Most veterans get their healthcare through the Veterans Affairs healthcare system or VA. But what if they have a Medicare Advantage program funded by the taxpayers as well?

Bruce Kitt is one of the Medicare Advantage industry’s most lucrative customers. The federal government pays his private Medicare Advantage insurer thousands of dollars a year to cover the cost of doctor visits, hospitalizations and other medical care that the 74-year-old retired aircraft mechanic might need.

But Kitt, an Air Force veteran who served in Thailand during the Vietnam War, gets almost all of his healthcare outside the Medicare system, through the Minneapolis VA Medical Center. The taxpayer-funded Department of Veterans Affairs health system provides low-cost or free care to Kitt and about nine million other qualifying veterans.

Mark Maremont, Christopher Weaver, and Tom McGinty expose this scandal in The Wall Street Journal.  They tell us Kitt’s Medicare Advantage insurer, an affiliate of CVS Health’s Aetna unit, pays for almost nothing other than a $100 monthly cash-like rebate to Kitt as an incentive to keep him on its rolls. The government paid the insurer at least $6,000 to cover him in 2022, the year he joined the plan.

“I don’t think I’ve used my Medicare in years,” said Kitt, who lives in Eden Prairie, Minn. When he needed some eye tests, the VA, not his Medicare Advantage plan, paid for him to go to an outside clinic. “I’m pretty happy with the VA,” he said. “I look at the Medicare plan as a backup.”

A Wall Street Journal analysis of Medicare and VA data found that Medicare Advantage insurers collected billions of dollars a year in premiums to provide medical coverage for about one million veterans like Kitt, even though they go to the VA for some or all of their healthcare needs. The analysis found the insurers paid far fewer medical bills for those veterans than for typical members. About one in five members of Medicare Advantage plans that enroll lots of veterans didn’t use a single Medicare service in 2021, the Journal found. That compares with 3.4% of members of other Medicare Advantage plans.

The federal government paid insurers an estimated $44 billion from 2018 through 2021 to cover Medicare Advantage-plan members who were also users of VA services, based on average payments for all members of those plans. The VA spent $46 billion on the same group’s medical care, according to VA data reviewed by the Journal. The figures exclude pharmacy costs, which many Medicare Advantage plans focused on veterans don’t cover.

Under the decades-old law that created Medicare, the VA can’t bill Medicare Advantage insurers for services it provides their members. The result is that the federal government sometimes effectively pays twice to cover the health needs of veterans—once in premiums for their Medicare Advantage insurers, then again for the VA to provide actual healthcare services.

The VA encourages veterans to sign up for some form of Medicare, even if they have access to VA health, in part because Medicare gives them the choice of going to a non-VA doctor or hospital. Medicare Advantage plans are attractive to many veterans because they offer perks that go beyond what Medicare requires, ranging from the dental benefits to gym memberships.

Medicare Advantage, the privatized form of the federal health program for seniors and disabled people, was expanded about two decades ago in an effort to deliver care more efficiently. The insurers get paid a lump sum every month to cover members’ healthcare, with higher payments for patients diagnosed with more serious health conditions. The private plans now cover more than half of Medicare recipients. The program has proved popular, but also has cost taxpayers far more than traditional Medicare coverage, according to the Medicare Payment Advisory Commission, a congressional agency. One reason for this I discussed in a series of earlier posts, Home Nursing Visits Bilking Medicare for Billions – Parts I and II.

In a rare case of political irony, President-elect Trump has just named Dr. Jay Bhattacharya of Stanford University to head the National Institutes of Health (NIH). After nearly five years of disparaging scientists who disagreed with the policy of Covid lockdowns, the true scientists have emerged.

Allysia Finley, writing for The Wall Street Journal, calls it “the revenge of the Covid lockdown skeptics.” Francis Collins, the NIH chief between 2009-21, derided Dr. Bhattacharya as a “fringe” scientist for urging the government to focus on protecting the vulnerable while letting others go about their lives. Dr. Bhattacharya, Martin Kulldorff, then at Harvard, and Oxford’s Sunetra Gupta formally expounded this idea in the Great Barrington Declaration in October 2020.

It was far from fringe. Tens of thousands of doctors and scientists around the world signed the document. Before the Covid pandemic, the World Health Organization had opposed lockdowns to control disease outbreaks. Yet after the declaration’s publication, Dr. Collins urged a “quick and devastating published take down of its premises” in an email to Anthony Fauci. I was one of those doctors who signed that document.

In a Washington Post interview, Dr. Collins decried the declaration as a “fringe component of epidemiology.” “This is not mainstream science,” he added. “It’s dangerous” and “fits into the political views of certain parts of our confused political establishment.” Dr. Collins had it backward. We all now know this is true.

Lockdowns endangered democracy, the economy and children’s learning. The confused public-health establishment nonetheless embraced them. Mr. Trump initially went along but reversed course after Scott Atlas, a Covid adviser, arranged for Dr. Bhattacharya and other lockdown critics to educate Mr. Trump about the damage. Mr. Trump proved more open-minded than the mainstream experts, who continue to insist that lockdowns and school closings saved lives despite the evidence to the contrary. Such small-minded zealots again showed their authoritarian side by pressuring social-media companies to suppress lockdown contrarians.

Twitter blacklisted Dr. Bhattacharya in 2021 after he tweeted an article he had written on age-based risks, noting that “mass testing is lockdown by stealth.” He was right. Many school districts later dropped their mandatory Covid testing policies because so many kids with mild or no symptoms were forced to stay home.

Finley tells us Dr. Bhattacharya didn’t deliberately court controversy. People who know him describe him as apolitical and unassuming. Over two decades in academia, he published dozens of wonky papers, such as “Provider visit frequency and vascular access interventions in hemodialysis” and “Heterogeneity in healthy aging.”

Two relate to the NIH and help explain the public-health establishment’s lockstep support for lockdowns. Scientists respond to incentives as much as anyone, and they have a strong incentive to follow public-health leaders if they want to advance professionally and win government grants. These incentives evidently can influence scientific judgment.

In a 2018 working paper published by the National Bureau of Economic Research, Dr. Bhattacharya raised the question: “Does the NIH fund edge science?” The answer is yes, though less so than in the past. Dr. Bhattacharya found that the NIH increasingly funds researchers who seek to build on more-established ideas rather than those pursuing novel ones.

In a February 2020 paper, Dr. Bhattacharya analyzed why pharmaceutical advances are slowing. The phenomenon has been called Eroom’s law, a reverse spelling of Moore’s law, which observes an acceleration in computer-chip advancements over time. Dr. Bhattacharya concluded that career incentives encouraged “me-too research.” Citations by other scientists “have become the dominant way to evaluate scientific contributions and scientists.” That in turn has shifted research “toward incremental science and away from exploratory projects that are more likely to fail, but which are the fuel for future breakthroughs.”

Might similar incentives explain conformist behavior during Covid? A young scientist without a secure job might have been reluctant to contradict Drs. Collins and Fauci, lest doing so jeopardize NIH funding for her research. Scientific journals rarely published Covid studies with conclusions that ran against the grain. Research echoing the public-health orthodoxy yielded more citations in the press and journals.

Dr. Bhattacharya’s top charge at the NIH will be returning the agency to its original mission of funding innovation rather than political science masquerading as real science. It’s about time the real scientists were in charge; not just those who want to play the system. Too many lives are depending on our scientists to get it right.

Happy Thanksgiving!

In the United States, about one in ten people have diabetes. About 90-95% of those people have Type 2 Diabetes, which means they develop it later in life rather than as children, who are considered Type 1 Diabetics. According to the National Institutes of Health, that amounts to about 38.4 million Americans with Type 2 Diabetes.

That’s a lot of people! But now there is good news for these people. Huey Freeman, writing for The Epoch Times, tells us there is new information that suggests a low carbohydrate diet can make a real difference in their lives.

Freeman says, “Type 2 diabetes patients who went on a low-carbohydrate diet saw their insulin production double, potentially eliminating their need for medication, according to a new study published on October 22 in The Journal of Clinical Endocrinology & Metabolism.”

Type 2 diabetes occurs when insulin-producing pancreatic beta cells become less effective. Insulin is needed to regulate blood sugar levels, and when there is not enough being produced, blood sugar levels rise, causing various diseases linked to Type 2 diabetes.

No conventional drug for Type 2 diabetes has been shown to improve beta cells’ immediate insulin secretion. Beta cell function usually declines despite treatment with anti-hyperglycemic agents, the researchers wrote in the study.

“This study shows people with type 2 diabetes on a low-carbohydrate diet can recover their beta-cells, an outcome that cannot be achieved with medication,” Barbara Gower, lead author and professor of nutritional science at the University of Alabama–Birmingham, said in a statement. “People with mild type 2 diabetes who reduce their carbohydrate intake may be able to discontinue medication and enjoy eating meals and snacks that are higher in protein and meet their energy needs.”

Carbohydrates are converted into sugars in the liver. That means a high carbohydrate diet produces more sugar which increases the burden on the pancreas to produce insulin to regulate the levels of sugar in the blood. A low-carb diet reduces the demand on the pancreas to produce insulin, which is in low supply in diabetics.

Insulin Production Doubled

Researchers conducted a randomized clinical trial with 57 Type 2 diabetes patients who weren’t using insulin treatments. The trial was designed to determine whether a change in diet alone would affect the beta cell function in people with Type 2 diabetes.

After discontinuing participants’ medications for one to two weeks, researchers divided participants into two groups: a low-carb group eating 9 percent carbohydrates and 65 percent fat and a high-carb group eating 55 percent carbohydrates and 20 percent fat.

After 12 weeks, participants whose diet was low in carbohydrates experienced a twofold increase in activity in the insulin-producing cells. Those served the higher-carbohydrate meals had a 32 percent increase in beta cell activity.

The researchers concluded that a carbohydrate-restricted diet “has beneficial effects on [beta cell] function in patients with mild [Type 2 diabetes]. ”The new research could be very beneficial for diabetes patients, Dr. Jason Fung, a physician and the author of “The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally,” told The Epoch Times.

“People with Type 2 diabetes need to know that a dietary intervention, reducing carbohydrates, has the potential to reverse their disease without the need for medication,” Fung wrote in an email. While medication can help manage Type 2 diabetes, it cannot reverse the condition on its own, as it does not address its root cause: diet, according to Fung.

Improved Beta Cell Activity May Halt Diabetes Progression

Beta cells’ insulin secretion immediately after meals, known as first-phase secretion, is important in removing excess glucose from the blood.

The researchers noted that inadequate first-phase secretion leads to high blood sugar levels, which initiates the development of Type 2 diabetes. The study showed that low-carb dietary interventions could increase beta cell activity, suggesting that this dietary approach may be able to stop diabetes before it takes hold. “This result reinforces the results of many other studies that showed the same thing: that reducing carbohydrates could reverse Type 2 diabetes,” Fung said.

This is great news for diabetics and for older adults who may yet develop diabetes. This should be very comforting as you prepare to celebrate Thanksgiving!