We Must Fight Privatization of Medicare and Medicaid to Win Single-Payer

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      But over the years, private interests have encroached on that early promise, turning what was once a public good into another profit-making opportunity for the health care industry. Their first big breakthrough was when former President George W. Bush passed the Medicare Advantage program (also known as Medicare Part C) in 2003. Suddenly, millions of elderly Americans — and the billions of dollars that the government was spending on their care — were now available to private companies.

      By offering coverage that traditional Medicare did not, such as for nursing home and long-term care, plus hearing, vision and dental care, companies were able to increase profits by signing up elderly Americans and getting both government money to pay for the care, plus the extra premiums that Medicare Advantage charged. What had once been administered as a purely public, not-for-profit program by the government has now become an increasingly corporate-controlled system. In 2020, 42 percent of Medicare beneficiaries were enrolled in a Medicare Advantage program.

      The same pattern has played out with Medicaid. In the place of Medicare Advantage programs, we now have Medicaid Managed Care Organizations (MCOs). Here, states give blocks of money to private, for-profit organizations to provide coverage to Medicaid beneficiaries. With the passage of the Affordable Care Act in 2010, Medicaid was expanded to all adults with incomes up to 133 percent of the federal poverty level in states that didn’t opt out. By 2018, 69 percent of Medicaid beneficiaries were enrolled in MCOs.

      With the privatization of Medicare and Medicaid, the government has ceded decisions over who gets care and for what to private companies whose driving interest is increasing their bottom line. This inevitably leads to narrowed networks, refusal of care and curtailed benefits. Meanwhile, the government is paying for both the health care of its elderly and poor — and covering whatever profits health insurance companies can skim off the top. Meanwhile, health insurance companies know that Medicare for All is an increasingly popular policy. In theory, this could wipe out their very existence. Instead, they are trying to dismantle Medicare and Medicaid piece by piece, and turn a public good into another cash cow for the industry.

      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

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