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Report Shows Big Insurance Profiting Massively From Medicare Privatization

A new analysis released Monday shows that insurance giants are benefiting hugely from the accelerating privatization of Medicare and Medicaid, which for-profit companies have infiltrated via government programs such as Medicare Advantage. According to the report from Wendell Potter, a former insurance executive who now advocates for systemic healthcare reform, government programs are now the source of roughly 90% of the health plan revenues of Humana, Centene, and Molina. Over the past decade, Potter found, the seven top for-profit insurance companies in the U.S.—the three mentioned above plus UnitedHealth, Cigna, CVS/Aetna, and Elevance—have seen their combined revenues from taxpayer-backed programs soar by 500%, reaching $577 billion in 2022 compared to $116.3 billion in 2012.

US Funneled Billions To Ukraine While Cutting Health And Education

February 24 marks the one-year anniversary of the Russia–Ukraine war, and in the past year, the US Congress has approved $113 billion in aid to Ukraine. Meanwhile, working people in the US are in dire economic straits, and desperately need relief from their government. When US President Joe Biden delivered his State of the Union Address in early February, over 160 million people—almost half of the nation’s population—reported having trouble paying weekly expenses. The cost of living had jumped by 8% while wages had only increased by 4% in the past year.

Physicians Tell Biden HHS To End Medicare Privatization Pilot

A national physician group this week called for the complete termination of a Medicare privatization scheme that the Biden White House inherited from the Trump administration and later rebranded—while keeping intact its most dangerous components. Now known as the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the experiment inserts a for-profit entity between traditional Medicare beneficiaries and healthcare providers. The federal government pays the ACO REACH middlemen to cover patients' care while allowing them to pocket a significant chunk of the fee as profit. The rebranded pilot program, which was launched without congressional approval and is set to run through at least 2026, officially began this month, and progressive healthcare advocates fear the experiment could be allowed to engulf traditional Medicare.

AARP And The AFL CIO Are Pushing Medicare Disadvantage

Medicare Disadvantage insurance plans induce seniors by offering advantages that traditional Medicare doesn’t offer – like vision and dental coverage. That’s the upside. The downside is that when you actually get seriously ill, the disadvantage is that when you get sick, you might not get the coverage you were promised. Now, about half of all seniors in the United States are in Medicare Disadvantage. The unions should be fighting against the move to privatize Medicare. Instead of fighting, they are joining with the insurance companies to corporatize Medicare. The big daddy of unions, the AFL-CIO, is itself now partnering with the giant insurance company Anthem to push Medicare Disadvantage plans on its retired union members. The first ad for the campaign read: “Introducing AFL-CIO Medicare Advantage group plans, provided by Anthem. Comprehensive coverage available exclusively to retired union members.”

Privatization Scam Threatens To Replace Traditional Medicare

In 2016, the Trump administration instituted a new little-known federal agency, the Center for Medicare and Medicaid Innovation, which has been moving enrollees, often without their consent, to for-profit middlemen known as Direct Contracting Entities (DCEs). Rather than saving money and supposed greater efficiency, they add to the cost of coverage by taking their own cut of profits. As a redesign of the DCE model, the Centers for Medicare and Medicaid Services (CMS) has allowed an expanded ACO REACH (Accountable Care Organization Realizing Equity, Access, and Community Health) program to start on January 1, 2023, with more than twice the number of DCEs. This is a corporate agenda being promoted and accelerated by CMS, with the ultimate goal to privatize and replace traditional Medicare altogether by 2030, without even a vote in Congress. Despite all those good words in its title — equity, access and community health — the 35-year track record of Medicare Advantage has failed on all of those counts.

Architects Of Medicare Privatization: Congress, Biden And The CMS

It is easy and appropriate to target the private health insurance companies who earn excessive profits from the Medicare Trust Fund through Medicare Advantage plans, especially given the well-documented evidence of overcharging and fraud. But it is essential that we remember that it has been the U.S. Congress and the Executive Office that promoted the privatization of Medicare, to varying degrees, since it was first signed into law by President Johnson in 1965 and enacted the following year. In 2017 The Commonwealth Fund published “The Evolution of Private Plans in Medicare,” which detailed the increasing role in healthcare granted to private companies since 1966 through Acts of Congress and the Office of the President.

Labor Leaders Provide Cover For Privatization Of Medicare

Such a statement from the AFL-CIO would suggest that labor is determined to protect Medicare and even support improving and expanding it to all Americans. Additionally, President Biden and Democrats regularly criticize Republican threats to reauthorize and voucherize Medicare. Meanwhile, what’s left out of both the Democrat talking points and the AFL-CIO’s 2022 national resolution on healthcare is any acknowledgment that the real threat to Medicare and healthcare today is the decades-long tax-subsidized privatization supported by both major parties. With major support from organized labor, including AFL-CIO President George Meany at the signing, Medicare was signed into law in 1965. Before Medicare, only 60% of those over 65 had insurance since it was unavailable or unaffordable via private insurance (seniors were charged 3x the rate of younger people).

Protest Demands Biden Administration Terminate Medicare Privatization

Seattle, Washington - Approximately 75 spirited protesters celebrated the 57th anniversary of the enactment of Medicare here on Friday, July 29, with a picket line and rally outside the Columbia Center chanting, “Whose Medicare? Our Medicare!” and “Medicare is not for profit! Keep your corporate hands off it!” The Columbia Center is where the Northwest Regional Director of the Department of Health and Human Services (HHS), Ingrid Ulrey, has offices, along with other staff of HHS, including the Division Director of the Center for Medicare Services (CMS). The protesters demanded that President Joe Biden and Congress terminate ACO REACH, which stands for Accountable Care Organization Realizing Equity, Access, and Community Health. It’s an impressive sounding name, but it amounts to letting a profit-seeking third party like an insurance company or private equity-backed firm step in and get paid by Medicare to manage the care patients receive.

Amazon Joins The Medicare Privatization Spree

Amazon, the $1.25 trillion company founded and led by Washington Post owner Jeff Bezos, has announced that it is acquiring One Medical, a private equity-backed primary care provider that generates over half of its revenue from Medicare. While Amazon’s profits from its core consumer retail business are dwindling, in part because of heightened competition from brick-and-mortar retailers that were shut down at the beginning of the COVID-19 pandemic, the corporation’s cloud computing division, Amazon Web Services, continues to enjoy robust profits thanks in part to generous government contracts. Now Amazon could be attempting to build on that federal largesse by seeking to milk revenue from Medicare, the national health insurance program for seniors and people with disabilities.

‘Value-Based Care’ Is A Pretext For Privatization

Later this month, right before Medicare’s 57th birthday on July 30, corporate health care and the government players who facilitate their lucrative businesses, will gather for a summit on value-based care.   They will speak of driving health equity, of reaching underserved communities, of coordination of care, and accountable care.  They will insist that physicians share in risk just like insurance companies.  They will advocate the transformation of health care to value-based care, supposedly founded on payment for quality rather than quantity, value instead of volume, and outcomes not fee-for-service.  They will assert that this transformation brings equity, improves care, and saves money. They have no evidence to back up their assertions. 

Privatizing Medicare

Capping five decades of battle by the labor movement for federal healthcare for elders, Medicare was signed into law in 1965 by President Lyndon Johnson. Funded by payroll taxes under Social Security, the new program provided comprehensive, low-cost care for retirees and the disabled. Medicare was part of the largest government domestic expansion since the depression-era New Deal. Shaken by civil rights protests, labor strikes and student anti-Vietnam war demonstrations, politicians responded with some valuable reforms. Medicare joined the Civil Rights and Voting Rights Acts, federal aid for education and housing, Head Start programs and food stamp allotments as victories of the Civil Rights era. Medicare proved wildly popular. Most of organized labor and virtually all organizations of seniors supported it. Adults no longer faced bankruptcy paying for medical care.

Machinists’ Retirees 751 Resolve To End ACO REACH

On June 13th the International Association of Machinists IAM 751 Retirement Club voted overwhelmingly to end the privatization of Medicare and to send their resolution to their congressional delegation, to President Biden, and to Secretary Xavier Becerra at Health and Human Services. Machinists’ District 751 represents 27,000 members who work at Boeing and some smaller shops across the state of Washington.  It is one of the largest organizations within the IAM. The privatization scheme the 751 Retirement Club opposes is ACO REACH, formerly called direct contracting entities (DCE).  It is a pilot program in which seniors who chose traditional Medicare are placed, without their consent, into plans that are run by insurance companies, private equity, and venture capitalists who can take as high as 40% in overhead and profit from the Medicare program.

Biden Hikes Medicare Prices, Funnels Profits To Insurers

Last week, the Biden administration quietly reaffirmed its decision to enact the highest Medicare premium hikes in history right before this year’s midterm elections. At the same time, President Joe Biden is endorsing a plan to funnel significantly more Medicare money to insurance companies and further privatize the government insurance program for older Americans and those with disabilities. In effect, the higher premium increases will subsidize the larger payments to — and profits for — private insurance corporations. This comes after Biden raked in roughly $47 million from health care industry executives during his 2020 campaign. The Biden administration announced on May 27 that due to “legal and operational hurdles,” Medicare recipients won’t see their premiums lowered this year, even though that rate was originally hiked last November in large part due to the projected costs of paying for a controversial Alzheimer’s drug that Medicare now says it generally will not cover. The Biden administration announced on May 27 that due to “legal and operational hurdles,” Medicare recipients won’t see their premiums lowered this year, even though that rate was originally hiked last November in large part due to the projected costs of paying for a controversial Alzheimer’s drug that Medicare now says it generally will not cover.

Physicians Slam Industry Push To ‘Fix’—Not End—Medicare Privatization

Physicians and progressive advocates on Tuesday urged the Department of Health and Human Services to reject an industry appeal to tweak and rebrand—not end altogether—a Medicare privatization scheme known as Direct Contracting, which the Trump administration launched in 2020. Members of Physicians for a National Health Program (PNHP), which represents 24,000 doctors and other health professionals, has been working for months to bring lawmakers' attention to the DC program and pressure the Biden administration to terminate it while it's still in an experimental phase. As a result of PNHP's efforts, dozens of Democrats—including Rep. Pramila Jayapal (D-Wash.) and Sen. Elizabeth Warren (D-Mass.)—have spoken out against the DC pilot, opposition that appears to have caught the notice of healthcare industry groups that stand to benefit from the program.

California Healthcare Bill Fails

Another effort to change the healthcare system in a U.S. state is dead in the water. This time, last week, lawmakers in California declined to vote on a measure whose proponents say would lead to a single-payer system in the state. Monday’s nonvote in California provides yet another instance in which a state cannot move forward with a proposal for single payer. But while supporters may argue that there just needs to be more political will, in reality, it is not impossible to achieve a true single-payer healthcare system on a state level. On a larger scale, the recent results in California show the futility of the current reformist strategy to win universal healthcare in the U.S. State-backed efforts for healthcare reform like those in California — or the push to pass the New York Health Act — have been touted by many on the Left as a path to winning universal healthcare on a national level, but they are actually counterproductive.
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