During a speech yesterday at an upscale Florida retirement village, Donald Trump announced a new executive order aimed at expanding the Medicare Advantage program — which allows private insurers to compete with traditional Medicare plans — so as to ward off the program’s alleged demise via Medicare for All. “Standing in solidarity with our nation’s seniors, I declare once again that America will never be a socialist country,” he said at the event. The order, titled “Protecting and Improving Medicare for Our Nation’s Seniors,” was originally, and hilariously, dubbed “Protecting Medicare from Socialist Destruction.”

With around one-third of Medicare-eligible seniors currently opting for private Medicare Advantage plans over traditional Medicare, one might be inclined to celebrate the fact that some 19 million elderly and disabled Americans are empowered to make the “choice” that’s best for them and their families. But a closer look exposes the problems inherent with this model, which further entrenches the commodification of health care and the byzantine financing system that facilitates it.

When it comes to health insurance, we’ve never actually needed “choice.” We never have. Trump’s move is simply a push for more privatization within one of the nation’s largest public welfare programs — doubling down on related measures by the administration to boost private plans within the Medicare market.