There are many reasons to oppose Donald Trump’s decision to appoint Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services. Oz is a snake oil salesman who has promoted quack cures on television and hawked bogus weight loss products. He has zero experience leading a large bureaucracy, never mind a large health care one like CMS. But Oz’s track record on Medicare, which covers about 66 million people, should concern us the most.
History suggests Oz will seek to boost the use of Medicare Advantage — and that he’ll do it with the support of Trump
History suggests Oz will seek to boost the use of Medicare Advantage, further privatizing the program — and that he’ll do it with the support of Trump. This, in turn, will drain government coffers while leaving many seniors in poorer health.
Medicare Advantage is, in fact, a worthy target for the volunteer commission known as Department of Government Efficiency, led by Elon Musk and Vivek Ramaswamy, which ostensibly aims to make government less wasteful and costly.
But don’t hold your breath.
Oz, in one of his more commendable positions, pushed for universal health care coverage — but he did it not by pushing Medicare for All but Medicare Advantage for All. In a 2020 opinion piece, he and a co-writer opined that the Americans on Medicare Advantage use the program “very successfully.”
This, to be blunt, is a lie.
Medicare Advantage now covers more older Americans than traditional Medicare. Promoters claimed it would save the American government money even as it could offer more choice in care by covering extras like eye exams and gym memberships, things traditional Medicare does not. Anyone familiar with the rapacious ways of American corporations and capitalism should have immediately spotted the con job here, but Americans forever want to believe in the power and good faith of the free market.
Instead, Medicare Advantage costs the government billions of dollars more a year while offering up narrow doctor and hospital networks and throwing one bureaucratic hurdle after the other in the way of patients seeking treatment. In many cases, this leads to poorer health outcomes than for those enrolled in the original program.
Traditional Medicare offers more and is a better bang for the buck. It spends an estimated 2% of its operating revenues on administration. Medicare Advantage, on the other hand, spends 550% more, with 13 cents of every dollar going to pay for everything from claims agents to executive salaries.
At the same time, the increasingly consolidated health care conglomerates offering up Medicare Advantage plans are raking in the bucks. The gross margins on the plans covering Americans over the age of 65 are more than double those of other health insurance offerings, including the coverage Americans receive via their employers. Such profits are helping fuel an epic mergers and acquisitions spree by the health care giants, which puts further strain on the American health care system.
As if all this weren’t enough, Medicare Advantage is rife with suspected fraud. The government is suing United Healthcare, alleging it reviews its enrollees’ medical records to make them appear more ill so it could collect more money from the government.
It’s often only when someone is fighting an illness that the downsides of Medicare privatization become obvious
So why would anyone sign up? Medicare Advantage can seem like a great deal for seniors living on fixed incomes who are younger and healthier, for whom a free gym membership is a more sought-after perk than ensuring that a convenient and well-regarded hospital or rehab facility is included in the coverage.
Moreover, popular personalities like, er, Dr. Oz, encourage people to enroll in Medicare Advantage. As The Lever reported, Oz talked up Medicare Advantage on his eponymous television talk show, including in at least one segment sponsored by an insurance agency where viewers were urged to call an 800 number ASAP to sign up.
Those numbers will almost certainly increase. The first Trump administration promoted Medicare Advantage, and it seems certain the same will also be true this time. The infamous Project 2025 continues this policy, recommending that it be the default option for people initially signing up for coverage under the government plan that offers all seniors health care.
It’s often only when someone is fighting an illness that the downsides of Medicare privatization become obvious. Once again, the taxpayer gets stuck with the bill. An analysis by the The Wall Street Journal found that between 2016 and 2022, people in their final year of life switched from Medicare Advantage to traditional Medicare at double the rate of other enrollees, costing the government billions of dollars. That’s likely because they — or their families — discover they need more care than Medicare Advantage plans provide.
That Oz likes Medicare Advantage and thinks everyone, regardless of age, should have it shouldn’t come as a surprise. Like the once and future president appointing him to run CMS, he is a huckster at heart. (Research published in the British Medical Journal in 2014 found that less than half of the medical recommendations on Oz’s TV show were supported by evidence. During the early days of the coronavirus pandemic, he also, contrary to evidence, suggested chloroquine and hydroxychloroquine were effective treatments for that virus.)
Pushing Medicare Advantage is nothing if not a sales job. But people on Medicare need a champion, one who will prioritize their health over the financial health of the giant insurers seeking to make a buck off elderly Americans. There’s nothing in the record that suggests Oz is the right man for that job — and much to suggest that he’s not.
