Article 43


Tuesday, March 22, 2022

Biden’s Medicare Privatization Scheme

image: save medicare

On January 19th [2021], The Daily Poster - which is by far the best news-source reporting on the Biden Administration - headlined BIDEN LIFTS HEALTH CARE PLAN FROM INSURANCE LOBBYISTS and reported that “the health-care plan that President Joe Biden will be proposing was written by the lobbyists for the mega-health-insurance companies and will include no public option and will include Nightmare Deductibles And Widespread Claim Denials.”
- Will President Biden Sell Us Out?

Dore argued that AOC and her progressive allies can best advance the cause of universal health care by denying Nancy Pelosi the support she needs to retain the Speakership - until she agrees to hold a House vote on Medicare for All
- The Left’s Most Naive Cynics Have Turned on AOC

Legislators don’t care if their constituents support X or Y policy. They start to care if they know that you have the capacity to hold them accountable and that you intend to carry out a public pressure campaign in response. Of course, the power of constituents also competes with the pressure House members receive from the health care industry.
- The Path to Winning a Floor Vote for Medicare for All in Congress

Health care coverage purchased through the ACA marketplace costs 83 percent more than Medicaid coverage, and ACA plans leave patients with ten times the amount of out-of-pocket costs, according to a recent study published in the Journal of the American Medical Association.
- Biden Lifts Health Care Plan From Insurance Lobbyists

The Center for Medicare and Medicaid Services INNOVATION CENTER recently ANNOUNCED that by 2030, they will move all Traditional Medicare enrollees into a “care relationship” with a 3rd party middleman, without seniors knowledge or consent, and without Congressional oversight.
- Direct Contracting: Quietly Handing Medicare to Wall Street


The hidden war on Medicare

Cuts to pathology and diagnostic imaging affecting the most vulnerable.

The Medicare rebate has been frozen pushing up costs for GPs and other health professionals. Reducing bulk billing as costs rise.

The proposed privatisation of Medicare billing would have affected service levels. YOUR PERSONAL RECORDS would have been handed to private companies and possibly ended up overseas. The government had refused Freedom Of Information requests for details of their studies:  external link FOI THE AUSTRALIAN. After the 2016 election, external link: THE GOVERNMENT DISBANDED THE MEDICARE OUTSOURCING UNIT

Billions of dollars have been cut from grants to hospitals

and much more

Save Medicare


image: biden image

Critics Blast Biden Rebrand of Trump’s Medicare Privatization Scheme

By Jake Johnson
Common Dreams
February 22, 2022

Rejecting pressure to terminate the program in its entirety, the Biden administration on Thursday announced it is redesigning a TRUMP-ERA EXPERIMENT that physicians and progressive lawmakers have criticized as a scheme to fully privatize Medicare.

Instead of ending what’s known as the Direct Contracting model, which the Trump administration officially launched in 2020, the Centers for Medicare and Medicaid Services (CMS) gave the program a new name: ACO REACH, which stands for Accountable Care Organization Realizing Equity, Access, and Community Health.

In addition to the name change and fresh veneer - a step in line with the healthcare industry’s CALL for a “rebranding” - CMS said the program will now span four years instead of eight and will include requirements aimed at ensuring “transparency” and “equity.”

The CHANGES are slated to take effect on January 1, 2023.

Physicians for a National Health Program (PNHP), a doctor-led group that has SPEARHEADED the opposition to Direct Contracting, was far from satisfied with the Biden administration’s changes, which the organization argued are more cosmetic than substantive.

“ACO REACH is Direct Contracting in disguise,” SAID Dr. Susan Rogers, an internal medicine physician and president of PNHP. “This new model doubles down on Direct Contracting’s fatal flaws, inserting a profit-seeking middleman between beneficiaries and their providers.”

Under Direct Contracting, so-called Direct Contracting Entities (DCEs) were paid monthly by CMS to cover a specified portion of a patient’s medical care. DCEs - the MAJORITY of which are currently controlled by investors, not healthcare providers - are allowed to pocket funds they didn’t spend on care.

In a STATEMENT, PNHP - which has implored the Department of Health and Human Services (HHS) to fully halt the program - outlined how the revamped pilot “perpetuates the dangerous flaws” of the Trump administration’s Direct Contracting experiment:

First, like the DC model, ACO REACH will pay middlemen a flat fee to “manage” seniors’ health, allowing them to keep 40% of what they dont spend on care as profit and overhead.

Next, Traditional Medicare beneficiaries will still be automatically enrolled into ACO REACH entities without their full understanding or consent, and once enrolled cannot opt out of an ACO REACH entity unless they change primary care providers.

Like DCEs, the ACO REACH program has virtually no limits on what type of company can participate; entities can be owned by commercial insurers, private equity investors, and other profit-seeking firms, including current Direct Contracting entities.

The new program increases provider governance from 25% to 75% (with loopholes built into the application process), but ACO REACH entities are ultimately accountable to investors.

“You can’t slap a band-aid on a tumor and call it cured,” said Rogers. “Direct Contracting - and now ACO REACH - threatens the health of beneficiaries and the future of Traditional Medicare. As physicians committed to the health of our patients, we urge HHS to abandon this rebranding effort and focus the agency’s efforts towards strengthening and protecting Traditional Medicare.”

CMS unveiled its raft of changes to the Medicare experiment just over a week after a coalition of industry groups - including active participants in the Direct Contracting program - requested that the Biden administration “fix” the model instead of ending it.

The industry organizations suggested that “a rebranding and name change would… help communicate how this model is part of the evolution to accountable care.”

CMS is headed by Elizabeth Fowler, who has previously worked at Johnson & Johnson and WellPoint, Inc. - now known as Anthem, one of the largest private health insurance companies in the United States.

While CMS said Thursday that it took into account “feedback received from participants and stakeholders,” the new ACO REACH program is more in line with industry demands than those of physicians, grassroots advocacy groups, and progressive lawmakers.

“Changing the name doesn’t change the fact that the Direct Contracting program is backdoor privatization of Medicare,” Alex Lawson, executive director of Social Security Works, SAID in a statement. “This dangerous experiment must be stopped before it further harms the health of vulnerable seniors, eats into the Medicare Trust Fund, and destroys traditional Medicare.”

“DCEs and their investors - which include private equity firms - are focused on generating profits,” added Lawson. “They are incentivized to deny and delay care as much as possible. There are no changes that can address that fundamental flaw at the heart of the program. President Biden must protect older adults and people with disabilities by ending the direct contracting program immediately.”

Rep. Pramila Jayapal (D-Wash.), who earlier this month LED MORE THAN 50 HOUSE DEMOCRATS in urging Biden to cut off the program, said Thursday that she will “continue to fight tooth and nail against any and all efforts to privatize Medicare.”



As Biden Continues Privatization Ploy, Sanders Vows to Reintroduce Medicare for All

By Jake Johnson
Common Dreams
March 21, 2022

Sen. Bernie Sanders on Sunday said he intends to reintroduce Medicare for All legislation in the U.S. Senate in the coming days as the Biden administration moves ahead with a Medicare privatization scheme and millions of Americans remain at IMMINENT RISK of losing their insurance once pandemic protections expire.

“In the midst of the current set of horrors - war, oligarchy, pandemics, inflation, climate change, etc. - we must continue the fight to establish healthcare as a human right, not a privilege,” Sanders (I-Vt.), the chair of the Senate Budget Committee, WROTE in a Twitter post. “I will soon be reintroducing our Medicare for All legislation.”

Sanders’ announcement came weeks after Biden’s Centers for Medicare and Medicaid Services (CMS) SAID that instead of terminating a Medicare PRIVATIZATION EXPERIMENT hatched under the Trump administration, it would rebrand the pilot program and make minor changes that critic - including physicians and Medicare for All advocates - say would leave the scheme’s most dangerous components intact.

Meanwhile, millions of people across the U.S. are set to lose Medicaid benefits once the federally declared coronavirus public health emergency (PHE) expires. In January, the Biden administration extended the PHE through April 16, but it’s unclear whether there will be another extension.

Writing for The Daily Poster earlier this month, healthcare policy writer Libby Watson WRNED that “the potential scale of this mass disenrollment could be huge: The Urban Institute ESTIMATED in September that up to 15 million people could lose their Medicaid coverage when the PHE ends.”

“The Georgetown Center for Children and Families estimated in a REPORT released in February that 6.7 million children are likely to lose coverage,” Watson added. “Many of the new enrollees over the past few years will genuinely no longer be eligible - not a surprise, since the income limits for Medicaid are very low - but many others who are eligible will lose coverage anyway.”

Throughout the coronavirus pandemic, progressives have argued that the best way to prevent such disastrous HEALTH INSURANCE CHURN is to establish a single-payer system under which everyone is guaranteed comprehensive coverage regardless of income or other factors.

LAST MARCH, Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.) REINTRODUCED Medicare for All legislation in the House with the backing of more than half of the chamber’s Democratic caucus. Despite strong support for the bill, House Speaker NANCY PELOSI (D-Calif.) has YET TO ALLOW FOR A FLOOR VOTE.

Jayapal and Dingell are AMONG THE PROGRESSIVE LAWMAKERS urging President Joe Biden to terminate the Medicare privatization experiment, which is now known as ACO REACH.

In an ANALYSIS released just before Jayapal and Dingell re-upped their bill last year, the consumer advocacy group Public Citizen estimated that hundreds of thousands fewer people would have died of Covid-19 in the U.S. if the country had a Medicare for All system.

“Under Medicare for All, everyone would have consistent coverage regardless of their employment status or employer,” Public Citizen’s report noted. “And because Americans would have their choice of providers, instead of facing the narrow networks their employers choose for them, they would face fewer challenges getting care, especially during a pandemic where some hospitals and providers are overwhelmed by demand.”


Posted by Elvis on 03/22/22 •
Section Dying America
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