text:  Here to help us understand is David Himmelstein, co-author of the new analysis, Less Care at Higher Cost, the Medicare Advantage Paradox, appearing in JAMA Internal Medicine. He teaches at Hunter College and Harvard Medical School. He's a researcher at Public Citizen and co-founder of Physicians for a National Health Program. He joins us now by phone from upstate New York. Welcome to Counterspin, David Himmelstein. Thanks for having me.