> I don't believe this is accurate. The causality runs the other way. Medicare takes the oldest sickest patients away from private enterprise. Private insurance

> I don't believe this is accurate. The causality runs the other way. Medicare takes the oldest sickest patients away from private enterprise. Private insurance gets to cherry pick healthy people and aggressively denies coverage whenever it can. As I explain below, Medicare reimburses providers rates that are below COGS. That's not a secret, and Medicare itself admits as much. It's not hard to see that, if Medicare reimburses rates that are below COGS, the only way providers can stay in business is by making up those losses with non-Medicare patients. The patient pool of Medicare is actually not relevant to this entire conversation, because we're talking about what Medicare themselves reimburse for individual services, so we're already comparing like quantities. But if you really want to explore that line of reasoning, note that privately-managed Medicare plans (who have the same general patient population as Original Medicare) systematically outperform Medicare on the three top metrics: medical outcomes, cost, and patient satisfaction.