Medicare Advantage Might Not Be a Boondoggle Anymore

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I’ve written periodically in this space about the problems with Medicare Advantage. In a nutshell, it costs a lot more but provides very little in the way of additional services. It’s really not much of a poster child for the benefits of program choice.

But wait! Apparently a big part of the problem with MA was the fact that people were allowed to switch in and out of their plans on a monthly basis. If they got sick, they could quickly switch into MA if that was a better deal for them. This obviously raised the cost of MA as sick people switched in to avoid the copays and other limitations of traditional Medicare.

However, that changed in the mid-2000s, when beneficiaries were required to choose a plan and stick with it for a full year. Austin Frakt provides the details of a new study:

By 2006-2007, health differences between beneficiaries in Medicare Advantage and those in traditional Medicare had narrowed….Also, in contrast to studies in the 1990s, more recent work finds that Medicare Advantage is superior to traditional Medicare on a variety of quality measures. For example, according to a paper in Health Affairs by John Ayanian and colleagues, women enrolled in a Medicare Advantage H.M.O. are more likely to receive mammography screenings; those with diabetes are more likely to receive blood sugar testing and retinal exams; and those with diabetes or cardiovascular disease are more likely to receive cholesterol testing.

That Health Affairs paper also found that H.M.O. enrollees are more likely to receive flu and pneumonia vaccinations and about as likely to rate their personal doctor and specialists highly.

So now things are a little murkier. MA still costs more than traditional Medicare, but only by 5-6 percent. And recent evidence suggests that MA beneficiaries might be getting enough additional benefit to justify that much extra money. It’s still not clear that MA is worthwhile, but it appears now to be at least worth further study.

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WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

“Great journalism really does make a difference in this world: it can even save kids.”

That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

Wow.

And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

If you can, please support the reporting you get from Mother Jones—that exists to make a difference, not a profit—with a donation of any amount today. We need more donations than normal to come in from this specific blurb to help close our funding gap before it gets any bigger.

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