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“The Blob” or Peace Health’s Latest Expansion Gambit

The slime of corporate greed knows no bounds, has no morals, and will win out if we do nothing.

The slime of corporate greed knows no bounds, has no morals, and will win out if we do nothing.


As Elisabeth Marshall reported in an excellent, recent opinion piece in the Cascadia Daily, like it or not Peace Health is about to absorb you, the Medicare program member, into its growing, medically oriented, all- engulfing Blob. “The Blob” is authorized by the federal government to form what is called Direct Contracting Entities (DCEs).  From Ms Marshall:

“Medicare allows DCEs to automatically search two years of seniors’ claims history without their full consent to find any visits with a participating DCE provider (is your primary care provider one?). This information is used as the basis for enrollment, and then to auto-enroll those patients in the DCE. You may already be “aligned” with a PeaceHealth DCE and may or may not receive a letter informing you of your automatic enrollment (aka “alignment”).”

I found my primary care provider's name on a spreadsheet published by PeaceHealth under the benign rubric of DCE Participant List. Really? And how much choice did these “participants” have? My guess? Bupkis. Are you ready to have these private corporations mucking about in your medical history? Not I. There is also a link to the DCE Participant Agreement which must be something that the physicians sign, however, we are not allowed to see it since it's password protected. So your primary provider is signing an agreement with the DCE, but you, as the patient, have no idea what your physician is bound to.  

Let's dig a bit more:

Dr. Foster

Benignly named the Cascadia Community Care Alliance, LLC, the actual organization is the Peace Health Direct Contracting Entity out of Vancouver WA. This is a for-profit company appendage to Peace Health and our local non-profit Blob. The LLC is, as Ms Marshal indicated, the local form of a Direct Contracting Entity (DCE) and has as its “governors,” Dr. Scott Foster and Mike Dwyer. Its registered agent is Craig Armstrong. According to a Peace Health web page, Dr. Foster “accepted a position [no date given] as medical director for specialists at PeaceHealth Medical Group" after nine years at Providence. He is now running PeaceHealth's DCE. Michael Dwyer is listed as a VP for Peace Health, who for his 40 hours of declared work a week, earns $725,320 a year. Mr. Armstrong is listed as an Assistant Secretary at a mere $254,874. I could find no information regarding the remuneration of Dr. Foster, but I can guarantee you that he makes more than that Assistant Secretary, Armstrong.  

[Nota bene: I stumbled on this information at OpenGovWA by accident while searching for additional information on the LLC created by PeaceHealth to serve as their DCE.  I will be looking further into all this in the coming weeks.]

For those who are not familiar with the overall plans of the federal government with respect to your Medicare or Medicaid, I would highly recommend viewing this 15 minute video produced by Physicians for a National Health Program. This will assist in your general understanding of this current maneuver by PeaceHealth to get into your Medicare knickers and make big bucks in the process. You become a cost center for them and as such, the less you cost them, the more money they make. 

According to a November 2021 article in Common Dreams entitled, “Congress ‘Asleep at the Switch’ as Biden Continues Trump-Era Ploy to Privatize Medicare”:

"The Biden administration paused the most extreme form of Direct Contracting—known as the Geographic (GEO) model—in March, but it is allowing the Global and Professional Direct Contracting (GPDC) pilot to move forward. According to CMS, the GPDC pilot is expected to play out over a six-year period

While lawmakers have largely been quiet about the Medicare experiment, a handful of Democratic members of Congress have echoed grassroots demands for an immediate end to the DC program in recent months."

The article goes on to explain that in 2022, you may end up in another world of Kafkaesque medical care where the rules are hidden and decisions are made by actuaries, accountants, attorneys and their minions, (e.g. the physicians,) and an occasional security guard. Representative Katie Porter (D-Calif.) said several months ago, “Next year, millions more Americans will find themselves in privatized Medicare, and most will never know what happened.” A fellow Medicare traveller in Bellingham received a missive (See file at end of this article: Required Annual Notice) from PeaceHealth,  that said in part, “We are writing to let you know that your doctor is a part of Cascadia Community Care Alliance, a Medicare Direct Contracting Entity (DCE) participating in a program within Medicare.” He came upon this email only after signing into PeaceHealth's patient portal. How many patients look at their portal messages regularly? Who even has the time? It is a simple process to send an email with important information directly to one's email account, except, apparently, at PeaceHealth. I have received no such message although I am in the PeaceHealth system. Am I also slimed by this for-profit entity? How would I know?

Above and beyond all this mishegoss is an altogether different aspect of having your Medicare snatched by private enterprise: the patently religious mission of PeaceHealth:  

“We carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way.”  

I am not sure about you, but I have no desire whatsoever to have my Medicare management under any, even remotely, religious-oriented body. If anyone thinks the fact that this DCE, set up as a separate, for-profit entity will forever avoid the Christianization inherent in the PeaceHealth organization, you might want to think twice, especially if you are a woman.

This reprehensible attempt to privatize Medicare, which was originally created to provide health care to some of our most vulnerable of citizens, must be stopped in its tracks. I encourage everyone reading this article to go to each link above and read the original source material. There are videos embedded in some of these web pages which provide easy-to-understand explanations of the nefarious efforts of individuals and corporations to rob Americans of healthcare that they have paid for from their earnings over decades. Of particular interest is the physician-led non-profit, Physicians for a National Health Program,  that is fighting to end the privatization of Medicare. The organization ask that you:

    "Sign and share our petition calling on the Biden Administration to end DCEs

    Watch and share the livestream of our Nov. 30 press event in Washington, D.C.

    Download and print our Traditional Medicare Death Certificate (available in one-page and large-scale versions)

    Read our press release: “Doctors to Biden: Don’t hand Medicare to Wall Street investors”

Locally, you can also write your representatives in Congress. I wrote to mine last week.

Act now!

Attached Files

Comments by Readers

Abe Jacobson

Feb 09, 2022

Nice research, thanks for your public service.

It might be worth underlining that the Direct Contract Model entails a really nasty surprise for those of us concerned about the guaranteed fraction of the Medicare that is going to direct patient care. 

In Traditional Medicare (before this corrupt DCE change), the portion going to patient care was 98%. In the corrupt DCE, by comparison, we are only guaranteed to have 60% of the dollars spent on our direct care. The other 40% goes to corporate profit.

To see the magnitude of this theft just here in Whatcom County, let’s suppose that there might be 30-thousand Medicare recipients (that number is notional, +/- 50%). Suppose further that of those 30-thousand, half (15-thousand) are in Traditional Medicare (as opposed to Advantage). Further suppose that the per-person Medicare expenditure is $10-thousand per annum. Then we are talking about $150 million per year of Traditional Medicare expenditures for seniors in Whatcom County. If we take 40% of that, this is $60 million ripped off from the patients in Whatcom County and put into corporate profit for the LLC. A lot of Porsches, Lamborghinis, and megahomes for the good folk in top management!

My numbers for population of seniors, and annual expenditure each, are just nominal but are probably not hugely off.


Dick Conoboy

Feb 09, 2022


I have since learned that of the amount saved by these DCEs (the “up to 40%”) actually has to be divided in half with one half remaining with the DCE and the other half being returned to the federal government.  I will search for a reference, however, the fact for Medicare members is that the aggregate number is 40% of each dollar that will likely never pay for any care whatsoever. 


Liz Marshall

Feb 10, 2022

A neighbor told me several years ago that Peace Health doesn’t recognize “Do Not Resuscitate” instructions. It would be interesting if there is an official written policy somewhere on that. I wonder if it would be their religious persuasion or a desire to make more money off the patient. I wonder if ignoring the instruction is legal or illegal in all 50 states, or state rules vary.


Ray Kamada

Feb 11, 2022

I’m usually long-winded but now let me be brief.

I regard DCEs as nothing more than thieves.


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