To the Editor:

There is a stealthy menace threatening all seniors and those who love them. It is called “Medicare Direct Contracting Program,” (DC) and it threatens to privatize what has been a publicly guaranteed support system that everyone has paid into since they started working.

This new system pays by a capitation system — that is, by the head. The government contracts with a for-profit entity — they term it a “Direct Contract Entity” (DCE) — to pay it a negotiated amount per beneficiary, telling the DCE that what it doesn’t spend on the beneficiary it can keep.

So what’s so new about that, you may ask. We already have it in Medicare Advantage (MA), which contracts with the government a negotiated capitation amount. To the extent that the population chooses MA (as of 2021 about 43%), then to that extent our seniors’ medical care is already privatized — so what’s the big deal?

THIS: While MA approaches you, and tries to sell you, DC approaches not you, but your doctor or his practice and tries to sell them, offering them hefty financial incentives. And when your provider signs on the dotted line, then whatever terms and limitations your provider has agreed to govern you as well; you’ll probably get a note saying that you are now “aligned” with that DCE. You’re signed, sealed, delivered — you’re theirs — unless you find another practice.

But it gets worse. Anybody or any entity with money — a hedge fund, for example — can apply to be a DCE. The governing motive, after all, is PROFIT. There’s a lot of money to be made in this business, so much, in fact, the CMS — which governs all Medicare, old and new — has had to halt DCE applications for a while; too many have already lined up like pigs at the trough.

All of which brings me to the one similarity between DC and MA — the ways which they maximize profit at the government’s expense, and yours. To start off, they might exaggerate their risk in insuring you to get the government to pay them more to keep you alive. And then, to maximize profits, they find ways to deny you healthcare.

As I write this, DC is now a pilot program, and thousands have been signed up without their full knowledge or consent.

Representative Jayapal has written a letter to HHS Secretary Becerra, demanding that he stop this. Forty-eight other Representatives have signed on to it.

But our Antonio Delgado has not. Despite writing supportive generalities about the importance of preserving the integrity of Medicare, and despite his support of not raising next year’s Medicare premiums, and despite urging from hundreds of his constituents, at the time of this writing he has resisted keeping traditional Medicare free from the profit motive. WHY?

I refer you to the news source that first got me started on this:

https://www.nrln.org/wp-content/uploads/2021/12/DCP-Nov-30-Jake-Johnson-article-2021.pdf

Here’s the Washington Post column that lays it out pretty well:

https://www.washingtonpost.com/opinions/2021/12/13/medicare-direct-contracting-privatization-health-care/

And here’s the video of Ryan Grim’s barn-burning exposé:

https://www.youtube.com/watch?v=EJIvLHizAME

Please check these out. Talk it up with your friends. Get angry. For until the general public knows what the authorities are stealthily trying to foist on them, these authorities won’t be moved to do anything about it.

Paul R. Cooper

Kingston