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Private insurers often require a cumbersome review process that frequently results in the denial or delay of essential treatments that are readily covered by traditional Medicare. The new model relies on an additional set of private companies for traditional Medicare that have a very clear incentive to deny care.

Private plans under Medicare Advantage have become increasingly popular, with a little more than half of older Americans and people with disabilities eligible for the program and some 34 million enrolled. But many are willing to forgo some of the additional benefits the private plans offer, like dental checkups and gym memberships, to avoid having to jump through numerous administrative hoops to get care.

How insurers make their decisions remains opaque. A spokesman for Health and Human Services, which oversees the Medicare agency, declined to identify which companies had submitted applications for the contract.

People enrolled in traditional Medicare who live in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington State will be included in the pilot experiment, which is expected to start in January and last for six years.

My girlfriend Krista has been overweight for the past year now. I’ve been trying to get Krista to go to the gym and she’s been refusing. Tells me she doesn’t have energy and makes up excuses.

Krista tells me I need to come with her to the gym. But I can't go to the gym with her regularly because of my busy work schedule. I work as an oil truck driver 14 hours days. So I’m always away or sleeping.

I asked Krista to go with my buddy Dale who’s a retired fitness coach. Krista says she’s not gonna go with a man. Always one excuse after another.

Today she told me she went on a 2 hour walk with a guy she works with named Cole. And how her and Cole are getting a gym membership together and they’re gonna go every day together.

Does this seem suspicious? Or should I end it?