. 

While wealthier individuals can often afford to pay out-of-pocket for treatments outside of these networks, many Medicare beneficiaries do not have that luxury. They are left with fewer options, making it harder to access independent providers who can offer unbiased advice and the best care.

Protecting Your Medicare Choices with Alternatives Like Medi-Share 65+

One way to safeguard your independence in healthcare decisions is to consider alternative options like health sharing plans. 

Medi-Share 65+ is an example of a health sharing plan designed specifically for Medicare beneficiaries. Unlike Medicare Advantage, Medi-Share 65+ allows members to choose their own doctors without being confined to a narrow network. This gives you greater control over your healthcare decisions and helps avoid the bureaucratic delays and denials often seen in Medicare Advantage plans.

Safeguarding Your Medical Privacy

Beyond access to care, corporate influence also extends to your medical privacy. 

Medicare Advantage plans, like other corporate-run healthcare systems, collect and store vast amounts of health data. This data is often shared or sold to third parties, including advertisers or insurers, who could use it to target you with ads or even influence your coverage decisions.

Many health apps and wearable devices also collect sensitive health information, which can be sold without your knowledge making it difficult for users to control how it’s used. For example, insurance companies could use this data to adjust your premiums or limit your access to certain treatments.

How to Defend Against Corporate Influence in Medicare

If you’re a Medicare beneficiary, especially on a Medicare Advantage plan, here are some strategies to help protect your healthcare choices and privacy:

• Consider Alternatives: Health sharing plans like Medi-Share 65+ offer more freedom in choosing doctors and making healthcare decisions. These plans prioritize patient care and transparency over profit.
• Be Selective with Providers: Look for healthcare providers who value your privacy and are committed to keeping your information confidential. Independent physicians, especially those operating in direct primary care models, often operate outside the traditional insurance system, allowing for more personal care.
• Opt Out of Data Sharing: Many apps and devices allow you to opt out of sharing your health data. Review privacy settings carefully and disable data-sharing options wherever possible to protect your personal health information.
• Know Your Rights: Familiarize yourself with the Health Insurance Portability and Accountability Act (HIPAA) and other federal laws that protect your privacy. Understanding your rights can help you advocate for stronger privacy protections and ensure that your data isn’t misused.

Conclusion

Medicare beneficiaries, particularly those on Medicare Advantage plans, need to be aware of how corporate interests can influence their healthcare. 

While these companies are focused on profit, it’s crucial to keep your care independent. Exploring alternatives like Medi-Share 65+, choosing privacy-focused providers, and taking steps to control your health data can help ensure that your healthcare decisions remain in your hands—not controlled by corporate profits.

Here’s to your health and wealth,

Wiley P. Long, III
President – MediGap Advisors

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