Medicare Advantage news conference

An advocate holds a sign during a news conference on Medicare Advantage plans in front of the U.S. Capitol on July 25, 2023 in Washington, D.C.

(Photo by Alex Wong/Getty Images)

US Agencies Urged to Tackle Medicare Advantage, Other 'Outrageous' Healthcare Greed

"There is much the Biden administration can and must do to address the national embarrassment that is for-profit healthcare in the U.S.," said Public Citizen's healthcare policy advocate.

The consumer advocacy group Public Citizen on Wednesday called on the U.S. Justice Department, Federal Trade Commission, and Department of Health and Human Services to do more to crack down on corporate profiteering that is further degrading the nation's healthcare system and driving up costs for patients.

In a letter to the three agencies, Public Citizen cited the growing encroachment of private equity firms and insurance company mergers as just two of many trends that the Biden administration must tackle as part of a broader effort to transform the nation's fragmented for-profit healthcare system.

"We need a rational approach to healthcare that would make patients' wellbeing the focus instead of profit," said Public Citizen, which supports transitioning to a single-payer healthcare system. "Cracking down on the worst actors is an important step as would be improving oversight of mergers as well as oversight of corporate actions."

The letter came in response to the three federal agencies' request for public comment on "consolidation in healthcare markets." In their request, the agencies expressed support for "robust competition in healthcare markets" and voiced concern that corporate mergers "may generate profits for those firms at the expense of patients' health, workers' safety, and affordable healthcare for patients and taxpayers."

Public Citizen echoed that concern in its letter, noting that "consolidation of actors in various parts of the healthcare system as well as increasing vertical integration, including insurers buying up provider groups, threatens to further increase corporate
profits at the expense of patients."

"Whether it's private equity, insurance companies, or Big Pharma, Americans deserve to have healthcare that puts patients first."

The group also pointed to Medicare Advantage as "one of the ripest sources for profit for insurers," noting that the privately run plans "delay and deny necessary care to seniors," "limit access to care," and overbill the federal government by making patients appear sicker than they are.

"All of these practices require the creation of significant oversight mechanisms by relevant agencies, which struggle to keep up with the innovations in grift that Medicare Advantage plans undertake year after year," Public Citizen's letter states.

Eagan Kemp, Public Citizen's healthcare policy advocate, said in a statement Wednesday that "private equity is swallowing up U.S. health care whole and putting the squeeze on patients" with the "sole aim" of raking in "outrageous profits."

"Whether it's private equity, insurance companies, or Big Pharma, Americans deserve to have healthcare that puts patients first," Kemp said. "The U.S. consistently lags behind other wealthy countries when it comes to the quality of our profit-based healthcare system. More consolidation will only make things worse."

"There is much the Biden administration can and must do to address the national embarrassment that is for-profit healthcare in the U.S.," he added, "and we appreciate this multi-agency effort to expose the problems associated with greed in healthcare."

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