Seniors for Sale!


Show Notes

Today we venture into the bizarro world of Medicare (the program serving those 65 and older as well as some people with disabilities) to explore the largest Medicare rate hike in history. Our guest Alex Lawson, the Executive Director of Social Security Works, will help explain what’s happening. Social Security Works is the convening member of the Strengthen Social Security Coalition, which represents over 50 million Americans. SSW fights to protect and expand Social Security, Medicare, Medicaid, and to lower prescription drug prices.

Today we venture into the bizarro world of Medicare (the program serving those 65 and older as well as some people with disabilities) to explore the largest Medicare rate hike in history. Our guest Alex Lawson, the Executive Director of Social Security Works, will help explain what’s happening. Social Security Works is the convening member of the Strengthen Social Security Coalition, which represents over 50 million Americans. SSW fights to protect and expand Social Security, Medicare, Medicaid, and to lower prescription drug prices.

Today we’re talking about the massive increases in Medicare Part B (physician and outpatient services) premiums for this year. Hospital care is called Part A, and once you’re eligible for Medicare you can get hospital coverage automatically. BUT for Part B, you have to pay a monthly premium – just like a private health insurance plan. There’s a super shady history behind this! 

The origins of the Part B premium go back to the Jim Crow era. When Medicare was first implemented, some in the South feared that Federal law would require the integration of physician offices. By requiring a premium, Part B would be a “voluntary” program and integration requirements wouldn’t apply. This allowed physician offices (as well as nursing homes) to remain segregated much longer than hospitals.

In 2022 Medicare Part B premium rose 14.5%, from $148.50 to $170.10 PER MONTH ($21+ increase), and the annual deductible rose from $203 to $233. For perspective, the Part B premium was less than $50 back in 2000, and there was only a $3.90 increase last year. This is the LARGEST premium price hike in Medicare history.

For most American seniors, those premiums are deducted right out of their Social Security checks. For an American senior who depends on Social Security benefits of an average of $19,000 a year, those increases mean a significant cut to their income. A senior living on an income 175% of the poverty level will spend nearly 9% of his/her income this year on Part B alone.

This comes down to Biogen’s new Alzheimer’s drug, Aduhelm. Regardless of the fact that this drug failed, Biogen put all their eggs in the Aduhelm basket. They corrupted the Food and Drug Administration (FDA) to get it approved, despite the fact there is no evidence it is effective and it can actually cause brain bleeds and death.

Aduhelm is so expensive that it accounts for at least 50% of the Part B premium increase.  

The drug itself initially cost $56,000(!) for one person; the price was slashed in half by Biogen because of low demand. The other costs associated with the treatment are charges for the infusion of the drug and charges for the regular brain scans that are required while taking the drug. Those brain scans are to monitor progress of the treatment, but also to make sure your brain isn’t swelling up, which is a side effect 35% of clinical trial participants experienced.

It’s estimated that only a small fraction of Medicare beneficiaries will use this drug, which, remember, doesn’t work. But to make more profits for Biogen, American seniors’ premiums went up more than they ever have.  

Right off the bat, the Veterans Administration declined to cover Aduhelm. Many private insurers are also limiting approval of Aduhelm. CMS – the Center for Medicare and Medicaid Services – usually follows the lead of the FDA, whose drug approval process is considered the gold standard. But this process was so out of bounds that CMS did something unprecedented: they declined to completely cover Aduhelm (only covering its use in clinical trials). However, at the same time they greenlit the premium hikes.

So after they declined to cover Aduhelm, they rolled back those increases right? Nope. Even though it would have been a political win and the right thing to do, CMS and the Department of Health and Human Services, left the premium hikes in place because it would have been too difficult to change the premiums in the middle of the year. (They have said they will take the 2022 rate hikes into account when setting 2023 premiums.)

While Aduhelm ultimately didn’t work out, Biogen created a play designed in a board room to rob the entire Medicare population, and every other drug company took notes. Expect to see more pharmaceutical companies threatening the same in the future.

The corporate corruption of the FDA led to a catestrophic failure to protect the public from harm (Aduhelm and brain bleeds, OxyContin and addiction and overdose deaths, and many other examples) and we can expect that they will waive through other unsafe drugs in the future.

So what would this process look like under Medicare for All? We’d have one public system that would evaluate data and negotiate drug prices. The whole system would be transformed and the problem would be eliminated. No other nation with a public healthcare system would have approved an Aduhelm.

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