DOGE Consolidating Healthcare Benefits,Ā Intrepid News, April 1, 2025, by Dorough E. Sizdah
The Department of Government Efficiency (DOGE), headed by Elon Musk, appears poised to consolidate all federal mechanisms that pay for healthcare. The new agency, āCaring for America,ā will absorb funding and personnel from dozens of existing departments and programs. Overall spending will be reduced by a claimed $250 billion per year, via procedural streamlining and elimination of contracting overhead.
The programs to be combined include Medicaid and Medicare (currently part of CMS), the Veteranās Health Administration, the Childrenās Health Insurance Program (CHIP), Affordable Care Act exchanges, PACE (for seniors), the Ryan White Care Act (HIV care), the Indian Health Service, Federal Employees Health Benefits Program (FEHBP), Federally Qualified Health Centers, and dedicated immunization efforts, among others. Benefits will be standardized at the highest existing level.
DOGE employees and senior policy staff from the affected agencies envision this shift as start of a āUnified Financingā approach to health care. All medical providers would be paid directly for services, without use of intermediaries, and based on prices set in collective bargaining with representatives of the provider groups. Mr. Musk developed procedures for payment efficiency based on his design of PayPal, a popular electronic payment software which was his first major business success.
One confidential source characterized this consolidation of federal health program bureaucracy and payment mechanisms as a first step to broader health insurance streamlining. Next on the DOGE insurance agenda is integrating coverage currently provided via job-based insurance, with the massive savings from eliminating tax subsidies to companies for insurance premiums redirected to the new payment agency. Any funds needed beyond projected savings will derive from trims to tax cuts, said the source.
Congressional progressives were shocked, though pleasantly so. Senator Bernie Sanders said, āThatās spectacular. Itās the first big step toward Medicare for All! Iām so glad Mr. Musk finally endorses real efficiency. I will work with him, if heās serious about this.ā
The plans were leaked initially from a health policy chat room in Signal.
Comment:
By Jim Kahn, M.D., M.P.H.
A few days ago, HJM warned about DOGEās dismantling of federal health capacity. Now there is a truly pleasant surprise: a sheep in wolfās clothing. āUnified Financingā is what single payer is all about. Consolidation of sprawling federal healthcare financing streams set the stage for administrative simplification, elimination of costly intermediaries, and standardization of comprehensive coverage. A huge step forward ā¦ we then just need to bring in people insured at work and of course the uninsured.
How is it possible that Elon Musk pivoted in this way to a favorite policy of progressives? Is the āEā in āDOGEā now to be taken seriously? ā using government reform to eliminate waste and foster efficiency? Did PayPal provide the technical expertise needed to achieve payment reform?
Alas, it seems impossible. For those still asking āCan this be true?ā I remind them, itās April 1 ā April Foolās Day. This vision for Musk and DOGE is a prank. In these tumultuous times, I hope youāll forgive ā even enjoy ā a short satire break.
The fact is, single payer IS efficient, as well as generous. We must keep spreading the word, and fighting for the proverbially (but not truly) elusive āfree lunchā ā we CAN get universal health care and save money, by focusing on health care justice and eliminating profiteering.
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