CMS Primary Care Fiddling Instead of Real Reform: We need to go to the streets

Summary: CMS is proposing a 10-year comparison of primary care payment models (fee-for-service and capitation, with support for care delivery systems). At first glance, why not? On closer scrutiny, this is another delay for an experiment in our current flawed system that will yield limited and equivocal results. Let’s focus on real reform.

Making Care Primary (MCP) Model, Centers for Medicare & Medicaid Services, June 8, 2023


By Don McCanne, M.D. and Jim Kahn, M.D., M.P.H.

…Real reform can’t be off the agenda for the next decade, while we wait for this and other tweaks to our broken system. This CMS proposal requires a response from us. We already have a great start: Medicare for All legislation in both the Senate and the House (Thank you Sanders, Jayapal, Dingell, and the many others). We need to go to the streets, not with guns, but with our placards and loud, passionate voices! And this time, let’s not just go home when the shouting is done. Let’s complete the job!…

Louisville’s Union Legacy: Fighting Racism, Taking on Corporate Power


Toni Gilpin, who wrote the book on the union at International Harvester in Louisville

Senator Gerald Neal whose father was a leader of that Local Union 236

Thurs., June 8, 2023, 6:00 pm, IUE-CWA Hall, 5153 Poplar Level Rd., Louisville

The Farm Equipment Local 236 in Louisville came to represent, Gilpin argues, “the most perfect embodiment of the FE’s ideology.” Part of this was quantifiable, as the radical FE’s commitment to shop-floor militancy, including a liberal reliance on walkouts to win grievance disputes, was on full display at the IH plant in Louisville, where “wildcat” strikes became commonplace. But it was also evident in Local 236’s adherence to what could be called “lived solidarity” – the belief that day-in, day-out collective struggle against management, involving Black and white workers together, was essential to undermine racism and forge the class cohesion necessary to take on rapacious capitalists.

The combative, and extraordinarily united, Local 236 membership, moreover, took their fight for equity beyond the plant gates and into the community, challenging segregation in Louisville’s parks, hotels and hospitals. I illustrate all this through the stories of various Louisville FE members, including Jim Wright, who was Black, and Jim Mouser, a white man; both became leaders within Local 236 but also close friends who regularly spent time together outside of work, often with their families, at a time when interracial socializing in Louisville was a rarity.

How the FE’s linkage of workplace militancy and antiracism succeeded at transforming Harvester workers in Louisville, often in profoundly personal and heartfelt ways, is a moving – and timely – story, I’d say.

Medicare Advantage is ripe for Comer’s oversight committee to investigate

Kay Tillow

May 11, 2023 5:40 am

(Getty Images)

Congressman James Comer, of Kentucky’s 1st District and chairman of the House Oversight Committee, is much in the news these days. The oversight committee is supposed to ensure the efficiency, effectiveness and accountability of the federal government and all its agencies.  Comer has been investigating everything from Chinese money laundering to Hunter Biden’s laptop to the origin of Covid-19.  Those may, indeed, be serious concerns, but there is a domestic health care issue that requires urgent attention.

Kentucky health care advocates have asked Rep. Comer to look into an issue central to the nation’s health and financial wellbeing.  Private, for-profit Medicare Advantage (MA) plans are siphoning billions from the Medicare Trust Fund while they delay and deny care to seniors and the disabled.

The Centers for Medicare and Medicaid Services (CMS), the government agency that oversees Medicare, is also in dire need of a thorough investigation. From 2008 to 2023 Medicare Advantage insurers collected $124 billion in overpayments, according to the Medicare Payment Advisory Panel. As terrible as it is to think of profiteers ripping off Medicare funds, it’s even worse that these Advantage plans are cheating on the care they owe to the patients.

Listen to Single Payer Radio with Dr. Mike Flynn, Dr. Eugene Shively, and Mark McKinley

Tune in to Single Payer Radio on WFMP-LP at 106.5 FM on Monday at 2:00pm, Tuesday at 7:00 am, and Wednesday at 11:00 am for the latest updates on health care in our community and nation and the struggle to win universal health care.

Retired surgeons Eugene Shively (L) of Campbellsville and Mike Flynn (R) of Louisville in the Forward Radio studio hosting Single Payer Radio. The program is produced by Mark McKinley.

If you are outside the Jefferson County area, you can livestream the program at Archived programs can be found here or on your favorite podcast.

ACO REACH and the Privatization of Medicare

Kathleen Healey, MD, Co-Chair of Physicians for a National Health Program–CA, describes how Medicare’s new ACO/REACH program places seniors and the disabled into for-profit plans without their consent. ACO REACH, along with Medicare Advantage, is draining the Medicare Trust Fund as private equity, venture capital, and insurance companies delay and deny care in the pursuit of profit.

Kentuckians for Single Payer Health Care offers free presentations on this topic. Contact us at 502 636 1551,

KSPH Reaches Out at the MDC Awards Ceremony

Jill Harmer and Kay Tillow staffed the single payer table at the March 31, 2023, Awards Ceremony hosted by the Metro Disability Coalition. MDC is a solid supporter of Improved Medicare for All. Jill Harmer made certain that the brochures on single payer and the flyers opposing ACO REACH were placed in many hands. The event was held on the 16th floor of the U of L Rudd Heart and Lung Center.

Kentucky can put Medicare for All on the Ballot

Kentucky cities can place questions on the ballot by vote of the city legislative body or by petitions

Last November, rural Dunn County, Wisconsin, which twice voted for Trump, voted by a majority for a national, publicly-funded, not-for-profit, health care plan that would cover all medical costs.  Townships in Southern and Central Illinois voted by 64% and 84% majorities for Improved Medicare for All.

These examples open a way to challenge the politicians who say the people oppose single payer.  Can such ballot initiatives inform and energize a grass roots movement in the fight for Improved Medicare for All?

Former State Representative Joni Jenkins has provided us with the Kentucky law that allows Kentucky cities to place such a referendum on the ballot:

83A.120 Procedure for referendum on public question.

“Any public question authorized by statute may be submitted to the voters of a city by either a resolution of the city legislative body or a petition meeting the requirements of this section.”

Are you interested in getting this question on the ballot in your city?

“Shall Congress and the President of the United States enact into law the creation of a publicly financed, non-profit, national health insurance program that would fully cover medical care costs for everyone in the United States?”

Let’s talk about the possibilities. Kay (502) 636 1551,

Dave McCool, Dr. Edgar Lopez, and Larry Hovekamp carry the banner in Louisville’s Easter Parade

Twice rural Dunn County voted for Trump. In 2022 they voted for public, non-profit health Care.

On November 8, conservative, rural Dunn County in Wisconsin voted 51.4% for national, publicly-funded, non-profit healthcare for everyone.  That same county had voted for Trump in the last two presidential elections and still in 2022 voted by majority for Republican candidates.

On December 14, 2022,  two members of the County Board of Supervisors, John Calabrese and Monica Berrier, spoke on the meaning of this expression of popular support for single payer health care in a conservative county.

Watch and share the video.

Story on the vote:

Video of Dr. Corinne Frugoni on Medicare Privatization and ACO REACH

On December 15, 2022, Dr. Corinne Frugoni made a powerful presentation for Kentuckians for Single Payer Healthcare, and she has graciously shared her power point slide show as well.  Write to to request it.

Thanks to Paul Hoppe, the video of the program is up on our youtube channel.  Please share it widely.

We urge you to take action and organize in your community so we can bring understanding about what is happening and, also, build a powerful movement to stop this privatization of Medicare that threatens our seniors and our entire Medicare program.

In addition, below are links to resolutions passed by various organizations, unions, and political bodies.  Please use them to get further resolutions passed, and please send copies of any resolutions passed to

Please write to your representative and senators and urge them to encourage President Biden to terminate ACO REACH.