THIS TIME ON CODE WACK!
Medicare Advantage is overcharging the federal government – and you won’t believe by how much! How’s this affecting taxpayers like you and me and what can be done about it?
To find out, we spoke to Dr. Ed Weisbart, the national board secretary for Physicians for a National Health Program and president of the Consumers Council of Missouri.
SHOW NOTES
WE DISCUSS
What are a couple of key differences between traditional Medicare and Medicare Advantage, from the consumer perspective?
“Medicare is the program that … covers your hospital stuff, it covers your doctor stuff. … it’s seamless. They never say no, they never get in your way. You can go to almost any doctor in the country and there’s nobody trying to make a profit off of it. They operate with like a 2% overhead. It’s a terrific program.
“Medicare Advantage is really neither Medicare nor an advantage. … instead of having the Medicare program just pay for your doctors and hospitals for you, … Medicare prepays insurance companies … for every person that’s in there.
“And of course, you know, once the insurance companies are prepaid for you, they don’t want to let go of that money.…
“So they have all sorts of games to kind of get in the way. They keep you from going to certain doctors and hospitals. They delay paying for your care, even just stand in the way for a week or two of being able to get care. That’s money that’s still in their bank that they can make a profit off of. ” – Ed Weisbart, MD
Yet more and more seniors are getting Medicare Advantage. Why?
“It’s cheaper on the front end. What people don’t really realize is that although it may be cheaper initially, it’s not a lot cheaper and … people in Medicare Advantage actually have more trouble accessing health care than people in good old traditional Medicare.
“People in Medicare Advantage have longer delays. … people in Medicare Advantage don’t go to the better hospitals as often. They have a longer time getting diagnosed. They have a longer time getting treated once they’re diagnosed with cancer, and they actually have higher death rates postoperatively if they have cancer surgery.
“So, you know, you’re kind of taking a gamble when you’re going into Medicare Advantage or gambling that’s spending a bit less money up front on premiums isn’t going to kill you. And sadly there’s evidence that it just might. So it’s not a good choice.” – Ed Weisbart, MD
Your organization, Physicians for a National Health Program, recently released a bombshell report about Medicare Advantage titled “Our Payments, Their Profits: Quantifying Overpayments in the Medicare Advantage Program.” What were the key findings of this report?
“The bottom line is that we overpay [Medicare Advantage insurance companies] … by at least $140 billion [a year]. … We could afford to have really good health insurance through the Medicare program and make it available to everybody in the country, but we have to stop … letting these Medicare Advantage companies drain our funds…” – Ed Weisbart, MD
So, are you saying we could improve Medicare by, say, adding dental, vision and hearing coverage and an annual out-of-pocket cap of $5,000, for about the same money we’re paying the Medicare Advantage companies?
“Yeah, we could fix all the things that are wrong with Medicare if we would just stop letting the Medicare Advantage corporations rip us off like this.” – Ed Weisbart, MD
Helpful Links
Medicare Advantage Overpayment >$100 Billion, Physicians for a National Health Program
Report: Medicare Advantage plans cost more, provide less, Cornell Chronicle
Protect Medicare, Physicians for a National Health Program
Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients, Journal of Clinical Oncology
Differences between Original Medicare and Medicare Advantage, Medicare Rights Center
Pitfalls of Medicare Advantage Plans, Investopedia
Episode Transcript
Read the full episode transcript.
Biography: Ed Weisbart, MD
Ed Weisbart, MD, is a national board member of Physicians for a National Health Program, president of the Consumers Council of Missouri, and health policy advisor for Code WACK!
He practiced family medicine for 20 years at Rush Medical Center in Chicago and spent seven years as chief medical officer of Express Scripts until retiring in 2010 to devote his time to advocating for healthcare justice.
He is an author and popular speaker about single-payer health care, the ongoing attacks on today’s Medicare program, and how to find common ground across political chasms.
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