Increasingly, the private component of Medicare, Medicare Advantage (MA), is coming under attack. The latest salvo was a front-page article on October 8, 2022 in the New York Times, titled “The Cash Monster Was Insatiable – How Insurers Exploited Medicare for Billions.” The article claims “most large insurers in the program have been accused in court of fraud.” Today’s guest, John C. Goodman, points out that the “fraud” insurers are accused of is not the typical fraud seen in Sixty Minutes exposes in which the perpetrators are sent to prison. Rather, the “fraud” alleged often involves the risk payments MA plans receive for taking care of sicker enrollees. Goodman says MA attacks are no accident. There is a huge force against privatization in Medicare by the government, politicians and the corporate media. Goodman discusses why MA is the better alternative for both enrollee and taxpayers.

On his health care blog, Goodman posted a rebuttal to the NY Times article on the day it was published. In the blog post, “Another Hit Job on MA Plans,” Goodman explains why risk payments are not overpayments, and certainly are not something that constitute fraud. Goodman points out in the podcast that some of the accusations come from whistleblowers who may receive rewards for their claims. Traditional fee-for-service Medicare has long been victimized by fraudsters and is rife with waste. Goodman points out MA plans, because they are private, have an incentive not to waste money. Medicare Advantage is the only system in the health care market that actually competes to take care of sick people.

New York Times Article: https://www.nytimes.com/2022/10/08/upshot/medicare-advantage-fraud-allegations.html

John Goodman Article: https://www.goodmanhealthblog.org/another-hit-job-on-ma-plans/