By Matthew Holt

Scott Gottlieb, who passes for what the right call a health economist these days, has an opinion piece in the WSJ singing the praises of Medicare Advantage plans.

Anyone reading the article would think that Medicare Advantage plans provide better and cheaper care than the FFS program, showing the triumph of private enterprise over government welfare. And that’s why evil Democrats hate them so much.

Unbelievably, Gottlieb ignores the extra payments Medicare Advantage have received over the standard Medicare program since 2004. Even Karen Ignagni doesn’t do that any more. The AHIP crew has long changed its argument from “we do it better and cheaper” to “we help poor black and Hispanic seniors get better benefits, and the fact that we rake a ton off the top and the taxpayer gets screwed is just the cost of doing business, sorry!” But Gottleib is back in the dark ages. Is this really the best the right can do?

If you want to know the reality, a commenter on the WSJ Health Blog points out the truth.

113% – That’s how much Medicare Advantage plans are paid in
relation to traditional Medicare (says CBO and MedPAC). If they are so
efficient, pay them 95% of traditional Medicare (as it was when they
were first added) or at least 100%. Why do we keep up the charade? Comment by Michael

Meanwhile, over on his excellent blog Health Care Policy and Marketplace Review Bob Laszewski gives Gottleib a better reaming than I could (but is slightly more polite about it!).

By the way, the really interesting question is whether the Medicare
Advantage plans are doing any better now that there’s widespread risk
adjustment in the way they get paid (which is only phasing in in the
last 18 months or so) and also what the performance of the Medicare SNP
(special needs plans) seems to be. Those are the ones that get rewarded
for taking on the really sick, and their incentives seem to be to do it
better and cheaper. Of course, there’s no data yet.

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