EMERGENCY! Wall Street’s privatization of Medicare at our expense is starting now!

The GOP is threatening to hold debt ceiling legislation hostage in order to savage Social Security, Medicare and other safety-net programs. However, the destruction of Medicare is already taking place, off-stage, with corporate entities lining up at the trough with the poisonous ACO-REACH program. Tell Biden to executive order this out of existence and make sure your legislators know you are wise to this threat, or in 7 years, Medicare will be no more.

“The ACO REACH program is Medicare privatization, hidden in layers of bureaucracy. Essentially, seniors are put into this program, which allows a profit-seeking third party like a health insurer or private equity-backed firm to step in and get paid by Medicare to manage the care that they get. Taking for themselves the profit that is whatever they don’t want to spend on the patient.” – U.S. Rep. Pramila Jayapal (D-WA) 

Dr. Corinne Frugoni explains how commercial insurance companies have been chipping away at our crucial public health programs for decades and the unconscionable profits they realize from Medicare Advantage. Now, the ACO/REACH program will allow third-party middlemen, including the same private equity pirates who wreaked havoc on wheelchair, air ambulance and retail industries, to pocket up to 40% of Medicare dollars in overhead and profit that should be dedicated to patient care, with a goal of completely replacing Traditional Medicare by 2030.

Our voices can change this!

“I learned the hard way. If Wall Street firms are allowed to make decisions about your health care, their profits will always come first.” – Rick Timmins

• Make it personal – add in examples whenever possible!
• Share this information and ask for action: Shake their phones off the hook and fill their email boxes.
• Get friends and family in GOP-controlled states to join in. It makes a difference!
• This issue threatens the healthcare and financial solvency of the elderly and the disabled and the families that support them.

Action #1: Call/email Biden – choose-a-script!

Script A :

President Biden, my name is [_____] from [city/state]. Please issue an executive order to cancel the ACO/REACH program. This Trump-era scheme was designed to allow his corporate donors access to the Medicare Trust fund, with a 40% profit incentive to skimp on medical services. Even worse, those who chose Traditional Medicare are being automatically enrolled in this privatization plot without their knowledge or consent. We cannot let Wall Street profiteers take over Medicare. We need to end this ruinous “experiment” and recommit to a humane, efficient, and truly public Medicare program. In the meantime, I’m making sure all my friends and family aware of this scam and how it started. Please end this program today!

Script B:

I am calling today to ask President Biden to issue an executive order to protect the ability of seniors and people with disabilities to manage their own care in traditional Medicare by quickly eliminating the DCE/ACO-REACH pilot program.

The Trump administration developed ACO-REACH to hand a beloved and trusted public program, traditional Medicare, over to his Wall Street donors. President Biden, end this ruinous experiment and recommit to a humane, efficient, and truly public Medicare program.

In the meantime, I’m am sharing information on the ACO/REACH scam with all my friends and family. Too many people, including our own legislators, don’t know what’s happening.

Thank you.

Script C – If you ARE on Traditional Medicare:

I am a senior on traditional Medicare and I do not want to be assigned to, aligned with, or enrolled in an ACO/ REACH program. My doctor and I can manage my care without intrusion from a third party with financial interests that will deplete our Medicare Trust Fund. Keep the Medicare dollar for health care and don’t use it for investor overhead and profit. 

I want President Biden to preserve my choice of traditional Medicare and stop Trump’s privatization scam by ending the ACO/REACH program with an executive order.

In the meantime, I’m am sharing information on the ACO/REACH scam with all my friends and family. Too many people, including our own legislators, aren’t paying attention to the risk us seniors face.

Script D – Wordy email (our specialty!) Feel free to use what you want, but letters with personal stories are more powerful.

Dear Joe,

While you were running for president, you said that every American should have a public health insurance option like Medicare. You said “As in Medicare, the Biden public option will reduce costs for patients by negotiating lower prices from hospitals and other health care providers. It also will better coordinate among all of a patient’s doctors to improve the efficacy and quality of their care, and cover primary care without any co-payments. And it will bring relief to small businesses struggling to afford coverage for their employees.“

So why are you allowing Wall Street to steal Medicare? ACO/REACH or whatever name they try to sell it with – it’s still a privatization scam by the corrupt Trump administration to throw Medicare money to their friends.

Traditional Medicare has only a 2% administration cost. Then Congress decided to give a profit/overhead of 15% to middlemen and endless insurance hassles to patients with Medicare Advantage, which overcharged us by $106 billion in 9 years, and an expected loss of $600 billion in 9 more years.

• Who is asking you to add a rapacious structure that skims a 40% profit/overhead off the top of Medicare, a structure that will ALWAYS put corporate profits over patient care?
• Who is asking you to run our Medicare Trust into bankruptcy? Or to make traditional Medicare disappear by 2030?
• Who is asking you to use our taxes to police these profit-driven firms and or to prosecute the inevitable cheaters?

Not us, Joe. We want this abomination stopped now, with an executive order, before more of these firms feel they have an entrenched interest.

Joe, keep your word. There is no closer effect you can have on our lives than knowing a real public health care system exists when we, or someone we love is wearing a paper gown on an examining table. Work publicly and transparently to overthrow all iterations of Medicare privatization and to create that public option for those not yet qualified for “real” Medicare.

Action #2: Call your legislators to fight against Trump’s corrupt leftovers.

Minimal script to your DEMOCRATIC LEGISLATORS: I’m calling from [zip code) and as a person [who is on Medicare now/who hopes a robust Medicare program is still there when I need it], I want [Representative/Senator] [___] to urge HHS Sec. Becerra and President Biden to stop ACO REACH and any other programs that lead to the privatization of Medicare and the resultant higher patient costs and degradation of care.

I also expect [him/her] to support and push through legislation that extends Medicare’s single-payer healthcare system to all, allowing us freedom to choose employment or start new businesses, while saving costs through efficiency, increasing health equity and allowing US companies to compete on equal footing with foreign companies with no healthcare cost burdens.

Minimal script to your GOP LEGISLATORS: I’m calling from [zip code) and as a person [who is on Medicare now/who hopes a robust Medicare program is still there when I need it], I’m upset that GOP party leadership is threatening to cut Medicare to “save money.” Want to save money? Remove “Medicare Advantage,” which cost us taxpayers over $106 BILLION in overbilling charges in 9 years. Then stop ACO/REACH, or explain at my kitchen table how replacing the 2% administration costs of Traditional Medicare with the 40% cut involved in privatizing the system is a good deal for me. I expect [Representative/Senator] to urge HHS Sec. Becerra and Biden to stop this wasteful program immediately.

I also expect [him/her] to support and push through legislation that extends Medicare’s single-payer healthcare system to all, allowing us freedom to choose employment or start new businesses, while saving costs through efficiency, increasing health equity and allowing US companies to compete on equal footing with foreign companies with no healthcare cost burdens.

(A documentary on why businesses want healthcare for all – Fix It: Healthcare At The Tipping Point https://vimeo.com/161798765)

Deeper Dive

Dr. Susan Rogers smacks the U.S. Senate testimony on DCEs/ACO/REACH program.

In May of 2021, four members of the U.S. House of Representatives (Reps. Mark Pocan, Bill Pascrell, Jr., Lloyd Doggett, and Katie Porter) sent a letter to Dept. of Health and Human Services Secretary Xavier Becerra expressing concern about Medicare Direct Contracting, and calling for an immediate freeze of the program.

These videos are from the January 26 webinar by the Physicians for a National Health Program (PNHP) (protectmedicare.net).

Video of full webinar:

How did ACO/REACH start? Accountable Care Organization (ACO)/ Realizing Equity, Access, and Community Health (REACH) actually started out under a more straight-forward name -“Direct Contracting Entities (DCEs). While Trump was handing out get-out-of-jail-free cards to Medicare fraudsters, officials at the Center for Medicare and Medicaid Innovation (CMMI) launched this dangerous and insidious pilot program…a privatization scheme which would automatically enroll more than 30 million seniors who’d deliberately chosen traditional Medicare into for-profit DCEs instead, without their full knowledge or consent.

Like with Medicare Advantage, our earlier foray into inserting rapacious capitalism between Medicare patients and their doctors, the core falsehoods at the foundation of DCE’s are that Americans use too many services, and that doctors are just in it for the money and spend all their time ordering unnecessary tests, unnecessarily taxing the Medicare Trust Fund. And despite the fact Medicare Advantage has always cost more than traditional Medicare – the scam that for-profit middlemen make everything less expensive/more efficient, remains ever-green.

Virtually any type of company can apply to be a ACO/REACH partner (Bezos/Amazon has bought in!), including commercial insurers, venture capital investors, and for-profit dialysis chains. These entities have already received a huge influx of money from the same private equity firms who’ve been busy destroying America’s retail industry, and who came so close to owning our infrastructure under Trump. Business-as-usual for them will be an inexorable march towards limiting seniors’ care in order to maximize their profits, while passing expenses right back to patients. Social Security Works has been more specific, noting that REACH private equity and insurer entities could implement policies that lead to delays in patient care and referrals to low-cost/low-quality providers, along with interfering in the practice of emergency room departments, home health, nursing homes and for-profit PACE programs 

In response to pressure from progressive Democrats and advocacy groups, DCE’s were rebranded as “ACO/REACH,” along with certain “lipstick-on-a-pig” changes, such as requiring more participating providers on an ACO’s board, and allowing beneficiaries to retain the freedom to choose between all Medicare-enrolled providers, a hollow promise in rural and underserved areas. A lot of money will go to policing: “Under the revamped model, CMS will more strictly ensure compliance with beneficiary protections, screen model applicants more harshly and more actively monitor participants, while enacting stronger protections against inappropriate coding and risk score growth, the agency said.” All this is necessary, – “a recent study found that Advantage plans cost the government $106 billion in overspending from 2010 to 2019, and nearly a third of that came in just the last two years. The price tag is predicted to balloon to $600 billion over the next nine years.”

We will note here, cynically, that if/when this system takes over, the GOP, following their IRS-playbook, will assuredly vote to remove the overseers that interfere with their donors’ access to profit-making, all in the name of cost-savings. To find out to which legislators these corporations donating, go to opensecrets.org and type in the corporation name, click on the summary report, and then select “Recipients.” Do not be surprised by how much cash goes to Democrats. There’s more than one reason why these privatization “experiments” keep happening and that we don’t have Medicare-for-All right now. If you see your legislator on a list as a recipient, ask them to stop taking donations from these entities.

The ACO/REACH program is growing, from 99 groups last year to 132 for 2023, without any oversight from Congress. Unless we stop it, these entities could spell the end of Medicare as a public, nonprofit, social insurance program and the most shocking part is that most of our legislators have no idea this is happening. Check here to see if your legislator signed on to Rep. Jayapal’s letter to HSS Secretary Becerra. If your legislator DID NOT SIGN ON TO THIS LETTER, send this video link (https://youtu.be/5p_ziUR57Iw) in your comment to them and ask that they watch it. There should be no excuses for not understanding what is happening to their constituents’ healthcare!

Then take a moment to write to Biden, and to your legislators about this program so they have no cover of ignorance. And talk to your Trump-loving friends and relatives too. There is no separate GOP and Democrat Medicare. No scrawled “R” on their doors will protect them from the downstream damage caused by their legislators’ single-minded service to their corporate masters. All us non-1-percenters are in this together.

Hey, you know what would be a real innovation? MEDICARE FOR ALL! No more multi-million dollar corporate salaries. No more “up-coding” for maximum profits. Cost savings from the massive buying power of the federal government. Medical ACCESS for all would actually save us about $450 BILLION dollars a year.

Reading and more resource videos

• Letter from Rep. Jayapal and other legislators to Xavier Becerra, Secretary of the Dept. of Health and Human Services. (01/05/2022)
• (STAT) Accountable care organizations don’t cut costs. It’s time to stop the managed care experiment.
• (protectmedicare.net) 1-page explainer
• (protectmedicare.net) Share your Medicare story
• (Verywellhealth.com) Single-Payer Healthcare vs. Universal Coverage
• Direct Contracting: Quietly Handing Medicare to Wall Street (one-page fact sheet)
• Direct Contracting policy primer (4 pages)
• (Healthcare Dive) CMS redesigns controversial Medicare direct contracting model
• Form sent to seniors in Indiana University Hospital System requesting voluntary alignment to a DCE
• Article about Direct Contracting in Health Affairs journal by former CMS Administrator Dr. Don Berwick and former CMS Innovation Center director Dr. Rick Gilfillan:
  • Part 1: The Risk-Score Game
  • Part 2: Building on the ACO Model
• List of current DCEs 
• (CMS.gov) Centers for Medicare & Medicaid Services – ACO REACH
• CONTRACT between CMS and Direct Contracting Entities 
• (CMS.gov) Direct Contracting Entities’ Financial Operating GUIDE from CMS
• (KNN) Researcher: Medicare Advantage Plans Costing Billions More Than They Should
• (Social Security Works) Direct Contracting/REACH: A Backdoor Medicare Privatization Scheme
• (PNHP) Corporations are REACHing for Traditional Medicare
• (PNHP) Read our letter to the Biden Administration – Commercial insurance companies have a long history of harming patients
• (American Prospect) Medicare Advantage Is a Massive Scam – The program rips off both the taxpayer and its own enrollees.
• “Is There a New Plot to Privatize Medicare Afoot?” interview with Dr. Ana Malinow, Thom Hartmann Program, September 20, 2021
• “Wall Street’s Latest Attack on Traditional Medicare,” interview with Dr. Ed Weisbart, Code Wack Podcast, October 18, 2021, (part one of this two-part podcast, which covers Medicare Advantage, available HERE)
• “Medicare Direct Contracting call-in,” interview with Dr. Ana Malinow, Redwood Community Radio, KMUD, October 1, 2021
• “Docs Come to D.C. to Protest Medicare’s Direct Contracting Program,” by Joyce Frieden, MedPage Today, December 1, 2021
• “Congress ‘Asleep at the Switch’ as Biden Continues Trump-Era Ploy to Privatize Medicare,” by Jake Johnson, Common Dreams, November 30, 2021
• “Biden moves forward with Trump Medicare privatization plan,” by Chris Tomlinson, Houston Chronicle, November 8, 2021
• “Direct Contracting Entities: The Latest Scam to Privatize Medicare,” by Lambert Strether, Naked Capitalism, September 27, 2021
• “This latest under-the-radar program could push Medicare deeper into private hands,” by Trudy Lieberman, Center for Health Journalism, March 11, 2021
• “Trump administration attempts to privatize traditional Medicare,” by Diane Archer, JustCare USA, December 17, 2020
• “Stop the corporate Medicare money-grab,” by Dr. Emily Kane, Senior Voice Alaska, December 1, 2021
• “Willie Sutton and the brave new world of Medicare privatization,” by Dr. Marvin Malek, VTDigger, November 30, 2021
• “Medicare and Social Security have been successful,” by David Ross Stevens, News and Tribune (Jeffersonville, Ind.), November 24, 2021
• “Medicare is on the menu,” by Dr. Robert S. Kiefner, Concord (N.H.) Monitor, November 12, 2021
• “A successful Medicare should never be privatized,” by Dr. Elizabeth Rosenthal, The Riverdale Press (Bronx, N.Y.), October 31, 2021
• (Levernews.com) Amazon Joins The Medicare Privatization Spree, The retail behemoth has acquired One Medical, which is in the Medicare privatization business.