The Democratic party, sometimes justifiably, has offered itself as the defender of Medicare, the country’s deeply popular program of health care for seniors and people with disabilities. Many Republicans, historically suspicious of the “socialist” programs of Social Security and Medicare, consistently look for strategies to chip away at the foundations of both. When President George W Bush in 2005 pushed for at least partial privatization of Social Security, the American public rebelled, and his proposal was buried.

In 2023 we see an accelerating movement toward privatization of Medicare. And who is currently leading the charge? Democrats — that’s right, Democrats — though in a far more under-the-radar movement than in 2005. Both Republicans and Democrats can be blamed for the decades-long progression to the fact that about half of American seniors now are insured with Medicare Advantage (MA) plans rather than traditional Medicare (TM). Critical to understand: Medicare Advantage is NOT Medicare. Most MA plans are owned by big for-profit insurance companies who have shareholders’ interests to consider. How are patients’ interests likely to fare with that competition? You decide. MA plans can work well for those who stay healthy, but when serious problems arise, denials of treatments often emerge, and MA companies cherry pick healthier applicants. They also “upcode”: send to the government dubious diagnoses that provoke additional reimbursements.

Now, the Biden administration has inexplicably advanced a program created by Trump’s White House, called REACH (bit.ly/3ZVcSty). This year it authorizes 132 provider networks (many owned by big insurers) to set up agreements with the government, which allow them to take 25% of unused funds in a contracted amount for profit. Contrast this scheme with traditional Medicare, whose baseline administrative costs are set at 2%. Remember those shareholders’ interests weighed against patient care? (bit.ly/3Zxd5DJ)

If Democrats don’t put a hard stop to this spiraling privatization of Medicare, they will find it impossible to run in 2028 or 2032 as defenders of Medicare. Their slogan: we saved Medicare by turning it over to for-profit corporate monoliths. Is that a slogan they want to run on? Democratic politicians, beware.

Tom Denton

Highland