Replac[ing] Medicaid with nonprofit medical centers

[MJ]

[ARTICLE LINK]

May 10, 2025
Open Letter to Bill Gates
How you can use fortune to replace Medicaid with nonprofit medical centers
Murray Sabrin

Dear Bill:

The Wall Street Journal reported you will accelerate giving away your fortune over the next twenty years focusing on “poverty, malnutrition, polio” and other medical challenges.

The purpose of this letter is to bring your attention to another program that the Gates Foundation, Warren Buffett, Michael Bloomberg and others who are using their wealth to address health care issues could finance.

There is one glaring omission in your mission as I read the Journal article, namely, there is no indication you plan to address the 71 million Americans who are enrolled in Medicaid, many of whom are ineligible according to various reports.

Medicaid costs the American taxpayers nearly $900 billion, with the cost split between the federal government and the states.

Since President Johnson signed the bill creating both Medicare and Medicaid neatly 60 years ago, Medicaid is considered an integral component of the federal government’s “safety net” by virtually everyone across the political spectrum. I beg to differ for several reasons, but that is a discussion for another time.

There is a proven program to replace Medicaid with medical care centers founded on philanthropy that would provide quality medical care with no cost to American taxpayers and reduce the federal budget by nearly one trillion dollars annually in perpetuity!

What a legacy that would be for you and the Buffetts and Bloombergs of America!

There is a practical reason to replace Medicaid. According to Peter Drucker’s assessment of government social services more than 33 years ago, he observed, “…government has proved incompetent at solving social problems,” and he concluded, “We now need to learn that ‘nonprofitization’ may be for modern societies be the way out of mismanagement by welfare bureaucracies.”

I urge you to become familiar­and visit­nonprofit health centers such as the Neighborhood Health Clinic in Naples, FL, which was profiled in the local newspaper the other day. The NHC does not accept any government funding.

When I was a New Jersey resident (1977-2021). I became familiar with two nonprofit health centers, the Zarephath Health Center (does not accept taxpayer support), and the Parker Family Health Center. Several years later after I had learned about the “Volunteers in Medicine” model to provide medical care, I was invited by the founder (a retired physician) to become a trustee of a nonprofit center in Bergen County, BVMI.

The umbrella organization of nonprofit health center is profiled here, https://nafcclinics.org/get-involved/start-a-clinic/volunteers-in-medicine/ . In 1995 I spoke with Dr. Jack McConnell who founded the Volunteers in Medicine center in Hilton Head after reading about his initiative in the New York Times.

The Gates Foundation could focus on creating centers on the west coast, Hawaii, Alaska and the Rocky Mountain states. Mr. Buffett could use his wealth to establish them in the middle of the country while Mr. Bloomberg and others could create nonprofits in the eastern third of the nation. Of course, any philanthropist could create centers wherever they wish, but this is a roadmap for helping low-income Americans get needed medical care without burdening strapped taxpayers.

The country needs “out of the box” thinking regarding health care and other issues. The opportunity to use a successful program to improve the lives of tens of millions of Americans and put a dent in unsustainable federal spending would be one of the greatest initiatives of the 21st century.

I hope my recommendation is met with enthusiasm by you and your fellow philanthropists.

Sincerely,
Murray Sabrin, Ph.D.
Associated Scholar, Mises Institute
Emeritus Professor of Finance
Ramapo College of New Jersey
murraysabrin.substack.com