By Brenda Gazzar
Code Wack Podcast, October 18, 2021

Part 2 of a two-part podcast featuring Dr. Ed Weisbart, national board member and Missouri chapter chair of Physicians for a National Health Program, discussing the latest threat to traditional Medicare called “Direct Contracting Entities.” What are they? How do they make money? Why is this a problem? And what can we do about it?

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Transcript

Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar.

So what in the world are direct contracting entities and how might they affect the health care of American seniors? Will this pilot program ultimately help or hinder quality care? Dr. Ed Weisbart, a retired family physician, former chief medical officer of Express Scripts and a national board member of Physicians for a National Health Program, weighs in on this troubling development.

Welcome to Code WACK!, Dr. Weisbart.

Q: There’s a so-called innovation to traditional Medicare being introduced, a pilot program called direct contracting entities or DCEs. That sure doesn’t sound anything like health care. Can you tell us what a direct contracting entity is and why we should care about this?

Weisbart: As a recent article in Health Affairs blog said, this is Orwellian in the way it’s titled, so if you find that this new phrase ‘direct contracting entity’ is confusing to you, it’s the craziest way to call it, cause if you remember from the previous episode, traditional Medicare is very direct, right? Medicare has a direct relationship with doctors so that sounds like a direct contracting entity but that’s not at all what this means. This new name direct contracting entities is a program that was begun under the Trump administration overtly to introduce the private industry – venture capital and private equity and for profit insurance – to introduce them into the 60% of Medicare that they don’t have access to today.

So, most Medicare members have said, I don’t want the commercial industry. I don’t want a for-profit middle person intermediary. I just want Medicare. Most — 60% have said that. And so, the industry has said “well, you know, we want some of that game. We want a part of that pie” and so they persuaded the Centers for Medicare and Medicaid Innovation to start what’s still a pilot program, where much as in Medicare Advantage, or as in accountable care organizations or in a few other programs,  Medicare would no longer pay doctors and hospitals. If you are in a direct contracting entity, Medicare would no longer pay your doctor and hospital for the most part. Instead, they would pay these new for-profit, venture capital private equity or insurance company or publicly traded companies. All of your money for health care would go there, and then they would be in charge of doling out the payments to doctors and hospitals and such.

It’s a little bit more nuanced than that. There are some variations to this but, in general, direct contracting entities, in direct opposition to the way the name sounds, creates a new level of fiscal intermediaries, a new at-risk group, whose interest is in you not getting care, not in you getting care. It’s a dreadful concept, it’s a dreadful concept. It’s something that it’s still in the pilot phases right now so we can stop it before it gets crazy out of control and we need to stop this new initiative, direct contracting entities.

Q: I see. So what does it mean for someone who’s in a DCE?

Weisbart: If you’re in one, you still retain all of your traditional Medicare benefits. Direct contracting entities can’t tell you “no, you can’t go to the doctor or no, you can’t go to the hospital,” at least on paper, but we know that their game will be to nudge you, to guide you. Nobody is really responsible for making sure that you know you have all those choices. You might get a letter once telling you you have that but the direct contracting entity is not going to want to emphasize that so they’re going to be guiding you to fewer choices, fewer hospitals and getting in the way of health care.

Q: Hmmm. So it’s basically creating a middleman…

Weisbart: That’s exactly right.

Q: …that takes a cut of the money that should be going directly to the providers?

Weisbart: And venture capital, Wall Street, private equity, they know this. They’ve looked at this model and some folks call it the Medicare Gold Rush now you know having this incredible rush of money coming into new startup industries and ventures to take advantage of this new entity called direct contracting entities.

Wall Street wouldn’t be investing so incredibly heavily, so incredibly quickly as they are right now if there weren’t a way for them to make a ton of money off of this, and where does that money come from? They’re investing in it because they know that there’s still money left in the Medicare Trust Fund that they can drain. They think that they can get the premiums to go higher for Part B. I don’t know what they’re really thinking but they’re not investing this money because they’re out to improve public health so we’re all going to pay for this. We have to stop it before it’s gotten out of control.

Q: Hmmm. So Dr. Weisbart, to clarify, the DCEs then do operate with a capitation system?

Weisbart: Yes, direct contracting entities themselves are capitated for your care by the federal government. That’s the concept. The direct contracting entities receive varying degrees and varying scopes of capitation for your health care, a monthly fee or an annual fee to cover some or all of your healthcare expenses so it’s exactly what you said. The direct contracting entity gets the money in, and then every dollar that they have to pay out on health care, frankly, is a dollar away from their bottom line, from their profits, from their return on invested capital to Wall Street. Every dollar that they pay, that they have to pay out comes out of their capitation so they have a compelling business interest to maximize those capitations by gaming the system, and to minimize how much they pay out by either directly or indirectly interfering with your care. They can’t completely say “no you can’t go for that care”, they can’t do that, but they can really kind of make it seem like they can.

Q: Um, so when doctors get a set amount per patient, healthier patients cost them less to treat than unhealthy patients. Doesn’t this incentivize doctors to avoid taking on sick patients?

Weisbart: Yeah. The other side of that equation is one of the key reasons I went to medical school. I thought the idea that if you “capitate” physicians — if you pay doctors a certain amount per month to take care of people in general — that would mean that it’s to my advantage to keep you healthy. If I can keep you healthy, well then you’re going to cost less and I’ll be able to make more money. If I did something stupid to you that was you know expensive or harmful, you would then become more expensive to take care of, and I would be partially paying for that. So I thought capitation was a brilliant idea.

What I didn’t know, and what I know now, is that the way to make money under capitation is not by making people healthier. Healthcare prevention takes a decade to pay off. Really good preventive medicine takes a decade to pay off and then it’s not a business case for prevention. We should do it, but it’s not a big money maker. The way to make money under capitation is to not have sick people in your practice. That’s the way to make money so I think you’re right. Capitation rewards you for not having sick people.

And there’s ways to modify and adjust it, but it’s a game of Whack a Mole. You’re always staying a step ahead of that so there is no good way to pay doctors and so because no matter what you do, you’re going to have some kind of an issue, but the most important thing to do I think is to remove the perverse incentives. Stop having it so that we doctors can make more money by shunning the sick. You don’t want to put us in that situation and stop putting it so that we doctors can make more money by doing unnecessary expensive things. You want to get rid of those kind of perverse incentives.

Q: How then do you think that’s affecting patients?

Weisbart: Like I said I went to medical school because I believed in this model of capitation in one form or another so I used to live and practice within the largely capitated system, and I was in charge of I think there were about 10 medical offices scattered around Chicago and we had one in particular that like all the others was largely capitated and it was a terrific place. They did great care. They were top of the charts on patient satisfaction, and on mammograms and all that stuff and they were profitable. Hooray. It proves the case. Then they got one patient in with a very expensive form of hemophilia and it was going to cost a million dollars a year. Actually it did cost  a million dollars a year to treat this one person.

And so, of course, you pay that, you know, we had to figure out ways to come up with the money for it because it’s a lot of money but we did, but I was in charge of the group, right. So there was a business imperative on me to make him not like us. We didn’t do any of these things but I was thinking about you know let’s not answer the phone if we know it’s him. Let’s put him on hold.  You know if he comes in for his visit, let’s make him wait an hour or two. We didn’t ever do that but let’s lose his chart a little bit. Let’s not call him with those test results. Playing that through the intent would be that after six months or so he would say you know that used to be a great office you know, but I don’t know what’s happened to them but it’s gone downhill and I’m going to find me a new doctor.

And maybe he would call and threaten us and tell us, you know, how terrible things were and that he was going to get a new doctor and I’d say, “oh, I’m so sorry.” We didn’t do any of those things but I’m still atoning for the fact that I thought all that through because that was the business pressure, was to make a sick person not want to go to our doctors.

Q: Right and what do you think is at stake then for patients?

Weisbart: For patients, as Dixon from PNHP recently said, nobody – literally nobody – is asking for the system to get more complicated. Nobody is saying, you know, if we’re just a little bit more complicated, that would fix things. Nobody is saying that but that’s what this will do, so you won’t be able to follow the money, right. Who is it going to? You won’t be able to track where your money’s going. You’re gonna have somebody in the middle of your care with direct contracting entities, who will say they’re your advocate and ally trying to help you through the system, but in reality, the business pressure on them, their motivation is not quite the same as what your physician in the exam room usually is.

So from a patient point of view, I think it’s a whole new exposure to a whole new level of complexity that’s going to drive up the cost of your care with no reason to think it’s going to improve quality. There are all sorts of analyses that say there’s no reason to think that. It’s not going to make health care better. It’s going to make it more expensive and more profitable for the foxes that are raiding the chicken coop.

Q: And how do you think the DCEs and the pilot program, if it moves forward, would affect the Medicare for All movement?

Weisbart: It really complicates it. When the movement was really first kind of growing with that name, there was a movement to not call it Medicare for All, but to call it single payer, because structurally that’s what it is — it is one payer, you know, let’s just have one payer. Get rid of all of these insurance companies and just have one payer, and let it be Medicare, have one payer — single payer. It really simplifies things.

There was a movement to have it just be called the single-payer movement and that group lost out to the group that said no nobody knows what a payer is, nobody knows what single payer is. Everybody knows and loves Medicare. Medicare is pretty simple. Let’s kind of go straight with that. So let’s make it Medicare for All. It fits on the bumper sticker better. It’s nice. Well, the world has changed a lot, and the Medicare program is under such direct attack (with) Medicare Advantage now, with all these denials and referrals and prior authorizations and networks. Most people don’t really understand when they have Medicare Advantage that they really don’t even have Medicare, so the more we let traditional Medicare get corroded by things like Medicare Advantage or direct contracting entities, the more we corrode Medicare itself, the harder it is to say, you know, let’s get Medicare for All. We’ve always said improved Medicare right it’s always been improved Medicare. I myself have often run into people who say, why would I want Medicare for all you know the problems I’ve had? And they are almost always problems with Medicare Advantage, and so we’ve had to have the discussion of that’s not Medicare, and once they understand that then they’re much more happy with “oh, yeah, let’s get rid of all of that stuff.”

So, confound that by having a third stream in here, having people with Medicare Advantage, having people in direct contracting entities, and then an even smaller group that’s holding on to that precious for dear life traditional Medicare, it makes our message so much more complicated. Now there’s two things to say “no, that’s not what we mean” about. Yeah, we can go back to the language of single payer. We can emphasize the improved Medicare for All, but it makes our job more complicated and it puts us on the defense, right,  because now we’re talking about how do we protect Medicare, but I would say that every problem is potentially an opportunity.

It’s giving us a chance to get people to really try to understand what Medicare Advantage is and isn’t. We should stop “advantaging” Advantage. We should not let DCEs enter this new space so it’s giving us an opportunity to reinform and educate people and point out the absurd complexity, and point out the Gold Rush coming in to take our money away. I think there’s a whole new suite of organizing tools that we can develop because of these outrageous new attacks so I think it’s potentially galvanizing us.

Q: Thank you, Dr. Weisbart. Was there anything we didn’t touch on or anything else you wanted to mention?

Weisbart: If somebody’s really wonky and wants to read more, there’s two great new pieces in the Oct. 1 week of the Health Affairs blog on this. I think if you just go to the Health Affairs blog and look up direct contracting entities, you’ll find two really terrific pieces from Rick Gilfillan and Don Berwick. So read those. They are dense but are really important. So join us. Go to PNHP.org, even if you are not a doctor.

Thank you Dr. Ed Weisbart.

Find more Code WACK! episodes on ProgressiveVoices.com and on the PV App. You can also subscribe to Code WACK! wherever you find your podcasts. This podcast is powered by HEAL California, uplifting the voices of those fighting for health care reform around the country. I’m Brenda Gazzar.

https://heal-ca.org…

By Claire M. Cohen, M.D.
Common Dreams, October 18, 2021

It is a mistake for activists to once again allow Democratic politicians corrupted by big money to determine the nature of the struggle for single-payer Healthcare. We must have a strong fight on the national level in order to win this. Otherwise, we are abandoning a struggle that has strong public support and giving Congress a free pass to do nothing.

The United States is not Canada. Due, in large part, to the racist culture of the United States, successful struggles for progressive policies on state levels do not automatically translate into national victories. In his article in Jacobin, Gerald Friedman’s main example, Medicaid, proves the point. The Medicaid Program, unlike Medicare, was set up so that states have great discretion and authority on how to implement their own programs. More “progressive” states in the Northeast and on the West Coast have had more coverage, fewer restrictions, and less means testing in their Medicaid programs for decades. States with more reactionary and racist governments, especially in the South, have had more means-testing and restrictions leading to less coverage. The better health outcomes of the more progressive states have not led the more reactionary states to see the error of their ways. If anything, these reactionary states have dug in their heals. In fact, as of this year, there are 12 states that are still refusing to expand Medicaid despite being offered large “carrots” by the Biden Administration. Also, my state Pennsylvania, which currently has a reactionary legislative majority, is taking its lead from those reactionary states, and going in a more regressive direction! Given the racial demographics of the states, it could well be that having some states successfully obtain single-payer would mean an increase in racial disparities nationwide.

The Southern states did not get rid of slavery or segregation because of the example of the Northern states. History shows that, if anything, they retrenched and fought steadfastly for their “peculiar” institutions. It was only when these struggles became national fights (the Civil War, the Civil Rights, and the Black Liberation struggle) that they were successful.

Furthermore, it was Medicare’s implementation as a national program that enabled it to have a powerful effect in ending segregation in medicine throughout the country. Yes, there were local struggles, but they were expected to meet the national mandates. It is a mistake to conflate local struggles for national goals with local struggles limited to local or state attainments.

Advocates for de-emphasizing the national struggle for single-payer (or even laying it down) in order to put the emphasis on achieving state single-payer programs seem to think that working for state single-payer programs will be a much easier battle. But peculiarities about the American governance system and HHS policy, in particular, are likely to make things more complicated and difficult. Secretary of Health and Human Services Becerra, with his reversals in order to be in line with Biden Administration health policy, has already shown that he can not be counted on to give favorable interpretations of section 1332 of the ACA, making it easier for states to implement their own single-payer programs. And even if Secretary Becerra decides to allow flexible interpretation of 1332, what is to stop states from being regressive (like Pennsylvania) instead of progressive?

Finally, there are two suggestions in the Friedman paper that appear confusing. In their paper, Friedman et al discuss states using Medicare Part C to establish a state single-payer system. But isn’t that in essence establishing a state Medicare Advantage? Is this what we want: the privatization of single-payer right off the gate? Also, they talk about not prohibiting employers from offering separate health insurance. Unless I’m missing something, I can see a multi-state company offering its employees United Healthcare, or CVS offering its employers Aetna, or even better yet, Walgreen offering its employees a DCE. My experience working as an employee in a big hospital chain is that it would not hurt them one bit to do this. So would that state really have a single-payer system?

The Democratic Party has been famous for watering down and derailing progressive struggles for at least fifty years. And activists have too often been complicit in their own failure by ceding to Democrats. Just because Biden lays down Medicare For All does not mean we have to or should. We need to do just like the Freedom Riders did during the Civil Rights movement, they forced the hands of the reluctant Kennedy brothers. We need to put our efforts together and force reluctant Democrats in Congress to pass what 80% of Democratic voters, and 60% of the entire electorate already support: expansion of national, single-payer, improved Medicare for all, not just for some. As Frederick Douglas said,” If there is no struggle, there is no progress. Power concedes nothing without a demand.” Let us not be so ready to concede in the face of President Biden’s obstinateness. Keep the struggle for national single-payer going until we win.

Dr. Claire M. Cohen is a black child psychiatrist in Pittsburgh who is a member of National Single Payer, PNHP and the Western PA Coalition for Single Payer Healthcare. You can contact her at cmcmd80@gmail.com.

https://www.commondreams.org…

By Brenda Gazzar
Code Wack Podcast, October 11, 2021

Part one of a two-part podcast featuring Dr. Ed Weisbart, national board member and Missouri chapter chair of Physicians for a National Health Program, discussing the differences between traditional Medicare and Medicare Advantage plans. Plus, why should we be concerned about the impact of Medicare Advantage plans on the Medicare Trust Fund?

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Transcript

Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help.

It seems like Medicare has been popping up in the news lately, in good ways and bad! But what’s always true is that our country struggles between treating health care as a public good and treating it as a profit-making venture. This conflict of visions is very apparent when comparing traditional Medicare to Medicare Advantage plans. Dr. Ed Weisbart, a retired family physician, former chief medical officer of Express Scripts and a national board member of Physicians for a National Health Program, is joining us today to talk about the latest attack on Medicare — and what we can do about it.

Q: Welcome to Code WACK!, Dr. Weisbart. So let’s talk about traditional Medicare versus Medicare Advantage. What are the main differences between these that consumers should know about?

Weisbart: So they’re really two entirely different programs. Traditional Medicare is a public program paid for straight through our tax dollars to the Medicare program and then Medicare, traditional Medicare, has relationships with doctors and hospitals and everything so it’s just nice and is clean. Medicare pays the doctors and hospitals.

Medicare Advantage is completely different. The people who have chosen to go into Medicare Advantage,  Medicare no longer pays doctors on your behalf. Medicare no longer pays the hospitals on your behalf. Instead, Medicare pays an insurance company, a Medicare Advantage insurance company, Humana,  Blue Cross. There’s many of them but they pay the insurance company and then you have what’s very similar to employer-style insurance, and that means that they can tell you which doctors you can and can’t go to. Traditional Medicare doesn’t do that. Medicare Advantage can tell you which hospitals you can and can’t go to. Traditional Medicare doesn’t do that, only Medicare Advantage does that. So, Medicare Advantage, you have a group in between you and Medicare, whose mission is a business mission trying to find a way to make a profit off of you being sick and such. That doesn’t belong in health care.

Q: So it sounds like (it’s) very similar to having private insurance.

Weisbart: It is — except that’s nowhere near as good as traditional Medicare. So really from a consumer’s point of view there’s probably three important things to consider … between traditional Medicare and Medicare Advantage. The first is a difference in coverage, the second is a difference in access, the third would be a difference in cost as a consumer, so the coverage in theory is the same, right? Traditional Medicare and Medicare Advantage plans both cover the same benefit package of what’s medically necessary, although in traditional Medicare you have a lot more doctors and hospitals to pick from. Medicare Advantage plans do cover the same range of benefits, but they get to decide what’s medically necessary and they may make different decisions. They have a business interest in making different decisions so they could take a narrower view of what is actually necessary than traditional Medicare does. The coverage is technically the same, but in real life the coverage for Medicare Advantage is not the same as in traditional Medicare.

The second difference is access, as I was alluding to with traditional Medicare you can go to any doctor or hospital that takes it which is like 93% of adult medicine doctors and you don’t need a referral. You don’t need to ask for permission. You don’t need to get prior authorization. If you want to go to a doctor that’s in Medicare’s network, you can go to that doctor , that’s almost any doctor and hospital, whereas Medicare Advantage, you typically have to get a referral typically from your primary care physician or from the Medicare Advantage plan, or it’s, if you’ve given up your traditional Medicare, and you’ve gone into Medicare Advantage, you want something that’s probably expensive because you’re that sick, you suddenly have to start getting permission and approval. That’s not treating you like an adult. That’s taking away your choice.

But the third difference is the cost difference as a consumer. With traditional Medicare there are copays and deductibles and so people who can afford to do it typically will buy a Medigap policy to take care of the copays and deductibles and if you do that, and you’ve got pretty darn good health insurance with traditional Medicare.

With Medicare Advantage, it’s different. You can’t buy a supplemental policy to go on top of Medicare Advantage. So when Medicare Advantage Plans charge you copays and deductibles, you can’t buy Medigap to cover that. If the Medicare Advantage plan says you’re going to have to pay all the costs for your out of network care, you want to go to the doctors across town instead of this side of town. You’re on vacation in Florida or wherever, and you want to go to the doctor there, and the Medicare Advantage plan says that’s out of network and is not covered, or they’re only going to pay half or what have you, you cannot buy insurance to supplement Medicare Advantage. So, in Medicare Advantage there’s actually a limit to how much it can go. You can’t have more than $7,550 in out of pocket expenses.

That’s a lot of money. There is no limit like it in traditional Medicare because if you buy a supplement, you’ve got almost no out of pocket costs, no matter what’s going on. So the reason people often pick Medicare Advantage if they do is because the premiums are lower than a Medigap supplement, so you can look at a Medicare Advantage plan, look at the low premiums and think ‘I’m indestructible, I’m not going to get sick. I don’t have to worry about if I get sick.’ ‘Well, why are you buying insurance in the first place,’ but they think that. They see the lower premium but they don’t realize that that comes with an exposure to now nearly $8,000 in out of pocket expenses, an exposure that doesn’t exist in traditional Medicare if you buy a supplemental policy, usually a couple couple hundred bucks for the supplemental policy which is not cheap but if you buy that, then you don’t have exposure at all.

The trade off is do I pay the premium for a supplemental policy of maybe a couple 100 bucks a month or do I avoid that but risk if I get sick having thousands and thousands of dollars out of pocket? So Medicare Advantage is a way worse deal.

Q: Wow right. That’s very interesting and we are talking about, you know, the sickest population, the over 65 is among the sickest in the country. Okay, how do the programs differ from a doctor’s perspective?

Weisbart: The differences from a doctor’s perspective are pretty similar to the differences from a patient’s perspective, in the sense that traditional Medicare is really easy to deal with, right, it’s really easy to deal with. If a patient comes in to see you and they have traditional Medicare at the end of the visit, we submit our bill to Medicare, and before too long Medicare pays the bill and there’s very little second guessing. There’s very little denials, very little of any of that stuff. So traditional Medicare from a doctors point of view is great. I can do the work that I need to do.  I don’t have to worry about where to send my patient. If I have a patient that needs radiology and Xray needs surgical centers or something done, pretty much all of those places take traditional Medicare and take the supplement so I can send my patients to the place that I think is the best for them.

Medicare Advantage is a whole different thing. (With) Medicare Advantage, you know, they have a game of delaying when they pay you, arguing down how much they’ll pay, saying ‘no, that’s not medically necessary, we’re not going to pay for it. Oh, you sent your patient to that radiologist — not so fast doctor we like this radiologist,’ and you know it’s a nightmare and the doctor may not know which one it is,  so the patient goes there and then comes back and has to tell us ‘gosh, doc you sent me to the wrong place,’ well how am I supposed to know? It’s a nightmare.  With Medicare Advantage, it’s frankly a nightmare for me and traditional Medicare from a doctor’s perspective is a breeze.

Q: Wow, thank you. In terms of health policy, what are the implications of having two competing programs when it comes to healthcare equity?

Weisbart: So, whenever you set up two different systems that compete against each other and they’re not really comparable, you have a disaster on your hands. So from a health policy perspective what we’ve done is we’ve created one option that’s designed to make profit for private commercial industry, and another enterprise that’s designed to improve the health of people, and as a result the for-profit one, well they want, the Medicare Advantage plans, well they want to find the healthiest people they can. If you’re actually genuinely sick, they don’t want you. It’s called cherry picking. They’re trying to find the healthiest people. If you are actually sick they don’t want you there, that’s called lemon dropping, and then once they’ve got the healthiest group of people, they want to make that group of people look sick. They want to find the more diagnoses, the more crazy things that they can find so that they can charge the government more. They can charge Medicare more, so from a health policy perspective, what we have is the Medicare Advantage plans are literally draining the Medicare Trust Fund.

When you hear the Medicare Trust Fund is in trouble, that’s not because of Medicare, that’s because of Medicare Advantage, so they’re draining the Medicare Trust Fund and when you do that, then of course that means that the premiums that seniors have to pay or Medicare people have to pay for part B, go up. So if somebody’s trying to find more profit in the system, they either have to block your health care which is of course what Medicare Advantage plans are designed to do, or they have to drain more money out of the system by draining the Medicare Trust Fund and resulting in higher premiums. So it’s a terrible idea. It’s a terrible idea.

And we talked about health equity and one of the areas of health equity that’s not fully recognized, I don’t think, is the problem with rural communities. We know that people who are sick are more likely to want to get out of Medicare Advantage once they’ve gotten sick. People in rural communities are twice as likely as people in nonrural communities to want to get out of Medicare Advantage. You go in because like I said the premiums are lower because we’ve so overpaid in Medicare Advantage, that they can afford to throw a few pennies at us for the premiums so the premiums are lower, so you go into it when you’re sick and especially, especially if you’re in an underserved kind of community, a rural community or any other underserved community. That’s not where the Medicare Advantage plans have their networks, because they put their networks in the most profitable areas not the sickest areas.

So, from a policy perspective, it does not accomplish our goals. Traditional Medicare, good-old fashioned Medicare that we’ve had since 1965, that’s done a phenomenal job at controlling the cost of health care, at rescuing seniors from bankruptcy and from poverty, at giving seniors wide choice over their own health care, and at actually making seniors healthier, and frankly, very little of that is true for Medicare Advantage.

Thank you Dr. Ed. Weisbart. Join us next time when we talk about the latest sneak attack on traditional Medicare.

Find more Code WACK! episodes on ProgressiveVoices.com and on the PV App. You can also subscribe to Code WACK! wherever you find your podcasts. This podcast is powered by HEAL California, uplifting the voices of those fighting for health care reform around the country. I’m Brenda Gazzar.

https://heal-ca.org…