Friday, November 22

Mehmet Oz once proposed massive changes to Medicare. Now he could run it.

Washington Incoming Senate Finance Committee Chair Mike Crapo, R-Idaho, immediately hailed the TV-famous doctor when President-elect Donald Trump appointed Dr. Mehmet Oz to a significant executive branch position managing Medicare and stated that he looked forward to reviewing his upcoming nomination.

According to Crapo, individuals who depend on federal government health care programs are far too frequently compelled to accept one-size-fits-all, bureaucratic coverage. Dr. Oz has been a supporter of giving patients the knowledge they need to make their own healthcare decisions.

It turns out that only four years ago, Oz, Trump’s choice to lead the Centers for Medicare and Medicaid Services, supported a health care plan that was essentially one-size-fits-all.

In June 2020, Oz and former Kaiser Permanente CEO George Halvorson co-wrote a Forbes article supporting a Medicare Advantage for All plan that called for enrolling all Americans not on Medicaid in Medicare Advantage, which uses private plans to cover enrollees, and doing away with employer-sponsored insurance and Affordable Care Act coverage. They suggested using a 20% payroll tax shared between companies and employees to pay for it.

According to Larry Levitt, executive vice president for health policy at the nonpartisan research group KFF, it’s ironic that this plan to offer universal coverage through private Medicare Advantage plans closely resembles Kamala Harris’ “Medicare for All” proposal from the 2020 campaign.

According to Levitt, the Harris scheme backfired on her politically. Republicans are unlikely to support a Medicare Advantage-for-all plan that calls for a significant tax hike and more people to be enrolled in government entitlement programs.

When Trump announced his decision to take over CMS, four years after Oz presented his Medicare Advantage for All plan, he made a vague promise that Oz would reduce fraud and waste in our nation’s most costly government agency.

Messages requesting response from Trump’s transition team representatives were not answered.

Although he hasn’t looked at the 2020 Medicare Advantage proposal, Sen. James Lankford, R-Okla., commended Oz for having done much research on these topics.

According to Lankford, we require a transformative individual. Where is he heading, we want to know? What is the viewpoint? He must, of course, respond to inquiries about his prior actions.

Oz’s evolution on Obamacare and Medicare

Trump claimed to have ideas for a plan to reform health care, but Oz’s changes on the subject left open the question of how a second Trump administration will achieve it.

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Oz would scarcely be a free agent in his role as CMS administrator; his job would be to implement Trump’s plan. However, Trump’s vagueness over health care may allow Oz to fill in the gaps.

Returning to the Obama administration, Oz gave Obamacare high marks for offering a safety net. In the latter stages of his 2024 campaign, Trump moderated his criticism of Obamacare, but he still demanded its replacement without providing an explanation.

When he ran for the Senate in 2022, Oz had opposed the Affordable Care Act and adopted a more moderate stance on health care that did not call for a revolution. On an AARP survey, Oz stated: We can increase the number of Medicare Advantage programs. Seniors favor these plans because they regularly offer high-quality care and have a necessary incentive to keep prices down.

Oz’s leadership of CMS has gravely alarmed some Democrats.

According to Sen. Patty Murray, D-Washington, a senior member of the Health, Education, Labor and Pensions Committee, there is no question that Dr. Oz and the Trump administration represent a serious threat to Medicare, Medicaid, and health coverage as we know it. Trump is infamous for driving up health care costs and destroying the Affordable Care Act whenever he could.

The position of CMS administrator is one of the most important in American healthcare, according to Senate Finance Committee Chair Ron Wyden, D-Ore., who will be a ranking member in January.

He stated that we will spend more than $4.5 trillion on American health care this year. Additionally, a large portion of it fits the type of frame he will be examining. I also have some serious inquiries.

Medicare Advantage changes on the horizon?

Oz might not have a difficult time if he is confirmed and decides to force more people into Medicare Advantage, as he has proposed. According to Tricia Neuman, executive director of the program on Medicare policy at KFF, enrollment has been rising consistently for a number of years, so in some respects Medicare is already headed toward privatization.

However, Oz would be treading carefully to avoid offending Medicare enrollees, according to Neuman: According to polls, older persons prefer having options when selecting coverage, even though Medicare Advantage has become more and more popular.

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According to Neuman, participants in our focus groups express satisfaction with both regular Medicare and Medicare Advantage, and they base their decisions on a variety of preferences.

According to Arthur Caplan, chairman of the medical ethics division at NYU Langone Medical Center in New York City, the push for private plans may also fail to address patients’ main concerns about the high cost of care.

About one in four older persons with Medicare reported delaying treatments, including as dental care, due to excessive prices, according to a 2022 research from the Commonwealth Fund, a health care think tank. For the same reason, a comparable percentage of people skipped follow-up appointments with physicians or specialist visits.

Republicans have long held the belief—which he shared when he ran for the Senate in Pennsylvania—that privatization is the answer to Medicare, but Caplan pointed out that this only removes a portion of the funds from the government coffers. It doesn’t actually address the unnecessary spending in Medicare. It doesn’t actually grant access, and the prices are excessive.

According to Wyden, Oz should anticipate inquiries concerning Medicare Advantage procedures such as prior authorization, which involve insurance companies assessing whether therapies are medically essential prior to their utilization. Seniors and other vulnerable people are becoming increasingly concerned that these insurance firms are using a variety of gimmicks to refuse coverage that they have paid for, according to Wyden.

According to Lankford, Medicare Advantage is not operating as intended because insurers are refusing claims or making late payments, and hospitals are becoming irate.

According to Sen. Mike Rounds, R-S.D., there is no such thing as an ideal health care plan.

He stated, “We start out giving the president the benefit of the doubt on nominees, but we’ll be able to ask him questions.”

How would Trump and Oz handle drug prices?

Another unanswered concern is how Trump would respond to the widely supported Democratic Inflation Reduction Act provision that gives Medicare the authority to negotiate prescription prices. The GOP uniformly voted against this proposal, which many Republicans denounce as price-fixing.

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According to Neuman, President-elect Trump has not made it clear during the campaign that he would support or attempt to reduce the Inflation Reduction Act’s negotiation provisions. What transpires with drug pricing in general and drug negotiations in particular is not entirely known.

Although it’s uncertain if the agency will be able to make the deadline so near to the inauguration, CMS has until February to choose the next 15 medications up for negotiation, according to Neuman.

Medicaid would probably also need to be addressed by Oz. Some Republicans believe that the government’s low-income assistance program may provide money to support Trump’s tax cut extension.

Many children and people with disabilities are enrolled in Medicaid, and if you delay coverage requirements, reduce eligibility for benefits, or simply leave it up to the states, you will have extremely restricted eligibility in poor areas like Alabama, Mississippi, and Arkansas, according to Caplan. Thus, it poses a serious risk of hurting those who are already at risk.

Democrat John Fetterman, who at the time questioned Oz’s commitment to defending safety net programs like Medicare and even said he would eliminate them, defeated him in the 2022 Senate election.

He now claims that he is amenable to speaking with Oz.

In an interview, Fetterman stated, “We’re going to have to hear what his answers are and then we’re going to go from there.” His views will be the same as those of Trump.

He will choose individuals with whom I will not agree, and they will never be my first choice. According to Fetterman, that is the general way that democracies operate. Even though it’s not Thanksgiving yet, I refuse to join in on the group panics.

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