Kentucky Health Care News

Protest Sat., Dec. 11, 2021, 11 am at Humana: 

How the Grinch Stole Medicare

Wall St. and Insurance Companies are stealing Medicare–End Direct Contracting

FOR IMMEDIATE RELEASE, December 1, 2021

Contact: Kay Tillow 502 636 1551, Chair, Kentuckians for Single Payer Health Care, www.kyhealthcare.org, nursenpo@aol.com

On Saturday, December 11 at 11:00 a.m. EST, Kentuckians for Single Payer Health Care and others will gather outside the headquarters of Humana, 500 W. Main St., Louisville, KY 40202 where they will demand an end to Medicare Direct Contracting, a program that could fully privatize Traditional fee-for-service Medicare without a vote by Congress.

The protest with feature Steven Katz in full costume as the Grinch with the reading and performance of “How the Grinch Stole Medicare,” an original poem from National Single Payer.   Jill Harmer and the Single Payer Singers, Stephen Bartlett and his band, and singer, songwriter John Gage will perform holiday and health care music.

Humana is one of 53 for-profit Direct Contracting Entities (DCEs) into which seniors who have chosen traditional Medicare can be placed without their consent.

Instead of paying doctors and hospitals directly for care, Medicare gives DCEs a monthly capitation payment to cover a defined portion of each seniors’ medical expenses, allowing DCEs to keep as profit and overhead (up to 40% of revenues) what they don’t pay for in medical services — establishing a dangerous incentive for DCEs to restrict seniors’ care.

Virtually any type of company can apply to be a DCE, including commercial insurers, venture capital investors, and for-profit dialysis chains. Applicants are approved by CMS without oversight from Congress. The DC “pilot phase” includes 53 DCEs in 38 states, potentially covering 30 million Traditional Medicare beneficiaries.

The DCE program places profit-making middlemen between seniors and their physicians and will totally privatize and destroy Medicare unless the public raises a powerful outcry to stop it. Kentuckians for Single Payer Healthcare advocates for a not-for-profit, improved Medicare for All, a national single payer system that includes everyone and removes all barriers to care.

More information on Medicare Direct Contracting:

  • Direct Contracting one-page fact sheet
  • Direct Contracting policy primer (4 pages)
  • 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 ONE and PART TWO
  • List of current DCEs
  • CONTRACT between CMS and Direct Contracting Entities
  • Direct Contracting Entities’ Financial Operating GUIDE from CMS

End of press release.

Most recent health care news stories from Kentucky.

Kentuckians for Single Payer Health Care Newsletter, June 17, 2021

Kentuckians for Single Payer Health Care KSPH

www.kyhealthcare.org
Facebook
Single Payer Radio
Twitter:  @ky4singlepayer
Instagram:  Kentuckians_for_single_payer

Events, news, opinion. In brief….

1.  Kentucky Single Payer Meeting on Zoom, Thur., June 17, 2021, 5:00 PM

2.  March for Medicare for All, Sat., July 24, 2021 in Louisville and 20 other cities

3.  Single Payer Radio on 106.5 FM, Mon 2pm, Tue 7am, Wed 11am

4.  Pitfalls of Medicare Advantage Plans, Investopedia

5.  Time to Abandon Pay For Performance, comment by Adam Gaffney, MD, MPH

6.  Liz Fowler is Back! And She’s Writing US Health Policy Again, by Kay Tillow

7.  The Buffett-Bezos-Dimon-Gawande insurance fail?, comment by Don McCanne, MD

8.  Build the MovementGive to Kentuckians for Single Payer Health Care

…details below.

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1.  Kentucky Single Payer Meeting on Zoom, Thur., June 17, 2021, at 5:00 PM

The next meeting will be on Thursday, June 17, 2021, from 5:00 PM to 6:30 PM.

If you are not on our zoom list, please email Kay Tillow at nursenpo@aol.com, and we will send you the information needed to access the zoom call.

We meet the first and third Thursdays of each month.  The following meeting will be on Thur. July 1, 2021.

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2.  March for Medicare for All, July 24, 2021 in Louisville and 20 other cities

Join us in Louisville to rally and march for improved Medicare for All.

Sat. July 24, 2021, 11:00 AM
Mazzoli Federal Bldg., 600 Dr. Martin Luther King Jr. Pl.

Cosponsors:  Kentuckians for Single Payer Health Care, Physicians for a National Health Program-KY, Kentucky Alliance Against Racist and Political Repression, Greater Louisville Central Labor Council
Louisville details:  http://kyhealthcare.org/posts/louisville-and-20-other-cities-plan-march-for-medicare-for-all-july-24-2021

National website:
https://m4m4all.org/
They are using this hashtag #m4m4all

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3.  Single Payer Radio on 106.5 FM, Mon 2pm, Tue 7am, Wed 11am

Tune in to Single Payer Radio.  Dr. Eugene Shively, Dr. Mike Flynn, and Mark McKinley host lively discussions on single payer and other health care topics.

Current program:  Dr. Bob Wojda and Teresa Casey discuss healthcare services provided to the homeless through their work at Phoenix Health Center in Louisville.  Podcast.

Upcoming interviews:
Dr. Henry Sadlo, Cardiologist
Ann Hagan-Grigsby, CEO of the Park DuValle Community Health Clinic

Please share on social media and tell your friends. Help expand the voices of the movement.

Single Payer Radio is aired each week;  Mon 2pm, Tue 7am, Wed 11am, on 106.5 FM.  At these times you can get the program on the internet, too.  Go to www.forwardradio.org and click “listen live.”  Programs are archived here:  https://www.forwardradio.org/singlepayerradio

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4.  Pitfalls of Medicare Advantage Plans

Investopedia

A Medicare Advantage Plan, also called a Part C or an MA Plan, may sound enticing. They are offered by private companies approved by Medicare.

Still, while many offer $0 premiums, the devil is in the details. You will find that most have unexpected out-of-pocket expenses when you get sick, and what they pay can differ depending upon your overall health.  Here’s a look at some of the disadvantages of Medicare Advantage Plans.

https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp

Kentuckians for Single Payer Health Care is eager to speak with those who have run into problems with Medicare Advantage–the privatized, for-profit Medicare that is so widely advertised.

Were you denied or charged more for Medigap because you had been on Medicare Advantage?  We want to hear about it.

Call Kay at 502 636 1551 or email nursenpo@aol.com.

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5.  Time to Abandon Pay For Performance

Time and Financial Costs for Physician Practices to Participate in the Medicare Merit-based Incentive Payment System: A Qualitative Study, JAMA Health Forum, May 14, 2021, by Dhruv Khullar, Amelia M. Bond, Eloise May O’Donnell, Yuting Qian, David N. Gans, and Lawrence P. Casalino

Comment:

By Adam Gaffney, M.D., M.P.H.

There is little evidence, in other words, that P4P programs substantively improve care — and growing evidence that they further inflate our already enormous administrative costs while sapping the time and energy of practicing doctors. For these reasons, P4P should not be included in a Medicare for All reform.

https://pnhp.org/news/time-to-abandon-pay-for-performance/

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6.  Liz Fowler is Back! And She’s Writing US Health Policy Again

by Kay Tillow
June 7, 2021

So, if Americans are seeing their doctors less and spending fewer days in the hospital, why are we still spending more than wealthy countries on health care?

There is a battle raging over what must be done to cover everyone and rein in costs. Single payer, improved Medicare for All, advocates assert that the key is to remove profit-making insurance companies and hospitals from the system, slashing administrative waste to the point where savings can improve care for those who are covered and expand it to those who are uninsured.

https://ky.aflcio.org/news/counterpunch-liz-fowler-back-and-she-s-writing-us-health-policy-again

https://www.counterpunch.org/2021/06/07/liz-fowler-is-back-and-shes-writing-us-health-policy-again/

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7.  The Buffett-Bezos-Dimon-Gawande insurance fail? A powerful policy lesson!

How Amazon, JPMorgan, and Berkshire Hathaway took on America’s health care system—and lost, Fortune, June 1, 2021, by Erika Fry

Comment:

By Don McCanne, M.D.

I contend that the Haven health reform effort of Warren Buffett, Jeff Bezos and Jamie Dimon, along with Atul Gawande, was a spectacular success, as an experiment in health policy. They proved beyond any reasonable doubt that the private sector is incapable of fixing our highly dysfunctional health care financing system. The only model that has shown promise is a single payer Medicare for All system. But you cannot set that up as an employer-sponsored system; it will have to be a public system for all the people.

https://pnhp.org/news/the-buffett-bezos-dimon-gawande-insurance-fail-a-powerful-policy-lesson/

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8.  Build the Movement–Give to Kentuckians for Single Payer Health Care

The corona virus pandemic exposes our need for a single payer health care system.  None of us will be safe until all of us have care.

Your donations can help to hasten that day.  You may contribute on line here.

Or make out your check to PNHP-KY and mail it to KSPH, PO Box 17595, Louisville, KY 40217

________________________

Issued by:

Kentuckians for Single Payer Healthcare
P. O. Box 17595
Louisville, KY 40217
(502) 636 1551

Articles do not necessarily represent the position of KSPH.

nursenpo@aol.com

www.kyhealthcare.org

Facebook: https://www.facebook.com/pages/Kentuckians-for-Single-Payer-Healthcare/276722622460445

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