Category: Health

What’s wrong with “Medicare Advantage” plans?

At this time of year, ads hawking “Medicare Advantage” plans flood every possible media outlet, imploring seniors to call 1-800 numbers and contact their local insurance brokers for “free Medicare evaluations” where brokers can sign them up for Medicare Advantage (MA) plans, also called Part C plans, that offer premiums a bit lower than traditional Medicare and freebies like vision screenings, dental cleanings, gym memberships and a monthly allowance to spend on drugstore merchandise.
These plans definitely sound alluring, but don’t be fooled.
What seems like a good deal up front will likely be far more expensive in the long run because “Medicare Advantage” plans are not real Medicare plans. They are private insurance sold by for-profit insurance companies and they push subscribers into dealing with big bureaucracies that decide which doctors you can and can’t see, what care you can or can’t get, and that can deny you care for vague reasons if it isn’t in the companies’ best financial interests to pay for it.
In the words of my former colleague Wendell Potter, former Vice President of Corporate Communications for Cigna Health Insurance, who became an insurance whistleblower, “Medicare Advantage” plans are neither Medicare nor an advantage. They’re a scam to keep people locked in the private, for-profit health insurance market where companies can continue to exploit them for years, even decades, to generate profits.
What’s so bad about Medicare Advantage plans?

“Medicare Advantage” (MA) plans were introduced 25 years ago on the theory that competition in the private insurance market would result in better insurance and more efficiently-run plans. MA plans are funded by the government, which pays private insurers a set amount for every person they enroll. The amount varies based on how healthy subscribers are, and the government pays higher rates to private insurers for the sicker subscribers.
Insurers must spend 85% of the money they get from the government on patient care. The other 15% is pure profit, so insurers have a built-in incentive to deny coverage to preserve their profits. Enticing seniors into purchasing MA plans early by offering them lower premiums and freebies while they are younger and relatively healthy, generates more profits for insurers in the long run. But as MA subscribers age and need more medical care, they increasingly face getting denied by their insurer for treatments and procedures they may need. This can force MA subscribers to have to go without care, or pay out of pocket for more of their own medical care.
What you need to know:
“Medicare Advantage” plans are private insurance plans that use the name “Medicare” to generate trust among seniors. They are NOT real Medicare plans. If you buy a “Medicare Advantage” plan, you are paying a private insurer to become a gatekeeper between you and your medical care.

1-800 phone number television ad touting “free Medicare benefits review” to recruit Medicare Advantage subscribers
MA plans restrict subscribers to closed networks of doctors and hospitals, called Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). These networks typically are limited and restricted to local areas, and can potentially block subscribers from getting the best care for a given condition. For example, if you are diagnosed with a rare form of cancer that can only be treated at a specialized national medical center like Mayo Clinic, Memorial Sloan Kettering in New York, or MD Anderson Cancer Center in Texas, but this medical center isn’t in your network, your “Advantage” plan can refuse to pay for the care you need. If you have an accident or get sick while outside of the state, and seek care at an urgent care clinic or an emergency room nearby, you could get stuck with thousands of dollars in medical bills because the doctor and medical facility you used were outside your network and your MA plan won’t cover it. MA plans also require doctors get pre-approvals from insurers for many tests and treatments, and get pre-authorization for surgeries and procedures, so if you come down with a fast-moving illness that requires quick medical care, getting pre-approvals and pre-authorizations will needlessly delay your care and cost you precious time that could make a big difference in your medical outcome. Under MA plans, you usually need a referral to see a specialist. MA plans can also put people in the desperate position of having to battle an insurance company while they are sick or injured, to get the care they need.
Contrast this with original or “traditional” Medicare plans, which do not operate off a profit motive. Original Medicare is a government program. The only mandate original Medicare has ever had is to “help the nation’s elderly meet their hospital, medical, and other healthcare costs.”(pdf) Traditional Medicare subscribers can go to any doctor and any facility in the country that accepts Medicare assignment (payment). In most cases, you don’t need a referral to see a specialist. No pre-authorization or pre-approval is required for tests, treatments or procedures you need. Original Medicare has less hassles and headaches and pays it’s portion of the Medicare-approved costs for your care easily, and whenever and wherever you need care. After you pay the annual deductible for the year, which is in the $250 range, there are no further deductibles, copays or coinsurance to worry about.
Fraudulent billing and overcharging are pervasive
Another big problem with “Medicare Advantage” plans is that the corporate insurers that provide these plans have often engaged in fraudulent billing as a way to bilk the government out of more money.
Audits reveal Medicare Advantage plans typically overcharge the government by millions of dollars, at a rate of more than $1,000 per patient per year, on average. Often companies add fraudulent billing codes for conditions patients don’t actually have, like chronic obstructive pulmonary disease (COPD), diabetes or cardiovascular disease, to make subscribers appear sicker to the government so they can collect more money while not actually providing services. The costs to American taxpayers of this fraudulent billing have skyrocketed over the past decade as more seniors are coerced into signing up for “Medicare Advantage” plans. This fraudulent added expense is also hastening the demise of Medicare overall, since costs of the program have increased greatly due to these private insurers’ malfeasance.
In October, 2022, the New York Times reported that 9 of the 10 biggest Medicare Advantage plan providers in the country have been accused of billing fraud. The federal government has sued four of the five biggest players in the national health insurance market — UnitedHealth, Humana, Elevance (formerly Anthem) and Kaiser — for fraudulently over-diagnosing subscribers so they can fraudulently charge the government more money.
So what should you do?

Local TV ad seeks to get people who already have original Medicare to switch to a privately-owned Medicare Advantage plan, to the detriment of the subscriber
A 2021 survey found over half of people in America are confused by health insurance, so if you’re confused, you’re not alone.
Private insurers like customers who are confused or clueless, because it’s easier to manipulate a confused person into buying a plan that will benefit their company’s bottom line, but likely be detrimental to the subscriber in the long run.
Medicare Advantage plans are fraught with problems like denials of care, fraudulent billing, difficulty in getting pre-approvals and pre-authorizations for tests, treatments and procedures, copays and coinsurance. Medicare Advantage plans have been raking in record profits for private insurers while undermining original Medicare by unnecessarily raising program costs through rampant fraudulent billing. At the same time, private insurers are putting the most vulnerable subscribers at risk by denying them care and subjecting them to bureaucratic obstacles to try to keep them from getting necessary treatments and procedures, especially if they are expensive.
So when you sign up for Medicare, don’t be fooled.
Be sure to sign up for traditional, government-operated Medicare, which pays 80% of medical costs. Get a supplemental plan to cover the 20% the government doesn’t pay, and get a Plan D drug coverage plan. At all costs, DO NOT sign up for a “Plan C” or a “Medicare Advantage” plan. If you’re already on a Medicare Advantage plan and want to get out of it, you can switch to original Medicare during the open enrollment period that runs from October 15 to December 7 of each year. After you sign up, your original Medicare plan will take effect on January 1 of the coming year. See an insurance broker to make this change, but beware that brokers may still try to persuade you to keep a Medicare Advantage plan instead of original Medicare, because brokers often get paid higher commissioners for recruiting people into MA plans, or for keeping them in such plans.
Forgo the lure of the slightly lower premiums and freebies up front in favor of signing up for a traditional Medicare plan. Traditional Medicare puts beneficiaries’ best interests — and not profits — first. It will give you better, simpler coverage that will be easier to understand, that will be more reliable and that will make your medical care more affordable and less of a hassle in the long run.
If you have the time and want more information on why MA plans are bad, I suggest watching this 12 minute video (below) by a doctor that explains the problems with “Medicare Advantage” plans, and why people are better off avoiding them:
It’s well worth the time to watch it before you choose a plan. The doctor in the video talks fast and packs in a lot of information, but I guarantee you will understand everything he has written on the white board by the time he’s done.

Board of Public Health & county commissioners violated state public health law with their new intergovernmental agreement

Stephen D. Daniels, new Chair of the Mesa County Board of Public Health,  violated Colorado Title 25 by giving control over the health department’s budget to the elected county commissioners. No provision in the state public health law permits that.

When the Mesa County Commissioners had the Board of Health (BOH) sign their new Intergovernmental Agreement (IGA), the commissioners, County Attorney Todd Starr and all 7 members of the new BOH all either knowingly or unknowingly violated Colorado Revised Statute Title 25, Article 1, Part 5(k).

KREX TV explores how the County seized control over all of Mesa County Public Health Department’s contracts when it only contributes 4.2% of the agency’s budget

KREX reporter Michael Loggerwell’s story about Mesa County’s new Intergovernmental Agreement (IGA) with the Health Department- Part 1

KREX-TV News recently did a two-part series about the Mesa County Commissioners’ new, post-Jeff Kuhr Intergovernmental Agreement (IGA) that more tightly regulates the County’s relationship with the Public Health Department (MCPHD), and how it differs from the old 2012 agreement in important ways that could negatively affect public health and safety in the county.

CDPHE now says Vertex used an approved test for lead at the Ascent Classical Academy building; lead levels still in question

How much lead exposure does it take to poison a child? This much.

AnneLandmanBlog received the following email from Bradley Turpin, Milk and Institutions Program Manager in CDPHE’s Division of Environmental Health and Sustainability saying the company that performed the post-remediation testing for lead at the new Ascent Classical Academy building (the old Rocky Mountain Gun Club at 545 31 Road) did in fact use a test that they are allowed to use in this instance. He apologized for the confusion caused by their former statement that bulk testing would be appropriate in this situation. The official did not comment on the current lead levels in the building, but CDPHE does appear to be involved in overseeing the remediation.

Ascent Classical Academy used the wrong kind of post-remediation lead testing in the Rocky Mountain Gun Club building, according to CDPHE

How lead is dispersed at shooting ranges (Georgia Dept. of Public Health/Seattle Times)

The Vertex Company LLC of Denver, which Ascent Classical Academy hired to test the old Rocky Mountain Gun Club building for lead contamination after the building was remediated, did the wrong kind of testing, says an specialist with Colorado Department of Public Health and Environment (CDPHE).

Caren Johannes of CDPHE’s Hazardous Materials and Waste Management Division Compliance Unit, who oversees closed shooting ranges, looked over online remediation report (pdf) that Ascent posted its website on August 11, 2023, and concluded that the Vertex Company did the wrong kind of testing for lead in the building, so their results will not be valid.

Ascent Classical Academy’s lead remediation report shows 30 of 66 areas tested in their new school do not meet HUD requirements

How much lead exposure does it take to poison a child? This much. And so far no one has  guaranteed there isn’t this much lead remaining in the old Rocky Mountain Gun Club building, which is being repurposed to serve as Ascent Classical Academy’s new charter school in Grand Junction

Notice: Since this article was written, AnneLandmanBlog has found out from Colorado Department of Public Health and Environment (CDPHE)’s Hazardous Waste department expert in charge of dealing with closed firing ranges that Ascent contractor Vertex Companies of Denver utilized the wrong type of post-remediation testing technique for this facility, rendering the results in the report Ascent posted on August 11 invalid and essentially useless. Read more about it here.

The 8-page, post-lead remediation testing report that Ascent Classical Academy Grand Junction posted on its website August 11, 2023 (pdf) shows that 30 of the 66 sites tested for lead in the old Rocky Mountain Gun Club building at 545 31 Road, which is to serve as the new charter school, still have lead levels 5-23 times above HUD allowable limits.

And Ascent did not test the air inside the facility.

Derek Shuler, CEO of Ascent Classical Academies, in 2018 (Photo: YouTube)

The post-remediation testing was performed by the Vertex Company, which included a disclaimer in the report that essentially says it wasn’t feasible to test all areas of the building, so there may still be areas where lead dust levels exceed HUD limits.

Why we need to worry about County Commissioner Janet Rowland’s takeover of Mesa County Public Health Dept.

A Facebook post by Janet Rowland during her 2020 campaign. The Washington Times is owned by the Unification Church and is noted for spreading misinformation about Coronavirus, climate change, the harmful effects of secondhand smoke and other issues. As of May, 2023, there have been 1.13 million deaths from Covid in the U.S., a number far from “ridiculously low”

In the wake of Commissioner Janet Rowland’s recent coup over the Mesa County Public Health Department, if the the past is a predictor of future behavior, under Rowland the Health Department is likely in for a significant reduction in its ability to respond to public health threats, and area residents will likely face more danger from emerging health threats.

Ascent Classical Academy still has not provided proof to the public that their new school building is lead-free

UPDATE as of 8/11/2023, 4:00 p.m.Ascent Classical Academy updated it’s blog today with a link to a report (pdf) provided by remediation project manager, the Vertex Company. The actual remediation was performed by Hudspeth Environmental Remediation Company based in Centennial, whose website says they specialize in asbestos and lead paint removal. According to the chart provided in the report, many areas remain 5 to 23 times above HUD’s recommended lead clearance cleanup standard of <10 µ/sq.ft. (less than 10 micrograms per square foot). Among these are the men’s bathroom on the first floor, which had 71 µ/sq.ft,  the floor of the first floor “men’s restroom in the tactical area,” with 83 µ/sq.ft., the former “Handgun range – floor in NE corner” at 68 µ/sq.ft., “Handgun range – floor in middle by west wall” at 57 µ/sq.ft., the “Handgun range – center of floor in room south of handgun range,” which had 130 µ/sq.ft., the “Handgun range – floor in SE corner” at 98 µ/sq.ft. and “Handgun range – floor in room south of range” with 230 µ/sq.ft.

The “Discussion” part of the report states,

“As it is not feasible to sample all areas of all surfaces, the wipe sampling strategy utilized by VERTEX does not provide for, nor ensure that all surfaces within a subject property undergo wipe sampling; thus, the possibility exists that lead-in-dust concentrations on surface locations not sampled during an assessment may be in excess of HUD and/or CDPHE Regulation 19 cleanup standards.”

Translation:” It’s not feasible to test the whole property, so there may be lead concentrations in places we didn’t check that may be in excess of HUD and CDPHE’s cleanup standards.”

Ascent does not yet have a Certificate of Occupancy for the building.

The Ascent Classical Academy charter school is planning to move into the old Rocky Mountain Gun Club building at 545 31 Road, which formerly served as an indoor shooting range for 7 years. The inside of the building is currently being rebuilt and their website says the first day of school will be Tuesday, September 5, 2023, but to date, Ascent still hasn’t provided the public with documentation from a government health authority that their building poses no threat of lead poisoning to occupants, and they appear to be withholding information on the remediation status of the building.  [See above update.]

County teeing up new Public Health Board members to fire Dr. Jeff Kuhr as longtime Director of Mesa County Public Health Dept., despite being told there is “insufficient evidence” of wrongdoing

Jeff Kuhr won plaudits for helping Mesa County get through the Covid-19 pandemic.

If Mesa County Commissioner Janet Rowland gets her way, the new, temporary members recently intstalled on the Mesa County Board of Public Health (BOPH) will do the Commissioners’ bidding and fire longtime Mesa County Health Department Director Dr. Jeff Kuhr, even though there is insufficient evidence of any financial wrongdoing by Kuhr and even though a large majority of the local public thinks the county commissioners are engaging in a blatant overreach of their authority.

Mesa County Commissioners working to seize control of Mesa County Board of Public Health

MCPHD Director Jeff Kuhr, Ph.D. won plaudits for helping Mesa County get through the Covid-19 pandemic

Mesa County Public Health Department (MCPHD) Director Dr. Jeff Kuhr has been under attack by the Mesa County Commissioners, who for some reason have been working for months to generate credible reasons to fire him. Commissioner Janet Rowland in particular has targeted Kuhr, accusing him of financial impropriety and grievous errors in MCPHD’s procurement processes. The Commissioners have ordered the Mesa County Board of Public Health to fire Kuhr, but they refused, saying there is no actual evidence that he’s intentionally done anything wrong. Not only that, but the State of Colorado rates MCPHD as having the lowest possible financial risk (pdf) in its compliance with federal and state contracts, making it clear that the state trusts MCPHD, but our right wing commissioners don’t. (This financial risk rating is done every three years, but the state skipped it during the pandemic. The MCPHD is currently undergoing this analysis again.)

Ascent Classical Academy auctioning off fixtures from Rocky Mountain Gun Club

Ascent Classical Academy’s auction. There is no notification that these items were taken out of a lead-contaminated building

A classified ad in today’s Daily Sentinel gives notice that an auction is being held online to benefit the new Ascent Classical Academy charter school. All of the fixtures that were in the old Rocky Mountain Gun Club building, the building to be used to house the school, are being auctioned off to raise money for the school.

Since lead contamination is a well-known hazard at former shooting ranges due to the very fine lead dust thrown off by bullets when they are fired, the building is undergoing remediation for lead. All of the fixtures previously inside the building, including the HVAC system, cabinets, furniture, artwork, lumber and other items were also contaminated with lead.

Lead poisoning caused by exposure to lead can cause serious health problems, especially in young children.

Mesa County Commissioner Bobbie Daniel endorses fraudster Greg Haitz for City Council

Greg Haitz

Greg Haitz’s campaign sent out a mass email today, March 20, that appears to be from Mesa County Commissioner Bobbie Daniel, saying Daniel endorses him for a seat on Grand Junction City Council and asking people to send a minimum donation of $50 to his campaign.

If Commissioner Daniel actually endorses Haitz for Council, then she is endorsing someone who is openly perpetrating a fraud on Grand Junction citizens by selling a “dangerous” and “reckless” weight-loss program on his business website,

Bobbie Daniel (R), shown here with indicted former Mesa County Clerk Tina Peters

“Dangerous” and “reckless” are the words the U.S. Food and Drug Administration (FDA) uses to warn people about the type of weight loss program Haitz is currently promoting for $199 — a discount from his usual much higher price of $399, according to his website.

State Sen. Janice Rich (R) introduces bill to require CPR training in High Schools

Sen. Rich, shown here in 2022 when she was a House Representative, has a track record of introducing beneficial, bipartisan legislation and getting it passed. Here she is seen at the signing on April 12, 2022 of HB22-1040, “Homeowners’ Reasonable Access to Common Areas,” which limited homeowner associations’ (HOAs) ability to restrict homeowners’ access to their own common open space and amenities. (Left to right: House Rep. Edie Hooton, Rep. Janice Rich, Gov. Polis, Sen. Tammy Story)

State Senator Janice Rich (R) is doing something we haven’t seen in years from our elected state Senator: Introducing thoughtful, beneficial, bipartisan legislation that can benefit everyone.

Sen. Rich recently introduced SB23-023, a bill that requires high schools that teach the state’s comprehensive health education program to instruct students in how to perform cardiopulmonary resuscitation (CPR) and use an automated external defibrillator (AED).

The bill has the potential to save many lives.

Need help finding and paying for an abortion in Grand Junction? Contact Cobalt. They’ll help.

Cobalt Advocates and the Cobalt Abortion Fund are a terrific resources for anyone seeking an abortion on the western slope

If you live in Grand Junction, Mesa County or anywhere on the western slope, need an abortion and are having a hard time finding and/or affording one, your best resource and first stop should be Cobalt Advocates.

Cobalt believes nothing should come between you and your reproductive decisions, no matter who you are or where you live. Cobalt operates the Cobalt Abortion Fund, a dedicated abortion fund that helps people cover the cost of an abortion. They also help with the costs and logistics and other needs people often have when getting an abortion, like transportation and lodging. The Cobalt Abortion fund is 100% donor-funded, and is the only independent fund of its kind in Colorado. Cobalt’s goal is to make sure no one has to endure a a financial or logistic burden when it comes to abortion.

“Gold standard” medical study finds Ivermectin does not reduce risk of severe Covid-19

A large number of Mesa County residents harbor the mistaken belief that the anti-parasitic drug Ivermectin, used to de-worm horses and prevent heart worm in dogs, can treat Covid-19, even though the U.S. Food and Drug Administration (FDA) says this is not true.

The bogus idea that Ivermectin is effective against Covid was promoted locally by Grand Junction area chiropractors who spread medical misinformation about Covid-19, including one who urged people to buy livestock-strength Ivermectin and administer it to themselves as a Covid-preventative. Some local chiropractors spread medical misinformation and discouraged people from getting safe and effective vaccines against the disease as a way to help sell their own proprietary brand of supplements they claimed would prevent Covid-19. Members of the Mesa County Republican Party even introduced a resolution for their party’s platform to try to make Ivermectin an over-the-counter drug in Colorado.

After Ivermectin poisonings surged across the country in 2021 due to the spread of this dangerous misinformation, the FDA created an entire web page explaining why people should not use Ivermectin to try to prevent, treat or mitigate Covid-19.

Now there’s even more proof that using Ivermectin to treat Covid is pointless: A large-scale “gold standard” study on using Ivermectin to treat Covid was just published in the New England Journal of Medicine, and it concluded Ivermectin does not reduce the likelihood of hospitalization from Covid-19.

Open burning still a scourge in Mesa County in 2022

It’s a beautiful spring day in Mesa County, and once again the time of year when palls of thick smoke from open burning envelope entire neighborhoods, turning beautiful, fragrant, warm spring days into days of physical illness, suffering and despair for Grand Valley residents.

With the biggest medical center between Denver and Salt Lake and a wide variety of retirement housing, Grand Junction has long been an attractive area for retirees. But many people who settle here are unaware of the archaic open burning tradition here that exacerbates health problems and can pose an extraordinary health threat to sensitive people with illnesses like chronic obstructive pulmonary disease (COPD), asthma, bronchitis and those who use supplemental oxygen for lung and heart disease.

StopTheMandateGJ kicked off Facebook, starts new page, tries to evade another shutdown by using code words

The anti-vaccine group StopTheMandateGJ had its Facebook page shut down January 7th for violating Facebook’s Community standards after Facebook started cracking down on “vaccine misinformation superspreaders” last fall. The group was organized by local chiropractors Greg Haitz and Daniel Vaden of the Rimrock Wellness Center at 12th and Patterson Road, and for months spearheaded protests outside hospitals, getting groups of people to wave signs against getting vaccinated against Covid-19.

Greg Haitz

The group is trying to get re-established on Facebook again, though, and this time the page administrator tells users how to use code for words like “vaccine” and “jab” to avoid getting shut down again. The admins also tell users how to link to articles and web pages containing misinformation without the links being detected by Facebook:

Mesa County Commissioner Janet Rowland reports she suffered a stroke on 2/24, is doing well

Mesa County Commissioner Janet Rowland has reported on her personal Facebook page that on the evening of February 24 after getting home from work, she suffered a type of stroke called a subarachnoid hemorrhage. She recognized the signs, called 911 and was rushed to the emergency room. Serial CAT scans over the next 24 hours showed no additional bleeding.