As I See It: Your concern should be your health (and our nation)

If you are eligible for Medicare and not on Medicare "Advantage," you may soon receive a letter from the Centers for Medicare and Medicaid Services announcing that your health care provider is working with an accountable care organization, or ACO, known as "Belong Health."

"Belong Health" is available in the mid-Willamette Valley to "improve your health care experience and better meet your individual health needs." The ACO works with your hospital to help your primary care provider coordinate your care. All sounds good so far.

But Belong Health ACO is owned by a venture capital company, Maverick Ventures, the very name of which should give us all pause. Centers for Medicare and Medicaid Services rules allow ACO-REACH companies such as Belong Health to retain (for profit and overhead) as much as 25% of what they receive from Medicare.

In other words, only 75% of the money Medicare sends to Belong Health may reach hospitals and care providers for patient care coordination.

By contrast, traditional Medicare takes out only 2% to 3% of your Medicare money for administrative overhead. Medicare "Advantage" companies can retain up to 15%.

Venture capital, private equity, and private insurance companies can take between 13% to 23% more than traditional Medicare does of our Medicare money for themselves instead of your health.

If you receive the Centers for Medicare and Medicaid Services letter, please read it carefully and consider not being part of the plan. Look for the phrase, "If you don't want Medicare to share information with your health care providers for care coordination, call 1–800–MEDICARE (1–800–633–4227)."

It takes patience and time to extract yourself from this form of Medicare privatization. It's likely worth your effort later when you need health care, don't want a venture capital company in the room with your doctor, and want to be sure Medicare remains financially sustainable.

Medicare "Advantage" profits by marketing to healthy and lower-cost patients, gaming risk pools, using narrow networks of providers, upcoding diagnoses for higher reimbursement, and restricting your care through prior authorization (traditional Medicare does not require). Medicare Advantage companies inappropriately issue millions of denials for care that meet legal Medicare coverage rules.

Privatization through ACO-REACH programs such as "Belong Health" present an additional threat to Medicare sustainability and your freedom to access care that traditional Medicare would otherwise guarantee. Accountable care organizations are just another way to privatize and milk the Medicare system and threaten its long-term survival.

Medicare Advantage plans look attractive initially because of low premiums and attractive perks. Many people have had good luck with their plans, but people with chronic or severe illnesses often find that they cannot get the care they need. They then try to get back into traditional Medicare.

The industry and their lobbyists have made it extremely hard to get back into traditional Medicare, which has far fewer restrictions and far more egalitarian purpose than Medicare Advantage plans.

For more information, please visit Mid-Valley Health Care Advocates, Health Care for All Oregon, Physicians for a National Health Program and One Payer States. As you peruse the sites, imagine how you can involve yourself in the movement for a simplified publicly owned health care system.

The concern should be your health and the health of our nation, not whether you "deserve" care.

Finally, please find the Oregon Universal Health Plan Governance Board online and attend its meetings 9 a.m. to noon on the third Thursdays of the month. The board is developing a universal health plan for Oregon. It needs your oversight and input about what you want in a health care system and how to pay for it.