Medping today history.
The statements of Robert F. Kennedy Jr. before the Senate Committee Finance Wednesday revealed a lack of knowledge concerning the main health programs he supervises, if he was confirmed as secretary of the HHS.
On several occasions during the 3.5-hour hearing, Kennedy seemed to confuse health insurance, Medicaid and Medicare, and seemed wrongly to refer to the health exchanges of the affordable care law.
“Medicaid does not work for the Americans, and this does not work specifically for the target population,” he said in response to the questions of Senator Bill Cassidy, MD (R-La.), A doctor, who asked him how he would improve the health care service system.
“I am on Medicare Advantage and I am very satisfied,” replied Kennedy. “Most people who are on Medicaid are not satisfied. The bonuses are too high, the franchises are too high, the networks are narrow.”
In fact, Medicaid plans generally have no bonuses, or if they do, under federal law, they must be kept low depending on the income.
Questioned by Cassidy what reforms he would offer, Kennedy replied: “Well, I have no proposal to dismantle the program.” Later, he gave vague answers to Cassidy’s question on how he would improve the double eligible programs, some 12 million beneficiaries – often with complex health problems – who are eligible for Medicare but because of their low income, are also eligible for Medicaid.
“Well, the two eligibles are not very well served in the system,” replied Kennedy. “And you know, I suppose that my answer is to make sure that the programs are consolidated, they are integrated and that the care is integrated. I can’t wait to work with you, Dr. Cassidy, to make sure we take good care of people.”
Cassidy then asked how he had proposed to integrate the programs. “Is Medicare more? Medicare could less? Medicaid could more? Medicaid country less? How do we do that?”
“I’m not exactly sure, because I’m not in it. I mean, it’s hard to integrate them …” he replied, finally saying: “I don’t know the answer to that. I can’t wait to explore the options.”
Kennedy also said that Medicare beneficiaries “prefer to be on a Medicare advantage because he offers very good services. People cannot afford it. It is much more expensive.”
In fact, the beneficiaries of the MA plan generally do not pay bonuses or very low bonuses and choose their plans due to low or non -existent initial costs. However, it is true that the plans generally cost me much more to the trust fund than if the same beneficiaries were in traditional health insurance – 82 billion dollars more in 2023 according to the Medicare Payment Advisory Commission.
At another time, Kennedy declared that Medicaid is “entirely paid by the federal government”, while in fact it is paid by a mixture of state and federal money, states contributing between 17% and 41% during the financial year 2023. It is an important concept to understand, because each Medicaid coverage program and the conditions of eligibility can vary enormously through the federal by HHS agencies.
The American Public Health Association (APHA) and the American Academy of Pediatrics (AAP) organized a joint media briefing on Wednesday after the hearing, questioning Kennedy’s ability to manage the agency, which has 13 distinct and important divisions, thousands of programs and 80,000 employees.
“… [H]He has shown that he did not have much health experience, and in many of his answers, we saw that he had a … shortage of experience in management, “said Georges Benjamin, MD, executive director of the APHA.
Benjamin noted that it is important that someone in this position is “rigorous on scientific evidence, and not the choice of cherries and to understand things like the financing of health care, that he really did not know the difference between Medicaid and health exchanges”.
“He talked about copaiaments and bonuses that are too high for Medicaid when Medicaid has no bonuses to start,” said Benjamin. In addition, “he made a statement that the NIH (National Institutes of Health) do not spend much money for chronic diseases, which is absolutely not true”.
Benjamin was questioned – given the number of Kennedy approvals – if at this stage of the process should be better informed of Medicare and Medicaid, and programs problems for two eligible.
“He didn’t understand any of this,” said Benjamin. “And you know, it’s not rocket science. … [HHS] Do a lot, but I said earlier that the nation spends 5 billions of dollars [on healthcare] And we are at the bottom of other industrialized nations in terms of health results. There are many reasons for this, but it’s not the guy to solve this problem because he really doesn’t know. He does not even understand the basics of what the department does. “”
Julie Sweetland, PHD, principal advisor at the Frameworks Institute, which conducts research on social issues and the language, said in the briefing that Kennedy had transmitted “some cases of disinformation”.
Several times, he has suggested “that most Americans are not satisfied with Medicaid, although some of his comments suggested that he was perhaps not clear about what Medicaid was. … In fact, we know that more than 8 registered on 10 positively assess the performance of Medicaid, according to a 2023 kff survey”.
Susan Kressly, MD, president of the AAP, was asked about Kennedy’s declaration to the Committee: “Most of the experts are suitable today, even people who did it at the time, Coids vaccines are inappropriate for 6 -year -old children who have essentially no risk of covid”.
Such remarks, as well as Kennedy’s often repeated opposition to other vaccinations – which he now denies – raises concerns that he would find ways to discourage vaccinations, perhaps by not requiring that they are covered as an essential advantage of health insurance or health plans.
Kressly said Kennedy was wrong because children can suffer complications for months worked after their recovery, she said. In addition, they “tend to be differences in infectious diseases because they are not very good at blowing their noses and keeping their germs”, which can affect their family members, schools and communities, she said.
“Covid is not something that does not affect children at all,” she said. “In fact, it has huge impacts.”
