By George Bohmfalk, M.D.
The Aspen (Colo.) Times, January 2, 2022
My main area of advocacy is Medicare for All, which I believe to be the best solution to nearly all of our nation’s health care shortcomings. However, as of the last days of the Trump administration, Medicare itself is being subjected to a potentially fatal attack.
Without congressional authorization, bureaucrats in Trump’s administration developed a program openly designed to privatize Medicare. Called Medicare Direct Contracting (DC), this program allows commercial insurers and other for-profit middlemen to “manage” care for seniors enrolled in Traditional Medicare. This is in addition to the for-profit Medicare Advantage programs, which for years have cost taxpayers more than Traditional Medicare while restricting their choice of physicians and hospitals and providing no improvement in health care outcomes.
Slowly but surely, millions of seniors who deliberately chose Traditional Medicare are quietly being enrolled into Direct Contracting Entities (DCEs) without their full knowledge or consent.
Virtually any type of company can apply to be a DCE, including venture capital investors. There isn’t even a requirement that DCEs be majority-owned by health care providers, opening the door to ownership by profit-driven entities with no health care expertise whatsoever.
Traditional Medicare spends an impressive 98 percent of its budget on patient care. But DCEs are allowed to operate with very loose restrictions on how much of their revenues must go to patient care. This incentivizes them to limit payouts by rationing care and keep even more than the 15% that Medicare Advantage programs are allowed for their own profit and overhead. This detail alone should alarm taxpayers.
As this is a creation of the Center for Medicare and Medicaid Services’s “Innovation Center,” this pilot program can be scaled up to cover all of Medicare without so much as a vote or hearing in Congress. Very few Members of Congress appear to be even aware of its existence or its existential threat to Traditional Medicare.
To prevent Medicare from becoming completely and stealthily privatized, this program must be stopped in its tracks. The only way to stop it is by order of President Biden or insistence by enough Members of Congress.
Please make it your New Year’s resolution to help the millions of seniors and Americans living with disabilities who depend on Medicare, bring this nefarious program to a quick end. Please contact U.S. senators Hickenlooper and Bennet and your Congressional representatives and implore them to instruct Health and Human Services Secretary Xavier Becerra to terminate the Direct Contracting program immediately. The Capitol switchboard at 202-224-3121 can connect you with the office of any elected official.
Most seniors love Medicare. It is simple, efficient, and empowers them to manage their health. Traditional Medicare has proven its value for more than half a century. Rather than sell it off to the highest profit-driven bidder, we should strengthen and improve its benefits while working to expand it to cover every American.
Dr. George Bohmfalk is a retired neurosurgeon and a member of Physicians for a National Health Program.