June 11, 2019

Melissa Locker, “1.1 million Americans lost health insurance coverage in 2018,” Fast Company, May 13, 2019

After some steady gains in coverage under Obamacare.

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Jonathan LaMantia, “Study links understaffing to hospital infections,” Modern Healthcare, June 5, 2019

The principal demand of the nurses’ union in their labor action against NY-area hospitals: staffing levels. This is a huge study (n=100,000).

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Susannah Luthi, “Employers, hospitals and insurers butt heads over transparency proposals,” Modern Healthcare, Jun 6, 2019

Cat-fight between insurance companies and hospitals/doctors. Insoluble under the current system, ergo one wins, one loses. Note jealous secrecy vis-à-vis “price data” and competitive threats. “Broad public disclosure of negotiated rates will lead to healthcare cost increases and distortions of market competition,” says the industry. The market can work, but only in secret!

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Eva Ferguson, “U.S. citizens are dying and we can save them,” New York Times, Jun 4, 2019 [one of 12 winners of the Student Editorial Contest out of 1,000 entries]

Who gets to live & who has to die?

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Alyssa Fisher, “TV producer shares tragic story of father’s death to shed light on mental health crisis,” Fast Forward, Jun 4, 2019

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Click on the Twitter box to read the whole thread.

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Peter Sullivan, “Liberals rip Democratic leaders for writing drug pricing bill in secret,” The Hill, Jun 6, 2019

Pelosi-style tweaking that incidentally hands Trump an election-year talking point v/s a measure that has some teeth. See below.

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Peter Sullivan, “GOP senators ask PhRMA for solutions to lower drug prices,” The Hill, Jun 6, 2019

No secrecy here! GOP majority is going to ask drug companies how THEY would like to “regulate” prices. Then let’s ask some raccoons for their favorite garbage-can designs.

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Ryan Blethen, “Sen. Patty Murray introduces bipartisan bills aimed at lowering prescription drug prices,Seattle Times, Jun 6, 2019

How-town paper applauds bipartisanship, which has worked so well in the past. Now that Republicans need something for next year’s elections, Dems gear up to politely provide them a win. “What heartens me is that Republicans and Democrats both hear about this issue,” Murray said. R’s have had a change of heart! We’re all in this together!

June 3, 2019

Bethany Bump, “At packed hearing, NY lawmakers weigh single-payer health care,” [Albany] Times-Union, May 28, 2019

Industry rep stumbles over triple-negative-laden tongue-twisters to say things are not great: “‘With health care, I don’t think anyone here would admit that it’s not complicated or that the current system is working at its best,’ said Jamie Schutzer, legislative committee chair of the NYS Association of Health Underwriters.”

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Aisling McCrea, “Freedom-loving Americans should demand universal healthcare,” Current Affairs, May 09, 2019

A curious and amusing foreigner’s take on the odd ways Americans defend our bizarre health system.

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Bill Boyarsky, “The 2020 election hinges on health care,” Truthdig, May 29, 2019

Good intro showing how Obamacare helped the working poor, but then veers off into the how-do-you-pay-for-it dead end and ends up endorsing tweaks to the ACA and “tough regulation” of health insurance as the way forward. “Tough regulation” is likely to occur under the current regime? And they say Bernie S is unrealistic!

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Adam Cancryn & Rachel Roubein, “‘Medicare for All’ backers find biggest foe in their own backyard,” Politico May 25, 2019

Hospitals plead “we’re the providers, not the middlemen,” but then ally with the middlemen again M4A.

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Danielle Keeton-Olsen, “Big health has already dumped $1.2 million into the 2020 election,” Tarbell, May 22, 2019

Big bucks to the DNC, Mitch McConnell, and “Medicare X” proponent Chris Coons.

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Associated Press, “Healthcare CEOs again lead the way in pay,” May 24, 2019

Average industry CEO pay: $16.1 million last year, highest of all industries.

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Roberto Sirvent, “BAR Book Forum: Howard Waitzkin’s Health Care Under the Knife,” Black Agenda Report, May 29, 2019

Some rather turgid leftist prose in this otherwise interesting analysis of healthcare reforms from the Clintons’ 1990s attempt through Obamacare. Also draws an interesting line in the worldwide history of social medicine from Engels to Virchow to Allende.

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Susannah Luthi, “Supreme Court rejects HHS’ Medicare DSH changes,” Modern Healthcare, Jun 3, 2019

Interesting that even the Trumpian court would not rubber-stamp radical administrative changes at HHS.

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Raymond Feierabend, “Why I worry about the health care merger craze,” Tarbell, May 30, 2019

Consolidation in rural areas and its impacts.

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Jonathan LaMantia, “Union lowers medical bills with direct negotiations,” Modern Healthcare, May 29, 2019

Interesting example of how unions have to negotiate over health insurance rather than working conditions, wages, etc. Note crazy rate increases.

May 30, 2019

Zach Carter & Daniel Marans, “Nancy Pelosi plans to go easy on big Pharma,” Huffington Post, May 23, 2019

Pelosi plans to give Trump a major political win just in time for campaign 2020 season. Note the comments about how lame the measure would be and the sneeringly dismissive attitude of the corporate sector toward Doggett’s alternative.

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Jonathan LaMantia, “Physician practices increasingly turn to private equity for capital,” Modern Healthcare, Apr. 26, 2019

“Deals,” “transactions,” “growing your business,” “private equity,” “lucrative specialties,” “annual returns”—this is medicine?

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Emily Birnbaum, “[Corey] Booker: I support Medicare for All, but I’m a pragmatist,” The Hill, May 5, 2019

How to sound sorta like Bernie Sanders and still wink-wink at your pharma/insurance backers.

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Susannah Luthi, “Senate committee unveils sweeping healthcare bill package,” Modern Healthcare, May 23, 2019

The GOP-controlled Senate tries to get out ahead of the groundswell of dissatisfaction with our creaking healthcare system.

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Shaye Mandle, “Commentary: Why healthcare’s future must be collaborative,” Modern Healthcare, May 18, 2019

From an industry CEO, taking note of public pressure: “The days of healthcare’s various sectors all tilting at one another must come to an end for the good of patients and for the health of the industry as a whole.” Translation: given the proliferation of pitchforks, let’s stop fighting among ourselves before we’re put out of business.”

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Sahil Kapur, “‘Medicare for All’ falters as top Democrats fret over backlash,Bloomberg, May 22, 2019

Pretty good summary of the competing positions among Dems.

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Dean Baker, “The wonderful world of free-market drugs,” Patreon, May 27, 2019

Pay-walled (but only costs $1 per month for Baker’s timely posts). Here is a sample:

“This is not a story where we need the government to correct an inequity created by the market, we need the government to stop intervening in a way that creates tremendous inequities and inefficiencies.

“I find that people . . . have a hard time even understanding what the market for prescription drugs looks like in the absence of patent and related monopolies, so I thought I would devote a blogpost to describing my view of such a world.

“The first and most basic point is that in nearly all cases drugs would be cheap. Drugs are very rarely expensive to manufacture. They are expensive for patients because drug companies have patent or related monopolies and they use these monopolies to charge very high prices to the people who need their drugs. If there were dozens of competing manufacturers producing the same drug, they would be no better positioned to get away with charging incredibly high prices than a supermarket could get away with charging incredibly high prices for food. . . .

And there is huge money at stake here. In the case of prescription drugs alone the United States will spend more than $460 billion in 2019 for drugs which would almost certainly sell for less than $80 billion in a free market. The difference of $380 billion is more than five times annual spending on food stamps. It is almost 9.0 percent of the federal budget.”

May 23, 2019

Sen. Rick Scott, “An America First drug pricing plan,” South Florida Sun-Sentinel, May 21, 2019

You know it’s bad when this right-wing ideologue is writing op-eds about how to get drug prices down.

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Joe Harpaz, “Price transparency: Why are drug prices such a bitter pill to swallow?” Forbes, May 17, 2019

Pretty good general explanation of the convoluted U.S. system—which the author basically approves of.

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James Hamblin, “Everything Trump has and hasn’t done about drug prices,” The Atlantic, May 10, 2019

Points out that Trump needs progress on pricing to salvage his team’s promises to totally revamp of Obamacare. Since that was a blatant head-fake, now the GOP needs to show progress for 2020 on something—such as runaway drug prices. One weird statement: a “relatively small 24 percent” of the population has trouble paying for meds(?) On the other hand: “Though drug prices are a popular talking point, if the overall goal were actually keeping American people alive and well, it would require a systemic reform of the health-care system.”

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Linda Marsa, “A 5-point plan to lower prescription drug prices,” AARP Bulletin, April 30, 2019

The Five: allow Medicare to negotiate; import from Canada (or elsewhere); rewrite patent laws; clips the wings of the middlemen (PBMs); reassert control over federally funded research. All worthy ideas—that do not challenge the role of private insurance. Nonetheless, that the massive AARP is behind change is another telling sign.

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Adam Cancryn & Sarah Owermohle, “House passes drug pricing bills paired with Obamacare fixes,” Politico, May 16, 2019

Good background on the “bipartisanship” magic sparkle fairy: Dems put poison pills in a bill that some Republicans would otherwise like (to give them cover for the election season). Juicy irony of Rs blaming Ds for “politicizing” the legislation. Both sides want to take credit for action on drug pricing, but Rs insist on simultaneously undermining Obamacare.

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Christian Urrutia & Nicholas Faust, “Truvada: A spotlight on Pharma’s greed,” The Hill, May 21, 2019

Op-ed by the Break the Patent campaign. The AIDS activist community—another potent lobby—is gunning for Gilead. This drug was completely developed by the NIH and private philanthropy, so Gilead’s profiteering is indefensible. AOC led the charge in the hearing.

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Ike Brannon, “Louisiana is creating a drug-price revolution,” The Hill, May 20, 2019

The author, from the Jack Kemp Foundation (“a nonprofit charitable organization committed to advancing growth, freedom, democracy and hope”), loves this state’s approach to getting drug costs down: pay a lump sum in advance. “The fact that a market-based model potentially could provide such benefits bodes well for future pricing innovations that could save taxpayer money.”

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Everett (Washington) Herald, “Drug price information should help control costs,” [editorial], May 21, 2019

A fairly mainstream editorial on why we should know more about drug prices. Not everyone thinks it will make much difference.

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Nicholas Florko, “A new study sparks a war of words over the drug industry’s commitment to research,” Stat, May 14, 2019

Advocates blast Pharma outlays for advertising and profit; industry defends itself saying other guys are worse.

May 15, 2019

Raina Lipsitz, “What happened to New York’s plans for single-payer health care?” The Nation, May 2, 2019

An excellent update on affairs in Albany. Note comment from newly elected state senator Gounardes: “I’m not trying to spike my support for the New York Health Act. I just want to make sure we’re doing it thoughtfully [because] if we don’t get this right, the cause is done.”

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Steve LeBlanc & Martin Crutsinger, “States bring price-fixing suit against generic drug makers,” Associated Press, May 11, 2019

Signing onto the lawsuit: 43 states and Puerto Rico. Another sign that both parties are scrambling to get ahead of popular outrage over drug prices. This was highlighted on 60 Minutes May 12 in a take-no-prisoners segment.

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Susannah Luthi, “Industry enters new battle phase over surprise billing,” Modern Healthcare, May 11, 2019

This proposal from Trump would entail “significant disruption” in hospital billing—a common criticism of M4A. Sounds like progress!

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Martha Bebinger, “Addiction medicine mostly prescribed to whites, even as opioid deaths rose among blacks,” Kaiser Health News, May 8, 2019

Another confirmation that treatment at point-of-care varies by race.

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Ilana Novick, “Conservative Dems’ rural voter project is all about sinking Medicare-for-All,” Truthdig, May 14, 2019

Good background on the One Country Project, a “dark money” group, using the two former lawmakers to push an anti-Medicare-for-all agenda connected to the anti-M4A Partnership for America’s Health Care Future (PAHCF). Brainchild of a former Democrat senator from North Dakota who writes that “most Americans are satisfied with the health care they receive.”

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Rachana Pradhan & Dan Goldberg, “5 key questions about the country’s first public option,” Politico, May 14, 2019

Washington state will try to “thread the needle” with the public option, a complex attempt to improve outcomes by making the state compete head-to-head with private insurers (but requires cooperation by these companies in a scheme designed to compete with them). The plan is the brainchild of Washington governor Jay Inslee, also seeking the Democrat presidential nomination. If he gets it, the Washington plan will start just as Trump begins his second term in 2021. Ha!

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Dean Baker, “Getting to Medicare for All,” Patreon, May 1, 2019

Baker puts out the argument for a step-by-step approach and assumes that success will lead to M4A by example. One glaring error: “Actual legislation of course requires specific revenue sources, not a menu.” No, it doesn’t—unless Pelosi et al. enforce that stupidity with voluntary self-bondage like Pay-Go or the like. The Pentagon has NEVER had to devise a revenue source for its vast spending plans, and no one EVER asks, “How are we going to pay for bombing [X country]?”

However, would reducing the Medicare eligibility age by one year be a good intermediate step? Discuss.

May 12, 2019

Kevin Freking & Ricardo Alonso-Zaldivar, “Trump calls on Congress to end “surprise medical bills,’” Associated Press, May 9, 2019

Trump announces action against “surprise billing”—this has a distinct smell of campaign 2020. The issue lends itself to tweaking the system around the edges without requiring major surgery as well as benefiting one of the large players in the industry (at the expense of others). Thus, it is perfect for a slugfest in Washington with piles of lobbyist cash being hurled at both sides. See the following article.

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Julie Rovner, “Surprise! Fixing out-of-network bills means someone must pay,” Kaiser Health News, May 9, 2019

Nine states are working on this topic also, but they cannot regulate employer-provided insurance, thus the essential role of the Feds.

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Michael Ollove, “This state has a bundle of ideas to lower drug prices,” Pew Stateline, May 7, 2019

States may not wait for Washington to bring relief.

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Susannah Luthi, “GOP senators warn drug price controls could come,” Modern Healthcare, May 7, 2019

You know it’s bad when Tea Party Republicans start calling for price controls.

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Ricardo Alonso-Zaldivar & Curt Anderson, “Trump backs Fla. plan to import lower-cost meds from abroad,” Associated Press, May 9, 2019

Florida is a key battleground state for 2020. Just sayin’.

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Amy Goldstein, “Why Vermont’s single-payer effort failed and what Democrats can learn from it,” Washington Post, Apr. 29, 2019

We will hear more about the failed Vermont program. The author makes no distinction between a one-state plan that would have to be self-funded and a national single-payer reform that could pay for itself through the U.S. Treasury (the way F-35s are paid for). Nonetheless, this is important information for advocates.

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Amber A’Lee Frost, “A watered-down Medicare for All won’t work. Just ask Ireland,” New Republic, Apr. 26, 2019

All the halfway, “road to”, moderate-sounding programs have an Achilles heel: they try to combine a public market aimed at low-income citizens while leaving intact the bloated private market.

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Jonathan Tepper, “Medicare for All and the myth of free markets,” American Conservative, Apr. 25, 2019

This magazine consistently breaks with current GOP orthodoxy. In this critique of the failures of Obamacare, the author shares many of our arguments. (“It would be almost impossible to create a more convoluted, uncompetitive, and byzantine healthcare system than the United States has today.”) However, his solution is to seek the unicorn of “better markets” to combat the “monopoly of private healthcare companies.” His prediction: “If Republicans do not champion competition, the only alternative to private monopolies will be a government-run monopoly. Citizens may view it as a welcome relief from private tyrannies.”

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Shelby Livingston, “Industry battles Medicare for All traction,” Modern Healthcare, Apr. 27, 2019

“Health insurers and hospitals are starting to sweat.” First, they ignore you, then they mock you, . . . etc. Despite the fear, note the enthusiasm among industry players for “expanding” the Medicare population through the faux-M4A proposals like Medicare buy-in.

“Insurance company CEOs are now starting to speak out publicly against the proposals while advocating for private-sector innovation and cost-cutting. They are being forced to make the case for why they should exist because their centrality to the future healthcare system isn’t guaranteed, and they know it.”

May 5, 2019

Wendell Potter, “Propaganda machine stalls at Medicare for All hearing,” Tarbell, May 2, 2019

Potter was a high-level industry shill, so he knows its message: FUD=Fear, Uncertainty, Doubt.

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Jeff Stein, “‘Bring it on’: Biden and Sanders teams kick off debate over Medicare-for-all,” Washington Post, Apr. 29, 2019

Biden’s new position is the Medicare buy-in idea. This is the “public option” floated during the ACA debate when Biden and Obama were in the White House and had a huge congressional majority. The public option served to sidestep (and confuse) discussion of single-payer. Perhaps it is arising now for the same reason?

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Susannah Luthi, “House lawmakers throw down gauntlet for Medicare for All,” Modern Healthcare, Apr. 30, 2019

“Industry jitters” indeed.

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Gregor Smith, “Corporate media’s open hostility to Medicare-for-All,” Truthdig, Apr. 30, 2019

A steady flow of “doom-mongering stories” from mainstream media. And Bloomberg warns of the “pain to come” for the industry.

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Noam M. Levey, “Health insurance deductibles soar, leaving Americans with unaffordable bills,” Los Angeles Times, May 2, 2019

Describes the “explosion in cost-sharing” in the employer-provided health insurance to which Americans are supposedly so attached. Average deductible for a single worker in 2006: $379; average today: $1,350.

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Bernie Sanders, “Medicare For All’s moment is here: Don’t back down,” Buzzfeed, May2, 2019

Bernie thanks us for moving the needle on the entire debate. You’re welcome!

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Carmen Heredia Rodriguez, “Summer bummer: A young camper’s $142,938 snakebite,” Kaiser Health News, Apr. 30, 2019

This week’s medical bill horror story.

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Bloomberg [editorial], “Two kinds of Medicare for All,” Apr. 30, 2019

Argues—in absence of evidence—that Medicare buy-in schemes will work without dismantling for-profit insurance.

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Peter Sullivan, “Trump urges Dem senator to revive bipartisan ObamaCare talks,” The Hill, Apr. 30. 2019

The bipartisanship magic sparkle fairy! Trump is for it, maybe Biden also?

Apr 29, 2019

Harris Meyer, “Kansas bypasses Obamacare; will other states follow?” Modern Healthcare, Apr. 23, 2019

Kansas has allowed its farm bureau to issue insurance plans that deny coverage for pre-existing conditions, breaking with a key principle of the ACA. Unregulated insurance policies are likely to cause surprise to purchasers when they actually need to use it. Trump officials enthusiastically back this and similar steps backward.

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By Matt Fuller, “Democrats add single-payer champion Ady Barkan to ‘Medicare For All’ hearing,” Huffington Post, Apr. 24, 2019

This came as a result of the outrage over Pelosi’s decision to exclude single-payer supporters from the Apr. 30 hearing on the Jayapal single-payer bill while welcoming critics. However, as the companion piece [below] points out, Barkan isn’t really a policy expert.

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Lambert Strether, “House Democrats schedule hearing on HR1384 (#MedicareForAll) for this Tuesday, April 30,” Naked Capitalism, Apr. 29, 2019

A detailed look at how the Democrat leadership is stacking the deck against the Jayapal bill by restricting testimony to witnesses who either oppose single-payer or promote alternatives. Even the last-minute addition of Ady Barkan does not make up for the lack of testimony from real pro-single-payer policy experts (Angell, Woolhandler, Gaffney). Strether insists that stopping M4A is the #1 policy goal of Pelosi & the corporate wing.

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Simon Davis-Cohen, “Iowa privatized Medicaid: It has been a disaster. Here’s why,” Tarbell, Apr. 25, 2019

Promise: savings and quality care; outcome: claim denials, lost hospital revenues, private profits. So it worked!

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Harris Meyer, “Worries mount as VA races to launch private-care program in June,” Modern Healthcare, Apr. 27, 2019

Now that privatization is working so well in Iowa, how is the dismantling of the VA proceeding?

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Jasper Craven, “In the Bronx, AOC advocates for a ‘VA for All,’” The Nation, Apr. 18, 2019

Creeping privatization with almost universal Democrat support. (Sanders opposed.) AOC: “Ultimately, they are trying to fix the VA for a for-profit health-care industry that does not put people or veterans first.”

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Trudy Lieberman, “Examine short-term health policies with extra care before buying,” Tarbell, Apr. 25, 2019

Anything pitched with shrill urgency on late-night cable probably isn’t the best deal.

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Caroline F. Pearson, Charlene C. Quinn, Sai Loganathan et al. “The forgotten middle: Many middle-income seniors will have insufficient resources for housing and health care,” Health Affairs, Apr. 24, 2019

This academic article has attracted considerable attention for its startling conclusion that 54% of all middle-income seniors will be unable to pay for both housing and medical care within a decade.

Apr 24, 2019

Sharice Davids, “I’ll work with everyone on health care, regardless of party,” Kansas City Star, Apr. 4, 2019

A column penned by this first-term Democrat (LGBT, Native) member of congress that perfectly expresses the mainstream Dem approach to healthcare: the bipartisanship unicorn, pursuit of “affordable” services (instead of removing them from the commercial marketplace), emphasis on “lower health insurance premiums” (sidestepping runaway costs and profiteering), and pushing for state-based commercial exchanges (likely to absorb expensive patients while private insurance gets the lucrative ones). She notes that 70% of the questions that she gets at public forums are about healthcare—meaning officials like her can’t ignore it.

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Dean Baker, “Payments to hospitals are not going to hospital buildings,” Beat the Press, Apr. 21, 2019

A good example of how mainstream coverage adds to misinformation: if a single-payer system keeps Medicare distortions in place, bad things will happen. And?

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Drew Altman, “For low-income people, employer health coverage is worse than ACA,” Axios, Apr. 15, 2019,

While most people get their health insurance at work, employer-based coverage is poor for those who need it most. Since costs are rising faster than incomes, job-based benefits will deteriorate as costs are shifted to workers. “For firms that employ disproportionately low-wage workers, it can simply be too expensive for employers to provide good coverage.”

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Luke Thibault, “The corporate campaign to kill Bernie’s Medicare for All bill is here,” Jacobin, Apr. 19, 2019

[United Healthcare CEO] Nelson [who earned $7,580,440 last year] explained that the company is “trying to be thoughtful about how we enter in the conversation because there’s a risk of seeming like it’s self-serving.” Really?

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Rachana Pradhan & Dan Goldberg, “As Dems debate Medicare for All, a less radical idea stalls in blue states,” Politico, Apr. 8, 2019

So-called “public option” health insurance plans attempt to cover more people while leaving the profit-driven system intact. While candidates like to offer something to voters short of single-payer, attempts to create these plans still draw the ire of and opposition lobbying by private insurance companies. “New Democratic governors in Colorado, Illinois, Minnesota, and Nevada have voiced support for a public option. Several have said little about it since the campaign, however.”

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Shelby Livingston, “UnitedHealth revenue grows with Medicare members, OptumHealth patients,” Modern Healthcare, Apr. 16, 2019

A reporter’s word choice can be an ideological tell: Sanders’ plan is “aggressive” while proposals to get Americans to buy into Medicare Advantage (private insurance programs) are “moderate.”

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Joanne Kenen, “Obamacare fight obscures America’s real health care crisis: Money,” Politico, Apr. 3, 2019

“The Obamacare wars have ignored what really drives American anxiety about health care: Medical costs are decimating family budgets and turning the U.S. health system into a runaway $3.7 trillion behemoth.”

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Susannah Luthi, “How Washington’s drug-pricing promise could lose its way,” Modern Healthcare, Apr. 20, 2019

Hard-hitting article demonstrating the gap between the rhetorical “pageantry” about high drug prices and the dependence of the principal elected officials on Pharma loot.

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David Dayen, “Nancy Pelosi’s drug-pricing talks with the Trump Administration are about mediating fights between corporate interests,” The Intercept, Apr. 22, 2019

That would be “among”—there are more than two interests. The basic line-up is: Republicans are in the pharmaceuticals’ corner, Democrats back the PBMs and hospitals. Each party has a corporate interest behind it, and they slug it out while burying any attempt to eliminate the profit motive entirely.

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Harris Meyer, “Faulty state renewal processes blamed for Medicaid coverage declines,” Modern Healthcare, Apr. 9, 2019

How to reduce Medicaid rolls: hugely complicate the eligibility verification process, set up a dysfunctional call center that keeps you on hold for an hour, and reduce the time you have to respond to endless demands for more information. Savings!

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Anna Staver, “Colorado health care: 8 ways lawmakers want to make it cheaper,” Denver Post, Apr. 6, 2019

“It seems like every state senator and representative is trying to pass a health care bill this session.” Desperate attempts to tweak the commercial system without biting the single-payer bullet.

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Richard M. Perloff, “Single-payer has become a campaign buzzword that by 2020 may become a buzzsaw,” Cleveland Plain Dealer, Apr. 3, 2019

This op-ed from an academic hits major pro- and anti-single-payer points without revealing where the author stands while lamenting that “polarizing cudgels” have replaced “thoughtful health care debate.” Many such commentators—and most elected officials—desperately wish that the healthcare problem could be solved technically rather than politically. It can’t.

Apr 21, 2019

Zach Carter & Daniel Marans, “Democrats ran on lowering drug prices. Now they could cut a bad deal with Donald Trump,” Huffington Post, Apr. 19, 2019

Lots of rhetoric about getting tough with Pharma, followed by watered down action. Exactly what should be expected when corporate cash rules Congress—unless there is outside pressure.

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Peter Sullivan, “Dems struggle to unite behind drug price plan,” The Hill, Apr. 5, 2019

Pelosi’s office talks of “bold, tough” measures—being negotiated with the White House.

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Shelby Livingston, “Fears of Medicare for All, drug rebate overhaul feed selling of health insurer stocks,” Modern Healthcare, Apr. 12, 2019

Shares in insurers get slammed by popularity of M4A and criticism of Pharma, PBM intermediaries.

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Rachel Bade, “Obama cautions freshman House Democrats about the price tag of liberal policies,” Washington Post, Mar. 26, 2019

Obama breaks a long silence to repeat GOP talking points.

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Shelby Livingston, “Health insurers migrating to Medicare, Medicaid,” Modern Healthcare, Mar. 30, 2019

How curious! While commercial insurance is pitched to us as the proof that the private sector is more efficient, the industry gets more and more of its income from managing government money rather than from its own premium revenues. A telling quote: “You have to do things lean and mean” when profits come from Medicaid.

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Michael Ollove, “Trump greenlights major Medicaid changes,” Pew/Stateline, Mar. 26, 2019

Best known is the states’ job requirement, but there are other ways of chipping away at the program: premium payments, “lock-out” periods for paperwork errors, elimination of transportation assistance, etc. Trump is losing in federal court on the work requirement—so far.

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Michael Hiltzik, “Health Secretary Azar’s attacks on Obamacare make him Trump’s most dangerous Cabinet member,” Los Angeles Times, Apr. 1, 2019

A thorough take-down of the Medicaid work requirements by a senior reporter, which outlines exactly how the dog-whistle talk of “able-bodied” beneficiaries is ideological red meat that has no basis in public health and doesn’t even pretend to have.

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Gerald Schifman, “Retirement plan payout boosted Mount Sinai CEO’s pay above $12 million in 2017,” Modern Healthcare, Apr. 8, 2019

Read about the money vacuumed up by the selfless titans of the medicine biz.

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Tara Bannow, “Industry leaders share ideas, point fingers on limiting hospital prices,” Modern Healthcare, Apr. 13, 2019 https://bit.ly/2GkU8fU

A deep dive into what makes hospital stays so expensive—according to hospitals. “When you have an integrated system—a plan, hospitals and doctors—all in a single entity or working in these close collaborations, you naturally see savings and you see greater value.” What does that remind us of?

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Jessica Kim Cohen, “VA says private care program will roll out in June despite claims of software flaws,” Modern Healthcare, Apr. 2, 2019 https://bit.ly/2UFp8jT

Classic from the neoliberal playbook: disrupt and worsen a public service, denounce the public service as inefficient, turn over more and more of its functions to for-profit competitors, thus further weakening the public service. Rinse and repeat.

Apr 15, 2019

Beth Snyder, “Call it lobbying on the air: Pricing debate spawns big ad spending by pharma, PBMs,” Fierce Pharma, Apr. 9, 2019

M4A’s popularity has pushed Congress and the White House to find ways to neutralize the pressure against spiraling costs while shielding the for-profit model. In response, Pharma and healthcare trade groups are spending millions on advertising and lobbying.

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Jessie Hellman, “Cigna says it will cap insulin costs at $25 a month for some patients,” The Hill, Apr. 3, 2019

“The announcement comes as insurers and drug manufacturers face growing questions from Congress and the Trump administration about the rising cost of insulin.” Whenever negative PR starts to bite, the companies suddenly get religion.

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Peter Sullivan, “Key House lawmakers reach bipartisan deal to advance long-stalled drug pricing bill,” The Hill, Apr. 3, 2019

The measure is designed to stop drug companies from buying off generic competitors to preserve their market-gouging share.

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Ezekiel J. Emanuel, “Big Pharma’s go-to defense of soaring drug prices doesn’t add up,” The Atlantic, Mar. 23, 2019

The pharmaceutical industry exercises monopoly control and can manipulate patents, thus wildly excessive profits. The excuse about needing all that loot for R&D is an ancient canard.

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Beth Mole, “Pfizer CEO gets 61% pay raise—to $27.9 million—as drug prices continue to climb,” Ars Technica, Mar. 16, 2019

Price hikes easily outpace overall inflation, and hefty winnings for the bosses are not far behind.

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Branko Marcetic, “Individuals working for Wall Street, private equity and big pharma love to donate to Cory Booker,” In These Times, Apr. 12, 2019

Swearing off corporate PAC money may mean less than it appears.

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Jessie Hellman, “Five major court battles over Trump’s health agenda,” The Hill, Mar. 31, 2019

A round-up of the judicial obstacles to the Trump agenda. However, the federal courts are now getting filled with Trump appointees, so final appeals could go either way.

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Harris Meyer, “CMS, states face difficult choices on Medicaid expansion, work requirements,” Modern Healthcare, Mar. 30, 2019

Work requirements do little to get beneficiaries into the workforce but do reduce the Medicaid rolls via red tape. The whole debate goes to the heart of why healthcare should not be subject to eligibility requirements at all but rather a universal benefit covering both the pious and the unbelievers.

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Jay Root & Shannon Najmabadi, “Thousands of Texans were shocked by surprise medical bills. Their requests for help overwhelmed the state,” Texas Tribune, Feb. 12, 2019

The idea of forcing providers into arbitration has been put out as a way to help patients hit with surprise “balance bills” for charges not covered, especially for ER visits. Here’s a good example of how that approach could be undermined. Of course, with single payer the whole problem disappears. Note that even the Republican state legislator quoted isn’t satisfied with the stopgap solution.

*

Wendell Potter, “The biggest lies from new insurance industry ads,” Business Initiative for Health Policy, Feb. 4, 2019

A four-minute video slicing and dicing the industry’s initial propaganda salvo.

Apr 11, 2019

Sarah Kliff, “The doctor’s strike that nearly killed Canada’s Medicare-for-all plan, explained,” Vox, Mar 29, 2019

This is a great article addressing the political obstacles Canada overcame and showing how important uncompromising leadership will be for single-payer, as opposed to the continuing hunt for a bipartisan sparkle fairy unicorn.

*

CQ Roll Call, “‘Medicare for all’ doesn’t just rival Canada’s system. It goes further,” Mar. 27, 2019

Capitol Hill reporters weigh in on the healthcare debate. Most of their caveats about M4A are fairly minor or fixable. For example, any potential doctor shortage could be alleviated by allowing in more foreign graduates. The “pharmaceutical innovation” argument is bogus.

*

Alex Kacik, “Healthcare’s mission is lost amid politicization,” Modern Healthcare, Mar. 30, 2019

Stabenow: let’s “depoliticize” the debate about healthcare. Huh? Does she mean that her anti-single payer suggestions are politics-free? Read closely to see the diagnosis offered by the industry execs invited to her non-political hearing—it’s the patients’ fault!

*

Eric Levitz, “Your insurance is getting disrupted — with or without Medicare for All,” New York, Apr. 8, 2019

The author cuts through oppo arguments: “Unfortunately, politicians aren’t usually comfortable saying, ‘I support a suboptimal policy because I am afraid of taking on the special interests who oppose the optimal one.’”

*

Tara Bannow, “CHS quadruples CEO Wayne Smith’s incentive pay in 2018,” Modern Healthcare, Apr. 5, 2019

Smith’s total compensation at the for-profit healthcare corporation in 2018: $7 million, most of it in “incentive” pay. You get the incentive bonus by “improved company performance on net revenue.” Smith also has accrued $48.5 million in pension benefits—why not retire and start a think tank! On healthcare policy!

*

Ricardo Alonso-Zaldivar, “Feds charge 2 dozen in billion-dollar Medicare brace scam,” Associated Press, Apr. 9, 2019

If you watch late-night cable TV or the true crime channels, you’ve seen the ads for this scam. Not a good idea to give out your Medicare ID number!

Apr 8, 2019

Stephanie Goldberg, “Illinois’ Medicaid managed-care program is costing hospitals,” Crain’s Chicago Business, Mar. 29, 2019

A good example of the huge costs of billing administration to sustain the private insurance industry. (“But how are we going to PAY for it??”)

Hospitals and systems are having to staff up with dozens and dozens of employees to chase down claims,” says A.J. Wilhelmi, CEO of the Illinois Health & Hospital Association.

*

Robert King, “Study: Reinsurance to cost feds $30 billion to support ACA insurers,” Modern Healthcare, Mar.22, 2019

Reinsurance is a government subsidy to “stabilize the ACA marketplaces,” i.e., defray the cost of expensive patients. Therefore, the proposal is that we provide about $10 billion a year in recognition of the fact that these companies cannot both insure everyone via a risk pool AND receive an attractive profit.

*

Merrill Goozner, “Ban balance billing,” Modern Healthcare [editorial], Apr. 4, 2019

“Congress, in a rare display of bipartisanship, is considering legislation that would rein in a system that benefits everyone but patients.”

Private equity firms owns much of what goes on in the nation’s ERs. Result: hefty profits, cost escalation, surprise “balance billing,” patients get screwed. Forty-six states have passed or are considering bans, but the federal government hasn’t acted.

*

Emily Kopp, “By striking at Obamacare, Trump could unravel his own drug pricing proposal,” Roll Call, Mar. 29, 2019

A good summary of the incoherence at the heart of Trump’s public statements on drug pricing and healthcare. “By backing the wholesale repeal of the 2010 health care law, President Donald Trump could unravel his own plan on prescription drug prices.” GOP candidates fear they will get slammed on health policy in 2020.

*

Mary Ellen McIntire, “How ‘Medicare for all’ went from pipe dream to mainstream,” Philadelphia Inquirer, Mar.31, 2019

“To succeed, liberals would need a grassroots movement propelling the effort.” Yes, we know!

*

Michael Corcoran, “Sorry, Wrong Number: Patient fights back after CVS Caremark denies her the drug she needs and records her calls,” Tarbell, Apr. 8, 2019

Tragicomic. But imagine if the patient were not savvy about the system and determined to get answers.

There are congressional hearings on the PBMs (pharmacy benefit managers) tomorrow (4/9).

Apr 2, 2019

Josh Dawsey, Ashley Parker & Damian Paletta, “Mulvaney pushes the health-care fight Trump wants despite GOP’s misgivings,” Washington Post, Mar. 27, 2019

This is a major escalation, probably encouraged by Trump’s political triumph in the Mueller/ Russiagate investigation. Some Republicans fear electoral losses, but Trump’s political instincts should not be underestimated.

*

Brendan Pierson, “Two Republican attorneys-general urge court to uphold Obamacare,” Reuters, Apr. 1, 2019

Tossing out Obamacare wholesale is not a popular idea even with the GOP hardliners who trashed it since its inception. But as the article points out, they themselves set up the ACA for destruction by taking the health insurance mandate out of the tax code.

*

Robert Pear, “House Democrats to unveil plan to expand health coverage,” New York Times, Mar. 25, 2019

Meanwhile, what is the Democrat strategy? This reporter’s lede elevates his personal opinion to the category of indisputable fact: “Democrats won control of the House in large part on the strength of their argument that Congress needs to protect people with pre-existing medical conditions and to lower the cost of health care.” If you accept that thesis, then incrementalism is obviously the right political choice for 2020. The author also continues to believe in the magic bipartisanship fairy in health policy.

*

Catherine Rampell, “If the GOP built their ideal health-care system . . . it’d be Obamacare,” Washington Post, Mar. 28, 2019

Why there is no GOP replacement for Obamacare—unless Trump signs on to single-payer.

*

Robert King, “HHS’ Hargan: Medicare cuts will shore up program,” Modern Healthcare, Mar. 27, 2019

“We had to destroy the village in order to save it.”

*

Susannah Luthi, “VA seeks more funding to complete community care consolidation,” Modern Healthcare, Mar. 26, 2019

OTOH, Trump Administration does want more healthcare money for one goal—to further privatize the Veterans Administration.

*

Clio Chang, “5 women on what it’s actually like to have universal health care,” Elle, Mar. 21, 2019

Testimonies from a women’s magazine. (Teen Vogue has also been good on the subject.)

*

Susannah Luthi, “Analysts, some legislators want regulation of contracts to stop surprise billing,” Modern Healthcare, Mar. 23, 2019

The “surprise” in the headline being the bills one gets from physicians’ practices embedded within hospitals such that one can be treated in-network by out-of-network docs. A possible legal fix is in the works, but a single-payer system would eliminate the mess without the need for tinkering.

“If you squeeze the balloon in one place it pops up in another.” How about popping the balloon?

*

Adam Cancryn & Dan Diamond, “Exclusive: Key Trump health official spends millions on GOP-connected consultants,” Politico, Mar. 29, 2019

Just to remind ourselves that the corruption trough is still full of slop, here’s a dirty little secret about Trump’s CMS administrator.

*

Sarah Kliff, “I read 1,182 emergency room bills this year. Here’s what I learned,” Vox, Dec. 18, 2018

Five main points that can be summarized as: what a mess.

*

And finally from the NY Times . . .

When House Speaker Nancy Pelosi introduced legislation this week to strengthen the Affordable Care Act, Democrats across the ideological spectrum were quick to express their support. But not Bernie Sanders. When asked on Tuesday night whether he, too, supported the House bill, Mr. Sanders was defiant. “No,” he said tersely. “The incremental reform that I support is phasing in ‘Medicare for all.’”

Mar 25, 2019

Bryce Covert, “How does losing Medicaid help you get a job?” The Nation, Mar. 7, 2019

Stories of people kicked off Medicaid by tricky work rules. The policy can only be termed a “failure” if we refuse to see that this is the goal.

*

Merrill Goozner, “Medicare for All isn’t the only way to go,” Modern Healthcare (editorial), Mar. 16, 2019

This knowledgeable health reporter lays out the case for M4A, but proposes other ways of getting “everyone in” and at the same time controlling costs. Good for debate!

*

Nathaniel Weixel, “Trump officials take bold steps on Medicaid,” The Hill, Mar. 20, 2019

The Trump administration is pulling out all stops to help red states do an end run around Medicaid expansion rules established by Congress. So far, nine states have a green light to reduce Medicaid rolls via work requirements. Next steps: block grants and per capita spending caps.

*

Wendell Potter, “Democrats on the take: New DCCC Chair is a best friend of health insurers,” Tarbell, Mar. 15, 2019

Potter, a former communications director for a big health insurer, takes no prisoners in exposing how industry cash buys influence.

*

Andrew Perez, “Democratic senator who opposed Medicare for All will lobby for health-care interests,” MapLight/Splinter, Mar. 14, 2019

Exhibit A: Joe Donnelly (D-IN), who fought M4A, lost his seat, cashed in with a lobbying firm, and is still called a “moderate” Democrat (rather than a “corporate” one) in reports such as these. In his recent losing campaign for re-election, Donnelly ran an ad that said, “Socialists want to turn health care over to the government. Over my dead body.” Voters preferred an actual Republican to the imitation version.

*

By Dr. Hagop Kantarjian, “How to fix out-of-control drug costs to serve patients, not drug company profits,” Tarbell, Mar. 21, 2019

Some of the measures being discussed to bring down insane drug prices.

*

Dena Bunis, “Bipartisan bills in Congress would increase access to generics,” AARP, Mar. 21, 2019

There appears to be some GOP support for putting an end to some of the more egregious Pharma practices to maintain their monopolies.

*

Libby Watson, “Look at these absolutely ordinary Americans who hate Medicare for All,” Splinter, Mar. 19, 2019

Pretty sloppy work by an anti-M4A lobby.

*

And finally,

Luke Thibault & Tim Higginbotham, “Don’t let Beto O’Rourke kill Medicare for All,” Jacobin, Mar. 22, 2019

The bait-and-switch of the public option worked in 2009, won’t work this time.

Mar 19, 2019

Lanhee J. Chen & James C. Capretta, “Three Obamacare tweaks that both parties can love,” Politico, Feb. 12, 2019  https://politi.co/2SOJia8

Two pundits (Hoover & American Enterprise Institute respectively) argue for “realistic” and “practical” measures based on “compromise and step-by-step progress.” Review their ideas and ask yourself whether any of these steps would provide meaningful improvements.

*

Wendell Potter, “Here’s how the drug industry funds ‘experts’ to discredit efforts to lower prices,” Tarbell, Feb. 19, 2019

How Big Pharma manipulates news coverage of imported drugs to make people think they’re counterfeit. The ubiquitous industry shill Sally Pipes is heard from once again.

*

Michael Corcoran, “Establishment Democrats are undermining Medicare for All,” Truthout, Mar. 17, 2019

Interesting account of why 29 supporters of the M4A bill last year (when it had no chance of passage) have now defected and why so many incoming Dems are not signing on. As the DNC “pleaded with new candidates not to support single-payer” to neutralize the threat of having to deal with it, the prophecy of political damage is self-fulfilling.

*

Shelby Livingston, “Some insurer CEOs see bigger paychecks in 2018,” Modern Healthcare, Mar. 18, 2019

Meanwhile, good to know that the health insurance industry is thriving!

*

David Kendall & Jim Kessler, “We don’t need government-run health care to get to affordable, universal coverage,” Washington Post, Feb. 19, 2019

Through “two simple, game-changing features [to Obamacare]: a universal cap on premiums and out-of-pocket expenses, and an automatic coverage system that places the uninsured in a plan they can depend on and afford.” Simple! (and no doubt painless!) The authors don’t explain why Obamacare didn’t do this in the first place.

It’s amazing how these proponents of such “practical” and “moderate” solutions get away with statements such as: “Much of the cost of our plan will be offset through aggressive measures we propose to tame the medical-industrial complex.”

*

Devesh Madhav Vashishtha, “Single-payer health care is the only moral prescription for America,” Seattle Times, Feb. 19, 2019

Contrast with the above especially in the inclusion of actual patient stories.

*

Chris McKenna, “Can single-payer health care work in NY?” (Middletown NY) Times Herald-Record, Feb. 17, 2019

A good summary of the kinds of arguments we will hear on both sides of the New York Health Act campaign.

*

Lydia Coutré, “Feds approve Ohio’s request to implement work requirements,” Modern Healthcare, Mar. 15, 2019

Work mandates get few people jobs but paperwork requirements do succeed in knocking people out of coverage—including active workers.

*

Eoin Higgins, “Capuano’s trip through the revolving door: From Medicare-for-All supporter to health industry lobbying firm,” Sludge, Mar. 8, 2019

One-time proponent of M4A, now an industry lobbyist. Follow the Benjamins!

*

Sheryl Gay Stolberg & Robert Pear, “Medicare for All is divisive (in the Democratic Party),” New York Times, Mar. 18, 2019

Thesis: that healthcare was instrumental in the Democrat takeover of the House of Representatives last fall but now threatens disunity in 2020 due to the fight over single-payer v/s Obamacare tweaks (aka “incremental moves” or “centrist” solutions like Medicare buy-ins).

Note this editorial statement dressed up as a statement of fact: “Ms. Pelosi cannot afford to put moderate freshmen in Trump-friendly districts on the spot by putting Medicare for All up to a vote.” This implies that single-payer will not be attractive to Trump voters—a highly contestable assertion.

*

Shefali Luthra, “‘Medicare-For-All’ gets buzzy in unexpected locales,” Kaiser Health News, Mar. 12, 2019

In contrast to the NYT reporter’s evidence-free assertion above, here is a story about people campaigning for single-payer in deep red states and getting a favorable hearing.

Mar 12, 2019 bis

Susannah Luthi, “Pharma CEOs survive Senate grilling with few concessions,” Modern Healthcare, Feb. 26, 2019

Despite all the tough talk about drug prices, most of the policy suggestions entail tinkering around the edges. This article is not terribly informative about the specifics—too insider—but it reveals how little the elected officials plan to do about it. “Following the hearing, stocks for most of the companies represented there rose slightly or held steady.”

Carl Gibson, “Pharma & insurance gave $43m to the 130 House Democrats not backing Medicare for All,” GritPost, Mar. 5, 2019

Some details of HR 1384 (Medicare for All) and a list of the House Dems who have not signed on along with the dollar amounts they got from opponents.

Mar 12, 2019

Colette Swietnicki, “Enough already! Pass the New York Health Act!” Chelsea News, Feb. 20, 2019

Bravo to our committee member Colette for publishing this article!

*

Angelica LaVito & Berkeley Lovelace Jr., “Pharma execs offer Senate ideas to lower drug costs – except actually cutting prices,” CNBC, Feb. 27, 2019

The hearing was called, “Drug Pricing in America: A Prescription for Change, Part I.” But Chair Grassley (R) insisted that he didn’t want a “blame game,” thus ensuring that those who are to blame aren’t blamed.

*

Rachel Bluth, “Lawmakers united against high drug prices bare partisan teeth,” Kaiser Health News, Mar. 7, 2019

Misleading headline as there is no evidence in the article (or anywhere) that lawmakers are universally against high drug prices, notwithstanding their rhetoric. Does include a couple of interesting facts, such as the business expense deduction for all those drug ads.

*

Trudy Lieberman, “Health care journalist struggles to navigate her own health crisis,” Tarbell, Feb. 25, 2019

An expert in what goes on in hospitals relates what went on in the hospitals when she experienced them as a patient.

*

Adam Cancryn, “Establishment looks to crush liberals on Medicare for All,” Politico, Dec. 10, 2018

More headline mush: if single-payer advocates are the “liberals,” who is the Democratic Party “establishment”?

“Deep-pocketed hospital, insurance and other private-sector interests, backed in some cases by key Obama administration and Hillary Clinton campaign alumni, are now focused on beating back another prospective health care overhaul, including plans that would allow people under 65 to buy into Medicare.” So don’t take seriously offers to compromise for something in between like the “public option.”

*

William K. Black, “MMT takes center stage—orthodox economists freak,” New Economic Perspectives, Mar. 11, 2019

MMT= Modern Monetary Theory. This may sound dense, but for single-payer advocates it is essential to have at least a passing grasp of this concept to combat the “how do you pay for it?” meme. The core argument is that federal taxes do not pay for federal spending and that federal budget deficits are essentially an accounting technicality. (Note that this is NOT true for New York State because only the federal government creates dollars.)

Black is very engaging (and funny), and can be seen on YouTube videos explaining the idea and debunking orthodox smokescreens. Worth the effort to prepare oneself for the debates ahead.

*

Susannah Luthi, “Pharma CEOs survive Senate grilling with few concessions,” Modern Healthcare, Feb. 26, 2019

Despite all the tough talk about drug prices, most of the policy suggestions entail tinkering around the edges. This article is not terribly informative about the specifics—too insider—but it reveals how little the elected officials plan to do about it. “Following the hearing, stocks for most of the companies represented there rose slightly or held steady.”

*

Carl Gibson, “Pharma & insurance gave $43m to the 130 House Democrats not backing Medicare for All,” GritPost, Mar. 5, 2019

Some details of HR 1384 (Medicare for All) and a list of the House Dems who have not signed on along with the dollar amounts they got from opponents.

Rep. Anthony Brindisi (D-New York) $42,832 since 2017

Rep. Antonio Delgado (D-New York) $76,579 since 2017

Rep. Sean Patrick Maloney (D-New York) $352,271 since 2011

Rep. Joseph Morelle (D-New York) $77,025 since 2017

Rep. Kathleen Rice (D-New York) $73,406 since 2017

Rep. Max Rose (D-New York) $33,698 since 2017

Rep. Tom Suozzi (D-New York) $201,085 since 2015

Feb 24, 2019

Several “red” states’ voters endorsed Medicaid expansion in referenda last November. (The vote was 53% in Utah, and 61% in Idaho.) But those legislatures are digging in their heels to water down or prevent the changes.

UTAH

Igor Derysh, “Utah GOP rolls back Medicaid expansion approved by voters, denying health care to thousands,” Salon, Feb. 13, 2019

“The [Utah] Republican law would repeal the voter-approved measure and expand Medicaid only to those making up to 100 percent of the poverty level [$12,174].” So those making more than that 1K a month would have to buy a policy on the exchanges.

*

By Phil Galewitz, “Utah and Idaho lawmakers seek to scale back voter-approved Medicaid expansions,” Kaiser Health News, Feb.5, 2019

Among the measures to water-down the Medicaid expansion are adding work requirements and monthly premiums or simply heel-dragging [Maine].

*

IDAHO

Betsy Z. Russell, “[Governor] Little says he won’t let the legislature leave town without funding Medicaid expansion,” Idaho Press, Feb. 21, 2019

Idaho situation looks a little better. The governor pointed out that in the current [perverse] system people have an incentive not to earn more if that will disqualify them for Medicaid.

*

FLORIDA

Rachanna Pradhan, “Groups quietly mount Medicaid expansion ballot campaign in Florida,” Politico, Feb. 6, 2019

Meanwhile, more ballot measures are planned although Florida referenda require a 60% majority to pass. Other possible state targets: MS, MO, OK, SD, WY. Note that the main backers are partnering, at least informally, with the health insurance industry.

*

ARKANSAS

Jacqueline Froelich, “Medicaid in Arkansas has lost thousands of people from its rolls,” National Public Radio, Feb. 18, 2019

Predictably, Medicaid work requirements don’t get many people jobs. But they are successful in pushing people off Medicaid.

*

Peter Sullivan, “Top Dems call for end to Medicaid work rules after 18,000 lose coverage in Arkansas,” The Hill, Feb. 21, 2019

Work requirements for Medicaid are getting push-back from the Dems nationally. Would be nice to see it translate into single-payer, i.e., no work requirements for anyone! Do you need to be employed to get the fire department to put out your fire?

*

FLORIDA

Christine Sexton, “[Governor] DeSantis goes light on Medicaid Cuts,” Health News Florida, Feb. 4, 2019

Curiously, once elections are over and the ideological battles are out of the headlines, officials don’t always act on their rhetoric. This goes for both Republicans and Democrats.

*

GEORGIA

Andy Miller, “Senate panel backs waiver bill to insure more Georgians,” Georgia Health News, Feb. 19, 2019

Like Utah, Republicans controlling the GA state legislature voted to restrict Medicaid benefits to those at the most extreme levels of poverty. But this will cost the state more money unless the Trump Administration offers a waiver and agrees to pay the full 90% of the cost for a more punitive plan.

*

GEORGIA

Ariel Hart, “Nonprofit hospitals back Kemp Medicaid waiver plan for Georgia,” Atlanta Journal-Constitution, Feb. 21, 2019

The perils of teaming up with major players in the health care industry: they can be fickle allies.

*

MARYLAND (SORT OF)

Sarah Klifee, “All-payer rate setting: America’s back-door to single-payer?” Vox, Feb. 9, 2019

We revisit the “all-payer” concept as part of the debate on what intermediate steps may take us closer to single-payer v/s further away. On Maryland still uses this procedure. Note that the author calls single-payer a “pipe dream,” but argues that her idea of uniform pricing brings us closer to it. However, the article outlines how insurers may game the system if they are allowed to remain in it.

Feb 18, 2019

Here’s an assertion for discussion, phrased by the first author below: “While we wait and perhaps agitate for a better health care system, it’s worth examining other potential remedies that can improve what we currently have coming from a different political logic that the current political alignment may find even slightly palatable [my italics].” Is this savvy strategy or another slippery slope to a hoodwinking?

Marshall Auerback, “This may be the only viable alternative to ‘Medicare for All,’” Economy for All/ Independent Media Institute, Feb. 13

His new term: “all-payer,” meaning price uniformity so that insurers, PBMs, hospitals, pharma, individual providers can’t game the system with variable rates. The metaphorical equivalent is taxi meters so you aren’t forced to negotiate trip by trip. Is this a fair comparison? Would it work? Is it a step toward or away from single-payer?

*

Amanda Michelle Gomez, “Health care industry players come out swinging against bill to expand Medicare,” Think Progress, Feb. 13, 2019

Note that any incremental measures, including Auerback’s “all-payer,” will attract vociferous and well-funded opposition.

*

Wendell Potter, “How to spot the health insurance industry’s favorite Democrats,” Tarbell, Feb. 11, 2019

Potter, who used to run PR for big insurance, says Bennet’s talking points are “straight out of the insurance industry’s PR and lobbying shops.”

*

Glen Ford, “Pelosi sabotages Medicare for All, but corporate media pretend not to notice,” Black Agenda Report, Feb.14, 2019

[Correctly uses the plural form for media, which is very rare—but I digress.]

Argues that Pelosi’s strategy is to “orchestrate a defense of what’s left of Obamacare while softening up the drug industry over prices—in a possible alliance with Donald Trump, who signaled his willingness to partner with Democrats on the issue.” This would be in exchange for keeping single-payer off the table once again.

*

Jay Deady, “We’re missing the true point of hospital price transparency,” Stat, Feb. 4, 2019

A corrective to the idea that “all-payer” transparency will solve much.

*

Eoin Higgins, “Some Democrats that ran on Medicare for All are backing away from it now,” New York, Feb. 1, 2019

Note hedging phraseology, such as “health coverage [not health care] is a right,” the “public option” as a “pathway” to Medicare for All, which is now a “long-term goal” that we should be “striving toward” [not enacting].

Feb 13, 2019

Gustavo Rivera & Karla Lawrence, “Creating a single-payer health care system that works for all New Yorkers,” Gotham Gazette, Feb. 11, 2019

A nice pitch from a Bronx senator and co-sponsor of the New York Health Act.

*

Ryan Grim, “Top Nancy Pelosi aide privately tells insurance executives not to worry about Democrats pushing ‘Medicare for All,’” The Intercept, Feb.5, 2019

“Primus pitched the insurers on supporting Democrats on efforts to shrink drug prices, specifically by backing a number of measures that the pharmaceutical lobby is opposing.” See next article.

*

Thomas Neuberger, “Pelosi advisor proposes non-binding arbitration as road to lowering drug prices,” Down with Tyranny, Feb. 12,2019

A cynic might see a mainstream Dem strategy here: oppose Medicare for All and offer aggressive action against pharmaceutical drug pricing as an alternative. Then, once the heat is off on single-payer, dilute the pharmaceutical action into a nothingburger like “compulsory arbitration.”

This is exactly the playbook used to neutralize single-payer support during the Obamacare debate: offer the “public option” as the progressive add-on to the insurance-friendly ACA; then once single-payer is off the table, dump the public option.

*

Lev Fasher, “Democrats eyeing 2020 put an early spotlight on drug prices,” Stat, Jan. 11, 2019

On the other hand, the hostility to Pharma is real. Even candidates from big Pharma states like Massachusetts and New Jersey have to salute the flag on price-gouging.

*

Nicholas Florko, “How PhRMA finally lost: the inside story of the group’s biggest lobbying failure in years,” Stat, Jan. 2, 2019

And here’s good background on the run-up to this shift in the discourse and “early signs that the industry’s towering influence is waning.” Fascinating detail on congressional sausage-making.

*
Seth A. Richardson, “In a Democratic primary, Sherrod Brown’s lack of support for Medicare-For-All could prove problematic,” Cleveland Plain Dealer, Feb. 2, 2019

Brown bird-dogged by an educated voter.

Jan 31, 2019

Samantha Young & Ana B. Ibarra, “Newsom diverges sharply from Washington with health care budget,” California Healthline, Jan. 11, 2019

California’s new governor has proposed three major reforms: a state health insurance mandate to replace the ACA mandate eliminated by Trump; coverage for undocumented young adults; and a consolidated drug purchasing program that will give the state vastly more negotiating power to bring down prices. Although other states (NJ, VT, DC, MA) already have state-level mandates, the California package attracts attention—and praise.

*

Susanna Luthi, “California’s drug-pricing plan could pare down 340B program,” Modern Healthcare, Jan. 23, 2019

The 340B program changes will mean “a potentially huge money shift” away from hospitals. This could be done nationally, but note that the Democratic Party control of the House makes this unlikely since “Democrats have shown themselves friendlier to hospitals” on this issue.

*

“California gets it right with its new health-care initiative,” [editorial], The Washington Post, Jan. 10, 2019

The Washington Post editorializes that Newsome is getting it just right by “adding to the existing Obamacare framework” rather than single-payer. This could be a template for national action, says the Post approvingly.

*

Sharon Bernstein, “New governor tackles drug prices in first act,” Reuters, Jan.7, 2019

This measure to boost the state’s negotiating power on drug prices threatens hospital profits. Apparently, it does not require legislative action but can be done by executive order. Good to know!

*

KQED/CalMatters.org [no author] “Newsom’s tactic: Not yet health care for all, but health care for more,” Jan. 28, 2019

Note the confusion over what single-payer is in the first line. Newsom echoes this ambiguity by calling for a “universal healthcare system” based on a state-subsidized private health insurance.

*

San Jose Mercury News [editorial] “While Trump tweets, Newsom leads on health care,” Jan. 23, 2019

This paper also applauds Newsom’s actions while mentioning that rising health insurance costs are “threatening California businesses’ ability to compete.”

*

Melody Gutierrez, “Gov. Gavin Newsom proposes healthcare mandate, Medi-Cal expansion to more immigrants without legal status,” Los Angeles Times, Jan. 7, 2019

This writer claims that Newsom’s announcemet, while it “stopped short” of a single-payer system, “was characterized as the first step down that path.” This passive voice construction leaves unclear who made that characterization and, needless to say, how they reached that conclusion. Newsom’s phrasing is: “a critical step toward reaching universal healthcare.” The doctors association phrasing is a bit more revealing: “helping make healthcare affordable and available to all Californians.”

*

David Crane, “California should transition retired public employees to Covered California,” San Francisco Chronicle, Jan. 20, 2019

Retiree health costs are a huge burden on the state’s finances, so this opinion piece calls for their benefits to be folded into the state Medicaid system.

Jan 23, 2019

Peter Hilsenrath & David Wyatt, “3 ways Trump could disrupt health care for the better,” The Conversation, Jan. 18, 2019

Do these changes take us closer to single-payer, or are they window-dressing at the margins? An important tactical discussion!

*

Drew Armstrong, John Tozzi & Riley Griffin, “California businesses, government would join in drug buying pact,Bloomberg, Jan. 7, 2019

Note the recent upsurge of interest in “price transparency” and also the fact that California is a huge market (unlike, say, Vermont). thus can negotiate from a stronger position.

*

Ana Staver & Nic Garcia, “Colorado Democrats introduce public option health care as they take control of General Assembly,” Denver Post, Jan. 4, 2019

The “public option” is much less persuasive as a progressive step. The pilot program is unlikely to constrain costs and could weaken support for a more radical (and effective) program.

*

Katie Thomas, New York Times & Charles Ornstein, ProPublica, “Top cancer doctor, forced out over ties to drug makers, joins their ranks,” Jan. 7, 2019

That was clarifying.

*

Julia Conley, “To galvanize local push for Medicare for All in 2019, nurses’ union organizing nationwide ‘Barnstorms,’” Common Dreams, Dec. 31, 2018

Something we need to discuss soon!

*

Isaac Arnsdorf & Jon Greenberg, “Increased privatization of the VA has led to longer waits and higher costs for taxpayers,” Pacific Standard, Dec. 31, 2018

“An analysis of VA claims data shows that sending more vets to private care has not had the positive effects that were long promised by conservatives.” What a surprise, profiteering from no-bid contracts for friends of John McCain. Note that the creeping-privatization program began under Obama.

Jan 14, 2019

Peter Sullivan, “Booker tries to shake doubts about pharmaceutical ties ahead of 2020,” The Hill, Jan. 13, 2019

Mainstream Dems can’t please their corporate donors quite so easily any more if they have presidential ambitions.

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Michael Corcoran, “Biggest threat to single-payer? Democrat support for a public option,” Truthout, Jan. 4, 2019

“[T]he next big fight for single-payer may not be with Big Pharma or the GOP, but rather, Democrats who insist on putting their energy behind weaker policies.”

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Dan Goldberg, “Democratic governors steer party to left for universal health care,” Politico, Jan. 13, 2019

Dheck the fine print for what “steer to the left” actually means. Often it is medicaid/Medicare buy-in, public options, state subsidies that preserve for-profit insurance, lower premiums on the exchanges, state-wide mandates to expand the insured pool, etc., none of which = single-payer.

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Russell Mokhiber, “Single payer not single payer,” Counterpunch, Jan. 11, 2019

Refreshingly blunt on the rewrite of HR 676. “Single payer threatens corporate power.” And an important debate about whether a planned “new” 676 is really single-payer or not.

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Steffie Woolhandler & David Himmelstein, “Aligning House and Senate single-payer bills: Removing Medicare’s profiteering incentives is key,” Health Affairs, Nov. 19, 2018

A deeper dive into the differing schemes for hospital payments between the House and Senate versions, one of which will preserve profit incentives for hospitals to game the system and concentrate on more generously reimbursed care.

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Kip Sullivan, “Senate Medicare for All bill would increase healthcare spending; needs better cost controls,” Health over Profit, Jan. 7, 2019 I

And here is the Sullivan analysis referred to in the Counterpunch article. He argues that (Sanders’) Senate version contains ways for private insurance to worm its way back into a single-payer system.

Jan 8, 2019

Jonathan Michaels & Will Cox, “The biggest moments of 2018 in the fight for universal health care,” Shadowproof, Dec. 4, 2018

“Universal health care” is not the same as single-payer—as the authors eventually point out—so why the misleading headline? But this is an interesting round-up.

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Ben Beckett, “A house divided,” Jan. 3, 2019, Jacobin

This is a useful rundown on the lukewarm support—or outright opposition—to single-payer among certain union leaders highlighting that union members and union officials do not necessarily have the same interests.

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Sarah Kliff, “A $20,243 bike crash: Zuckerberg hospital’s aggressive tactics leave patients with big bills,” Vox, Jan. 7, 2019

Mr Facebook touts “access” to care, but that can include surprise $20K bills. Access is one of those weasel-word obfuscations like affordable or guaranteed or universal–none of which mean single-payer. Note the hospital’s defense of price-gouging: we serve poor people!

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Michael Lighty, “Now that everyone is for Medicare for All, opponents say let’s dilute it,” CommonDreams, Jan. 3, 2019

Big difference between “Medicare for All” and “Medicare Advantage for All.”

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Ralph Nader, “25 ways Canadian health care system is better than Obamacare” Eurasia Review, Dec. 31, 2018 https://bit.ly/2VnNqfQ

Example #15: In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong? In the United States, the first thing they ask you is: “What kind of insurance do you have?”

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Julie Appleby, “Short-term health plans hold savings for consumers, profits for brokers and insurers,” Kaiser Health News, Dec. 21, 2018 https://bit.ly/2VnOW1w

The Trump Administration backs yet another approach to undermining the insurance pools that are the basis of Obamacare. If we were all in the same pool, this sort of tinkering would be harder.

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Bruce Japsen, “Medicare at 55 could gain momentum in 2019,” Forbes, Dec. 30, 2018 https://bit.ly/2HbvhyG

More tinkering with insurance-based health care. “Because it includes private insurers, the House Democrats Medicare buy-in proposal could also win support of the insurance industry given the popularity Medicare Advantage plans.”