Janine Jackson interviewed Public Citizen’s Eagan Kemp about Medicare Advantage for the March 31, 2023, episode of CounterSpin. This is a lightly edited transcript.
Janine Jackson: You may have seen television ads warning ominously of “DC liberals” breaking promises to seniors with proposed cuts to Medicare Advantage, and calling on local legislators to fight back.
American Action Network (3/3/23)
You might wonder why a multimillion-dollar scare campaign would be the first recourse of a deep-pocketed industry that was genuinely concerned with senior citizens’ healthcare and well-being. But the health insurance system in the United States is nothing if not confusing.
And as with any situation created and sustained by human actions, you’re right to wonder: Is this the best we can do? How can we do better? Or, more pointedly, why can’t we do better, when we know we have a population that needs healthcare, and a country that can afford it?
News media could play an informing and an explaining role here, but that’s not what seems to happen.
Eagan Kemp is healthcare policy advocate at Public Citizen, and he joins us now by phone from Salt Lake City. Welcome to CounterSpin, Eagan Kemp.
Eagan Kemp: Thanks so much for having me.
JJ: I’m going to ask you multiple things, and we can’t do justice in the time we have. But I do want to ask you just to orient us a bit, because, right now, we’re kind of in the midst of competing claims.
The proposed changes to Medicare Advantage are either going to take needed medicine away from seniors, or they’re about combating fraud and overbilling.
Understanding that we’re not talking about a perfect response to a perfectly defined problem, what are we kind of looking at right now with Medicare Advantage and the Biden proposals on changes? What’s a useful way to understand that?
Eagan Kemp: “Traditional Medicare has always cost less. It’s always served seniors more consistently. But it doesn’t place ads.”
EK: Yeah, it’s really a crucial time for Medicare Advantage and for the Medicare program more generally. I think the reason that you’re seeing these ads trying to scare people into getting their legislator to protect Medicare Advantage is that a lot of Medicare Advantage insurers have been caught with their hand in the cookie jar.
Just to step back briefly, traditional Medicare has been around for a long time, and has served hundreds of millions of Americans.
But the Medicare Advantage plan is more recent; it’s just around in the past couple of decades, but it’s been growing quickly. And the Medicare Advantage plan, the big difference there is they’re able to profit off of the healthcare for seniors, whereas traditional Medicare is nonprofit. It serves seniors where they are in terms of what they need.
And as Medicare Advantage has grown, it’s become more profitable, and these companies have gotten better at taking advantage of seniors, and now they’ve been caught. And so there’s been more research highlighting areas where seniors have struggled to get the care they need, how much extra it costs the US in terms of, if you just covered those seniors through traditional Medicare.
So they really are trying to defend their profits at a time when they can see the Biden administration and Congress really put them in the crosshairs, and begin to make steps to hold them more accountable for their actions.
JJ: So who’s behind this current information campaign, and what are their goals here?
EK: Yeah, it’s a great question. And the biggest player is what we refer to as AHIP, or America’s Health Insurance Plans, which really is sort of a cabal of all the biggest insurers that put money in, and then use AHIP as cover for lobbying and direct political influence, glad-handing with politicians and, to the extent possible, with the White House.
And so they are always going to work on behalf of insurers’ ability to profit, regardless of what that means for seniors. They’re seeing the losses that pharma has had recently when it comes to things like insulin, when it comes to things like negotiating the cost of some drugs with Medicare.
And insurers are scared too. They see that they’re next on the chopping block, because they’ve had it so good for so long, and Medicare Advantage has never delivered on the promise of actually lowering the cost of care, or improving the quality of care.
Washington Post (3/23/23)
JJ: Let me ask you how that fits with the Washington Post editorial I saw, I guess, a couple of weeks ago, “A Fiscally Responsible Government Cannot Keep Its Hands Off Medicare.”
I was trying to sort of mentally separate Medicare and Medicare Advantage. I see you connecting them. And I see now the Washington Post saying, we just got to get into those funds. Like, what’s the connection there?
EK: Yeah, it’s a really important connection. And I think it’s one of the more challenging ones, because I think one of the things that the Medicare Advantage plans and the private insurers that profit off this do well is conflating the two, conflating Medicare Advantage and traditional Medicare.
And the real issue is that traditional Medicare has always cost less. It’s always served seniors more consistently. But it doesn’t place ads, it doesn’t fill the airwaves the way that Medicare Advantage plans do when someone’s turning 65.
These Medicare Advantage plans do a lot of often misleading advertising, so that they can do what we refer to as cherrypick the healthiest seniors, and then “lemon drop” sicker seniors, and make sure that they stay in traditional Medicare.
And it’s something that Medicare Advantage plans have gotten better at. And the more people that are in Medicare Advantage, the more it’s a threat to the long-term health of the entire Medicare program.
Right now we’re close to 50% of seniors on Medicare Advantage. And we know that it would cost a lot less to cover those seniors in traditional Medicare. And so it is existential for the Medicare program.
And it’s something that in the short term, the Biden administration and Congress really need to crack down on bad actors in Medicare Advantage, but in the long term, moving towards a system that both improves and expands traditional Medicare, while at least putting Medicare Advantage on a level playing field. But in the long term, it’s just unclear that there’s any positive role for Medicare Advantage.
Public Citizen (3/21/23)
JJ: Let me ask you, because I wanted to give you an opportunity to connect this, and to talk about a new report that Public Citizen has done, but I know listeners will understand, who are regular media consumers: For elite media, if anything is a public/private partnership, well, then that is the holy grail. That is exactly what we want. Because heaven forbid anything be wholly public, or publicly supported.
And so public/private is the exemplar, just narratively, is my feeling from elite media.
And I know that you’ve just released a new report on the role of private equity in healthcare. The “role” maybe is too gentle of a phrase. The report is called “Private Equity’s Path of Destruction in Healthcare Continues to Spread.” So let me just ask you to break down a little bit for listeners: What is the problem that you’re mapping here? And how does it connect with these broader healthcare issues?
EK: Yeah, I think it really connects at the nexus of profit. So private equity companies are generally large, privately held, they don’t have a lot of accountability or transparency.
Many of them, even if you knew their name, and then you tried to search them on Google or somewhere else, you would not be able to find an ounce of information. They’re very secretive. They hold their secrets and investments close. Some of the bigger ones, you might be able to find a bit about. But they are shady actors, and their primary drive is profit above all else.
And in healthcare, that’s particularly scary, because they also move much more quickly than even traditional healthcare actors. To me, they’re even scarier in terms of their actions than traditional insurers, that are also focused on profit, but do have a longer timeline that they plan to have in the industry.
If you’re a private equity company, you want to buy in and you want to get out within three to five years, and you want to pull as much as you can in terms of profit out. So it means really taking underhanded tactics, like selling a hospital out from under the hospital administration.
So you might buy this entire healthcare system, you sell that hospital immediately, cash that check, and now you’re charging that hospital that you just bought a very expensive lease. If this is not a high-margin hospital, or if it’s in a rural area or an urban area, it may have a really difficult time staying in business.
But as a private equity company, you don’t care, because you’re about to sell that, or you’re about to flip it to somebody else, and you’re going to move on, and that’s a real dedication to profit across the healthcare industry. And that’s really what we go into the report, over nearly 15 different areas where private equity has engaged recently in the healthcare system, and scary places where they’re going next, such as hospice or end-of-life care.
JJ: I’m just going to ask you, finally and briefly, and we’ll clearly talk much more in the future, but we know that policy is shaped by people’s understanding of what is possible. And we know that news media shape that understanding.
So for me, corporate news media are chockablock with what they would call “news you can use,” like: Can I apply for disability while on Medicaid? Does it make sense to divorce my spouse so that we could see if maybe I could get my meds covered?
It’s reporting that assumes that you’re over a barrel, and that masses of us are over a barrel, but is somehow too timid to say, this is crazy and cruel and unnecessary, and to talk about systemic change. And if anybody does, well then they’re a freak, and they’re actually a problem that needs to be contained.
And so knowing that you can’t say all you’d want to say, what are your thoughts about media coverage of this issue?
EK: Yeah, it is a challenging area. I think that some of the real bad actors in both private equity and in Big Pharma, and Medicare Advantage and other insurers, I think there is starting to be a bit of a different tone.
I think Americans are having enough pain points, and talking about them or coming together to push for things like Medicare for All. I think that’s why, during the 2016, the 2020 presidential debates, there was just so much angst and frustration around the healthcare system, and real support for things like Medicare for All.
And the corporate media are certainly not there yet. But I think enough stuff is starting to break through that they can’t just ignore it. And so you are starting to see even the New York Times or the Washington Post really cover in more detail some of the fears around prescription drugs, or around Medicare Advantage, or some of the abuses that we’re seeing, even during Covid-19, by insurers and others.
And it’s an important time for folks to tell their stories and to also get engaged, because the industries want us to stay demoralized and separated. But it’s when we come together that we can really push for the change that we need.
JJ: I’m going to end on that note. We’ve been speaking with Eagan Kemp. He’s health policy advocate at Public Citizen. You can find their work, including this new report on private equity and healthcare, online at Citizen.org Thank you so much, Eagan Kemp, for joining us this week on CounterSpin.
EK: Thank you, appreciate it.
The post ‘Medicare Advantage Has Never Delivered on the Promise’ appeared first on FAIR.
This content originally appeared on FAIR and was authored by Janine Jackson.
Janine Jackson | Radio Free (2023-04-05T19:10:09+00:00) ‘Medicare Advantage Has Never Delivered on the Promise’ – CounterSpin interview with Eagan Kemp on Medicare Advantage. Retrieved from https://www.radiofree.org/2023/04/05/medicare-advantage-has-never-delivered-on-the-promise-counterspin-interview-with-eagan-kemp-on-medicare-advantage/
Please log in to upload a file.
There are no updates yet.
Click the Upload button above to add an update.