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'The Corporatization of Medicare' 

Editor: 

The Views piece I wrote with Dr. Corinne Frugoni in last week's NCJ (Is Medicare a public good or a market commodity?"), signaled the growing privatization of traditional Medicare by Medicare Advantage programs and DCEs (Direct Contracting Entities). Since writing that piece some weeks ago, the public outcry to HHS (Health and Human Services), CMS (Center for Medicare Services), CMMI (Center for Medicare and Medicaid Innovation) and Congressional leaders has borne fruit. The DCE program will end and will be replaced by an incomprehensible program dubbed ACO REACH (Realizing Equity Access and Community Health). This "new" program is offering precious little in change beyond its mind-bending acronym.

As Dr. Susan Rogers, an internal medicine physician and president of physicians for a National Health Program, observes, "ACO REACH is Direct Contracting in disguise. ... This new model doubles down on Direct Contracting's fatal flaws, inserting a profit-seeking middleman between beneficiaries and their providers."

In addition, like DCEs, ACO REACH entices private equity and other Wall Street speculators to invest, allowing these middlemen to keep up to 40 percent of the dollars they don't spend on care, and has the potential to ensnare 30 million Medicare beneficiaries without their knowledge or consent.

And, like the DCEs, this "new" program is moving forward, claiming financial savings and better health outcomes, without Congressional oversight, and without supporting data or evidence but with built-in opportunities to rake in ever greater profits subsidized by taxpayers. 

As Dr. Rogers says, "You can't slap a Band-Aide on a tumor and call it cured. ... Direct Contracting — and now ACO REACH — threaten the health of beneficiaries and the future of traditional Medicare."

Again, we must tell our representatives and the federal departments of HHS, CMS and CMMI that we are not deceived by tortured acronyms that attempt to hide the corporatization of Medicare.

 Patty Harvey, Arcata

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