July 3, 2022
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Do you know what’s good about changing jobs, Adrian Ma?


Dozens of introductory Zoom meetings.

WEISSMANN: (Laughs).

MA: No. What’s great about changing jobs, Dan Weissmann?

WEISSMANN: Rethinking all of Medicare.

MA: Ah, yes.

WEISSMANN: Mitra Kaboli is a journalist and recently left a job to become self-employed. She therefore logged into Healthcare.gov.


MITRA KABOLI: And it was really difficult. I forgot how it was.

WEISSMANN: She thought she would go around somewhere else.


KABOLI: I already have Cigna, so I thought I was on the Cigna site. You know, I was putting information to get a quote, and I had to put it on my phone number. And the next thing I know, I get a phone call.

WEISSMANN: Just one (laughs)?

KABOLI: Well, actually my phone has been ringing for several days now.

WEISSMANN: Yes. But that first call, she took it. The person on the other end of the line offered him a really good deal – in fact, maybe a little too good to be true.

KABOLI: It was, like, Red Flag # 1 that I was like, not at all.

MA: Yeah. Except for the moment – remember, she basically thought she was getting a call from Cigna, so she let that question sit for a while and listened to the pitch.


KABOLI: It was something like $ 300 a month, which is less than half of what I’m paying now. No deductible – never seen before. And we went through the list of all my doctors, and they were, like, in the network, apparently.

MA: And you might have guessed it – Mitra was caught up in what we might call a scam, scam, bait and trade. This one uses up to date tools – doesn’t it? – like deceptive websites, search engine manipulations, and a nice sharp hook right now – the stress of buying health insurance.

I am Adrian Ma.

WEISSMANN: I am Dan Weissmann. I’m doing a podcast called “An Arm And A Leg” on why health care is so expensive.

MA: And today on THE INDICATOR – the anatomy of a scam – what scams can tell us about ourselves as rational economic actors.


WEISSMANN: So to really understand this bait and switch, let’s hear from someone who exposed themselves to it on purpose.


DANIA PALANKER: I’m Dania Palanker. I’m an assistant research professor at the Center on Health Insurance Reforms at Georgetown University.

WEISSMANN: And you recently did a secret buyer survey.

PALANKER: Yes, I did. I did a study to see what would happen to someone who went to buy health insurance and started by doing an internet research online.

WEISSMANN: And you’ve been looking for terms like cheap health insurance or even Obamacare or ACA membership. Is it correct?

PALANKER: Exactly.

WEISSMANN: And the first results – still ads, but carefully crafted to look legitimate. Dania picked out the three most frequently encountered outcomes in this research and followed them, but not as herself. Instead, she created two characters.

MA: I love this part. She discreetly defrauds the crooks. And she even created Google Voice numbers – one for each character.

WEISSMANN: I know. One character was young and healthy. The other was in his 40s and had high cholesterol and heart disease. So she needed what nerds call an Obamacare-compliant plan – the kind that has to cover pre-existing conditions, like this heart problem.

MA: And three-quarters of the people on the phone didn’t offer that to him. Instead, they pushed for junk insurance. And it’s a real term researchers like Dania Palanker use for plans that don’t meet Obamacare regulations.

WEISSMANN: And these people said things that were clearly wrong, even when asked the right questions.


PALANKER: Yeah. Like, will that cover me if I have a heart attack? Absoutely.

WEISSMANN: And of all the garbage insurance sellers, only one of them would send anything in writing. The others wanted a credit card number first, and they had reasons. There was always a reason.


PALANKER: The people you talk to have a script written to draw you in, to make you think they’re doing the best thing for you.

WEISSMANN: What are they saying?

PALANKER: They say they’re going to find you a cheaper package, and then they make you feel good. I mean, it’s like they’re chatting with you in a comfortable way. And each question has what appears to be the correct answer if you don’t know it’s the wrong answer.

WEISSMANN: And the biggest bad answer is how they drive you away from the plans in the Obamacare market.

PALANKER: They tell you that they are more expensive, that they are unaffordable for you, that they have the right deal.

MA: The good deal – that’s the mark of a scam, isn’t it? I have a special thing just for you.

WEISSMANN: And in this case, by the way, that’s just not true. And not just because the alternatives these people are selling are crap, but because the health insurance in the Obamacare market is actually a really good deal this year.

MA: Right. The US bailout, that big stimulus package that Congress passed earlier this year that included big grants for the Obamacare plans – sometimes giant grants.

WEISSMANN: Yes. And here’s what’s interesting – Dania says some of the individual salespeople she’s heard of weren’t even necessarily trying to lie to her. She thinks they were just following their scripts.


PALANKER: One of the people I spoke with actually put me into the Healthcare.gov computer and went there. And it was like, see what high deductibles you have? And I said, I see a plan with no deductible for $ 2. And he was silent. He didn’t know what I was saying. So it was clear that he wasn’t lying to me. He did not know that these subsidies existed.

MA: So we have no idea how many of these people you get calls from who are intentionally trying to deceive. But they’re using high pressure sales tactics – you know, telling you things that’s wrong, selling you something that’s crap.

WEISSMANN: And they bought your phone number from someone who was really trying to cheat you, who set up a website and Google AdWords so that when you searched for Obamacare or Cigna, you found them instead. Dania Palanker says the Federal Trade Commission and state regulators have tried to prosecute these people.


PALANKER: Sometimes when the FTC found out who was behind it, that entity went bankrupt. But I have also spoken to state regulators who say they have removed one of these entities and another is reappearing. And it’s a bit of a mole.

MA: The scam still exists. And really, anyone can fall for the trap. Mitra, the journalist we met earlier, has come to the brink.

WEISSMANN: But when the salesperson pressured Mitra for a credit card number, she managed to slow things down.


KABOLI: I was like, why isn’t there a website where I can compare plans side by side as usual?

MA: So Mitra said to the guy, listen, I’m going to call my doctors first and confirm they’re taking the plan you’re talking about.


KABOLI: So I called all my doctors, and they were like, I don’t know – I don’t even know what you’re talking about.

WEISSMANN: I told Mitra what’s interesting is that even if you start to see the red flags you still spent, like, an hour of your life calling all your doctors, just in case. where it might be legitimate.


KABOLI: I know. It’s, like, the heartbreaking thing when something is too good to be true. Like, you want it to be true.

WEISSMANN: Yes. I feel like Mitra sums up what con games offer. It’s that chance to hope that maybe this time we got lucky in an easier way, a special offer, a way out.

MA: That’s what makes scams and scams great examples of what behavioral economists have tried to tell us. We are not always rational economic players. Most of the time, we see what we expect to see and what we want to see, whether it’s there or not.

WEISSMANN: Yeah – especially if we’re in a rush or faced with something stressful or confusing or really expensive. So, for example, I asked Mitra to show me the site that had plunged her into all this. And she recovered her browser history.


KABOLI: Now that I look at the page, I tell myself that it is obviously not Cigna.

WEISSMANN: I know (laughs).

KABOLI: Like, I’m embarrassed. I know what Cigna’s site looks like.

WEISSMANN: I left a dude from – I got to what I thought was an hp.com support page and ended up giving some random person the credentials to take over my computer to help repair my printer.

KABOLI: Oh, my God.

WEISSMANN: Yes. Health insurance isn’t the only area where someone is cheating Google to lead you astray. Changing all those passwords was a nightmare.

MA: Dan Weissmann, you got caught. You fell in love with one of them.

WEISSMANN: Yes. I clearly need a behavioral economist to sit on my shoulder at all times.

MA: Probably me too. Dan Weissmann is the host of the “An Arm And A Leg” podcast on why healthcare is so expensive. By the way, registration for health insurance in Obamacare Markets is open until January 15. So be careful.

WEISSMANN: This episode of THE INDICATOR was produced by Julia Ritchey with assistance from Marcia Caldwell and Gilly Moon. It was verified by Taylor Washington. The main producer of THE INDICATOR is Viet Le. Our editor is Kate Concannon. And THE INDICATOR is an NPR production.

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