This month marks the end of 58 years of Medicare as we know it. Designed as a public safety net for people 65 and older as well as people with disabilities of all ages, this program has been and still is a cherished lifeline for millions of Americans, including a large population of the Humboldt County.
All of this is disappearing. Private corporate powers have chiseled traditional Medicare for many years: So-called Medicare Advantage programs promise cheap health insurance to traditional Medicare beneficiaries with additional benefits such as dental, visual and auditory limitations – benefits that traditional Medicare recipients subsidize but do not. to receive. These plans seem like good business until inevitable aging requires more specialized and expensive medical help, at which time the bureaucratic labyrinths and barriers to care designed to keep corporate profits high appear. Nearly 50% of all Medicare patients have been persuaded to enroll in these “beneficial” plans.
In addition, privatized plans use unethical and fraudulent approaches to maximize the financial return of companies and their investors which drain the Medicare Trust Fund. In 2020 alone, the CMS (Center for Medicare and Medicaid Services) estimated that $12 billion to $25 billion was fraudulently billed to Medicare Trust Fund. The minimum fines imposed are accepted as a pat on the wrist and the cost of doing business by perpetrators. The full sums stolen will never be recovered.
This month, however, marks the official launch of an even greater threat to traditional health insurance. ACO-REACH (Accountable Care Organization Realizing Equity, Access and community health) is a rebranding of an earlier program, DCE (Direct Contacting Entities) which inserts for-profit intermediaries into traditional health insurance through private financial interests.
REACH programs offer even higher corporate rewards. While Medicare “Advantage” programs may retain 15% of all fund revenue for benefits and overhead, REACH programs may retain 25% to 40% of billed monies. This is a dangerous incentive to ration and restrict care for the elderly. These financial incentives do not exist in traditional health insurance, which only spends 2% on administrative costs and requires no profit. How do these entities extract high profits for their investors?
1. Maximize the money from the Medicare Trust Fund using diagnostic codes that exaggerate a patient’s health problems.
2. Minimize healthcare costs by reducing office staff, hiring less trained staff and increasing the number of patients a doctor sees.
3. Enroll as many beneficiaries as possible by automatically “assigning” traditional Medicare seniors to their program if their primary physician joins REACH – without the seniors’ knowledge or consent. They can opt out, but only by finding another primary care physician who is not yet part of a REACH program.
REACH agents are not limited to health insurance companies; rather, they can be led by private equity, venture capitalists, investment bankers, or anyone with the means to access our Health Insurance Fund. It is hard to imagine any moderation in a program whose end result is profit, which must necessarily come before patients. CMS is unabashedly trumpeting its intention to see ALL Medicare privatized by 2030. Very importantly, this dangerous trend of completing Medicare privatization through REACH programs is happening without congressional oversight.
The longer REACH takes root, the harder it will be to extract. Until we elect representatives who don’t belong in corporate money, we must look to a massive public response to demand protection for the health and safety of older people. That’s why now that REACH has begun, it’s essential that everyone takes action to defend traditional health insurance.
Traditional health insurance is not perfect. There is a lot to do. Medicare supplemental plans are expensive. No long-term care, vision, hearing or dental care means additional expenses for seniors. This is why so many grassroots organizations are fighting to improve Medicare and extend it to all that is left of our children and grandchildren.
Start by going to protectmedicare.net and sign the petition for President Biden which has the power to eliminate REACH with the stroke of a pen. Also find additional information about privatization and steps that can be taken by anyone to end this threat at: pnhp.org and healthcareforall.org. Educate yourself and share information with your family, friends, colleagues, community, religious or political groups.
Please join the Humboldt Health Care Chapters for All CAs and Physicians for a National Health Program in this grassroots effort. Contact [email protected].
Patty HarveyHCA/PNHP-Humboldt, resides in Willow Creek.
