Dr. Scott Foster’s letter (February 17) confuses me as to the nature of Peace Health’s “Direct Contracting Entity.”
Dr. Foster states that PeaceHealth is a nonprofit. Nobody would dispute that statement.
But what about the new caregiving vehicle, whose official name is “Peace Health Direct Contracting Entity” (PHDCE)? According to its incorporation documents, the PHDCE is a for-profit Washington Limited Liability Company. Dr. Foster's statement elides that key detail.
The two listed officers of this for-profit LLC are Dr. Foster and Mike Dwyer. To say the least, this is a very odd arrangement. A nominal nonprofit, PeaceHealth, is intimately joined with a for-profit LLC, PHDCE, sharing key management.
“Your Doctor could soon be working for Wall Street” was a headline in the Business section of The Seattle Times recently. The article tells of a program put in place by the Trump administration that could fully privatize Traditional Medicare without a vote by Congress. Private investors, retailers and health insurers are dumping billions into primary care ventures, buying up doctors' offices and health clinics across the country. These will be directly affected by this new program.
Medicare Direct Contracting is a pilot program put in place to enroll Traditional Medicare recipients into a Direct Contracting Entity (DCE) without their knowledge or consent. Medicare now has direct to provider (doctors, hospitals, etc.) payments for services. With this new program, the money goes to the DCEs monthly and they pay the providers. Medicare must pay 98% of the money it gets for patient care. These new entities (DCEs) need only pay 60% of the funds they get from Medicare to providers for health care, leaving up to 40 cents of every Medicare dollar for their profit.
According to an article recently in “The Hill,” any type of company can apply to ‘manage’ this money as a DCE including commercial insurers, venture capital investors and Wall Street Hedge Funds chosen with no oversight from Congress and possibly having no healthcare expertise at all. Why should unnecessary middlemen be getting any of our Medicare dollars to do exactly what is already being done by Medicare for 2 cents of every dollar paid in?
As this is still a pilot program, we can still do something to stop it. Senator Elizabeth Warren has said total privatization of Medicare is happening: “President Biden should stop the DCE model immediately.” Please call, write or email Health and Human Services Secretary Xavier Becerra, and let him know how you feel. He has the power to end this program now. Please help to save Traditional Medicare.
Reading the piece on the Bellingham athletic club closure, I felt saddened, then disappointed, and then enraged at the broad brush with which individuals experiencing homelessness were depicted. I have been a volunteer homeless outreach advocate in Bellingham for 10 plus years, and I also work near the 1616 Cornwall Ave. building, or “Armageddon” as one interviewee euphemized.
Stating that a “workout facility designed for downtown’s executive class” is incompatible with the atmosphere of Cornwall Avenue and reduces the problem down to one in which, yet again, the interests of the powerful and privileged are placed above the genuine human needs of our most vulnerable populations.
We know that solutions to homelessness exist because we have observed them work in other places. We know that by providing supportive housing, case management, transitional housing and robust medical and behavioral health care, the problems created by homelessness can be eased or even eliminated. We know that doing so is more cost effective than the strain put on social services, medical services, emergency services et al. by those problems. So why is the city not strongly committed to exploring these options? Why has the Bellingham City Council said — again and again — that they are waiting for “community partners” to step up and address these issues?
When I first came to Bellingham, in 2008, it was a community of progressive people who seemed to really care about the issues of poverty and homelessness. Now, one of the most popular news media organizations in the area can barely veil their contempt of poverty and those experiencing it. Base Camp has an incredibly high rate of violence, theft, sexual assault and COVID transmission within their facility. Is this really “The best we can do?”
Problems related to poverty are not going away on their own. Any “downtown revitalization project” that fails to account for care toward our most vulnerable populations is doomed to fail. Pressuring the city that additional shelter facilities will “cause problems for the neighborhood” is the same recycled “Not In My Backyard” approach that we have seen time and time again. Ignoring the problem will not address the issues. Criminalizing the problem will not solve it.
I am ashamed of the one-sided perspective from which this article and countless others like it have been written. The solutions to homelessness are right under our noses. It is up to us as a community whether we want to enact those solutions or exacerbate the problem. Thank you for your time.
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