The right to choose health care


To the editor:

Did you see Joe Namath under that red banner titled “Medicare Helpline”?

The Hall-of-Famer — once applauded for his 90-yard passes — now offers help by encouraging Medicare enrollees to call a toll-free number that never includes staying in traditional Medicare, despite its 94 percent satisfaction rate.

Millions of viewers haven’t heard how dangerous Namath’s “advisories” are. Just as millions haven’t heard about another menace to Medicare — a stealth attack that’s underway.

By 2030, Medicare may be fully privatized — right out from under us. How? There’s a history.

In 2010, the Affordable Care Act authorized, as part of the Center for Medicare and Medicaid Services, the Center for Medicare and Medicaid Innovation. These “innovations” were purposely excluded from Congressional control. Under the Trump administration, it created another acronym: DCEs, or direct-contracting entities. President Biden hasn’t ended them.

DCEs — both private-equity backed startups and publicly traded health care companies — envision huge profits, even larger than those enjoyed by Medicare Advantage, the most lucrative segment of the entire insurance sector.

Why so profitable? Well, Medicare Advantage plans are essentially middlemen who charge taxpayers (Medicare) more by upcoding their bills — saying you’re sicker than you really are — and by giving taxpayers (patients) fewer services by denying coverage when you get really sick.

But DCEs don’t depend on sports legends hawking toll-free numbers. They lure your doctors by promising more money than traditional Medicare fee-for-service. If your doctor is in, you’re in. No choice. Then the Medicare Advantage playbook begins, without having to pay for Joe Namath or commercials.

Another version “auto-aligns” Medicare patients if their family physician is affiliated with a DCE. CMS has even searched claims histories of senior citizens — without their consent or knowledge — to find any visits with participating DCE providers. A single visit is enough to make you a subscriber to that DCE.

This tactic has been paused by the Biden administration, but not halted.

Unless we act, Medicare will soon be automatically privatized — right under the noses of Congress.

What can we do? We can advocate for the New York Health Act, which our representatives campaigned on. Let’s ask them to keep their promises.

Why? It will help 50 percent of New York City residents on Medicaid who are shunted into separate and unequal health care. And the more than 18 percent of Bronx residents with no insurance at all. And the 60 percent of workers without job-based health benefits. And even workers with job-based benefits who face unaffordable yet ever-increasing copays.

New York Health covers all necessary care for every New York state resident: primary and specialty care, prescriptions, hospitalization, vision, dental, hearing, long-term care, mental health, substance abuse treatment, reproductive care. It guarantees health equity for everyone who lives or works in New York.

Call your legislators: Alessandra Biaggi in the senate at (718) 822-2049, and Jeffrey Dinowitz in the Assembly, at (718) 796-5345. Ask them to publicize what’s happening at the federal level with DCEs, and to explain how the New York Health Act will keep us safe.

Our health — your life — may depend on it.

Judith Esterquest
Barbara Estrin

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