Health Care:  Making Care Primary Model

Date: July 17, 2023
Host: Jim Schneider
​Guest: Twila Brase
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According to the U.S. Census Bureau, the population of those 65 and over grew nearly 5 times faster than the total population over the 100 years from 1920 to 2020.  In the year 1920 those aged 65 and over was about 1 in 20 of our population.  However, in the year 2020 that number changed to about 1 in 6 people.  The older population increased from 4.9 million in 1920 to 55.8 million in 2020.  That represents a growth rate of 1,000%.

How can this be sustained by Social Security benefits?  How will this affect health care for older Americans?  

On June 8th, 2023, the Centers for Medicare and Medicaid Services announced a new “voluntary” primary care model called, “Making Care Primary”.  It’s being tested in 8 states.  Twila Brase indicated that this plan will ration healthcare to seniors.

Twila is the president and co-founder of Citizens’ Council for Health Freedom. She’s a registered nurse, a certified public health nurse, and author of the eight-time award-winning book, Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records.  She is the speaker on the daily Health Freedom Minute heard on stations across the nation.  Additionally, her efforts led to a national law requiring parent consent for research using newborn DNA, a national campaign exposing HIPAA as a data-sharing rule, an online nationwide directory of direct-pay-practices, The Wedge of Health Freedom and the Patient Toolbox designed to help patients understand their options in coercive situations and maintain control over their treatment decisions.

Twila explained that currently there are two types of Medicare options that are offered to people when they’re about to turn 65: traditional (original) Medicare and Medicare Advantage.  This latter option is a health plan version of Medicare.  She explained that traditional Medicare gives you the freedom to go anywhere in the nation to see any doctor or any hospital you want.  There is no network.

Since Medicare is slated to be insolvent by 2031, Twila believes the Medicare administration is trying every way possible to get physicians to conform to the way Medicare wants them to treat seniors and to get patients to go into a managed care arrangement.  This is whether they are in the HMO version of Medicare or the traditional (original) version.  

This means that the federal government will pay physicians more who volunteer for this 10 year program.  Under this system, these physicians will be accountable to the government for how they spend the money.  The federal government will not want these physicians to spend the money on any care that the government doesn’t label as valuable.  It may be valuable to you or even medically necessary, but on the other hand, it may be deemed too expensive or you’re deemed to be too old.  The idea here is to get the physicians to follow government treatment mandates even though the senior may have the traditional Medicare plan.

Under this scenario, doctors could end up having to pay penalties back to the federal government if they spend too much money during the year.  This means doctors could find themselves failing to make decisions in the best interest of the patient.  Twila noted it’s about putting a conflict of interest between the patient and their doctor.

Discussion also included: Medicare dollars for social needs, new data rules regarding so-called reproductive health care, the idea of health equity and how this could affect medical school admissions, and more including comments from listeners.      

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