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This week on Talk World Radio, the sneaky and sleazy bipartisan privatizing of Medicare. Our guest, Kay Tillow, is chair of Kentuckians for Single Payer Health Care and Coordinator of Unions for Single Payer Health Care. She is a retired union organizer who has worked for decades with nurses and other hospital workers.
Total run time: 29:00
Host: David Swanson.
Producer: David Swanson.
Music by Duke Ellington.
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*****
How the Grinch* Stole Medicare (*Could also be Cringe)
With every senior in the nation
Original Medicare has been quite a sensation!
It’s the government that runs Medicare
Which is how it has managed to be cost-effective and fair!
But the for-profit privatizer known as the “Grinch”
Could hardly wait to throw in a wrench.
He schemed and he plotted
And figured out just what to do!
He bought off officials and
The whole list of DC who’s who!
He came up with plans
That were no more than scams:
Medicare Advantage that denied care
Accountable Care Organizations to risk-share
Health Maintenance Organizations to limit choice
And finally, Direct Contracting Entities to stifle your voice!
[Senior] What is a Direct Contracting Entity?
What is this thing we are hearing about, this DCE?
[Narrator] You know those plans called Medicare Advantage?
Run by corporations that profit and your health mismanage?
Imagine the Grinch in charge of your health care
Imagine the Grinch in charge of your Medicare!
[Senior] You mean, even if I choose to avoid those plans
I’m still going to end up with the Grinch, without my consent?
[Narrator] Alas, without your knowledge as well, I lament!
[Senior] Wait a minute! Why would the government
Hand Medicare to the Grinch like a present?
[Narrator] They say it’s to control costs and improve care
But it’s another way for Wall Street to grab it’s share.
There are now 53 DCEs in 38 states and DC
[Senior] You mean there is probably one near me?
[Narrator] Yes! This new scheme could trap
More than 30 million seniors on Original Medicare!
[Senior] Oh, no! I don’t want to go into the DCE lair!
[Narrator] Most DCEs are owned by Wall Street firms,
Medicare Advantage, private equity and venture capitalist worms!
And very soon, who will be making decisions but the Grinch?
[Senior] Oh, no! He will ruin our health care with his stench!
[Senior] How does this work? What, where, and when?
[Narrator] That was the problem:
How could the Grinch entice seniors into his den?
He puzzled and pondered, and plotted and rotted
And this is the scheme he concocted:
Lure doctors to join Direct Contracting Entities
With promises to share in his profits
And once a doctor joined, his patients would follow
From doctor to Grinch, that was the plan they could swallow!
[Senior] And as expected, to increase his money creations,
The Grinch will demand lots of prior authorizations
Deny care and life-saving medications
Drain good money from the Trust Fund
Jack up B premiums till we’re stunned
And spend only 60% of their revenue
On our health care, too!
[Narrator] The one bit of health care
He’ll leave behind
Is a routine well visit
Too small to find!
[Senior] All the while not proving
He’s saving money and our care’s improving!
In the end,
The Grinch DCE is not our friend
Just a scheme to get between doctor and care
No more choice, no more Original Medicare!
This is not right!
Lots of money for them and no health in sight!
Is there anything we can do to end this plight?
[Narrator] Yes! The good news is that our movement is growing
To end the corruption this Grinch has been sowing.
Privatizing health care always adds cost
Make sure that Medicare is never lost!
So right now, today, get on the ball!
Improve it! Expand it! Demand national, single payer, Medicare for All!
Here’s what you can do:
Write or call Health and Human Services Secretary Becerra to stop Direct Contracting Entities now!
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll Free Call Center: 1-877-696-6775
Write to your member of Congress demanding a halt to DCEs now!
https://www.house.gov/representatives/find-your-representative
https://www.senate.gov/senators/senators-contact.htm
Join a DCE protest soon by going to www.nationalsinglepayer.com
Join National Single Payer at www.nationalsinglepayer.com
Find out more about DCEs here: https://www.youtube.com/watch?v=L27IqMLr934
Press release on Dec. 11, 2021, 11 am protest at Humana in Louisville: http://kyhealthcare.org/news/kentucky
Protest: How the Grinch Stole Medicare: http://kyhealthcare.org/posts/protest-how-the-grinch-stole-medicare
Facebook event: https://www.facebook.com/KSPHmed4all/photos/gm.1236096000134715/2431752350290784/
Kentuckians for Single Payer Health Care www.kyhealthcare.org, 502 636 1551
##
I just listened to Kay Tillow talk about the evils of what’s called the Medicare Advantage Plan. She may know a lot more than I do about private insurance taking over Medicare, but I’ve just joined a Medicare Advantage Plan based on the enthusiasm of my sister, who has been on an Advantage Plan for the past year. And it sounds like an improvement to what I’ve had.
First off, those of us on Medicare who can afford it, always have a supplemental plan that is offered by private insurers. That plan was costing me about $167 a month, in addition to a drug plan with another private company, in addition to the $150 that the government was taking out for what they call Part B. Part B is taken out of our Social Security. With the drug plan, I was paying about $337 out of pocket each month, plus various co-pays along the way at doctors’ and partial costs for drugs as well. There’s nothing great about all of that, and that’s traditional Medicare.
Regular Medicare plans don’t expect you to see, hear or have teeth. Medicare Advantage has quite a bit of coverage for glasses, hearing aids and dental work. Also, Medicare Advantage eliminates the supplemental plan and so, theoretically, will save me $187 a month, as I won’t pay for a separate drug plan, either.
I don’t believe there’s any way that the government or an insurance company can sign you up without your consent. Kay Tillow says this happens. I had to sign forms to go on an Advantage plan sponsored by Anthem, and I also had to call up my supplemental insurance provider to cancel out of my old plan.
Furthermore, I have one year to try this out, and if I don’t like it, I can go back on my old plan with no penalty or underwriting involved.
Do I think insurance companies have you coming and going one way or the other? Yes! All plans seem to be overly complicated, covering all of something, half of something else, nothing of something else, etc.
I’ve chosen a PPO (Preferred Provider Option) which means I can go to any doctor in the nation that subscribes to helping Medicare patients. I pay an extra $30 or $40 co-pay to use a doctor not in my immediate network. And there’s the rub….many doctors are not even taking people on Medicare, regardless of your plan! For example, in Charlottesville, there are only a handful of dentists willing to stick to the payment reimbursements, so the choice is not large and I may have to switch dentists because I do not yet know if my dentist is on board with this or not. Also, UVA and UVA doctors just accepted Advantage patients for the first time this past year. Before then, only doctors affiliated with Sentara would take Advantage patients.
I’m willing to give it a try this year. Maybe I’m naïve, but it actually feels like the federal government is moving seniors like myself in the direction of single payer with the Advantage plans. I’ll know more after I’ve been on the plan for a while, but right now, it feels like an improvement over what I’ve had in past years.