Lying by Omission: is this legal everywhere?

A short thread on a similar topic from 2005, “Is this illegal? Lying by Omission” centered around Antiques Roadshow-type stories: finding a bargain at a yard sale and such. The consensus was that capitalism is about buying cheap and selling dear, and the buyer is not obligated to tell the seller what an item is really worth.

I’m wondering about something different.

In the USA the Medicaid Enrollment Period is in full swing and anyone who sees any television at all knows that a number of companies are trying to get seniors (who are eligible for Medicare) to sign up for their particular “Medicare Advantage/Medicare Part C” plans. Of course this is a highly lucrative business, or the companies would not be spending so much to advertise. Medicare Advantage is elected by more than half of the (in 2024) 67 million seniors and disabled people who are on Medicare. Advertising is a big reason for this. And it’s incredibly profitable: a $450-billion/year system that

*see below for a link to the WSJ 2024 article that’s the source for this quote. I regret I don’t have a subscription (so can’t offer a gift). But it’s well worth trying to find for anyone interested in the topic.

Companies were permitted to offer this product as something of a political compromise: Democrats wanted Medicare and Republicans wanted corporations to be able to make profits off Medicare. In 1997 Congress created Part C and it’s been exploding in growth ever since—because it is, again, so damned profitable.

The profits come from two main sources: money paid by the senior electing a plan (various out-of-pocket costs and plan premiums, etc.), and—mostly—the federal government. It pays these private companies a monthly amount per beneficiary, in order for the company to pay for medical services that would otherwise be covered directly by the government (for those who don’t elect an Advantage plan and instead retain “Original Medicare”). A big part of the treasure chest of cash that taxpayers hand the MA companies comes from denying care: “In 2019, Medicare Advantage Organizations denied 13% of prior authorization requests that would have been accepted if the beneficiaries were in original Medicare.” (See Wikipedia link below.)

An even larger portion of the taxpayer-supplied treasure chest comes from the fact that Medicare pays these companies a base rate for each person who elects MA—but adds onto that sum for diagnoses of particular conditions. Extra money goes to Humana and the other companies for chest pain, kidney disease, atrial fibrillation, etc,–diagnoses that double and triple the per-enrollee pile of money paid to the company. (The WSJ article goes into detail about the fakery surrounding diabetic cataracts, one of the most lucrative diagnoses:

Again: collect the cash; provide no treatment = major profit!

But the “lying by omission” I’m asking about isn’t so much the lying these companies do by failing to disclose, in their ads, that

Instead I’m wondering about the lying-by-omission involved in this part of the Medicare Advantage advertising:

Insurers promise benefits that are also available to those who elect Original Medicare over Medicare Advantage, strongly implying that the only way to get these benefits is by electing their MA plan.

Low income seniors qualify for all the ‘goodies’ the commercials promise: rides to medical appointments; no co-pays; no monthly premiums; see any doctor who accepts Medicare; covered prescription drugs, and having your Part B premium paid for you each month. But you’d never know that from the commercials.

I realize that this post looks like I’m making a thread about Medicare Advantage, but it’s not really just about that. It’s about the entire phenomenon of deliberately misleading advertising. I’m just wondering if world-wide, this is as legally-acceptable as it is in the USA. Is it okay to mislead by failing to mention relevant facts (such as that MA is NOT providing anything that Original Medicare isn’t, and in many cases MA is providing far less)?

My guess is that the answer is that this is perfectly legal worldwide. But I’d love to hear I’m wrong about that.

https://www.wsj.com/health/healthcare/medicare-health-insurance-diagnosis-payments-b4d99a5d

Medicare Advantage plans can provide dental, vision and hearing benefits which original Medicare doesn’t provide.

As a former dealer in antiques and collectables, at least one case in one state has found that “lying by omssion” when buying an item is in fact legal. IIRC A family decided to sell a painting. A friend bought it for a few hundred. He never shared his knowledge of the painting or painter. He then immediately sold the painting for IIRC seventy thousand. The family sued, claiming that by not disclosing the painting’s true worth he had commited fraud. The court ruled that a seller was not legally obligated to disclose any such information. The seller and the buyer had a contract. They agreed on a price. The buyer paid it. The painting was his to do with as he pleased. Antique and collectable dealers throughout America were very pleased with this ruling.

You’re right about that, but again, there is lying by omission. You get those dental, vision, and hearing benefits one of two ways:

  1. You pay a monthly premium for the plan you elect (which has those benefits), or
  2. You qualify for those benefits by virtue of being low-enough income/assets. In this case, the MA plan is giving you something you’d have anyway, likely via SSI (Supplemental Security Income) or via having your Part B premium paid for you.

I’m not saying that no senior makes out better by electing an MA. Some do. If you’re healthy (don’t need treatment) and confident you’ll meet with no accidents (again, don’t need treatment) then you’re not in danger of having needed treatment denied by the MA company. And you may even come out ahead with the ‘goodies’ such as dental coverage. Assuming you’re happy with the providers that the MA company’s network lets you see.

One way another, the middleman must be paid (and paid handsomely). Either the MA-enrollee is getting less than they would have gotten with Original, or the taxpayer is underwriting what the MA-enrollee is getting (and most likely both).

I’m not trying to talk anyone here out of their choice of insurance.

But I’m wondering about the lying going on in the commercials, and whether it would be as acceptable everywhere as it is in the USA.

No doubt. But would the decision have been similar under Canadian law? German law? Etc. (Not that I expect anyone to be able to rattle off this information–I just wondered if someone wandering by the thread would happen to know.)

How can lying by omission not be legal? Wouldn’t literally every transaction contain something, however trivial or farfetched or disputable, that is omitted? Every transaction, from buying a Coke to winning a $100 million dollar auction for a Picasso.

For that matter, every post on every message board fails to cover the complete subject. The OP omits pages and pages of information about Medicare Advantage. Should we get the mods to crack down on this heinous crime?

BTW, my current MA program costs $0/month. I’d don’t feel taken.

One major way with Medicare is cherry-picking: you advertise in venues where people are generally healthy and not in those where they are likely sick.

What seems to be the main point of Advantage plans, as a business, is that the profits of the middle-man businesses, i.e. the insurance providers, are mostly being paid by the federal government, using (of course) taxes as the source of funds. Have I got that right?

This seems like a very good target for Democrats to get their teeth into, with a goal of saving billions of tax dollars every year, just by eliminating Part C plans. Or by refusing to further subsidize Part C plans for the insurance companies, which means the insurance companies will drop them post haste.

I never thought of that, but it does make sense.

That may be an inarguable point. But even so, I’m wondering about some situations in which lying-by-omission has been penalized in some way (other than reputational)–for example, lemon laws. Perhaps no lemon law actually concerns having failed to disclose facts about a vehicle (such as that it was underwater for two weeks following recent flooding).

In American real estate I believe there are some legal consequences to failing to disclose material facts (for example that a murder took place in a particular house).

Advertising may be a special category in that the carrier of the advertising can be held accountable for what they broadcast. But I don’t know if leaving out important information ever comes under that heading, at least in the USA.

Yes, absolutely.

(In re the links in the OP: the WSJ article is quite eye-opening about the cost to taxpayers, but even the wikipedia page has some solid information on the topic.)

I agree. Though since Bill Clinton, Democrats have been reluctant (to say the least) to confront any corporations about anything. So I’m not very optimistic that even if they regained power, they’d do anything.

It would be nice, at least, if the facts could be a bit more widely disseminated.

One thing to consider: some jurisdictions have rules about things you must disclose in some sales, like real estate. See our Canadian laws, for example.

That we mandate certain disclosures in some cases suggests that it’s not a legal requirement in all cases.

Logically, yes. (Which is why I thought this topic worthy of debate. I also hoped for information, such as you provided.)

So far, all the examples I’ve seen place the penalty for omission on the seller. Are there any examples that place a failure to disclose burden on the buyer? (I think fraud in providing the full amount agreed to is not omission of facts, it’s omission of something tangible)

Maybe insider trading laws? If I have information that a stock is about to rise, it’s usually illegal to act on that.

In buying and selling real estate, English law requires that you disclose any ongoing dispute with your neighbours, or past subsidence problems that have been fixed.

Heh. When I was in my late tweens I would go to rummage sales and buy comic books that were worth a helluva lot more than the dime they were asking for. Usually from some kid that got them from an older sibling. Was it criminal, immoral, and/or unethical to not break the 11th Commandment (“never wise up a dummy”)?

If it were then we would not have used car dealers.

I think they also operate on the 12th Commandment (“Never give a Sucker an Even Break”).

Can you give an example of what you mean by placing the burden on the buyer? The only one I can think of is the one mentioned in the OP , where I know something I’m buying is actually worth more. It’s possible for a law to require me to disclose that - but as far as I know, that’s not legally required anywhere. Insider trading laws don’t require me to disclose that I have insider knowledge - they require me not to act on it.

Is it okay to mislead by failing to mention relevant facts (such as that MA is NOT providing anything that Original Medicare isn’t, and in many cases MA is providing far less)?

I don’t think you have this right. SSI requires a pretty low income - ($963/month from non-work sources, or less than $1971 from work for one person) It doesn’t provide medical or dental benefits although most people are on SSI are going to be eligible for Medicaid and SNAP. Medicaid in some states provides transportation to medical appointments, but I don’t think states are required to provide that. Medicaid or Meals on Wheels might provide home-delivered meals but not Medicare. The fact that someone on Medicare may be able to get services form another agency/program doesn’t mean Medicare is providing those services. Medicare advantage sometimes is , in fact , providing benefits that original Medicare doesn’t.

GEICO isn’t required to mention in their ads that Progressive has better customer service or vice-versa. Tide doesn’t have to tell me in their ads that All is better for people with allergies. An independent insurance agent has no obligation to me , and can sell me the policy with the largest commission. I can’t see why a company selling MA would be required to tell me "if your income is low enough you might be able to get these benefits by applying to one or more additional government agencies for assistance.

I just turned 64. I get my health insurance from the county I retired from n 2007 but I am required to take Medicare as soon as I am able and the insurance becomes the co-insurance. Seems simple but even when I read the requirements on that it makes my head spin.