Here's How Trump And Oz Can Fix Medicare
AFP via Getty Images
Now that Dr. Mehmet Oz is in place to lead the Centers for Medicare and Medicaid Services (CMS), he must quickly and directly tackle one of the greatest threats to preventative and individualized care in our country: Medicare Administrative Contractors (MACs). Oz's decades of experience as a physician and cardiac surgeon will be critical.
MACs, under the purview of CMS, are private health insurance companies that administer Medicare claims. While their purpose is to 'improve efficiency,' they've done everything but that. MACs serve as an unaccountable middleman between patients and doctors, driving up costs and worsening patient outcomes. They have repeatedly used their authority to make broad-sweeping decisions about coverage that prevent patients—especially seniors—from accessing vital preventative care such as genetic testing for cancer.
There's an urgent need to tackle illness and chronic diseases at their core, and embracing early intervention tools is a vital step toward reaching wholly preventative care. Dr. Oz can achieve a win for millions of Americans by confronting MACs head-on and protecting the coverage of diagnostic cancer testing. According to the National Cancer Institute, more than 2 million Americans were diagnosed with cancer in 2024. While a cure has yet to be found, we continue to see impressive breakthroughs in treatment every day.
Genetic testing is one such breakthrough. It allows doctors to find potential mutations or other changes in genes that could increase a patient's risk for certain types of cancer. For those who have already been diagnosed, these tests help guide—and personalize—treatment plans, which may help patients avoid having to undergo more invasive interventions, such as chemotherapy or radiation therapy. For America's seniors, access to these treatments hangs in the balance—and is becoming increasingly restricted.
Through a review process called a local coverage determination (LCD), MACs determine if a 'particular item or service' should be covered under Medicare. This is supposed to be an unbiased, evidence-based process. But recent LCDs have called into question the MACs' adherence to this process.
In 2023 Palmetto GBA, one of seven MACs nationwide, proposed limiting the coverage of blood tests for patients with organ transplants. After justified backlash, Palmetto GBA rescinded this guidance. The subsequent revelation that the MAC ignored expert recommendations justifiably raises questions about the intentions of these groups and their 'unbiased' and 'independent' status. Less than two years later, Novitas Solutions has finalized an LCD that prevents Medicare from covering a range of genetic tests used to help treat patients with cancer or those suspected of having cancer.
Experts have pointed out that not only do these decisions hurt patients but also that the process through which they are arrived at is extremely flawed. There has been little consistency as to what the MACs classify as 'medically necessary.' Furthermore, they make hasty decisions about coverage, often without considering important medical evidence or the impact on patients. By deprioritizing preventative treatments such as genetic testing for cancer, MACs also drive up the cost of healthcare, leaving taxpayers to foot the bill.
Recent studies have also supported the fact that at least two of the tests impacted by Novitas' LCD would actually lower the overall cost of care. A study evaluating a bladder cancer recurrence test that Novitas doesn't want to cover found the test to be safe, patient-friendly and saved a health provider $39,000 over a three-year period.
Another study found that when doctors used a genetic test for skin cancer, they were able to better assess whether or not a patient needed adjuvant radiation therapy (ART). This test would not only prevent the unnecessary use of a highly risky and invasive treatment but also save taxpayers close to $1 billion dollars in annual costs.
President Trump, Congress and the Department of Government Efficiency are looking to reduce government spending and alleviate the burden on taxpayers. Clearly, effective precision medicine tests such as these are a clear avenue that should be pursued. Allowing this LCD to stand will remove patient access and burden many Americans physically and financially.
MACs are a cautionary example of the problems with socialized medicine and the consolidation of healthcare. In countries with a single-payer system, such as in Canada and the United Kingdom, patients are left with little to no choice in the type of healthcare they receive. Budgetary constraints allow government bureaucrats to decide who gets care and what care they receive. We can't allow the U.S. to fall victim to these same systems. There are currently seven MACs presiding over the entire system, making decisions that impact our entire country.
It's simple math: Poor decision-making plus unaccountable middlemen equals bad healthcare. At the mercy of MACs, seniors on Medicare continue to lose access to groundbreaking genetic tests that are essential to keeping them healthy as well as improving the quality of life for all.
There's no reforming healthcare or 'Making America Healthy Again' without reforming the MAC system. Dr. Oz must use the mandate given him by President Trump to hold MACs accountable and protect our country's patients.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
New York Post
31 minutes ago
- New York Post
Trying to lose weight? This common mealtime mistake could be sabotaging your progress
Lifestyle choices impact your weight, but your genes can tip the scales, too. New research suggests that people with a higher risk for obesity may be sabotaging their efforts to slim down by making a simple mealtime mistake. The good news? Scientists found an easy switch that can help fight back against what's written in your DNA — and it's not about changing what's on your plate. Advertisement 3 While lifestyle factors like diet and exercise are crucial, genetics can influence a person's predisposition to weight gain Creativa Images – The study followed nearly 1,200 overweight and obese adults in Spain taking part in a 16-week weight-loss program. About 80% were women, with an average age of 41. Researchers calculated each person's polygenic risk score for body mass index (BMI) — a genetic measure of their obesity risk. Advertisement They also tracked when participants ate, splitting them into 'early' and 'late' eaters based on the midpoint between their first and last meals of the day. After a 12-year follow-up, participants gained 2.2% more body weight for every hour that their meal midpoint was delayed. 3 Eating earlier in the day is linked to better long-term weight loss success, researchers found. ayselucar – The researchers also found a 'significant interaction' between meal timing and genetic risk scores. Advertisement Over the study period, participants with a high genetic predisposition for obesity saw their BMI increase by more than 2 points for every hour they delayed eating. No such link was observed in those with lower genetic risk. People with both a high genetic risk and later meal times had the highest BMI, while early eaters kept theirs lower. 'These findings suggest that early eating may be especially relevant for individuals with a genetic predisposition for obesity and not for others,' the study authors wrote. 3 Projections indicate that the majority of US adults will be overweight or obese by 2050. chathuporn – Advertisement The implications are serious. Across the country, more than 100 million adults have obesity, and over 22 million have severe obesity, according to the Centers for Disease Control and Prevention. This extra weight increases their risk for a wide range of chronic health conditions, including type 2 diabetes, heart disease, stroke, high blood pressure and even some cancers. It also drives up healthcare costs. In 2019, adults with obesity spent an average of $1,861 more per year on medical care than those at a healthy weight. For those with severe obesity, excess costs topped $3,000 per person. Without strong interventions, the problem is only expected to grow worse. While surveys have found that many overweight Americans want to slim down, research shows that conventional methods like calorie restriction often fail to keep the weight off long-term. The study authors said that understanding the link between genetic risk for obesity and meal timing could pave the way for personalized prevention and targeted behavioral interventions in the future. One example they highlighted is precision nutrition, which designs eating plans based on a person's DNA, microbiome, and metabolic responses — moving beyond the one-size-fits-all approach.
CNBC
6 hours ago
- CNBC
From Starbucks to Smoothie King, restaurants seek to cash in on consumers' protein frenzy
Restaurant chains are joining in on the protein frenzy, hoping to encourage diners to pay more for extra macronutrients during a time when many consumers aren't spending as much. From "gym bros" to users of GLP-1 drugs like Ozempic, many Americans are trying to add more protein to their diets, with the goal of building or maintaining their muscle mass and feeling more satiated after meals. Moreover, diet trends that don't emphasize protein intake, such as the ketogenic diet, have fallen out of favor. "A lot of younger consumers are more proactive about their health habits, so they're looking for ways to support health now but also to support their health in the future," said Julia Mills, a food and drink analyst for market research firm Mintel. "Generation Alpha, Gen Z, millennials — these consumers are very active on social media, so they're constantly being fed this message that you need more protein, and protein helps you gain muscle and makes you stronger." Roughly a third of consumers said they loved high protein in the second quarter of 2025, up from 24% three years ago, according to Datassential, which tracks restaurant menus and consumer preferences. The trend has fueled a protein takeover in grocery store aisles, from protein-packed Eggo waffles to Khloe Kardashian's Khloud protein popcorn. But it's also hitting the menus of restaurants that are seeking ways to encourage diners to pay for premium food and drinks. Take Starbucks, for example. The coffee giant said in late July that it will roll out a cold foam packed with 15 grams of protein later this year; the regular cold foam add-on typically costs customers an extra $1.25 per drink. The new foam comes as the chain's U.S. sales have been shrinking for the past year as coffee drinkers brew their java at home or seek out trendier options. Rival Dutch Bros launched a protein coffee in early 2024 and charges customers an extra $1 for the customization. The menu addition fueled strong same-store sales growth and profits for the upstart chain. Eateries are seeking to attract diners like Jared Hutkowski, a 42-year-old director of brokerage in Harrisburg, Pennsylvania. He works out six days a week and tries to hit his daily protein goal to improve his physique and overall health. When he dines out, he tries to maximize his protein, although he sometimes goes for pizza anyway. "The biggest factor is what I am in the mood for that day, and then I normally try and select a meal that has a least a serving of some type of protein in it," Hutkowski said. This year, 28.4% of U.S. restaurant menus call out "protein," up from 5.9% a decade ago, according to Datassential. And the trend looks like it has staying power. Datassential predicts that by 2029, more than 40% of eateries will highlight protein on their menus. "Protein is one of those things that's never been vilified, because no one's ever said that eating too much protein can be bad for you," Mintel's Mills said. In the short term, consuming more protein than your body needs likely won't cause health issues, but in the long term, it could cause kidney problems, according to Diane Han, a registered dietitian based in San Francisco and the founder of Woking Balance Wellness. The recommended daily amount of protein intake varies by body weight but is roughly 46 grams for women and 56 grams for men, according to the Centers for Disease Control and Prevention. For restaurants, protein's step change happened several years ago. In 2021, protein only had a menu penetration of 11.5%; by 2022, more than a quarter of restaurant menus used the term, based on Datassential data. That year, Dine Brands' IHOP, for example, introduced pancakes with 18 grams of protein per flapjack. Fast-casual eateries are the restaurant segment most likely to call out protein on their menus, thanks to the common practice of asking customers to pick their protein or offering to double their portion, according to Datassential. Fast-casual salad chain Sweetgreen introduced a line of "protein plates" in late 2023 as part of an effort to introduce more hearty options for dinner customers. The menu addition has helped the company grow its dinner business from 35% of sales to about 40%, executives said in March. Many restaurants are also leaning into U.S. consumers' desire for convenience. Accessibility may be why Datassential found that consumers tend to prefer protein-packed beverages. For Smoothie King, protein has been a menu staple since its founding more than 50 years ago. But in October, the chain took one step further, launching a menu aimed at consumers who take GLP-1 drugs for weight loss or diabetes. The rapid weight loss that can occur from the medications can cause muscle mass to drop, so doctors often advise patients to increase their protein intake to maintain their muscle. "It's a convenient, on-the-go way to get in your protein that you're looking for in your diet," said Lori Primavera, Smoothie King's vice president of research and development and product marketing. Many restaurants are also choosing to highlight existing protein-packed options, rather than adding new menu items that would slow down kitchens or add to much complexity to their operations. For example, Panda Express introduced its own protein plates earlier this year. The line, created in partnership with a registered dietitian, includes pre-existing menu items but packages them as a balanced meal, highlighting protein and fiber content. Chipotle Mexican Grill employed a similar strategy back in 2019 when it introduced "lifestyle bowls," marketed to fit different dietary goals, like the paleo diet or offering double protein. Likewise, in July, Chick-fil-A put the spotlight on its own high-protein options in a company blog, highlighting its grilled nuggets and the Cool Wrap, which features a grilled chicken breast, cheese and lettuce in a tortilla. But for the eateries that want to add new menu items, nachos with a choice of protein, restaurant-made protein bars and egg dishes that highlight high protein content are all increasingly popular options, according to Datassential trendologist Claire Conaghan. Eggs are one reason why breakfast, brunch and lunch eatery First Watch has always been "protein forward," CEO Chris Tomasso told CNBC. The chain hasn't adjusted its menu specifically to address consumers' demand for more protein, but TikTok influencers have highlighted how to order a high-protein meal when visiting its restaurants. "We hope that continues to be a trend because we're right down the middle of the fairway on that," Tomasso said. Of course, protein isn't the only way to win over health-conscious consumers. Hutkowski said his primary issue with eating at restaurants is that most of the food is cooked in oils, butter and heavy greases that rapidly add to his intake of fats for the day. "A restaurant finding cleaner ways to cook would be much more attractive to me than overly loaded protein dishes," he said.
Epoch Times
7 hours ago
- Epoch Times
These Drug Prices Won't Soon Go Down—Here's Why
Pharmaceutical companies can continue to charge the federal government—and Medicare beneficiaries—full price for a handful of drugs that might have seen price reductions as soon as next year. That's because Congress changed the law to outright exempt or delay consideration of more than 300 medications for the Medicare Drug Price Negotiation Program.
