How Medicare is quietly being privatized.

“Direct Contracting,” a scheme launched under the Trump administration, is inviting corporations to profiteer off of Medicare.

Healthcare is big business — literally one of the most lucrative corporate endeavors in the country, accounting for one-fifth of our total economy. And the way that the business of healthcare interferes with actually providing Americans with appropriate, accessible, and affordable healthcare has been a frequent subject of my writing in these pages. From hospital consolidation to drug pricing, rising premiums to healthcare inequities, the fact that our healthcare system is designed to maximize profit for a few large corporations is the root, if not all, of the problem. 

The fattest slice of that very, very large pie is healthcare for seniors — the Americans who most often need care. American seniors are insured through Medicare, a government health insurance program that’s supposed to offer them affordable, comprehensive healthcare. But as this is the American healthcare system we’re talking about, the knives are constantly out for Medicare — looking for just another bite. 

Late last year, I wrote about the Medicare (dis)Advantage program, a frontal assault on Medicare, which cajoles beneficiaries into selecting privately managed Medicare plans. The private health insurance corporations that administer these plans get to keep the money they don’t spend on healthcare as profit, putting $27 billion of taxpayer money into the pockets of health insurance corporations in 2018 alone. 

As bad as Medicare Advantage is, a new plan hatched under the Trump administration — and being allowed to proceed under the Biden administration — is even worse. But unlike Medicare Advantage, most seniors haven’t even heard about it.