I don’t disagree with any of this; I should have specified that it IS Medicaid (and other programs), not Medicare itself, that would provide the parallel-to-Medicare-Advantage benefits for the low-income seniors being discussed.
My basic point was, as you mentioned, about what’s promised in the ads and the implication they all carry that they are offering something wonderful that isn’t available without enrolling in Medicare Advantage. (That’s the lying-by-omission.)
Another lying-by-omission implication in these ads that irritates me is the careful wording that may lead many seniors to believe that ‘it’s time to elect your Medicare Advantage plan’—as though this is a task they MUST accomplish.
The entire taking-advantage-of-possibly-confused-seniors industry is huge, of course, and features plenty of lying of all kinds (by omission and otherwise). But it’s not just seniors. The “carefully-worded commercials” phenomenon is also on display in the vehicle-service contract industry (such as the ubiquitous CarShield), which no doubt snares many seniors, but also younger people. Note how carefully those commercials describe what the companies do: never ‘pay your repair bill’ but always ‘get your repair bill paid.’ (Anyway, I suppose that’s a different thread.)
If we’re speaking in the abstract then lie by omission is not always legal even in the US. There are several situations where a business is required to disclose something e.g. if I want to advertize a drug, I need to mention any serious side effects.
Two I can think of
A person has a fiduciary duty. For example you pay me to appraise your estate sale and I talk about this and that but DON’T mention the original Van Gogh then offer to buy the estate for $2000 to help you out.
Advertising without revealing you are being paid for it. Youtube creators used to get nailed for this all of the time. Under this umbrella would be advertising medicine without mentioning side effects like Mijin mentioned.
The moral issue only comes if you bargain down from the asked for price. If you pay the asking price, IMHO your conscience is clear.
I am lucky- as a fed I get my insurance for the rest of my life (and for my wife also) at the same reduced price i got as an employee. I did sign up for Medicare A, since that was free.
Right. And I would say it’s not lying by omission without that duty to disclose. It is just a failure to disclose. I don’t lie by admission when I meet someone and only tell them my name but not my age, where I live, or what my SSN is. Otherwise everybody lies by omission anytime they don’t tell someone everything they know about anything.
Well, there is the matter of personal ethics where knowing an adverse fact but not disclosing it to someone who will be disadvantaged by it might be the more mundane (although subtle, in this case) form of “lying”.
Lies (committed or omitted) remain lies regardless of their legal xontext. Ethics and the law are two systems which don’t always match up.
But since the question is not about "unethical " or “immoral”, the point that “any lie is not illegal unless a law makes it illegal” is critical to remember.
I don’t disagree, but note that private companies are permitted to offer Medicare Advantage plans because the federal government grants them that privilege.
In some similar situations there are duties of disclosure imposed by that federal government; for example, to deal with various embarrassing incidents connected with reverse mortgages, the feds did impose some duties to disclose on the private companies who were allowed to offer RMs that were insured by the feds (specifically by HUD).
Well, when I said “law” earlier, I didn’t mean just legislative law. Regulations are the same in this context, and if the executive regulations of a government-mediated process dictate specific duties of disclosure, failing to disclose would be a violation of the regulations, with the possibility of penalties.
I don’t think that “lie by omission” means not telling someone everything you know but nor do I think it is only limited to the legal requirement to disclose.
Because there is also whether a person believes the other person needs to know some information.
For example, if I’m making dinner, and a guest asks if a dish is vegan, and the answer is it is, but the gravy in a jug that I put next to it is not vegan, there is an expectation that I would warn them about the gravy, either immediately, or if I see them reach for the jug.
I don’t know if this is a perfect example, but my point is just that colloquially there can be a meaning for this term as well as what it means legally.
This thread was inspired by my irritation at the careful wording of commercials that, in my opinion, is intended to deceive those not paying close attention. It’s like CarShield “CarShield will get your repair bill paid” which most listeners probably take to mean “CarShield will pay my repair bill.” Which it doesn’t. But the lawyers who write these things are very, very careful.
Similarly with the Medicare Advantage ads. The wording carefully implies things that aren’t true. This may not be illegal on its face, but it can and should (in my view) have consequences for companies that are getting rich because the federal government has granted them that chance to get rich.
EVERYONE who selects a Medicare Advantage plan must already have signed up for “original” Medicare parts A and B, so how is it that a percentage of patients are being denied care that original Medicare covers?
In my experience, health care providers bill Medicare when that’s the insurance designated by eligible patients, and it’s only after Medicare approves or denies its share that the commercial Advantage plans decide if and how much of the slack they will pick up.
If your provider wants you to have an MRI that’s covered by Medicare, what mechanism would allow a secondary Advantage plan to deny all coverage for it?
There’s a difference between Medicare Advantage and a Medicare supplement. Medicare advantage ( also known as Medicare part C) policies bundle doctor, hospital and prescription coverage all together and if you get yours through say UnitedHealthcare, that is who will be approving treatment and making the initial claims decision.
Supplemental policies don’t provide doctor and hospital coverage - they provide prescription coverage, might pick up copays or balance billing - but for doctors and hospitals you still have original Medicare.