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Conservatives Have Come Up With A New Way Of Ruining Your Life: DCEs



Earlier today, you may have read, once again, about how Manchin was never serious about allowing Build Back Better to pass once he tricked gullible progressives-- though not these 6-- into voting for his own shitty transportation bill. "Operating in bad faith" is the most polite way of putting it. "If you were a fossil fuel lobbyist and had to construct an ideal strategy not only to kill BBB but to gum up the works for as long as possible it would look a lot like what Manchin has been doing." Or maybe you read the post from a few hours ago about Maine's conservative Democratic governor, Janet Mills, vetoing a bill to allow farm workers to unionize.


My grandfather-- my political mentor and a huge FDR fan-- taught me at a very young age that after FDR the Democrat Party was no friend of the working man. He always said, "the only thing worse than a Democrat is a Republican."



Fewer and fewer from the working class are buying that any longer. This morning, AlterNet showed another reason why: Biden pursues Trump plan that creates big profits by denying health care. Ever hear of DCEs, direct contracting entities? Think of what Bernie-- and so many of us-- have been trying to accomplish with the health care system. This is the conservative response-- hand health care to our bankster buddies on Wall Street-- although it wasn't Biden who launched it. He may be bringing it to fruition, but it was Trump who got it going. Diane Archer, the founder of Just Care USA and the senior adviser on Medicare at Social Security Works, wrote that "The overwhelming evidence demonstrates that the plan will drive up healthcare costs, inhibiting people from getting needed care. So-called Direct Contracting Entities, DCEs, must pay for the care of the people assigned to them. Here’s the sweet part for Wall Street: In addition to the normal profits from providing services, these firms can keep as much as 40 percent of the money they don’t spend on care. Talk about a financial incentive to deny treatments... 'The Biden administration is forcing our nation’s elderly into a new form of Medicare Advantage plans, against their will and generally without their knowledge or consent.'"


Since people on Medicare did not sign up for this, they likely do not know or understand what’s in store. Yes, they should have received written notice of their new status. But the Centers for Medicare and Medicaid Services, CMS, treats the change as if it does not affect the quality of care provided to these older and disabled people.
Astonishingly, CMS does not require DCEs to tell people that they have the right to opt out, let alone alert them that there is good reason to do so.
Anyone enrolled in a DCE should worry that their primary care doctors will limit their access t costly necessary care. The DCEs are likely paying these doctors more to keep patients away from specialty care or providing them with guidance to delay and withhold care. We have seen this profit-maximizing approach before and it isn’t pretty.
With Medicare Advantage, which corporate health insurers administer, the Office of the Inspector General found widespread and persistent inappropriate delays and denials of care and coverage.
The Biden administration continues to mislead people about Medicare Advantage or Part C of Medicare with information claiming it offers people more than traditional Medicare without explaining its risks, including considerable financial and administrative barriers to care.
These business models mean that providing quality health care and abiding by their legal obligations is at odds with profiting handsomely, reports by government agencies and independent researchers have shown again and again.
Private equity firms and corporations that own or operate dialysis centers, hospice programs, long-term care programs and even dermatology practices put their own interests first, to the detriment of their patients, government watchdogs found.
Similarly, the DCEs can deliver more for their investors when they avoid paying for costly care.
...Why would the Biden administration want to give corporations control over the health care of the most vulnerable Americans?
Wall Street loves it. And the Trump administration, which promised to drain the swamp and stop Wall Street predations, instead turned Washington into a prosperous paradise for the worst Wall Street predators.
This move away from quality healthcare service to profit-oriented denials of care is worth hundreds of billions of dollars a year in taxpayer money flowing to private industry.

Like I said, this, privatization of Medicare-- is the opposite of Medicare for All-- and the opposite of what the Blue America-endorsed candidates are fighting for. South Florida progressive Christine Olivo minced no words: "Joe Biden is Donald Trump. I saw this firsthand as I was actively fighting for the migrants at the border. Watching Biden continue the Trump era policy of deportations without due process was the eye opener for me. So, when I hear that Biden, yet again, is looking to continue the work of his predecessor by structuring a DCE model for healthcare, I am not surprised. When people say that Biden’s policy choices are going to hand the Republicans the midterms, I simply reply 'what’s the difference?'" Los Angeles Assemblywoman and congressional candidate Cristina Garcia also went right to the root of the problem: "Corporatists Democrats have this fundamental problem with advancing actual universal health care. They are trapped. If they reject the so-called market-driven solutions approach, they will no longer receive campaign dollars from the pharmaceutical and health care industry. If they embrace people-driven health care solutions, they will be attacked by the same special interests that once fed their campaign coffers. That's the slippery slope of neo-liberalism." Please consider contributing to Christine and Cristina here.


Former Orlando congressman and current Senate candidate Alan Grayson Pointed out that "Medicare Advantage, the first Medicare privatization scheme, has completely failed in its sole purpose, which was to save taxpayer money. It has, though, placed a 15% tax on the head of every Medicare Advantage beneficiary. Given that experience, why would anyone see any point in this Trumpian scam? Carter’s OMB Director: 'If it ain’t broke, don’t fix it.' Donald Trump (metaphorically): 'If it ain’t broke, only I can break it.'"


How is Congress letting this happen? Asleep at the switch? Apparently... though not Katie Porter. Take a look:



Katie: "This program was supposed to make Medicare more efficient. But actually it does just the opposite. Rather than allowing patients to go to providers directly under traditional Medicare, DCEs invite insurers and investors to step in and interfere with the care that Americans get... This Direct Contracting Entity model is just one more example of the Trump administration’s many attempts to wreck a functioning, successful, popular government program for the sake of lining the pockets of its corporate donors. The bottom line for Direct Contracting Entities is not to improve the quality of care. They drive up costs for patients to maximize their profits."


After rolling his truck this evening-- don't worry, Gary is fine-- Tom Winter, the progressive former state legislator running for Congress in the brand new western Montana district told me that "Trump-touted DCEs claim to reduce inefficiencies in American seniors’ healthcare. And they do…because in our for-profit healthcare model, the inefficiency is proper care provided to the patient. And the point is profits."



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