Really solid breakdown of how perverse incentives will inevitably corrupt this system. The part about contractors getting compensated based on denials saved is wild when you think about it. I've seen similar dynamics play out in corporate cost-cutting initatives where the metric becomes the mission, and suddenly "efficiency" just means finding creative ways to say no. What's particulary troubling here is that the 90% overturn rate on appeals basicaly means seniors will need to become appeals experts just to get care their doctors already prescribed.
Your post inspired this infographic in which I cited you.
How does the Epstein Class profit from denying your Medicare claim? Follow the money!
https://thedemlabs.org/2025/12/18/epstein-class-profits-from-denying-your-medicare-claims/
Thanks Deepak!
Really solid breakdown of how perverse incentives will inevitably corrupt this system. The part about contractors getting compensated based on denials saved is wild when you think about it. I've seen similar dynamics play out in corporate cost-cutting initatives where the metric becomes the mission, and suddenly "efficiency" just means finding creative ways to say no. What's particulary troubling here is that the 90% overturn rate on appeals basicaly means seniors will need to become appeals experts just to get care their doctors already prescribed.