Why It’s Dangerous To Get Sick In America

The U.S. health care system is cruel and dysfunctional. It’s also deeply corrupt. Below, we break down some of The Lever’s reporting on America’s extraordinarily complicated health care system — and the private interests and craven politicians who are profiting off misery.

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Medicare, the health insurance program providing single-payer care for senior citizens and people with disabilities, is being attacked from all sides. Despite its financial success and wide popularity, conservative politicians are increasingly emboldened to demand program cuts.

Profit-seeking private insurers are also taking advantage with an aptly named program: Medicare Advantage. Major insurance companies act as middlemen and find ways to cut services for patients so they can keep a growing portion of government payments for themselves. The Lever’s Matthew Cunningham-Cook reported last year that the largest-ever Medicare premium increase would pad the pockets of insurance executives who donated millions to the president’s election campaign.

Cunningham-Cook teamed up with Lever reporter Andrew Perez to reveal how Medicare Advantage’s private insurers are systematically overbilling the government and making their patients appear sicker than they really are. This scam has cost American taxpayers $20 billion since 2019, diverting dollars that would otherwise fund essential health care and the program’s financial stability.

Even Amazon is getting in on the frenzy. Cunningham-Cook reported that the megacorporation recently snapped up a small provider that’s been stealthily leading the charge to privatize what’s left of the traditional Medicare program. Previous reporting from Cunningham-Cook showed the Biden administration is expanding a Trump scheme that is forcing hundreds of thousands of seniors into for-profit health plans without their consent.

Medicare Advantage has a high price tag — and a staggering human cost. In his latest report, Cunningham-Cook speaks with patients who have had essential health care services denied by their Medicare Advantage insurers. These private plans are much more likely to wrongly deny claims or reject care options that are covered under traditional Medicare.

In nearly every state, once patients have opted for a Medicare Advantage plan, it’s almost impossible for them to return to traditional Medicare — essentially trapping them in the for-profit system.

Then there’s Medicaid, the government health insurance plan for low-income Americans. As Libby Watson reported for The Lever last year, the government regularly tosses people off this safety-net program for either exceeding income requirements or failing to file paperwork in a timely fashion. Such redeterminations stopped during the COVID-19 pandemic, transforming Medicaid into a far more expansive program.

Just as Medicaid enrollment reached an all-time high, Democrats allowed states to once again begin clearing out their Medicaid rolls. Andrew Perez recently documented the toll of this unfolding disaster: It’s estimated that as many as 24 million eligible Americans could now lose their health insurance — and so far, most of those losing coverage in states that are publicly reporting data on the matter are being terminated not because they exceed income requirements, but for arbitrary reasons like missing a piece of mail.

Those kicked off Medicaid coverage are then left to fend for themselves in the insurance-dominated exchanges, where costs can run high for poor-quality care. It’s little wonder, then, that when Lever reporter Nick Byron Campbell attended a recent industry conference for health insurance leaders last month, he witnessed Anthony Fauci deliver a speech about how the audience should keep doing what it’s doing to make health care affordable — only to be met with a room full of laughter.

All this corruption is making patients sick and CEOs very rich. Health insurance industry whistleblower Wendell Potter reported for us on how health insurance companies reported record profits and CEO pay last year. Health care executives' pay topped $335 million, while 100 million Americans were saddled with medical debt.

Luckily, there is something we can do to help fix our broken health care system. In our weekly roundup of good news, Lever fellow Keerti Gopal noted that Medicare for All, which would expand the government insurance system to cover all Americans, was recently reintroduced in the U.S. House of Representatives with a record number of cosponsors and a companion bill in the Senate.

Now, it’s up to organizations like ours to make sure that the dream of Medicare for All doesn’t fade into what David Sirota calls the political “memory hole.” Reform is still possible — and we’ll keep reporting until we get there.