Elizabeth Fowler Defending Trump Program to Privatize Medicare

January 16, 2022

Put aside Democrat versus Republican.

Liz Fowler

Let’s just look at corporations versus people.

Elizabeth (Liz) Fowler has a stellar corporate resume.

For seven years, she worked at Johnson & Johnson, as vice president for global health policy.

Before joining Johnson & Johnson, she was chief health counsel to Senate Finance Committee chair Max Baucus, where she was instrumental in banning single payer advocates from the deliberations that led to the insurance company dominated Affordable Care Act.

In her off time, Fowler is a runner

She runs marathons and triathlons around the world.

During work hours, she carries the torch for the health insurance industry and big pharmaceutical companies.

And it doesn’t matter whether she is in the public or private sector.

It’s the same goal – privatize public health programs.

She currently sits in the public sector, working for President Biden as head of the Center for Medicare and Medicaid Innovation.

During her first year in office, she has been very active, making public appearances on corporate sponsored podcasts, constantly pushing the corporate privatization agenda.

She even met with a group of single payer doctors last month during a Zoom call to defend her Medicare privatization policies.

The doctors were alarmed by a program instituted during the previous Trump administration called Direct Contracting Entities (DCEs).

DCEs are entities set up by private equity firms and others to enroll traditional Medicare patients without their knowledge into Medicare Advantage type organizations.

The Intercept reported last month that “in January 2019, ahead of the launch of a new direct contracting model, the Office of the General Counsel for the Health and Human Services Department warned, in comments on a draft of the proposal, that it appeared as if the new project was being set up to benefit specific companies.”

“We are concerned based on [Centers for Medicare and Medicaid Services]’s regular references to organizations like Chen Med, Oak Street Health, and Verily in the comments and otherwise, that this model has been designed with specific private sector entities in mind. If accurate, this could create ethics concerns, as the creation of this model would give those entities a leg up in the market,” read the guidance, a copy of which was obtained by The Intercept.

Instead of rejecting the program as one that would allow private corporations to eat Medicare from the inside out, Fowler embraced it.

More than 50 members of Congress earlier this month sent a letter to HHS Secretary Xavier Becerra calling for an end to the program.

“As you know, the previous administration started Direct Contracting Entities (DCEs), which are privately owned and controlled coverage networks in which for-profit companies are paid monthly to cover beneficiaries’ health care,” they wrote. “Any funds left over after it covers care are kept as profits creating a perverse motive to decrease the quality and volume of seniors’ care. These models ultimately aim to privatize traditional Medicare by funneling beneficiaries, without their knowledge, into a DCE. Unfortunately for patients in these entities, DCEs are incentivized to funnel patients to providers within their networks to maximize profits which can limit patients’ care options. These models transform the care of a traditional Medicare beneficiary to care typically seen in a private Medicare Advantage (MA) plan despite the fact that the patient chose not to enroll in an MA plan.”

The meeting with the single payer doctors took place on December 10, 2021.

Present were doctors from Physicians for a National Health Plan (PNHP), including its current president, Susan Rogers. Also present were single payer doctors from a new group called National Single Payer, including Ana Malinow, Judy Albert and Claire Cohen.

Fowler was joined by legal counsel, Judith Friedman.

Fowler and Friedman said that they were skeptical of the DCE program at first, but they wanted to improve the program, not stop it. They said the program will run for three years and then will be re-evaluated.

The doctors made clear they thought the program was on the wrong track, that it was a grave threat to traditional Medicare, and that it should be shut down, not tweaked or allowed to enroll seniors over the next three years.

Currently, more than 300,000 seniors in 38 states have been enrolled in the program – without their consent.

According to Malinow, Fowler said that CMMI wanted to do away with fee for service, which Fowler says is “the major driving force behind excessive health care costs in the United States.”

According to Fowler, we have to get away from the “financial incentives in the U.S. healthcare system.”

Fowler also said that accountable care organizations (ACOs) have been developed to organize and coordinate care with vulnerable populations in the hope of transitioning away from low-value care to high-value care.

“When I suggested that ACOs have not proven to save costs or improve care, Director Fowler agreed,” Malinow said. “When I asked why they used a failed model as their model of care, she did not answer.”

We reached out to Fowler to try and get an answer as to why, if she admits it’s a failed model, she continues to back it.

“We believe the remarks you reference may have been related to the Next Generation ACO Model, which ended in December 2021, and for which evaluation results to date show reductions in spending but do not indicate net savings to Medicare and do not show demonstrable improvements in hospital admission measures of quality,” the spokesperson said.

But it’s the same for all value based program models – no evidence of savings, no evidence of improved quality of care.

So why continue to back them?

Again, no answer.