I ran across this three-part series while reading one of Kip Sullivan’s articles “Kip Sullivan on the Creeping Privatization of Medicare, ” Corporate Crime Reporter
PNHP Single Payer Healthcare Financing Series, Kip Sullivan JD
If you wish to understand the evolution of healthcare and how we got to this point the US, the detail is here on YouTube. Kip’s discussion starts in the seventies detailing HMOs (HMO Act 1973) during the Nixon era. He goes on to explain how it was an attempt to decrease the overuse of healthcare in the US and the resulting costs.
“Now there are a slew of these insurance companies like managed care organizations – accountable care organizations (ACO), medical homes, hospital readmission reduction programs, merit based incentive payment systems. And they are eating Medicare from the inside out.
Most troubling now is the direct contracting entity (DCE) which was conceived in the Trump administration but is being pushed by President Biden and Elizabeth Fowler who heads the Center for Medicare and Medicaid Innovation.
‘The proposal calls for a pilot test in ten cities where traditional Medicare beneficiaries will be assigned to a DCE and they will have no choice to get out,” Sullivan said. “In this case, the DCE may not be able to tell patients where they can go. But now they are being paid like HMOs, they will have tremendous incentive to keep people from going outside of network. And to deny services.
That is the problem with creeping privatization in traditional Medicare.'”
I am very concerned with being locked into a MA plan which has been over coding and over charging CMS for the care provided, if provided. As a result, MA Advantage plans owe $billions to CMS. It appears the effort to “force” people on to MA plans is off the table for 2022.
MA plans are more costly than Traditional Medicare and provide a lesser standard of care. I will follow up with the other two parts also.
This is also A YouTube Presentation