Every election cycle, we hear about the GOP’s plans to gut, dismantle or destroy Medicare and Social Security. And every election cycle, indignant GOP candidates announce that they would never do something so preposterous and frame the accusation as pure fiction.

You’d be forgiven for not following the Heritage Foundation’s 30-year gradual, but effective maneuvering to replace Medicare with a Medicare Advantage-style system. They’ve been remarkably successful at dictating the media narrative either through journalist brainwashing or, failing that, swift retribution for journalists that don’t adhere to their message. But as the real possibility of a Republican administration with a Republican-controlled Congress looms, this Bond villain-caliber objective may finally be within reach.

Imagine shopping for healthcare insurance the same way you shop for car insurance, except instead of refusing to pay for a cracked engine block, your insurer refuses to pay for your coronary bypass surgery. You’re left with two options: poverty or death.

What would a Medicare Advantage system look like?

The Heritage Foundation’s system would require individuals to navigate an impenetrable, a la carte healthcare marketplace composed of for-profit insurers, like Aetna and UnitedHealthcare, for their coverage. Indeed, their relentless efforts have already convinced 30 million Americans to switch to Medicare Advantage plans, with enticements like gym memberships, discounted groceries and limited dental coverage.

The shadowy tradeoff these Medicare Advantage customers unknowingly agree to is restrictions on crucial, high-priced medical care they may need in the future. The kicker? Once someone leaves Medicare for a private insurer, they may never be able to go back. They’ll be trapped in a program that leaves them to fend for themselves when they need expensive, life-saving care.

What should I be paying attention to?

Congress is considering a Heritage Foundation-endorsed commission that leans toward replacing Medicare and Social Security with programs that offer reduced benefits to fewer people.

Popular talking points, meant to conceal the true nature of these privatized programs, include terms like “consumer choice,” “competitive prices,” “empowering shoppers” and “encouraging innovation.” Likewise, The Heritage Foundation frames Medicare Advantage programs as a reduction in government spending, hence your tax dollars. What they don’t say is that instead you give that money to private insurers who provide only a fraction of Medicare’s coverage and pocket the profits.

This is only a quick summary of the decades-long plan to eliminate Medicare and Social Security. If you’d like to read more about The Heritage Foundation’s duplicitous activities and the innumerable downsides of Medicare Advantage programs, this report from the Center for Health Journalism goes into greater detail.