politics

Dr. Oz Shilled for an Alternative to Medicare

Trump’s pick to oversee the program is a hype man for private-sector competition.

Photo: Ahmet Serdar Eser/Anadolu/Getty Images
Photo: Ahmet Serdar Eser/Anadolu/Getty Images

In August, Dr. Mehmet Oz’s official YouTube account posted a video titled “Get $0/Month Medicare Coverage: What You Need to Know,” in which Oz lays a sales pitch on his viewers. “Which of these items can you get for zero dollars?” he says, pointing to images of a coffee cup, a pack of gum, and a newspaper, as if quizzing a toddler on the pictures in a children’s book. “Or how about a health-insurance plan?” he says. If you’ve ever watched daytime television, you know how the next part goes: Oz reveals he was, indeed, talking about the health-insurance plan, and the studio audience erupts into applause. He then brings out an insurance agent to paint a rosy portrait of Medicare Advantage before ending with a call to action, encouraging any seniors in the audience to call into a special phone number or visit a website to learn more and enroll.

In selecting Oz to head the Centers for Medicare and Medicaid Services, Donald Trump has landed on a prominent hype man for Medicare Advantage, the privately run alternative to government health insurance for senior citizens. (While Trump himself hasn’t offered up many specifics on health-care policy beyond wanting to cut “waste and fraud,” right-wing think tanks have long viewed Medicare Advantage as a cost-cutting solution to the perceived bloat of CMS. Medicare alone accounts for about $1 trillion in annual federal spending.) During his failed bid for a Pennsylvania Senate seat in 2022, the former heart surgeon turned TV host touted his vision of “Medicare Advantage for All,” inviting scrutiny into his financial disclosures, which showed that he owned $600,000 worth of stock in two of the largest Medicare Advantage providers (UnitedHealth Group and CVS/Aetna), not to mention about $8 million in other investments across the health-care sector. While Oz’s possible ascension to one of the most influential posts in American health care has prompted renewed focus on those investments, his ties to Medicare Advantage go deeper than that — extending back to promotional spots on his TV show paid for by one of the sketchier players in the business.

The video is taken from a 2019 segment of Oz’s now-defunct TV show, The Dr. Oz Show, though nothing in its YouTube description clarifies that, and it was posted to Oz’s account not long before the 2024 Medicare Advantage open-enrollment window began this October. It’s one of several promotional spots Oz has filmed in support of TZ Insurance Solutions, LLC, an insurance broker that runs the websites MedicareAdvantage.com and MedicareSupplement.com, among others. Yet another Dr. Oz Show segment promoting Medicare Advantage is featured on the “About Us” page of one of the websites, alongside promos made by other TV doctors. (A spokesperson for TZ Insurance Solutions denies that the company had any direct business relationship with Oz, and instead contracted with Sony Pictures Television.) Charitably, one could imagine that Oz truly believes in the products he’s pushing, though even a quick glance reveals TZ Insurance Solutions to be an aggressive telemarketing firm that repeatedly calls old people in an effort to get them to switch insurance plans — at which point the firm collects a fee from the insurer. (The company’s spokesperson denied that it engages in this “kind of conduct.”)

“They call me every day using different numbers! … Sometimes at least 40 calls a day! I just want it to stop!” reads a typical complaint on the Better Business Bureau page for TZ Insurance Solutions. Others are grimmer, with one complainant alleging the company repeatedly called their 86-year-old father — who has dementia and lives in an assisted-living facility — until he consented to switching insurance plans, despite having had the same coverage for two decades. On another complaint board filled with one-star reviews, someone made a similar claim, saying their 91-year-old father with Alzheimer’s had to change doctors after he was talked into switching plans. The legality of these alleged calls is an open question, depending on a few factors. Medicare regulates how Advantage plans can be marketed, including a stipulation that marketers can’t call unless “you’re already a member of the plan or you’ve given them permission to contact you.” In at least one instance, TZ Insurance Solutions allegedly found a way around that.

In early 2020, Florida resident Heather Gaker’s name was entered into an online “Super Sweepstakes” for $50,000. (She claims to not remember entering it herself.) Carefully hidden in the fine print beneath the “Confirm Your Entry” button was a notice that entering in the competition meant agreeing to phone calls from “marketing partners.” Shortly thereafter, Gaker was inundated with phone calls from TZ Insurance Solutions and an entity called Final Expense Assistant, which repeatedly tried to sell her burial insurance — something Gaker found to be unsettling. She filed a class-action lawsuit and eventually won a judgment, though the companies declined to make any admission of guilt. Back in 2013, a separate lawsuit against TZ Insurance Solutions from a former employee alleged that co-workers were e-signing insurance agreements on behalf of potential customers without their knowledge.

This all adds up to a less-than-stellar reputation for the company, but it obviously wasn’t enough to stop Oz from shilling for it. Nor did it deter the private-equity firm GTCR from buying TZ Insurance Solutions’ parent company, Tranzact, in October. Private-equity firms have invested heavily in Medicare Advantage brokerages and marketing, specifically, finding it to be an easy way to profit off the ever-growing program, which accounts for over half of all Medicare enrollees — 32.8 million of them — and $462 billion in federal Medicare spending. And while marketing for these plans is regulated, it’s still marketing, meaning it emphasizes perks like dental insurance and gym memberships while failing to mention the downsides of Medicare Advantage, such as restricted care networks and cumbersome prior-authorization requirements that delay and deny care to patients.

As head of CMS, Oz would run a massive bureaucracy that oversees health-care programs for around 150 million Americans through Medicare, Medicaid, and the Children’s Health Insurance Program. (Since it falls under the Department of Health and Human Services, he could also find himself reporting to Robert F. Kennedy Jr.) In his role, Oz would have leeway to make major changes to Medicaid, the safety-net insurance program covering low-income Americans, which conservatives hope to crack down on through methods like adding work requirements. It’s unclear just how drastically Oz could bolster Medicare Advantage, though he will have significant influence over government reimbursements paid to the plans. However, he would also arrive at a delicate moment in the program’s history — Advantage plans may have more enrollees than ever, but hospitals are starting to walk away from their contracts with them, citing low payment rates and complicated prior-authorization processes. Oz’s role would be a complex one with countless competing considerations, which is why it typically goes to a seasoned technocrat and not a TV host with no experience working in government.

As Oz awaits Senate confirmation, he’ll face scrutiny over any number of dubious schemes from his long career, be it his promotion of bogus weight-loss supplements or his backing of hydroxychloroquine as a treatment for COVID-19. (Surprise: He owned stock in a supplier of the drug.) As of now, it’s unclear to what degree Oz is financially entangled with Medicare Advantage — a spokesperson says he intends to release updated financial disclosures. But if he’s confirmed for the job and advocates for the program on the grounds of slashing federal spending, it’d be but one more tall tale: Medicare Advantage plans cost the government 6 percent more per enrollee than traditional Medicare does, and have a long record of overcharging the government through schemes like “upcoding,” in which they pretend a patient is sicker than they really are in order to secure bigger payments. (In 2022, Advantage plans upcoded their way to an additional $20.5 billion in taxpayer dollars.) Come to think of it, Medicare Advantage might just make a good target for Oz’s friends over in the Department of Government Efficiency.

Dr. Oz Shilled for an Alternative to Medicare