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Medicare is in Jeopardy and I’m blowing the whistle!

The Mercury News, October 21, 2022

Members of Congress are turning a blind eye to the passing of Medicare funds to the for-profit corporations who have lavishly contributed to their political campaign coffers.(Graeme Sloan/Sipa/AP)

Sixty-five million Medicare recipients are in for a big surprise when they discover the Medicare they’ve always relied on is being sold to Wall Street speculators by Washington politicians.

Medicare coverage decisions for seniors are increasingly conducted by profiteers driven by market return. They are incentivized by their organization’s profits, NOT the patient’s needs and best interests. As a result, America’s Medicare Trust Fund is being rapidly depleted by these corporate profiteers. We’re approaching a crisis for the Medicare Trust Fund: Part A Medicare Trust Fund will become insolvent by 2028 and coverage will be at risk.

The Medicare Trust Fund is taxpayer money intended to provide health care for seniors and the disabled. Unfortunately, our representatives in Congress have failed to represent us. Instead, they are turning a blind eye to the passing of Medicare funds to the for-profit corporations who have lavishly contributed to their political campaign coffers.

A New York Times article last week titled “The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions” calls out the fraud by the healthcare industry such as: “... additional diagnoses led to $12 billion in overpayments in 2020, according to an estimate from the group that advises Medicare on payment policies — enough to cover hearing and vision care for every American over 65.”

Congress has repeatedly failed to take any corrective action or even recognize the problem and needs to be held accountable. Even worse is a lack of transparency: Congressional members are NOT telling senior constituents that traditional Medicare is quietly being replaced with inferior plans & offerings designed to increase healthcare industry profits by incentivizing denial of health care to seniors. Congressional members aren’t feeling the pain for two reasons: First, Members of Congress are an entitled group with five- star medical coverage for themselves. Second, congressional representatives are cozy with healthcare industry lobbyists who spend millions every year attempting to influence Washington decisions that affect all of us.

Congressional silence on this Medicare Trust Fund debacle has misled seniors into abandoning traditional Medicare, which continues to be the best plan for most seniors. Congress is also failing to explore options to expand Medicare for seniors to include vision and dental - two of the largest out of pocket medical expenses for seniors once they retire. It appears that our representatives have failed their constituents on all these issues. Their silence is inexcusable.

Today, Washington politicians are in the process of moving seniors enrolled in traditional Medicare plan into a new model called ACO Reach. Aptly called “Medicare Advantage on steroids”, it amounts to no less than a conversion of quality health care to profit-oriented corporate management, where denial of care will generate hundreds of billions of dollars in profits for corporate health-care.

Over 250 Organizations and many members in Congress have called for the end to ACO Reach because it provides even more opportunities for corporate middlemen to profit at the expense of beneficiaries and the Medicare Trust Fund. These middlemen will pocket Medicare dollars that aren't spent on patient care and create an incentive to overbill Medicare at the same time.

Ending the destructive connection between the healthcare industry and Washington is LONG OVERDUE. In the meantime, a defensive play is in order. My strong recommendation to seniors: First, choose traditional Medicare in the open enrollment period - even switch back to traditional Medicare if you are in a different plan. Second, call 1-800-MEDICARE to keep your personal identifiable medical information from being shared with corporate health care (activate the data opt-out process).

If you would like to find out more about this topic, watch the below town hall meeting in which I answer many questions regarding Medicare

Rishi Kumar is a Silicon Valley hi-tech executive, councilmember at the city of Saratoga, and a candidate for U.S Congress from Silicon Valley’s district 16, running against Anna Eshoo. Rishi Kumar is committed to EXPAND Medicare benefits to include Vision and Dental.