All language subtitles for 1 1 Last.Week.Tonight.with.John.Oliver.S12E27.480p

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.