Kentuckians for Single Payer Health Care www.kyhealthcare.org (502) 636-1551, nursenpo@aol.com
On Saturday, December 11 at 11:00 a.m. EST, Kentuckians for Single Payer Health Care and others will gather outside the headquarters of Humana, 500 W. Main St., Louisville, KY 40202 where they will demand an end to Medicare Direct Contracting, a program that could fully privatize Traditional fee-for-service Medicare without a vote by Congress.
The protest with feature Steven Katz in full costume as the Grinch with the reading and performance of “How the Grinch Stole Medicare,” an original poem from National Single Payer. Jill Harmer and the Single Payer Singers, Stephen Bartlett and his band, and singer, songwriter John Gage will perform holiday and health care music.
Humana is one of 53 for-profit Direct Contracting Entities (DCEs) into which seniors who have chosen traditional Medicare can be placed without their consent.
Instead of paying doctors and hospitals directly for care, Medicare gives DCEs a monthly capitation payment to cover a defined portion of each seniors’ medical expenses, allowing DCEs to keep as profit and overhead (up to 40% of revenues) what they don’t pay for in medical services — establishing a dangerous incentive for DCEs to restrict seniors’ care.
Virtually any type of company can apply to be a DCE, including commercial insurers, venture capital investors, and for-profit dialysis chains. Applicants are approved by CMS without oversight from Congress. The DC “pilot phase” includes 53 DCEs in 38 states, potentially covering 30 million Traditional Medicare beneficiaries.
The DCE program places profit-making middlemen between seniors and their physicians and will totally privatize and destroy Medicare unless the public raises a powerful outcry to stop it. Kentuckians for Single Payer Healthcare advocates for a not-for-profit, improved Medicare for All, a national single payer system that includes everyone and removes all barriers to care.
More information on Medicare Direct Contracting:
- Direct Contracting one-page fact sheet
- Direct Contracting policy primer (4 pages)
- Form sent to seniors in Indiana University Hospital System requesting voluntary alignment to a DCE
- Article about Direct Contracting in Health Affairs journal by former CMS Administrator Dr. Don Berwick and former CMS Innovation Center director Dr. Rick Gilfillan: PART ONE and PART TWO
- List of current DCEs
- CONTRACT between CMS and Direct Contracting Entities
- Direct Contracting Entities’ Financial Operating GUIDE from CMS