Re: “New Medicare program using AI leaves WA patients in pain” (March 18, Business):
Medicare is a mutual benefit program — I’ve paid into it my whole working life and depend on it in retirement. It’s also the most efficient health insurer in the country, with administrative costs around 2%, compared to 18%-30% for some Medicare Advantage plans. That gap isn’t inefficiency. It’s profit — money skimmed from care.
Now Congress is greenlighting a pilot program — the “Wasteful and Inappropriate Service Reduction” program — that hands prior authorization decisions to the same for-profit contractors who plague Medicare Advantage. These insurers use AI to deny claims while refusing to disclose their methodologies or codes. The program’s own name says the quiet part out loud: The goal is reducing services, not saving lives. The experience of Keith Magnuson, featured in the article, proves it.
Giving private, profit-driven actors a veto over care in Traditional Medicare — even as a “pilot” — opens the door to permanent erosion of the program. If CMS wants to cut waste, there’s a target-rich environment in Medicare Advantage. Start there.
There is no benefit to Medicare participants in WISeR. Use health care dollars for health care — not CEO bonuses.
Kate Schwarz, Coupeville
