The comment below this article (from Beverly Mayhew, Senior Director, Marketing & Communications at PeaceHealth) gives me yet another opportunity to disabuse NWCitizen readers of the notion that privatization of Medicare will be of any benefit whatsoever. Why is it anyway that PeaceHealth, a non-profit medical group, has to “market” itself? But, Ms Mayhew, I digress…
First of all, PeaceHealth is not some benign entity in this region. Since I arrived here in 2002, I have watched PeaceHealth gobble up medical practices to a point where it is nominally the only game in town, a monopoly. Tens of thousands of residents have watched this takeover with growing anxiety. The creation of this for profit ACO of yours, the innocuously named Cascadia Community Care Alliance, is the capstone of PeaceHealth’s medical power grab. Individuals who had primary care (PC) physicians within PeaceHealth were moved to this “Alliance” in the dead of the night and often with no notification whatsoever. If your product is so good for the patients and so attractive an option, why the stealth? Furthermore, physicians were placed on your list of providers under this ACO without their knowledge or permission. My primary care doctor who was not in PeaceHealth was placed on the physician participation list [See FILES below] before it was removed from the “Alliance” web page. I had to call the CEO of my PC physician’s group to alert him to the fact that the “Alliance” had declared that his physicians were in this newly created PeaceHealth ACO. He put a stop to that nonsense mosh-skosh.
You contend that Medicare patients can leave the “Alliance” at any time just by changing their PC physician to one outside of the ACO. Sure, if you can find a PC doctor whose practice is not full AND accepts Medicare patients. You cannot be unaware of the absurdity of your statement given the degree of difficulty of what you have suggested. I harken back to my earlier statement that PeaceHealth has a near monopoly on medical services in this area.
That you or Dr. Foster would want to participate in the privatization of Medicare by creating this for-profit appendage to the risibly named non-profit PeaceHealth conglomerate strikes me as being at odds with the excellent care and benefits provided under Traditional Medicare without the insertion of private entities (extractive middle men) such as your “Alliance” under the relatively benign-sounding “value based” care, a euphemism for reducing services.
You stated, “The bottom line for Medicare benficiaries [sic]: Ask more questions of the ACO you are thinking about, learn who the sponsoring organization is, and compare the benfits [sic] and restrictions.” Just when was it you gave the thousands of Traditional Medicare patients with PC physicians in PeaceHealth the option to do this? The middle of the night?
For those readers who want to discover the real story behind these ACO Medicare privatization schemes, I suggest the following reading. Cut through the privatization argle-bargle from PeaceHealth.
No Amount of Fraud Deters Government Agencies When It Comes to Privatizing Medicare | Ana Malinow and Kay Tillow | Common Dreams | Feb 3, 2023
Architects of Medicare Privatization: Congress, Biden and CMS | Sandra Fox | CounterPunch | December 30, 2022
Labor Leaders Provide Cover for Privatization of Medicare – CounterPunch.org | Ed Grystar | CounterPunch | December 13, 2022
Value-Based Payment Is the New For-Profit Health Care Industry | Kip Sullivan, Ana Malinow, and Kay Tillow | Truthout | September 8, 2022
How This Rural Wisconsin County Put Publicly Funded, Non-Profit, National Health Care on the Ballot | Kay Tillow | Common Dreams | September 5, 2022
Value-based payment has produced little value. It needs a time-out | Kip Sullivan, Ana Malinow and Kay Tillow | Stat News | July 26, 2022
“Value-Based Care” is a Pretext for Privatization | Kay Tillow | CounterPunch | July 13, 2022
An Obscure Agency Is Threatening to Hand Medicare Over to Wall Street | Ana Malinow | Truthout December 3, 2021
Now that 2.1 million Medicare beneficiaries have been involuntarily moved from their Traditional Medicare into the ACO Reach privatization scheme, the creation of any more such entities has been halted. A decent presidential administration would now offer an off-ramp to the victims of this outrageous assault on their vital health insurance programs. Unfortunately, the sole escape from this “Reach,” for all intents and purposes, is death.
This from the President of Physicians for a National Health Plan (PNHP), Dr. Phil Verhoef:
“As you may have heard, we won a big victory recently in our campaign against the REACH program, which has placed corporate middlemen in charge of the care of 2.1 million Traditional Medicare beneficiaries. The director of the Center for Medicare and Medicaid Innovation [CMMI]—the agency in charge of REACH—announced that the program had been capped and would not be accepting any more corporate applicants. This means they are projected to fall far short of their goal of moving everybody on Traditional Medicare to a REACH-like plan by 2030.”
Dr. Verhoef went on to describe this admission as a “stealth announcement” by the Center for Medicare and Medicaid Innovation. This confession came during the CalPERS Education Day gathering.
“In a speech given to the California Public Employees’ Retirement System (CalPERS) on January 17, Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler revealed that there are no plans to further expand the number of organizations or beneficiaries in the controversial Medicare REACH model.”
I watched the video of the entire proceedings as Fowler bobbed and weaved through her pitch on the glories of ACO Reach. Throughout, she carefully avoided mention of the severe fiscal and health delivery problems with this privatization effort, ABOUT WHICH SHE HAS FULL KNOWLEDGE. Her evasive answers to questions from the CalPERS board members were a monument to the ability of political appointees to speak fluent argle-bargle, while simultaneously holding contradictory thoughts, without their heads exploding. Of interest in the CalPERS video was a presentation by Dr. Jim Kahn, Emeritus Professor of Health Policy, Epidemiology, and Global Health at the University of California, San Francisco. Dr. Kahn shredded Dr. Fowler's contentions by exposing the deliberate omissions, misstatements, and misrepresentations that are constantly being fed to the public about Medicare Advantage and ACO Reach. His riposte is well worth the time to watch and can be found at 2:54:00 on the video counter.
I invite readers to contact their legislators in Congress and President Biden to demand that these Medicare privatization scams be terminated permanently. While you are at it, contact Dr. Lorna Gober, recently announced as the new chief medical officer for PeaceHealth Northwest network, which includes St. Joseph Hospital here in Bellingham. Send a letter* to advise her that PeaceHealth moved thousands of their own patients, without permission or warning, into its version of ACO Reach. Demand that she speak out against this greedy and deceitful move against those whose health and well-being has been placed at risk for the sake of profits. This is all the more incongruous given PeaceHealth's “non-profit” declaration. More on that here: “The Blob” or Peace Health’s Latest Expansion Gambit.