I am a 77-year-old retired geriatrician. I moved into a Continuing Care Retirement Community four years ago. I am enrolled in traditional fee-for-service Medicare. I am in relatively good health, although I have had an inguinal hernia repair and a total right hip replacement in the past two years. I am concerned about future healthcare.
I have become aware that private corporations are taking over Medicare (they plan to complete this by 2030) using an innovative program started by the Center for Medicare and Medicaid Innovation. It is currently called ACO REACH. This program will replace my traditional Medicare with an inferior privatized Medicare type of insurance.
As an academic internist with boards in internal medicine, geriatrics, and palliative medicine (when I retired in 2009), I helped a medical school set up a geriatrics training program, and we certainly taught and worked to confront elder abuse, neglect, and fraud.
There is a need to collect stories of how privatized care harms seniors and educate the public about this program.

ACO REACH was started by Trump associates (a dormmate of Jerome Kirshner) expressly to place all of Medicare under private corporations. The initial program was called Direct Contracting. The details were worked out so that physicians would switch seniors' billings (invoices) from the government to private companies without the permission of seniors. Physicians were offered benefits, and they proved willing to switch. After all, physicians are underpaid by Medicare and feel no great allegiance to the program. This will have a devastating effect on the sickest of seniors. They will no longer have insurance. The program was renamed ACO REACH (under Biden) essentially to confuse both the public and physicians about the nature of the program. The Centers for Medicare and Medicaid Services (CMS) supports this program. Only the Secretary of Health and Human Services can cancel it (according to legislation written to protect innovations). Wall Street stands to make billions of dollars (estimates are that they could keep 35% of government dollars). Politicians are being aggressively lobbied and given large donations. The public is in the dark.

ACO REACH looks to be a significant future perpetrator of elder abuse, neglect, and fraud. It needs to be publicized, confronted and stopped. Most seniors learn of the program when they receive a letter from their physician practice telling them they are now under this new program. Their only recourse is to seek new providers. CMS uses a policy of "auto-aligning" patients to ACO REACH if one physician who has provided care is in the program and their billing exceeds 10%. Currently, seniors who find privatization under Medicare Advantage unacceptable can switch to traditional Medicare (although with problems obtaining Medicap coverage). This will go away. There will be no more traditional Medicare to switch to. CMS has announced plans to convert all of Medicare to ACO REACH by 2030. There is a difference between health insurance permitting physicians to order and prescribe what is needed and having a private company that decides what will be paid for.

What is my hope? That the Senior Lobby would rise and make this an issue of national importance. Private companies use limited panels of providers, denials of service requests, and payment refusals to accomplish their goal - to profit from the government's funds. Medicare Advantage has cost the government more and cornered the mostly healthy seniors. If all of Medicare becomes privatized, seniors will either face denials of service or pay for service out-of-pocket. This is different from what most of us planned for in retirement. This is not how Medicare was set up to provide services. It will take a significant effort on the part of organizations like yours to stop this program. You will face major corporations with deep pockets, politicians indoctrinated in the advantages of private companies providing better care than the government, and a public unaware of what is happening. CMS argues that private companies will provide better care more economically than the government. The facts do not bear this out.

My role is to draw attention to the developing problem. I am not a politician and need help to understand the process of using local or national media. My submission of an article to our local paper was denied publication. AARP is primarily funded by United Healthcare which stands to profit from ACO REACH, so they cannot speak honestly. Most politicians remain unaware of the looming problem and are content to entertain lobbyists and collect donations. Most media outlets seem reluctant to publicize such a controversial confrontation.