Medicare Privatization: Medicare Advantage and REACH

A threat to seniors and the future of Medicare

Thursday, Dec. 15 at 7:00 pm EST by zoom

Speaker:  Corinne Frugoni, MD

Retired family physician and former Co-chair of Physicians for a National Health Program—California

Recent federal reports and New York Times articles have called attention to the persistent threats to Medicare from private, for-profit Medicare Advantage plans.  These deceptively marketed plans have been exposed for denial of care as they reap billions at the expense of the Medicare Trust Fund.

Unfortunately, Medicare Advantage is not the only imminent danger to Medicare.  An under-the-radar pilot program called Direct Contracting Entities (DCEs), renamed ACO REACH, places seniors who have chosen traditional Medicare into for-profit plans dominated by private equity, venture capital, and insurance companies.  These plans, into which seniors are placed without their consent, create a profit incentive for the denial of care.  The Center for Medicare and Medicaid Services plans to have all seniors in such plans by 2030.

We now see DCEs operating in Kentucky.  One named “Oak Street” is open at 1731 Dixie Highway and at 5743 Preston Highway.  There are more in Louisville, Lexington, Pikeville, Hazard, Paducah, and Murray.  Most people are unaware of DCEs and ACO REACH and the new threat they pose to Medicare.  That’s why we are inviting you to a free, educational program.

This program is free but you must register in advance:
https://us02web.zoom.us/meeting/register/tZEqdOGupjMvHNDVj8YyT9DjuQCSqqmH7BzJ
After registering, you will receive an email with the zoom link for joining the meeting.

Please spread the word and join us.

The program will be followed by Q and A and your questions and discussion will be welcome.

Many organizations are calling for the termination of ACO REACH which President Biden could end with the stroke of a pen.  A sample resolution is here.  Further info is here.

Effective January 2023, the ACO REACH program begins allowing Wall Street firms and insurance companies to turn traditional Medicare into a profit-making enterprise.

Seniors who have chosen traditional Medicare can be placed into these for-profit entities without their consent, and the program can be implemented without an act of Congress.  In ACO REACH, denial of care brings more profit.

Traditional Medicare has a 2% overhead, while DCEs and ACO REACH can receive up to 40% in overhead and profit. Both seniors and the Medicare Trust Fund will suffer.

Kentuckians for Single Payer Health Care is working with other organizations to terminate ACO REACH before the harm is done.

KSPH is offering a free educational program to any organization that wants to learn more.  Just let us know at 502 636 1551 or nursenpo@aol.com.

In addition, your organization can pass a resolution to terminate ACO REACH.  Here is a sample resolution. https://protectmedicare.net/wordpress/wp-content/uploads/2022/09/WashingtonStateLaborCouncilResolution.pdf

This episode of Single Payer Radio is a conversation with doctors Garrett Adams and Mike Imburgia. Both have worked for decades providing care and have witnessed patients denied care in our current system that requires insurance, co-pays, and unaffordable out-of-pocket expenses. Both doctors have established clinics to address the need. Dr. Imburgia established the Have a Heart Clinic in downtown Louisville. Dr. Adams established the Beersheba Clinic in Beersheba Springs,TN a small rural community in Warren County TN on the Cumberland Plateau. More info www.haveaheartclinic.org www.beershebaclinic.org

On September 28, 2022, National Single Payer hosted an internet event on how the citizens of Dunn County, Wisconsin, a rural community of 45,000 people, petitioned their County Board of Supervisors and got a unanimous vote to place a referendum on the ballot in November. Other rural communities are following suit.

You can watch the video here: https://us02web.zoom.us/rec/share/8mRXeaZDP_TnH2wX2PUNJ_f6nS9SZexTTYs-ETexKpIpy17iExIihVNbadRH9VZc.J0v0ckCl-1msGYqy?startTime=1664408355000 Passcode: kB4$#F?A

The speakers were:

• John Calabrese, Dunn County Board Supervisor and member of Our Wisconsin Revolution

• Dr. Lorene Vedder of Physicians for a National Health Program and Wisconsin United to Amend

Question for the ballot referendum:

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 all Americans?

“Is it possible that the people of these rural communities, under the stress of a broken health care system, can spark a movement to fix health care for the nation?”

Facilitator: Kay Tillow

Sponsored by @NSPhealthcare

Is it possible that the people of these rural communities, under the stress of a broken health care system, can spark a movement to fix health care for the nation?

by Kay Tillow September 5, 2022

Citizens of Dunn County, Wisconsin, have a plan to place national, publicly-funded health care for everyone on their November 8th county ballot.  In June and July at meetings of the County Board of Supervisors, many spoke of a broken health care system and their proposal to fix it.  After the third meeting, the Board voted unanimously to put the following question on the ballot:  

“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 all Americans?”

Full story

Paul Hoppe, Steve Katz, and Mark McKinley (L to R) of Kentuckians for Single Payer Health Care joined the March for Medicare for All in Washington, DC, to demand that the nation move to a national single payer health care system to cover everyone. It was July 30, 2022, Medicare’s 57th birthday.

Helping them hold the banner are Dr. Claire Cohen and Dr. Judy Albert, both from Pittsburgh and leaders of PNHP, and NationalSinglePayer, and the Western Pennsylvania Committee for Single Payer. Dr. Cohen, a child psychiatrist, was among the rally speakers. Dr. Albert and other bicyclists rode to DC on the Appalachian Trail in a demonstration for Medicare for All.

On that same day in Madison County, Kentucky, Dr. Robin Reams, distributed flyers at a Kentuckians for the Commonwealth picnic, and Jill Harmer, Harriette Seiler, and Kay Tillow took the message to Louisville farmers’ markets on Bardstown Road and at the Beargrass Christian Church on Shelbyville Road.

On May 9, 2022, Dr. Susan Rogers, PNHP President, moderated a roundtable discussion about Direct Contracting/REACH, the dangers of privatization and so-called “value-based care,” and how to achieve true equity in our health system. Panelists included Dr. Linda Rae Murray, Dr. Abdul El-Sayed, and Dr. Claire Cohen. 

You can watch the video here: https://youtu.be/qR2X9NnFQa0

Dr. Linda Mae Murray earned her M.D. and M.P.H. from the University of Illinois at Chicago. Her career includes positions at Cook County Hospital in Chicago; the Manitoba Federation of Labour in Winnipeg, Canada; Meharry College; the Chicago Department of Health; and as chief medical officer of the Primary Care and Community Health Network of Chicago. Dr. Murray is the former president of the American Public Health Association, where she advocated for the guaranteed right to health care for everyone, argued that health requires peace, and that equity and social justice demands a whole and sustainable planet.

Dr. Abdul El-Sayed is a physician, former Health Director for the City of Detroit, and advisor on the 2020 Democratic platform as a Healthcare Unity Task Force appointee. He holds a doctorate in Public Health from the University of Oxford where he was a Rhodes Scholar, and he received his M.D. from Columbia University. He is co-author, along with Dr. Micah Johnson, of the book “Medicare for All: A Citizen’s Guide,” and is also the host of the podcast “America Dissected” on Crooked Media.

Dr. Claire Cohen is a Black child and adolescent psychiatrist who has been practicing in Pittsburgh since 1984. She attended Hahnemann Medical College (now Drexel University Medical School) and completed her General Psychiatry Residency at the University of Chicago, followed by a Child and Adolescent Fellowship at the University of Pittsburgh’s Western Psychiatric Institute. Dr. Cohen has worked in a variety of settings, including community mental health clinics, partial hospitals, school-based settings and, currently, an inpatient hospital setting. She is a leader in PNHP, National Single Payer, and the Western PA Coalition for Single Payer Healthcare. Please join me on Monday, May 9 and join the fight for REAL health equity! Please don’t forget to REGISTER in advance for this exciting event. 

Predictions are that when the emergency measures expire, more than 15 million nationally will be removed from Medicaid. What will happen in Kentucky? Listen to Barbara Casper, MD, and Dustin Pugel discuss this on Single Payer Radio.