The success of Medicare Advantage plans that claim to offer more but do less for your health by creating roadblocks for patient care is something that everyone who did not understand why they should be in regular Medicare has found out the hard way. With bait-and-switch marketing, you can succeed with a business model that is good for insurers but bad for your health. This has reinforced the current corporate healthcare model that is driving costs up while it makes the health of seniors worse through conveyor belt medicine models. Ultimately, this is costing insurers who incentivised this by paying the systems more while starving private practices and reducing competition. The middle men, known as insurers and precert companies,s are now being hurt even though they are being paid well by large system administrators that have nothing to do with healthcare. The ridiculous cost of drugs such as Ozempic is merely aggravating those cost problems since insurers are failing us by poorly negotiating those prices, too. Recently, United Healthcare has been investigated for overcharging Medicare. UnitedHealth’s stock dropped 22 percent in one day last April. According to CEO Andrew Witty, he called the financial performance “unusual and unacceptable” and argued the problem was fixable. That should raise alarm bells. According to Medpage Today. This means more algorithmic denials of care, worse outcomes, doctors having to do more just to get paid, etc. When we have a model where patients accessing care is the problem, we need to ask why and not just put up more roadblocks. Part of the issue is that the larger healthcare systems have continued to take market share with their conveyor belt models, which drive utilization, rather than outcomes. As this results in poorer health, patients visit the doctor more and flood urgent care facilities that are based on algorithms that are bad for our health, but may meet our immediate needs. Medicare, on the other hand, is also grappling with the problem, but more successfully in some ways, but not in others. For example, the legislature must fix the provider funding formula, which ignores inflation and financially harms providers outside the system who are needed as competition. Chiropractors still do not have full coverage under Medicare, which has proven to reduce costs, medications, and improve how we move as we age. Imagine a profession that can reduce pain and risk not been fully covered since 1972. Under Medicare Advantage, patients have the same limited coverage and become mere cash patients. So much for insurance. The model is broken, and the answer is to simplify. Medicare Advantage helps you escape back into our same old broken model of promises, denials, and deferred care. Medicare covers you fully if you have Part A and B, and you can purchase a secondary payer for a little more in all 50 states with one set of rules to cover drugs and your Medicare copayments. While it may require some changes, expanding Medicare to all of us can simplify the mess we call medical care in our country, reduce costs, and improve reimbursements to everyone since we have eliminated at least one layer of complexity, insurance. Insurance is a liability for health care; however, simplifying drug prices, eliminating middlemen, and improving competition can only help reduce costs in the USA. Moving back to a model of more generalist care rather than specialist models like ours will improve access, and fully including chiropractors in the Medicare and Medicaid systems will incentivise hospitals to hire the doctors who do best with less in the chiropractic profession. It’s the incentives, stupid. Until you incentivise better behavior properly and begin to pay doctors properly irrespective of speciality, we cannot fix this mess.