Trump scheme to privatize Medicare in 10 years continues under Biden, renamed today.

[CousinIT]

The dirty 'DCE' (direct contracting entities) scheme designed to privatize Medicare, has today been 'renamed' by the former big pharma exec who is running the program. Using this scheme, (especially along with "Medicare Advantage&quot will have Medicare COMPLETELY privatized in 10 years.

Link to tweet

Yesterday, the Centers for Medicare and Medicaid Services (CMS) made a decision about how to proceed with Trump’s pilot project for Medicare privatization. This decision is a betrayal―and we’re fighting to reverse it.

While Biden is dealing with the Ukraine crisis and choosing a historic Supreme Court nominee, his Director of the CMS Innovation Center chose to stab his administration in the back. Instead of ending Trump’s Medicare privatization experiment, Director Liz Fowler (a former Big Pharma executive) chose to simply re-brand it.

Let’s be clear: Changing the name doesn't change the fact that the Direct Contracting program is backdoor privatization of Medicare. Whether they’re called Direct Contracting Entities or Accountable Care Organizations, 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. 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.

Working people pay into Medicare with every paycheck. Those payments carry an implicit promise of simple, universal health care when they retire. Forcing seniors to deal with a private, profit-driven bureaucrat breaks that promise.

Most of these "Accountable Care Organizatons" are NOT accountable. Their only accountability is to sucking up as much Medicare money as possible while DENYING as much care to seniors as possible. Get this: THEY GET TO KEEP ANY MONEY THEY DON'T SPEND ON CARE. It doesn't take a genius to see where THAT is going to go. Most of them are INVESTORS focused on only increasing their PROFITS.

Biden appointed this vile woman to this position and he need to hear LOUD AND CLEAR that Americans do NOT WANT MEDICARE PRIVATIZED.

https://socialsecurityworks.org/2022/02/24/the-biden-administration-must-eliminate-direct-contracting-entities-from-medicare/

[Wounded Bear]

1. Definitely worth keeping an eye on...nt

[CousinIT]

3. POTUS and CMS Innovation Center need MASSIVE pushback

to ELIMINATE this scheme NOW. No time to 'keep an eye out'.

Time to act NOW.

https://www.facebook.com/medicare
https://twitter.com/cmsgov
https://twitter.com/CMSinnovates
https://twitter.com/POTUS

MORE info:

How "DCEs" (now deceptively renamed to "Accountable Care Organizations&quot Jeopardize Care, Drive Up Costs, and Turn Medicare Over to Corporations https://socialsecurityworks.org/dces-fact-sheet/

[Farmer-Rick]

2. That oh so stupid Medicare Advantage program is bad enough

It just puts a for profit entity between you and Medicare.

I get so many f*cking calls and stupid a** junk mail all pretending to be the real Medicare administration that I inadvertently threw out my real Medicare cards. They purposely confuse you and make you think you have to sign with them or you won't get Medicare.

The f*cking scammers call me night and day. Because I have blocked so many of them, the only ones that get thru anymore are the ones that call after 9 pm.....when I'm in bed. One called at midnight the other day. Of course I answer because I have 2 children and an old fashioned key pad phone by my bed. I keep it because when the electricity goes out it still works.

They are so desperate to steal your money. So many elderly people have fallen for the hype. At a time when you could use some peace and quiet in your life, a horde of greedy con artists descend on you let lose on you by your own government to try and swindle you out every last dime you have.

They are relentless and cruel. One called for my spouse the other day, who has been dead for 3 years. They are so thoughtless and greedy they can't even take the time to see if you're still alive.

America has turned into one constant con after another. Capitalism is horrible.

[CousinIT]

4. POTUS and CMS / CMS Innovation need to hear from YOU. n/t

[Farmer-Rick]

20. So I tried to write an email to

Liz Fowler to complain but I can't find the info anywhere. Weird. I did write to the White House but Liz should have to deal with the complaint since Biden is dealing with Putin's war.

They keep wanting me to log in and start an account. I already have an account and they can't stop making American seniors targets for every scam Medicare health insurance corporation out there. It's the system that's broken not just the scammers.

Do you have an email address?

[Grasswire2]

5. kick nt

[CousinIT]

6. ALERT: How "DCEs" Jeopardize Care, Drive Up Costs, and Turn Medicare Over to Corporations

How "DCEs" (now deceptively renamed to "Accountable Care Organizations") Jeopardize Care, Drive Up Costs, and Turn Medicare Over to Corporations

https://socialsecurityworks.org/dces-fact-sheet/

What are “DCEs” and how do they undermine Medicare?
“Direct Contracting Entities” or “DCEs” are a direct assault on traditional Medicare. They are an “experiment” that, over time, could force everyone in traditional Medicare—people who have chosen government-run health care—into corporate-run healthcare.

Who’s behind the DCEs?
The Trump Administration, originally through the Center for Medicare and Medicaid Innovation at HHS. Unfortunately, the Biden Administration appears to be continuing the program.

How do DCEs work?
Insurers and investors receive a flat dollar amount (“capitated fee”) for each person they manage under Medicare. The less money they spend providing medical care, the more money they can keep for themselves. DCEs can spend as little as 60 percent of what Medicare pays them on medical care.

How do people on Medicare end up in a DCE?
Generally, through no choice of their own. If their doctor joins one of these corporate plans, the Centers for Medicare and Medicaid Services automatically switches people involuntarily—and often unknowingly—into a DCE. DCEs can also market their services.

What happens if someone is switched into a DCE?
The government no longer directly covers their health care. A corporation or other private entity is now in charge, and it maximizes profits by withholding and delaying care. DCEs will drive enrollees to their network providers to minimize people’s care and costs. In turn, their providers benefit financially by following DCE treatment policies.

Theoretically, people in DCEs can see any Medicare provider they want. But their doctors will have a financial incentive not to refer them to out-of-network providers, and many people are unlikely to know they even have that right. People can also opt out of these plans, but they would need to find a new primary care physician.

Why do for-profit insurance corporations want to be DCEs?
Medicare is a massive money-making opportunity for the corporate sector. If corporations can take control of traditional Medicare, there are hundreds of billions of dollars to be made each year.

Why are DCEs bad for patients?
DCEs pit both the DCEs’ and its providers’ interests against patients’ interests: DCEs create an incentive for doctors to withhold care from patients, rather than treat them effectively. In particular, capitated payments create an incentive for insurers and investors to withhold care from people with serious health conditions in order to maximize profits.

DCEs inject a large unaccountable for-profit bureaucracy between patients and doctors: There is little bureaucracy to manage with traditional Medicare. With DCEs, patients might have to deal with these bureaucracies. Even if not, their medical providers will, causing delay and difficulty for everyone.

DCEs rob patients of the choice to stay within the traditional Medicare system they chose: Many people choose traditional Medicare because it affords them the freedom to see the providers they want to see and to get the services they want and need. By forcing them into DCEs, this program effectively robs them of that choice.

Why are DCEs bad for the country?
Cost: Traditional Medicare costs less per-person than the private alternative, Medicare Advantage plans. DCEs will almost certainly cost more per-person than traditional Medicare. (1)

Health equity: Traditional Medicare, unlike DCEs and MA, is designed to spread costs equitably across a large population and protect the most vulnerable enrollees with costly conditions.

Accountability: Traditional Medicare operates transparently, permitting oversight and accountability. The public does not get the same transparency, oversight, or accountability from DCEs.

Access to quality care: A disproportionate number of people leave MA when they need costly care, including at the end of life. That’s because corporate plans make it difficult for patients to receive quality care.

The DCE experiment can and should be stopped.
In 2021, there were 53 DCEs that could potentially control access to care for some 30 million people in traditional Medicare. CMS has refused to disclose the number of DCEs today or whether it is limiting the number of DCE enrollees. At a minimum, the DCE experiment should be paused. Congress gave CMS authority to experiment through CMMI, not to undertake a wholesale transformation of traditional Medicare that threatens care for millions of vulnerable Americans.

1 One recent NBER study found that a $10.40 prescription drug copay increase for people with Medicare led to one in five dropping all their medications. It further found that a high percentage of those who dropped their heart and other life-saving medicines because of their out-of-pocket costs died of heart attacks, strokes and more.

[Celerity]

7. K & R for visibility

[Trueblue1968]

8. PETITIONS, AARP .... contact your senators and house members. TELL THEM NO.

Most of these "Accountable Care Organizatons" are NOT accountable. Their only accountability is to sucking up as much Medicare money as possible while DENYING as much care to seniors as possible.

[CousinIT]

9. EXACTLY. And don't forget POTUS, too. AND CMS. Even if you're not on Medicare yet.

Because when you are, you won't want to be dealing with this parasitic deadly shit.

[Emile]

10. I was in a Medicare Advantage plan the first year of my retirement. When

I found it hard to find healthcare outside of network (which made it hard to travel), I switched to a regular Medicare plan the next open enrollment.

[CousinIT]

11. I've heard traditional Medicare w/ supplemental (MediGap) is best.

I'm not there yet but will certainly take this under advisement when I am. And I don't want to be dealing with this "Accountable Care Organization" bullshit which will have the entire thing privatized in a decade when I'm there either. And it seems "Medicare Advantage" is not so great either so will avoid that if I can.

Ugh.

[Farmer-Rick]

22. I will be eligible this May and the floodgates of robocalls, sales calls, a scams has been unleashed

And they specifically talk in mubojumbo so if you don't do your research you think you're dealing with Medicare. I get soooo much email since they figured out I'm eligible that I threw out my Medicare cards by accident because I thought it was just another scam health insurance corporation. I block about 5 numbers a day but they always come back with more.

I have part A and B and was automatically enrolled because I get Social Security from my dead spouse. If you get Social Security they will automatically enroll you. Go to your Social Security account and it will tell you if you are enrolled in Medicare. I have my Tri Care for Life so they act as my gap insurance and give me a prescription program that is better than part D.

Avoid Medicare Advantage and this other crappy program ACO or whatever they label it will obfuscate the destroy Medicare plan.

[Emile]

23. I was told if you took an advantage plan for two years it was impossible

to switch back to traditional Medicare. I didn't want to take that risk.

[CousinIT]

29. Wow. They want be sure you are stuck with the damn deny-care-for-profit crap.

I'm not even going there.

[Trueblue1968]

12. posted to twitter

[delisen]

13. Kaiser Permanente Med Advantage is putting me in danger of heart/kidney failure

These plans can get billions from Medicare if they classify patients as high risk. They take the money but do not provide the medical services or slow walk services.

I have been waiting two years for a surgery for a condition that can be completely cured by a 20 minute surgery. So long as they are getting additional money for my care they have no incentive to provide the care.

[CousinIT]

15. I'm so sorry. Yes this is exactly the danger in these damn privatization schemes. The're EVIL.

I hope many here contact POTUS and CMS as well as their reps about this. It's a damn abomination. I can't BELIEVE Biden is letting this continue. The former big pharma exec woman behind this right now is Liz Fowler. She's at the CMS Innovation Center: https://innovation.cms.gov/

[TexasBushwhacker]

21. Why didn't you change to a different provider

Or just switch to regular Medicare? They have open enrollment every year.

[delisen]

25. Regular Medicare high underwriting costs for supplemental if you don't sign up at retirement age

This means that your pay much more for supplemental if you have poor health and the premium can rise each year. This can make the premium cost unaffordable if you are not sufficiently poor and can’t qualify for Medicaid. In some states people can have no more than $2000 in a bank account to qualify for Medicaid.. They can be wiped out financially and unable to pay their property tax if they repair their leaking roof. They live in constant anxiety.

I have the month of March to make a change to another program. I am pondering options - none are excellent.

Meanwhile I filed a complaint and just received a telephone call from my surgeon who gave me some good information which may be helpful in speeding things up now.

So I have a couple of weeks to decide whether to stay and fight or leave and take a chance that another program will be an improvement.

My mistakes that got me into this position:

Signing up for Medicare Advantage instead of regular Medicare at 65.
Living in a Southern state with a Manchinite attitude toward non-rich citizens
Not thoroughly understanding my rights and insisting upon them
Accepting for awhile magical thinking of some physicians about what constitutes normal aging.

[Ms. Toad]

26. Unfortunately, that misunderstanding is enticing people to make bad choices.

Without supplemental insurance (Medigap), original Medicare leaves a significant amount of your health care costs coming out of your pocket.

You are only guaranteed access tp a Medigap policy if you sign up during your initial enrollment period (the 7 months centering on yoru 65th birthday) OR a special enrollment period (if you had creditable coverage through a larger employer beyond your 65th birthday.

Any other time, Medigap plans are free to charge you a premium based on your health - and are not even obligated to offer you a policy.

You can change Medicare Advantage plans every year - so had I made the costly mistake of enrolling in Medicare Advantage, I'd be shopping plans every year.

[Omaha Steve]

14. K&R!

[JanMichael]

16. If that happens I'm leaving this shithole country.

I can't stand these fucking companies. And if the Democratic Party doesn't stop it from happening then why be a Democrat? Might as well be some other moronic party that doesn't give a shit about people

Let social security and Medicare go to way of dinosaurs? FDR would be proud right? Johnson would be proud right? I would not be.

[Jspur]

19. I agree and feel the same exact way

that you do about this privatization scheme of Medicare. If they succeed this country is literally pushing a work till you die lifestyle.

I'm definitely looking to escape this country in the next 10-15 years the way things are going. I have no kids and I'm not married so it makes it much easier to leave. Only thing that keeps me here is my parents but once they are gone, I have no reason to be here.

[marie999]

17. Medicaid in North Carolina is going that way.

[CousinIT]

18. It'll be useless. Except to the billionaires sucking up the money for nothing. n/t

[dwayneb]

24. Thanks for the heads up

Might have missed it here, but what is AARP's take on this initiative?

Just a quick look at their website show me that they are tacitly supporting this.

[CousinIT]

30. Just personally I don't always trust AARP.

They supported some schemes to cut social security in the past if I remember.

I tend to go by what social security works says. This organization also works to protect traditional social security and Medicare benefits and programs: https://www.ncpssm.org/entitledtoknow/trump-plan-to-privatize-medicare-still-alive-and-well/

When it comes to protecting traditional SS and Medicare, these are the two I trust.

And the fact that this damned scheme was cooked up during the Trump admin gives me hives. ANYTHING that scheming creep did is not to be trusted. Why Biden is allowing it to continue is beyond me.

[wackadoo wabbit]

27. k&r

[Cuthbert Allgood]

28. Let me see if I remember all the responses.

Everyone wants a pony.
Unicorns.
But Daddy promised!
Let's not got the Republicans a talking point.

I'm sure I missed some.

Funny how millennials wanting things is scoffed, but once Medicare is threatened...

For the record, this move is bullshit.

[progressoid]

31. Well this sucks.

[dalton99a]

32. Kick

[CousinIT]

33. 'Band-Aid on a Tumor': Critics Blast Biden Rebrand of Trump's Medicare Privatization Scheme

"Changing the name doesn't change the fact that the Direct Contracting program is backdoor privatization of Medicare," said one progressive advocate.

JAKE JOHNSON

February 25, 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.

"This dangerous experiment must be stopped before it further harms the health of vulnerable seniors."

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."

https://www.commondreams.org/news/2022/02/25/band-aid-tumor-critics-blast-biden-rebrand-trumps-medicare-privatization-scheme

The links below are from two organizations who are primarily concerned with protecting and preserving traditional Medicare and Social Security. They are also very against this backdoor privatization scheme:

https://socialsecurityworks.org/dces-fact-sheet/

https://www.ncpssm.org/entitledtoknow/trump-plan-to-privatize-medicare-still-alive-and-well/