Original subtitles

Bye.

Thank you so much for joining us. It has been a busy week. The government

shutdown continued, there was a jewel heist at the Louvre, and Bravo wet

-dreamed George Santos.

Celebrating his release from prison after Trump commuted his sentence with a

-second video that took some wild turns.

Hey everybody, George Santos here.

I'm just sitting here with some friends at a good old American establishment.

IHOP, shout out to IHOP.

Anyway,

um Jesus is good. God is King, but I do want to say this.

I heard that Zionists are getting paid $7 ,000 for a post.

Um, where is my fucking check?

I didn't get it.

Excellent. Now, generally, I will give you way too loud fear to kids. Someone

screaming about Zionism and the words, where is my fucking check? But you...

So rarely get all three from one body, though maybe don't compliment their

coffee by saying, anything's good after prison.

Most brands want a better endorsement than that. It's why Waffle House's

is good food fast and not legally edible.

Trump commuting Santos' sentence was just one of many bold decisions he's

recently, with the most visible being this.

This morning, with these new images showing demolition work at the White

the Washington Post reports more than just the East Wing facade is being

replaced to make way for President Trump's $250 million ballroom. The Post,

citing a White House official, now says the entirety of the East Wing is being

rebuilt. You probably hear the beautiful sound of construction to the back.

You hear that sound?

Oh, that's music to my ears. I love that sound.

Yeah, of course you do. Now, look, obviously.

those images are distressing, especially when you know it's all to build a giant

ballroom in a style best described as Med Spa Versailles. And yet, the

demolition of the White House, a metaphor that, if anything, is too on

was just the tip of Trump's iceberg this week.

President Trump is pushing for a personal $230 million payout from the

Department as compensation for the federal investigations he's faced.

That money would ultimately come from American taxpayers.

The Justice Department officials who would likely sign off on the payment

once President Trump's own personal lawyers, all of it raising new ethics

concerns. One ethics professor telling the New York Times, the ethical conflict

is just so basic and fundamental, you don't need a law professor to explain

Yeah, you sure don't. And I do love that professor, giving the Times a comment

amounting to, do I think the president giving himself a payout is unethical?

yeah, doy.

Now, I should say, Trump has said he donates any settlement to, in his words,

charity or something.

But as the former White House counsel told CNN, there is still a problem

Well, keep in mind, he gave a lot of money to, you know, or took a lot of

out of the Trump University charity that he had. And, you know, he's familiar

with charities and he knows how to loot them.

Yeah, he does.

And I probably shouldn't have shown you that without warning you there was an

aggressive mustache headed your way.

Because it is hard to focus on the message when that is the medium. He

like steampunk Doc Brown. He looks like Santa post -divorce, but three

allegations.

He looks like something you'd find on the groom's side of the aisle at the

Monopoly man's wedding. And by the way, credit to Erin Burnett for keeping a

straight face there while interviewing a man who has styled his facial hair into

a biologically accurate recreation of the female reproductive system.

But incredibly, we're still not done.

Because Trump also posted an AI video of himself dumping shit on No King's

protesters, abandoned trade negotiations with Canada after seeing a TV ad he

didn't like, and authorized a $20 billion bailout to Argentina to ensure

experiment with libertarianism works out. And perhaps most shockingly of all,

there was this.

Tonight, this video showing another deadly U .S. military strike against a

allegedly smuggling drugs to the U .S.

Killing two narco -terrorists on board, according to Defense Secretary Pete

Hegseth. This is the eighth strike the Trump administration has announced

against alleged drug boats since early September, killing at least 36 people.

Yeah, we've actually now killed over 40.

so -called narco -terrorists, even though the administration has not

public evidence for its claims. But even if they have some, I've watched enough

JAG to know the typical approach to drug boats is to intercept them and arrest

the suspects, not murder them with no due process.

And all of this is bad enough before you learn this.

President Trump tonight suggesting he'll soon order strikes on cartels smuggling

drugs by land, too.

Something very serious is going to happen, the equivalent of what's

sea.

And we're going to Congress just to tell them what we're doing.

Yeah, he apparently plans to launch strikes on suspected drug traffickers in

Venezuela without congressional approval, saying, we're just going to

people, they're going to be like dead.

You know, the kind of chilling statement you expect to hear from a serial killer

or the mastermind behind Panera Bread's Charged Lemonade, but not, ideally, the

President of the United States. And look, we're taping this on Saturday. Who

knows what's happened in the last 24 hours? But this has already been a lot.

Because between tearing down the White House, trying to use the Justice

Department to pay himself and proudly sharing AI footage of him literally

shitting on Americans.

The president now also appointed himself judge during executioner of foreign

citizens. And it is infuriating that neither Congress nor the court seem to

interested in putting a stop to any of this because we are supposed to live in

country of checks and balances.

And if I may quote IHOP's most chaotic newspaper, where is my fucking check?

And now, this.

And now, people on TV try to understand 6 -7.

You understand the 6 -7 phenomenon that you hear?

Do you get it or don't get it? I don't really get it, but I know it's like a

thing. 6 -7.

No. They love it. I was at Kentucky Kingdom and kids were screaming it from

ride.

6 -7.

Why? Chances are you've heard this phrase, you've Googled this phrase,

asked Alexa, what is 6 -7?

We don't know.

It's annoying. It's annoying. No one knows what it means. It doesn't mean

anything. So it's like, why are you doing it? Whatever.

So the cool kids are saying, have you heard of it? I did, and I Googled it

because, you know, I'm trying to keep up. It means nothing. I know your

grandkids know what it means. I want you to go home today and be like, six

seven. Six seven.

Six seven. Six seven.

Oh,

my 12 -year -old granddaughter is going to be so impressed.

You love it, don't you? Say six seven. Six seven. Six seven.

Yes, just like my boy.

Good job.

Moving on. Our main story tonight concerns health care.

Ostensibly, the subject matter of the pit, which is slightly about health

but much more about the gentle head tilt of Noah Wiley. On behalf of several

members of my staff, engulf me in that hoodie, you casual Friday hero.

Specifically, we're going to talk about Medicare, the federal program for those

65 or older or with qualifying disabilities.

Now, open enrollment for it began on October 15th and will run through

7th. And it's why this time of year sees tons of ads like these.

Hi, I'm Joe Namath.

If you're on Medicare, this is important information.

I, William Shatner, here with a new message about Medicare benefits.

Hi, I'm Jimmy J .J. Walker. If you're on Medicare, listen to this. I'm Meredith

Vieira. What's complicated and confusing that many people over 65 deal with each

year? Medicare.

Okay, this isn't the point, but the question, what's complicated and

that people over 65 deal with each year, is just too broad, given that the

answer is everything.

Everything confuses them. Have you ever seen a 70 -year -old try to work an

Apple TV remote?

It's actually the reason Biden dropped out of the race last year. Apparently,

his team handed him an Amazon Fire Stick right before that debate, and we all

know what happened next.

These ads are ubiquitous. One analysis found that in Medicare's open enrollment

period a few years ago, over half a million ads like those aired on TV.

over 8 ,000 a day.

Normally, for an ad to be that overplayed, it needs to feature a

singing a song that makes you want to commit mass murder.

But while they're often framed as being about Medicare, they're actually

promoting something called Medicare Advantage, and that is different.

Because while Medicare Advantage has the word Medicare in it, it is not what you

may think. It's not health insurance provided directly to you by the

Instead, it's a different system where the government pays private insurers,

typically owned by companies like these, to administer your benefits for you.

Honestly, it probably shouldn't have the word Medicare anywhere near it because

it's misleading. It's kind of like the mountain chicken. Picture what a

chicken looks like in your head right now. Do you have it?

You're wrong, because it's this. It's a fucking frog.

Which is just wrong. Mountain chicken sounds like, at minimum, a chicken that

lives in the mountains.

Or what a starving stranded hiker would call human flesh. It's just mountain

chicken. It's mountain chicken. It's definitely not Jeff.

What it does not sound like, though, is this. That is a misuse of words. Anyway,

the point is, thanks to blanket advertising and the fact some employee

retirement packages offer these plans exclusively, more than half of eligible

Medicare beneficiaries are now enrolled in a Medicare Advantage plan, a

percentage expected to grow to nearly two -thirds by 2034, which is

Because these plans can have real issues. One expert has said the best

for Medicare Advantage is someone who's healthy. We see trouble when someone

gets sick.

But that is a problem.

Because statistically, most people will get sick. It's just a fact of life.

Like, all hamsters die.

Most cats hate you. And if Jeremy Allen White is on screen, he is sweating.

Acting is sweating. We all know that.

And that's by no means the only flaw here, because as you will see, while

plans can be great for companies' bottom lines, they can be woefully

insufficient for those who signed up for them and the providers who have to deal

with them. Medicare Advantage basically has all the problems of private

insurance, but applies to a more vulnerable population. So given that,

let's talk about Medicare Advantage, what it is, what the coverage can be

and whether you or someone you know should sign up. And to understand it...

You first need to understand how Medicare works, which already isn't

because as you'll know, if you've ever enrolled in it yourself or had to help

someone else do it, it is fucking confusing.

On a scale of one to inception, it is basically a tenet, and I don't say that

lightly. To put it very simply... Medicare currently has four components.

A, B, C, and D. Part A covers hospital and other inpatient care. That's what

you've paid into your whole life. And for most, you can enroll at 65 with no

additional premium due.

Part B covers doctor's visits and outpatient services.

Now, you do have to pay a monthly premium for that. That's typically taken

of your social security check. And even then, it only covers 80%.

of your cost of the remaining 20 you have to pay for out of pocket but you

buy a separate medi gap plan to cover that which typically costs 200 or more a

month and that gap is something adds pushing medicare advantage like to

highlight like this one featuring kelsey grammar doesn't look good he's missing

20 he should have got better insurance fingers crossed are you missing 20 too

That's what your Medicare insurance might not pay for.

That 20 % is critical to your health care and your wallet. See, original

Medicare only covers about 80 % of your Part B medical costs. The rest is up to

you. It can be thousands of dollars, rightly least expected.

So let coverants help find a Medicare insurance plan that doesn't leave you so

exposed.

Stop it! You stop it right now, Fraser!

Though, to be fair, that is not the creepiest thing he's ever said about the

medical profession, given his memoir features the quote, nice girls made me

really nervous, claustrophobic, but broken women, women in pain, women

to be fixed, ah, for these women, the doctor was in.

That is on the back cover, and it is wild to publish a book where you

essentially argue, if you fuck me, you might need professional help.

Anyway, that...

is part b now if you want prescription drugs and if you're a senior citizen you

definitely do you need to pay for a separate part d premium which helps

those and that leaves us with part c which is medicare advantage it functions

an alternative to all the other parts and it helps cover hospitals doctor

and usually drugs while offering often extra benefits like some dental vision

and hearing coverage or even debit cards to help pay grocery bills and it does

all of that For a relatively low upfront cost, as other than that standard

premium taken out of your Social Security check, over three -quarters of

enrollees pay no additional premium at all. So it is pretty appealing on the

surface. And while I don't have to show you one more ad for it, especially if it

basically recaps everything I just said, I'm going to do it anyway, because it

is magnificent.

Al, did you make that call?

Honey, we already have Medicare.

Why do I need to call?

Alan, the fa...

may be able to get additional benefits with a Medicare Advantage plan right

in our zip code with $0 monthly premiums. Honey, what do you mean

benefits? We turned 65, we got Medicare. That's all there is to it, right?

I'm talking about Medicare Part C, commonly called Medicare Advantage. We

traditional Medicare, which is only Medicare Parts A and B, but not Part C.

Wait.

So not everyone on Medicare has a Part C plan?

No. That's why we need to call because there may be plans available with

additional benefits that aren't covered under Medicare Parts A and B. We don't

have a Medicare Part C plan which covers everything in Part A and Part B plus

extra benefits in Medicare Part C.

What kind of extra benefits?

There are great plans that may be available with extra benefits like

vision, and hearing.

Did you say dental?

Studies!

And this is true only the first half of that commercial.

It has it all. Amateur porn -level acting.

Wild physical gestures.

The totally unnecessary undercurrent of a broken marriage. And the phrase, right

here in our zip code. It is perfect.

I also love the disclaimer saying, paid actor portrayal.

As if you'd be so sucked in by the natural delivery of... concuss Rob

over -caffeinated Amy Sedaris here that we might need to be reminded.

But the thing is, there are a lot of drawbacks to Medicare Advantage plans.

a start, they come at an inflated cost to taxpayers, which is a bit weird,

that a big part of the argument for creating this system over two decades

was that bringing in private insurers would help control costs. In fact, here

Orrin Hatch back then, one of its biggest cheerleaders, making his pitch.

Choice.

The right to pick the coverage you want.

That's what Medicare Advantage actually gives you.

Now, there are those who believe that socialism is the answer to everything.

Let government do it.

Government can do it more efficiently. Well, if you believe that, you haven't

watched the last 50 years.

Yeah, the whole argument was that it would expand choice and companies would

a better job at controlling cost.

than the government. And look, some things are better when the private

involved. Take novelty slippers.

Only through competition in the free market, you get innovations like hairy

slippers, creepy Marg Simpson slippers, Sigmund Freud slippers, Danny DeFito

slippers, and golden penis slippers. And if you're wondering who the fuck would

buy those, you are looking at him right here. Now, why did I buy these? I don't

know. Probably because there's something deep -rooted in my psyche stemming from

my childhood, at least according to my Sigmund Freud flipper right here.

But sadly, sadly, the private sector hasn't done as well with Medicare as it

with flippers, because these plans have never saved the government money.

In fact, a report last year estimated Medicare Advantage had cost the

over the previous 18 years an extra £591 billion.

And this is partly down to the fact that major companies involved need to make

profits for their investors, and they have found ways to do that.

One concern is how they get paid, because in traditional Medicare, a

treats you and the government pays a fee for it. But in Medicare Advantage,

plans get a fixed payment from the government for each member they take on,

regardless of whether you get treatment or not.

based in large part on what illnesses you're listed as having, because

are entitled to extra money when their patients are diagnosed with conditions

that are costly to treat.

Here's a report from several years ago explaining how it basically works.

The insurance company uses what are known as diagnosis codes to report that

person's level of sickness to the government.

Well, they pay one rate for plain old diabetes, and then they pay another rate

for diabetes with complications.

If you write down in the file that the patient has diabetes and has

complications with eyesight or other things, they'll get paid a higher rate.

Right, and in theory, that makes sense. You want insurers to take care of sicker

patients. Unfortunately, a lot of things that sound good...

turn out to be terrible in practice, like overalls on adults, or drinking a

beerita, or buying a flight that leaves at 6am to save money. Oh, sure, seems

like a good idea until you're at the airport at four in the fucking morning,

hey, at least you got to your destination by 10am and can't check into

hotel for another five hours.

Aren't you glad you saved $35 on that ticket?

The same is true here because the government paying more for sicker

given insurers an incentive to identify as many health conditions as possible

for each enrollee and potentially to then gain the system.

They can find lots of ways to add big money diagnoses to patients' charts

through a practice known as up -coding. This happens a lot.

One investigation found that Medicare paid insurers about £50 billion over

years for diagnoses added just by insurers. Not only that...

Many diagnoses were added for which patients then received no treatment, and

often neither the patients nor their doctors had any idea. Which isn't great,

it? The whole point of a doctor is for them to diagnose you, or in my case, for

them to look at me, down at the chart, look at me again, back at the chart, and

then say, 48 years old?

Are we sure about that?

And while insurers will claim they're just being thorough, they've been

repeatedly accused of essentially pulling a Munchausen by paperwork.

In 2022, the Times found eight of the ten biggest Medicare Advantage insurers

had submitted inflated bills according to federal audits, and that four of the

five largest players had faced federal lawsuits alleging that efforts to over

-diagnose their customers had crossed the line into fraud.

And some have been accused of getting very sneaky to add patient codes. For

instance, many tout home visits with ads featuring happy seniors excitedly...

greeting healthcare workers at their door. Here's how United Healthcare

advertises theirs.

Remember the good old days when doctors made house calls? United Healthcare

offers their Medicare Advantage members an annual visit from a licensed

clinician in their own home at no extra cost.

Home visits may include a review of your medical history, a check of your vital

signs, and a chance to talk about your health concerns.

With house calls, being healthy starts at home.

Yeah, and you can see how attractive that is. Not least because the senior

a visitor. And you know how happy that makes them. The elderly love exactly

three things. Having guests, talking to guests, and then freaking out when that

guest sits in their fucking chair.

But an investigation found that in programmes like that one, companies push

nurses to run screening tests and add unusual diagnoses, turning the roughly

hour -long stops in patients' homes into an extra $1 ,800 per visit on average.

And while United will insist most of the conditions it's coded for in its House

Calls programme haven't raised payment, some very much have.

For instance, documents show its software would suggest the diagnosis of

secondary hyperaldosteronism, a condition in which levels of the hormone

aldosterone rise without requiring it be confirmed by a lab test.

United Healthcare apparently diagnosed that...

nearly a quarter million times after home visits, leading to $450 million in

government payments over just three years, even though a former house calls

nurse said, in a million years, I wouldn't have come up with a diagnosis

secondary hyperaldosteronism. And of course not. I didn't even know what

hyperaldosteronism was before working on this piece.

And to be honest, I still don't really know much about it.

Aside from the fact that you can rearrange the letters to spell modernist

horseplay, which...

Isn't nothing, but it does feel close to it.

I have to tell you, United Healthcare claims that report misrepresents House

Calls, which is just about supplementing doctors' visits and identifying gaps in

patient care. I presume that they're currently making that same argument to

DOJ's Criminal Healthcare Fraud Unit, which is investigating its Medicare

billing practices. And I wish them the very best of luck with that. But they

not the only company who face these sorts of accusations.

An insurer called Independent Health faced similar claims, including that a

woman in one of their Advantage plans was apparently...

Coded for prostate cancer.

Because, according to an internal email, when a married couple have any disease,

both were assigned to that disease.

Which is both ridiculous and also kind of romantic.

Do you, Tracy, promise to take Doug's diseases from tip to taint as long as

both shall live? I do. I really do.

Now, again.

I have to tell you, Independent Health did not admit liability, but they did

$98 million to settle that lawsuit. You know, the exact kind of thing you do

when you're not liable for something.

So at this point, I think it's pretty clear these plans aren't a particularly

good use of taxpayer money. But are they good for patients? Well, on the

surface, cheaper premiums sound appealing. And if you're relatively

these plans can seem like a more attractive option. Just listen to this

explaining why she and her husband picked one.

We are very active. I play pickleball twice a week. We have a big garden. We

have animals that we take care of. And so we're always doing something. And we

wanted to retire while we were still able to do things together.

And we like the Advantage Plan because it seemed to set our needs for that.

Right, and I get that that makes sense for her right now, because from the

minute I saw that woman, I knew she played pickleball. She didn't need to

me that, everything about her screams, I'll dink your kitchen, then cross

lob until we bagel, because je suis la pickle bitch.

And Medicare Advantage plans go out of their way to recruit people like her.

Many even offer perks like gym memberships, which can be

attractive to relatively healthy beneficiaries.

But... Once you get sick, you can find out your plan has a lot of limitations.

For example, under regular Medicare, you can go to any doctor or hospital that

takes it, which is most of them. But... With Medicare Advantage, as with most

private insurance, you can typically only use doctors in the plan's network

service area. And as those can change at any time, a doctor who is in network

when you sign up can quickly fall out of it. And that can be a big problem.

Consider this woman who had cancer and who qualified for Medicare due to

disability but signed up for a Medicare Advantage plan thinking that it would

save her money.

I went for my routine checkup. I'd been a Dana -Farber patient since 2013.

And I got a bill.

They're saying the provider's in network in the building, but the building of

Dana Fava is out of network, and I'm not allowed to go there anymore, even

though I'd been going there and had the same insurance.

So after all of these years, I have now moved my care to a different hospital

because I can't go there anymore.

That is absurd.

Her doctor was in network, but the building wasn't.

It's one of those things that makes your brain hurt if you think about it for

too long, like how gravity works, or why some people's bodies shit when they're

scared, or how Bill Belichick's daughter was 17 years old the year his

girlfriend was born. Some things are just too difficult for you to

But it can be genuinely hard to find someone in network on an advantage plan,

and even if its list of providers looks good on paper, it can quickly collapse

under the slightest inspection, as this man discovered.

Is that enough for the senior population here? No.

course it isn't. And finding out half your list is just grocery store

would be frustrating because everybody knows you don't go there for an

endocrinology appointment. You go there to check your blood pressure in the

machine that makes your arm feel like it's being squeezed by Paul Mescal's

thighs. That is a thing that we all do and that is not a one -off either one

review found the majority of medicare advantage organizations had between 30

60 inaccurate locations in their directories but even if you can find a

you may then have to deal with something called prior authorizations now you're

probably familiar with them from employer -sponsored plans well

medicare almost always pays for the care your doctor says you qualify for

Virtually all enrollees in Medicare Advantage are required to obtain prior

authorization for some services. While these plans are supposed to cover all

medically necessary services that original Medicare does, actually getting

approval can be a grueling process, as this doctor explains.

We have to call for a prior authorization, and we can't do it

actually have to call on the phone, the old -fashioned telephone.

We have to call an 800 number, some number, and then we have to...

give them all the data, we have to give them the insurance information, we have

to give them the patient's date of birth, things like that.

And then what they do is they give us then an authorization to fax them the

information.

So I've called them to get permission to fax them a request.

And then once they've got it, I've got to call them while they discuss the fax.

That's another barrier and obstacle to care that's incredibly time -consuming,

has no value added, and it seems antithetical to trying to get prior

authorization. What I really am getting is a prior authorization to get a prior

authorization. Yeah, and everything about that sounds like a nightmare,

including the presence of the words fax machine.

I thought we'd stopped making them around the same time that we stopped

good romantic comedies. In fact, I think the last time I saw a fax machine, a

frazzled Michelle Pfeiffer was getting horned up for George Clooney. Remember

that? Remember good romantic comedies? The kind of films that feel like a

blanket and make you leak from all your holes?

What happens to this country?

Anyway, as you might guess, Medicare Advantage providers partly or fully deny

millions of prior authorizations each year, and that can be maddening for

who need care. Take what happened to Gary Bent. He had significant

from brain surgery, including being unable to stand or walk on his own. His

doctors said he needed a lengthy stay at a highly skilled rehab center. Now,

under traditional Medicare, that would have been covered, but... He had a

Medicare Advantage plan from United Healthcare, which only approved him for

few weeks at a short -term rehab facility.

And Gary's wife and daughter remember the advice they got from his care team

about trying to appeal United's decision.

They told me I would probably win one or two, maybe even three.

But then the speed with which these denials came would increase. They would

be fewer and fewer days apart and eventually I was going to lose.

We felt like this process was designed to wear us out and I would say it did

wear us out. Yeah.

And that's exactly what happened. They won two appeals, then lost a third after

an external reviewer sided with the company. While United Healthcare insists

was just following Medicare guidelines, Gary was sent home before his family

felt he was ready, with, by the way, a fever and neck pain. And within 11 hours

of being discharged, he was rushed to the ER where he was diagnosed with

meningitis. And that was just one step in a quick decline towards him dying the

following winter. A decline that his wife says was made worse by the added

trauma of having to fight for the care he needed and was entitled to.

And there are some things so awful, it's almost impressive to be able to make

them worse. It's like seeing a Cybertruck with Diddy's face painted on

don't know how you manage to do it, but I like this even less.

And the thing is, delaying, underpaying, or denying care doesn't just hurt

patients, it hurts hospitals too, particularly those in rural areas,

they don't have the time or resources to think into constantly appealing

decisions which have had real consequences.

This was once the geriatric psychiatry unit at Alliance Healthcare in Holly

Springs, Mississippi.

Now the hallways hollow and beds sitting empty.

This operating room only a few years ago was doing five or six procedures a day.

Now, zero.

Dr. Kenneth Williams is the CEO. He says the hospital can no longer afford the

unit, or any inpatient care for that matter.

All of this used to serve as people that really needed help, and now it's just

totally empty.

It's empty, it's gone, and it died the last few years with Medicare Advantage.

That is terrible.

Thanks to Medicare Advantage, that whole wing is now abandoned, and by the looks

of it, already haunted.

At any moment, it feels like Jigsaw's about to pop out with a realtor to just

check out the space.

And even hospitals which haven't had to close wings have stopped taking these

plans, with a 2023 survey finding nearly 20 % of health systems had stopped

accepting at least one Medicare Advantage plan that year alone. And if

thinking, well, you know what, that's okay.

If I get sick and I need a specialist, I'll just switch back to regular

Medicare. You may not be able to. Because remember, it has that 20 % gap.

that you need to cover. Now, when you first enrol, it's easy to buy a Medigap

plan to do that because they can't hold pre -existing conditions against you.

But in most states, once you've enrolled in a Medicare Advantage plan, Medigap

insurers are allowed to reject you based on them.

So as a practical matter, once a patient enters the Medicare Advantage system,

they typically can't afford to leave. Think of it like Scientology or a

chair. Easy to get in, very difficult to get out.

And when you take all this together, you get a system where the incentives are

clearly set up for insurance companies to make you look as sick as possible on

paper, while doing as little as possible to help you when you actually need it.

Now, the industry is going to dispute that.

They've even funded their own studies suggesting their plans actually save the

government money and deliver consistently better health outcomes than

traditional Medicare. Though, when Stat News asked more than a dozen leading

health policy experts to review a bunch of those studies, they found they had

fundamental flaws and obvious biases, and on the whole were so skewed, they

basically constituted an alternate reality. And look.

If these companies are living in such a dangerous fantasy world, they clearly

need professional help. Luckily, I happen to know a board -certified

who can see them. But bad luck, he's out of network, so fuck you!

So what can we do here? Well, as I've said before, so many of these problems

would go away if we had single -payer healthcare. And we could get closer to

that by making regular Medicare more expansive and easier to navigate, and

getting rid of that 20 % gap in coverage. But until then...

We should at the very least be calling Medicare Advantage by a different name,

and ideally one without the term Medicare anywhere near it, because as

seen, they're just not the same.

It's like the difference between a flashlight and a fleshlight.

Sure, they might sound similar, but they do drastically different things.

Unfortunately, though, it is tough to talk about potential reforms right now,

given who is in charge of Medicare currently, because in case you've

it is this fucking guy.

22 across, 8 letters, starts with M.

A government entity dedicated to the health of seniors.

Memorize!

It's Medicare.

Memorize, Fitz.

It's Medicare.

So guess what? I work for you now.

Yep, they put me in charge of Medicare. Now how cool is that?

Not cool!

Not cool at all!

And it is just wild to see someone who's been on TV for two decades give the

single worst line reading I've ever seen. And remember, we just watched

two go to town.

One of the many reasons it's not cool is that Dr. Ross not only promoted

Medicare Advantage in sponsored segments on his TV show, he once co -wrote an op

-ed titled Medicare Advantage for All Can Save Our Healthcare System,

suggesting that we roll it out for everyone.

And while he's recently acknowledged some of the problems that I've

he's also said the administration wants to give insurers an opportunity to

voluntarily fix them, which I would say is the most ridiculous thing that he has

ever said, except he did once do this.

So that's what you call a camel toe.

Can I actually show you what camel toes look like?

Of course.

Here's a picture of what a real camel toe looks like.

Television was a bad idea.

So, look, at the policy level, for now, we are kind of fucked.

But in the meantime, if you or someone you know is considering one of these

plans first...

If you can afford to buy a Medigap plan and enrol in traditional Medicare, you

should do that. But if you can't, you should at least understand the potential

drawbacks of Medicare Advantage. And whatever you do, do not call those

numbers on TV because they won't give you unbiased advice.

They get much higher commissions if they funnel you to advantage plans.

So if you want independent advice, you can call your state health insurance

assistance programs. You can find your state's number at this website.

And what I know, it is basically impossible to escape these ads right

thought the least we could do is provide one for you that is technically

accurate.

Al, did you make the call?

What call?

Mr. Feldman said we may be able to get additional benefits with Medicare

Advantage right here in our own zip code.

Our zip code?

Yeah, the zip code we live in. It covers the 8 .6 square miles of our

neighborhood. Yeah, I know what a zip code is. But, honey, we already have

Medicare, so we don't need to call anyone.

Al, do you listen?

I said Medicare.

Advantage. It has all the letters of the word Medicare, but none of the actual

Medicare. Wait a minute.

It's not regular Medicare? No.

That's why we need to call.

The Feldman's said their Medicare Advantage plan has dirt cheap premiums.

you say dirt cheap?

Yes, Al. Of course I did. What is wrong with you today?

With Medicare Advantage, you'll get free term memberships, a grocery allowance,

and a... The nurse will come to our house.

For a threesome?

Oh, you'd love that, wouldn't you, Al? No, not for a threesome. The nurse will

come to our house so that she or he can diagnose us with a bunch of diseases

that we don't have.

Doctors don't even know anything about.

But what about conditions I actually have, like my diabetes?

Not only will they cover it, but I will suddenly have diabetes, too.

Why? Because it's romantic, Al. Kiss me.

Hold on.

What? Do we at least get to keep our doctors?

Well, we get to choose from a list of doctors, but they're mostly just...

grocery stores, local middle schools, a JCPenney, and an abandoned Chuck E.

Cheese. Did you say Chuck E. Cheese?

And if you find a doctor that's covered well, you'd better hope that the

building that he or she works in is too.

Otherwise, you might be getting your prostate checked out in the parking lot

not in the front way. This is starting to sound like a bad idea.

No. No, it isn't. I want a Medicare Advantage plan.

Plus, the premiums are so low.

Just think of all the money we could save. Sure, the care might be worse, but

that's okay, because we're not sick right now in this very moment.

But what if we get sick later?

Well, then we're fucked, Al. But that's a later problem.

Right now, we're active. You golf, and I play pickleball with Paul Feldman twice

a week.

Didn't I play pickleball with Paul Feldman?

Oh, yeah. I've been playing with Paul for years.

He is great.

In fact, I think I'm in love with him.

Wait, did you say you're in love with him? Yes, Al. He fucks like a Toyota and

loves like a Subaru.

Now, please, call the number and get us a doctor so that he can treat our

herpes. Herpes?

Is that one of these fake diagnoses?

No, Al.

We both have herpes now.

Don't call this or any other number on your screen.

Medicare Advantage is not traditional Medicare.

It's administered by private insurance.

Your doctor may or may not be covered. And if you or your wife is playing

pickleball with Paul Feldman, seek medical attention immediately because

have herpes now. Paul Feldman gave you both herpes.

That's our show. Thanks so much for watching. We'll see you next week. Good

night.

Dirt cheap premium.

Dirt cheap premiums. Dirt cheap premiums. Dirt cheap premiums.

Dirt cheap premiums.