Medicare privatization. This began in 1982 and grew throughout the 1990s with 17.3% of Medicare recipients enrolled in 1999 in private plans when it went into decline. Since the start of Medicare Part D (passed 2003, went into effect January 1, 2006), numbers have begun to rise again. One of the reasons for this increase is that they are being aggressively, and often unscrupulously, marketed to unsuspecting elders. In addition, private plans receive government subsidies to make them competitive with Medicare itself. This is money that could go to reducing Medicare premiums generally but instead goes to higher overhead and profits for private providers.