Single Payer News – 2019
Jan 13, 2020
Michael Kruse, “The great American health care panic,” Politico, Oct 15, 2018
Over a year old, but could have been written yesterday. Healthcare costs are still the #1 issue on people’s (voters’) minds.
Bryce Covert, “How Medicaid expansion is transforming politics as we know it,” The Nation, Jan 6, 2020
Medicaid expansion, i.e., enrolling people in a simplified, single-payer system without expensive premiums, deductibles, and co-pays, is extremely popular across all political viewpoints. Who knew?
Michael Brady, “States can do more to make healthcare affordable, report says,” Modern Healthcare, Jan 7, 2020
Oregon has done best in cramming down costs through “efforts to increase price transparency, creating a permanent organization to oversee healthcare spending, establishing all-payer spending benchmarks and building out claims data for all payers.”
Libby Watson, “The hell that was health care reform,” New Republic, Dec 23, 2019
A first-rate summary of where we are ten years after the passage of the ACA. “The most right-wing Democrats support ‘improving’ the law in ways they rarely specify. The health care industry front group that exists to fight Medicare for All also pushes this line. . . . Republicans, electorally stung by their 2017 efforts to repeal the law, now go out of their way to avoid talking about it at all—preferring to see courts, packed by their lifetime-appointed judges, do the dirty work.”
Wendi C. Thomas, “What it looks like when a hospital we investigated erases $11.9 million in medical debt,” ProPublica, Dec 24, 2019
A great example of how exposing egregious practices sometimes creates enough public shame to bring relief.
Adrian Shipp, “Sanders’ proposals are the largest middle-class tax cuts in U.S. history,” undated (apparently Jan 7, 2020)
Brilliant framing! M4A, free tuition, and eliminating student debt as tax cuts, or if you will, pay raises.
Alex Parene, “A decade of liberal delusion and failure,” New Republic, Dec 20, 2019
General critique including but not limited to healthcare debate, includes this gem: “Much of the decade we have just endured has shown how the Democratic addiction to dispensing benefits through the tax code in complicated, indirect ways—combined with the usual insufficiency of these benefits—was nearly perfectly designed to foment mass resentment of others, imagined or not, who might secretly be getting the Good Benefits.”
Associated Press, “Budget deal advances VA private care program backed by Trump,” Dec 19, 2019
VA suffers delays; private providers get more funds; VA service deteriorates further; private providers get increases; rinse and repeat.
Connor Sheets, “How some sheriffs force their inmates into medical debt,” ProPublica/AL.com, Dec 26, 2019
Alabama is perverse. “The inmates are personally billed, and their bills can end up with collection agencies while they are still behind bars, wrecking their credit.”
Jan 6, 2020
Peter Sullivan & Jessie Hellman, “Ways and Means Committee announces rival surprise medical billing fix,” The Hill, Dec 11, 2019
“The subject is seen as a rare area of possible bipartisan action.” Make that “was seen”—lobbyists made sure it went nowhere. Reps. Richard Neal (D-Banking & Real Estate) and Kevin Brady (R-Oil & Gas), the chairman and ranking member of the panel, tossed in an alternative bill to sidetrack the Senate compromise measure. Result: gridlock.
Peter Sullivan & Jessie Hellman, “Five health care fights to watch in 2020,” The Hill, Dec 29, 2019
Hope springs eternal: last year ended in empty rhetoric and no action on surprise billings, but maybe this year will be different! Here’s some tough and determined language from a top Dem: “The president said when he ran and until relatively recently that he would support negotiated prices and I expect at some point he will go back to that, and we’re just going to keep pushing the Senate to try to achieve that,” said House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-Pharma).
Andrew Taylor, “I’m on Medicare and I still got a $25,000 hospital bill,” Los Angeles Times, Dec 20, 2019
One more scam: hospitals declaring that you are in “observation” rather than “admitted” so that everyone can get their claws into your savings and/or hound you with unpayable bills.
Edgar Walters, “What you need to know about Texas’ new surprise medical billing law,” Texas Tribune, Jan 2, 2020
States may act before anything happens nationally. Texas passed a decent law to protect patients from surprise billing, but it only applies to “state-regulated” insurance plans, a fraction of the total. Everyone else is still vulnerable.
Jackson Williams, “3 legal challenges could derail out-of-network surprise medical bills,” STAT, Jan 6, 2020
The author, who is a policy exec for dialysis patients, suggests that lawsuits against the double-dipping surprise billers could shift the momentum and force doctors into court. Another alternative is to contest collection agencies’ bills, which could disrupt the entire practice. Finally, nonprofit hospitals jeopardize their tax-exempt status with this practice. Worth reading in full!
Libby Watson, “Joe Biden’s individual mandate madness,” New Republic, Oct 23, 2019
From October but ever more relevant as the healthcare debate sharpens among Biden, Sanders and Warren. The individual mandate, through which we are all forced to join the common insurance pool, is key to how Obamacare works. But the products on offer were expensive and lousy with huge deductibles and co-pays. Watson: “Who would have thought that requiring people in the midst of all manner of post-recession struggles to pay for a product that offered little and cost a lot would be such a political loser?” Yet Biden gets little scrutiny on this bad policy hated by voters.
Mad Mike, “Our current healthcare system is a bad jobs guarantee,” Mike the Mad Biologist, Dec 24, 2019
Argues that we should not protect jobs whose primary function is to deny healthcare.
Joshua M. Sharfsein, “Why the FDA was unable to prevent a crisis of vaping among kids,” STAT, Nov 21, 2019
Not single-payer but a devastating account of how vaping companies dodged regulation with the connivance of the courts, the White House, and armies of lobbyists.
Dec 31, 2019
Mike Allen, “Axios Deep Dive,” Axios, Dec 10, 2019
Pretty good year-end summary of the state of play. Fun fact: “Health insurance through an employer costs an annual average of almost $23,000 to cover a family.” Also correct: “[Sanders’] likely 2020 rivals in the Senate signed on to Medicare for All as cosponsors, and many treated [it] as a catch-all or a loosely defined goal,” which worked as long as they didn’t have to confront Pharma and the insurance companies.
Christopher Cai & James Kahn, “Medicare for All would improve hospital financing,” Health Affairs, Dec 9, 2019
M4A would end the two-tier system that provides incentives to hospitals to serve privately insured patients and avoid Medicare/Medicaid.
Shelby Livingston, “Out-of-network billing by hospital-based specialists boosts spending by $40 billion,” Modern Healthcare, Dec 16, 2019
Surprise bills, which are hardly a surprise anymore due to the in-network/out-of-network scam. “Researchers found that assistant surgeons billed the highest out-of-network rates at 2,652% of Medicare, while anesthesiologists’ out-of-network charges averaged 802% of Medicare.” Congress squawked, then did nothing [see below].
Jeff Stein & Yasmeen Abutaleb, “Congress showers health care industry with multibillion-dollar victory after wagging finger at it for much of 2019,” Washington Post, Dec. 20, 2019
Details of the “no special interest left behind” bill of 2019. Industry buddies responsible include Senate Minority Leader Charles E. Schumer (D-N.Y.) “More than 20 of the roughly 40 Democrats who won House seats in districts won by Trump sponsored a bill to repeal the ACA’s medical device tax.”
Rachel Cohrs, “Healthcare consumers are the big losers in year-end funding deal,” Modern Healthcare, Dec 18, 2019
Winners: insurers and medical device manufacturers
George Bohmfalk, “Why a Medicare for All public option won’t work,” Charlotte Observer, Sept 12, 2019
This op-ed by a PNHP member is well argued except that Lincoln did in fact end slavery incrementally. “A public option cannot save that $500 billion [in administrative costs], nor can it reduce healthcare costs. It will only add one more choice of insurance provider to the current complex mix.”
Wendi C. Thomas & MLK50, “Profiting from the poor: Inside Memphis’ debt machine,” ProPublica, Nov 27, 2019
Nobody is as expert at squeezing cash out of the destitute like private equity, now busily acquiring physicians’ practices. “Growth is highest in specialties where the need for a long-standing doctor-patient relationship is low, such as emergency medicine, anesthesia and care provided to patients when they are hospitalized”—because then the patient is conveniently more vulnerable and/or unconscious.
Roxanne Liu & Brenda Goh, “Drugmakers slash prices in China to get on reimbursement list,” Reuters, Nov 28, 2019
So pharma will accept price cuts in exchange for volume—if the government concerned isn’t in their pocket.
Shelby Livingston, “Blue Cross of Idaho unveils souped-up short-term health plans,” Modern Healthcare, Nov 27, 2019
Insurers will screen for healthier buyers and offer them discounts. What could go wrong? Note that the deductible for a family is a mere $20K. Great insurance if you don’t get sick!
Harris Meyer, “Payer cost control moves swamped by provider consolidation: study,” Modern Healthcare, Oct 25, 2019
“‘After talking to all these employers, health plans, and providers, there doesn’t seem to be a clear market-based solution and it almost seems like government regulation is necessary to get this under control,’ said Katie Keith, an adjunct law professor at Georgetown and one of the report’s authors.” Ya think?
Ryan Cooper, “The broken Medicare-for-all financing debate,” The Week, Nov 5, 2019
Good summary of why the “how do you pay for it” debate is misguided. “Every year, Congress authorizes a big slate of spending, the government collects a bunch of tax revenue, and then makes up the difference with borrowing. If we are to discuss tax revenue, it should be in the context of the entire budget.” Elementary, but right-wing pundits (and debate moderators) like to single out benefits for the how-to treatment.
Bess Levin, “Trump has told friends that cutting Medicare could be a fun ‘second-term project,’” Vanity Fair, Aug 22, 2019
If you don’t move forward, you get pushed backward. Democrat complicity with tax cuts sets us up for deficit hysteria.
Dec 20, 2019
A federal circuit court has issued an important ruling on the Affordable Care Act (Obamacare), which important implications for the healthcare debate in election year 2020. Here are the high points and a few links to aid in understanding what happened, what it means, and what happens next.
The court ruled 2-1 that the individual mandate was an essential element of the ACA. (Recall that Chief Justice Roberts argued that the ACA met constitutional muster because Congress has the power to tax under the commerce clause.) Therefore, since Congress under Trump eliminated the tax penalty for not having insurance, the court said that the ACA in its current state imposes an unconstitutional burden.
But it did not toss the ACA entirely. Instead, it sent the whole mess back to the district court, putting off Judgment Day at the Supreme Court.
Shelby Livingston, “Appeals court strikes down individual mandate, stops short of scrapping entire ACA,” Modern Healthcare, Dec 18, 2019
Industry dislikes limbo. Rick Pollack, CEO of the American Hospital Association: “Sending the decision back to the federal district court that invalidated the entire law puts health coverage—and peace of mind—for millions of Americans [and our business model! -ed.] at risk.”
Republicans in Congress are worried about taking the rap for sabotaging the ACA’s popular provisions. Sen. Rick Scott (R-Fla.): “I think we ought to go ahead and pass something to make sure that even if it’s declared unconstitutional, we protect pre-existing conditions.”
Richard Wolf, “Federal appeals court strikes down key part of Affordable Care Act,” USA Today, Dec 18, 2019
Ensures that uncertainty will reign for at least another year. Dissenting judge Carolyn Dineen King: “The district court’s opinion . . . ensures that no end for this litigation is in sight.” That kicks the can down the road past the November 2020 elections.
Amy Goldstein, “Individual mandate ruled unconstitutional, ACA in limbo,” Washington Post, Dec 18, 2019
Provisions with no guarantee of survival: subsidies for individuals buying insurance; Medicaid expansion; coverage of children up to age 26; pre-existing conditions; free preventive care. “The law also is woven more subtly into many other aspects of the health-care system, from payment formulas for hospitals and doctors to experiments intended to nudge health-care from a system that pays for the quantity of medical services to one based on the value of care patients receive”—all of which could be blown up.
Irony: “One health agency created under the law is providing the underpinning for some of the Trump administration’s proposals to lower drug prices.”
Adriel Bettelheim & Susannah Luthi, “7 unanswered questions left by the Obamacare ruling,” Politico, Dec 19, 2019
Bonus for Trump: can reassure people about the popular measures and take credit for eliminating the unpopular aspect (taxes).
Bonus for Democrats: can remind people that the popular measures are still threatened by the GOP lawsuit.
Kevin Landrigan, “State law preserves some of Obamacare even if courts strike it down,” New Hampshire Union Leader, Dec 19, 2019
States may move to insert protections on pre-existing conditions and other aspects of ACA in case it gets destroyed by the courts. However, Medicaid expansion is mostly funded by federal dollars, so states will be facing huge bills to sustain that if the ACA gets tossed.
What is consistent in this odd mix of decisions? The industry, despite some griping, got everything it wanted. Taxes were axed, but the ACA provisions that boosted its business by bringing in more customers remain, for now.
Rachana Pradhan, “Trump slashed Puerto Rico’s Medicaid money as part of budget deal,” Politico, Dec 17, 2019
Puerto Rico’s Medicaid is capped, unlike how it works in the 50 states. Easy to punish people you don’t like and who can’t vote.
Dec 17, 2019
Alex Kacik, “Health systems weigh return on investment as they ramp up tech,” Modern Healthcare, Dec 11, 2019
We’re so used to healthcare as a corporate endeavor that phrases like “return on investment” sound normal. Also, the article assumes that digitization’s goal is to improve health rather than to boost billing. “About three-quarters of new healthcare employees indicated that a major reason they joined a company was the expectation they would be crunching data through AI and machine learning.” Not because they wanted to provide healthcare?
Julia Conley, “Ocasio-Cortez makes connection between 20% jump in health costs and industry-sponsored spa days for congressional staffers,” Common Dreams, Dec 12, 2019
The usual suspects wined and dined at a luxury spa to mull over the future of health insurance. Among those getting a facial from the industry were staffers for Majority Whip Jim Clyburn, D-S.C., Majority Leader Steny Hoyer, D-Md., Reps. Kurt Schrader D-Ore., Dan Lipinski, D-Ill., and Xochitl Torres Small, D-N.M. “After end-of-the-year reports showed healthcare costs for Americans rose an average of 20% in 2019.” Lobster bisque is expensive!
Dan Diamond, “Seema Verma requested $47,000 for items taken from an SUV that took her to a speech,” Politico, Dec 7, 2019
Verma lost her $5,900 Ivanka Trump-brand pendant while on government business, so she asked the U.S. Treasury to help her buy a new one. Oh, and her $325 moisturizer—important for those close-ups!
Harris Meyer, “South Carolina becomes first non-expansion state with a Medicaid work requirement,” Modern Healthcare, Dec 12, 2019
South Carolina has decided that poor people haven’t received enough punishment and so while NOT expanding Medicaid the state will force parents of minor children with incomes under 100% of the federal poverty level to “document 80 hours of work, job training or community service.” The documentation procedure is sure to be easy-peasy. Trump administration CMS head Seema (“I need $40,000 to replace my jewelry”) Verma signed off on it.
Shelby Livingston, “Chart reviews boost Medicare Advantage payments by $6.7 billion, OIG finds,” Modern Healthcare, Dec 12, 2019
Staff at for-profit Medicare Advantage plans now pore over medical charts to see where to upcode diagnoses for higher reimbursements. How many employees at the 553 MA insurance companies who reviewed 52.6 million charts were engaged in this legalized skimming? (“Moe Green” would have been impressed.) “The way the federal government calculates payments to Medicare Advantage plans gives insurers an incentive to make their plan members appear as sick as possible on paper. That incentive doesn’t exist in the original Medicare program.”
Denis Bunis, “Groundbreaking bill to lower prescription prices passes House,” AARP, Dec 12, 2019
Party-line vote, so it won’t survive in its current form. But the push to do something (anything) reflects election-year anxiety. The House progressive caucus including Jayapal threatened to block the vote and won some concessions.
Nicole Smith-Holt, “My son died from rationing insulin. Democrats’ drug pricing plan still wouldn’t help him,” USA Today, Dec 10, 2019
A mother opines on halfway measures.
Carl Gibson, “Pharma & insurance gave $36m to the 33 Senate Democrats not backing Medicare for All,” Gritpost, Apr 16, 2019
From April but worth having these insane numbers on file. “33 Democrats have received a total of $36,805,381 from those industries throughout the course of their careers.”
Larry Moss, MD [interview]: “We’re spending $3.5 trillion for the opposite of what we want, which is health,” Modern Healthcare, Oct 26, 2019
An industry CEO says, “We pay for volume and we pay for complexity. It bothers me every day that our financial incentives are the opposite of what our families and our patients need.” Stops short of proposing to revamp the financing model, but he does have interesting observations on a population-based approach to health: “The irony of this is the better it works, the worse for the health system financially in our current model. Because right now, we make our money by having the intensive-care unit full of kids with asthma and the ED full of kids with asthma.”
Dec 10, 2019
Roy M. Poses, “Which interventions can be paid for: The explanatory power of ‘Prasad’s Law,’” Health Care Renewal, Dec 05, 2019
A fascinating account of how the incentives to increase reimbursements distort medical care, producing, among other things, a chronically inadequate level of nurse staffing. (This was a key element of the recent near-strike of nurses here in New York.) The author proposes a new Prasad’s Law: “Medical goods and services that concentrate wealth can be paid for; medical goods and services that disperse wealth are ‘unaffordable.’”
William Lazonick et al., “Financialization of the U.S. pharmaceutical industry,” Institute for New Economic Thinking, Dec 2, 2019
Wonky and revealing: U.S. corporate chieftains are now dedicated to full-scale looting of corporate assets to reward shareholders, leaving the companies weakened and uncompetitive. This is particularly important for pharmaceutical companies that lay claim to a key role in matters of life or death. Key numbers: 18 top Pharma companies made $588 billion in the last decade and paid themselves $622 billion in dividends and buybacks, leaving nothing for research. “With all of the government funding and market protection provided to the pharmaceutical industry, one might assume that the U.S. government would regulate drug prices.” But one would be wrong.
Libby Watson, “Single-payer advocates are being drawn into the wrong debate,” New Republic, Nov 6, 2019
“Warren’s plan to pay for Medicare for All has sparked a conversation over how much we spend on health care, instead of how well we spend it.” Fun fact: the Cleveland Clinic has 210 million prices contained in 3,000 different price lists for its services.
Christina Jewett, “Medical device failures brought to light now bolster lawsuits and research,” Kaiser Health News, Dec 3, 2019
“For almost 20 years, malfunctions and injuries linked to 108 medical devices, including dental implants and pacemaker leads, were funneled into an FDA database that few patients, doctors or even FDA officials knew existed.” This is—or should be—a much bigger scandal than the bland KHN story makes out. A secret database on ongoing reports of medical harm? Seriously? “No. 1 hazard was misuse of the surgical stapler—which has been linked to 412 deaths, more than 11,000 serious injuries and nearly 100,000 malfunctions since 2011.” But no need to let the public know?
Maura Reynolds, “There’s a fear factor, a fear of change,” Politico, Nov 25, 2019
Taiwan went from a U.S.-style healthcare financing system to single-payer. We should be hearing more about this. Good explanation of why hospitals are fighting price disclosure.
Elisabeth Rosenthal, “Where the frauds are all legal,” New York Times, Dec 7, 2019
Why U.S. health care is so overpriced: hospitals and doctors get away with outrageous charges, and insurers let them.
Michael Anne Kyle et al., “Medicare beneficiaries with serious illnesses report problems paying bills,” The Commonwealth Fund, Nov 4, 2019
“More than one-third (36%) of beneficiaries [with serious illnesses] said they had used up all or most of their savings to pay for health care.” As with employer-based insurance, Medicare is pretty good until you really need it.
Harris Meyer, “Seema Verma’s bold initiatives land her in No. 1 ‘Most Influential’ spot,” Modern Healthcare, Dec 6, 2019
No doubt the millions of taxpayer funds spent on her PR firm helped boost her image. The slightly rah-rah piece says Verma “doesn’t shrink from a fight,” such as in “strengthening market forces,” promoting Medicaid work requirements, expanding short-term health plans lacking consumer protections, boosting the idea of Medicaid block grants, and dumping nondiscrimination protections for people based on sex and race. “Bold” indeed.
Lydia Saad, “More Americans delaying medical treatment due to cost,” Gallup, Dec 9, 2019
Sharp increases in families facing affordability issues, especially for those in lower income brackets.
Beth Mole, “Bonkers pricing of ‘free’ flu shots shows what’s wrong with US healthcare,” Ars Tecnica, Nov 19, 2019
A simple vaccination costs crazily different amounts. And nothing that runs up overall health spending is “free.”
Ryan Cooper, “The broken Medicare-for-all financing debate,” The Week, Nov 5, 2019
Finally, a head-on confrontation with the stupid “How do we pay for it?” question. He also has sharp words for the employer head tax in the Warren proposal.
Dec 5, 2019
Jessie Hellmann, “Trump’s drug importation plan faces resistance in US, Canada,” The Hill, Dec 1, 2019
Importing from Canada is no substitute for rationalizing drug pricing in the U.S. “Canada didn’t create that problem. It’s a made in America problem that needs a made-in-America solution.” Decriminalizing busloads of people going to Canada for deals is one thing; institutionalizing massive cross-border imports is entirely another. Pharma is also exploiting the issue’s problems to maintain the status quo.
Jeff Stein, “State lawmakers acknowledge lobbyists helped craft their op-eds attacking Medicare-for-all,” Washington Post, Dec 2, 2019
Elected officials publishing opinion columns pitched to them by industry lobbyists. Why not just put the legislative seats up for sale to the highest bidder? Maybe Christie’s could handle it. The (industry lobbying group) Partnership for America’s Health Care Future is targeting primary states with this propaganda. Not incidentally, the Partnership’s ED is Lauren Crawford Shaver, formerly of both the 2008 and 2016 HRC (“never, ever”) campaigns.
Caitlin Owens, “Hospitals are going to war against Trump’s price transparency push,” Axios, Dec 5, 2019 h
Extra-condensed summary of the hospital lobby’s war against even this minimal reform. Explains why Trump isn’t likely to get a quick healthcare victory in time for campaign 2020. Also explains why so-called “moderate” proposals from Biden et al. are no more politically viable than M4A.
Paul Waldman, “Why the health-care industry wants to destroy any Democratic reform,” Washington Post, Dec 2, 2019
Ditto above: the industry will try to crush ANY threat to its profits. This is not difficult. From the Partnership for America’s Health Care Future: “Politicians may call it Medicare-for-all, Medicare buy-in or the public option, but they mean the same thing.” They don’t, but PAHCF doesn’t care.
Farhad Manjoo, “The American health care industry is killing people,” New York Times, Dec 4, 2019
A great (and funny) rant about the argument that M4A will “kill 2 million jobs.”
Graham Brink, “Florida workers rank near the top in how much they pay for health insurance,” Tampa Bay Times, Dec 3, 2019
Relentless increases in premiums and deductibles. “In Florida, the cost of insuring a single person rose from $4,517 in 2008 to $6,674 last year, the study found.” That’s nearly 50%.
Nov 27, 2019
Adam Cancryn, “The army built to fight ‘Medicare for All,’” Politico, Nov 25, 2019
On the formation of the Partnership for America’s Health Care Future, the industry’s anti-M4A shock troops, chock full of Obama Administration grads. Note that it will oppose “every single Democratic proposal that would significantly expand the government’s role in health care,” meaning that halfway measures like “Medicare for all who want it” will get just as much heat as M4A. Fun fact: “Health care companies spent nearly $568 million on lobbying in 2018.”
Libby Watson, “The lucrative business of killing health care reform,” New Republic, Nov 21, 2019
An insider rant with more detail on the Partnership, including its subcontractors’ role in the 2016 Hillary campaign and the peaceful coexistence there of Obama veterans and Trumpian antitax lobbyists.
Ralph Nader, “American seniors are being duped,” Truthdig, Nov 22, 2019
How creeping privatization of Medicare advances with government/AARP collusion.
David Dayan, “How Elizabeth Warren misread the politics of health care,” American Prospect, Nov 18, 2019
This is a sympathetic political critique of Warren’s handling of M4A and how the issue has played out against her—at least temporarily. However, it is light on the trap of getting sucked into the “how to pay” argument.
Eric Grossarth & Mike Price, “BYU-Idaho reverses Medicaid decision, apologizes for community turmoil,” East Idaho News, Nov 25, 2019
Brigham Young U. students were told they couldn’t be on Medicaid as a substitute for the university health plan. Outrage ensued—a good example of how shining a little light on abuses often leads to a reversal.
[No byline], “4 health company executives accused in $1B fraud scheme,” Associated Press, Nov 25, 2019
The company allegedly falsely billed for services in putting “pharmaceutical company ads on tablets in doctors’ waiting rooms.” Quick question: why did this company ever exist in the first place?
Olga Khazan, “The stunning rise of single-payer health care,” The Atlantic, Nov 21, 2019
Remarkably naïve but for that same reason an interesting mainstream review of the popularity of M4A.
Alex Thompson, Holly Otterbeing & Alice Miranda Ollstein, “Reeling progressives meet behind closed doors after ‘Medicare for All’ barrage,” Politico, Nov 20, 2019
So now that M4A is getting a serious hearing, its proponents are “reeling”? A lot of discussion about how different aspects poll with voters (who barely understand them), but this presumes that voters can’t be educated. Relentless attacks on M4A from the Obama-Clinton-Biden wing certainly make things more difficult.
Jonathan Phelps, “NH residents stuck with huge health care bills from suspended ‘insurance’ companies,” New Hampshire Union Leader, Nov 16, 2019
Religious exemption facilitates insurance fraud.
Ben Conarck, “Good news: Your job offers health insurance. Bad news: It’s unaffordable, study says,” Miami Herald, Nov 21, 2019
This is the good, job-based coverage that we’re told people like.
Nov 20, 2019
Marshall Allen, “Why was a mother charged nearly $1 million for a premature birth?” ProPublica, Nov 4, 2019
This month’s horror story: $900,000 for premature birth and bureaucratic stonewalling. Asking politely didn’t solve the problem, but bad publicity did.
Shelby Livingston, “Number of uninsured kids continued to climb in 2018,” Modern Healthcare, Oct 30, 2019
“States put up more red tape, and the Trump administration ramped up its anti-immigration rhetoric and policies.” Most guilty states: West Virginia, Tennessee, Idaho, Alabama and Ohio. Texas had the largest rate of uninsured children (11.2%).
Steve Goldstein, “U.S. lobbying for U.K. drug price rise prompts Johnson, Corbyn clash over post-Brexit trade pact,” MarketWatch, Oct 30, 2019
Johnson’s U.K. Conservative government is in talks with American Pharma over how to price drugs: what could go wrong?
Stephanie Goldberg, “Health Care Service Corp. bosses rake in the green,” Modern Healthcare, Oct 14, 2019
Six or seven figures for sitting on the board of directors, and $3 million after retiring—nice work if you can get it!
Zachary Folk, “Regardless of who becomes president, ‘Medicare for All’ may happen in New York, bill’s sponsors say,” West Side Rag, Nov 5, 2019
In case you missed the UPA-led town hall on the subject!
Melinda St Louis, “Los Angeles city council votes to support Medicare for All, urges Congress to act,” Public Citizen, Nov 5, 2019
City councils can’t do much practically, but these votes signal a shift in the national discourse. Uninsured in the city: 437,000 residents.
Isaac Arnsdorg & Jon Greenberg, “Increased privatization of the VA has led to longer waits and higher costs for taxpayers,” Pacific Standard/ProPublica, Dec 31, 2018
From last year but germane: privatization does not solve detected problems. “In the four years since the government began sending more veterans to private care: longer waits for appointments.” But the private companies running the programs have absorbed 24% of their VA-based cash flows in admin and profits, so it’s a success!
Trudy Lieberman, “Be wary of the complex pros and cons of Medicare plans,” Tarbell, Oct 29, 2019
The government itself is promoting Medicare Advantage plans, which pushes more beneficiaries into coverage that works fine until you get sick.
Aída Chávez, “Trade unions join Pharma to attack Democrats over bill to lower drug prices,” The Intercept, Oct 25, 2019
Some unions are not only reluctant to back M4A, they have no problem lining up with Pharma to block relief on drug pricing.
Yves Smith, “Public pension funds criticized for profiting from private equity’s ‘surprise billing’ abuse,” Naked Capitalism, Nov 4, 2019
Surprise billing by hospitals for out-of-network services is a scam. Private equity is a principal culprit. [I’m told that before signing the hospital intake forms where you assume responsibility for bills, you can write “in-network only.”]
Jonathan Tepper, “Gougers ‘R’ Us: How private equity is gobbling up medical care,” American Conservative, Nov 13, 2019
Covers similar ground, but interesting that it comes from a magazine reflecting what used to be mainstream Republicanism. Also, “pirate equity” is great.
Alex Kotch, “As he attacks Medicare for All, Mayor Pete gets campaign cash from health care executives,” Sludge, Oct 18, 2019
In business the customer is always right.
Andrew Perez, “Top Democratic consultants have worked for anti-Medicare for All campaign,” MapLight/American Prospect, Nov 19, 2019
The big money rolls in to attack M4A. Note that many of the PR mavens behind these attack lines come from the Democrat camp—so much for “blue unity.”
Harris Meyer, “Sutter to pay $46 million over improper payment allegations,” Modern Healthcare, Nov 18, 2019
Even nonprofits have incentives to gouge government programs. Company statement: “Any assertion that the settlement was based upon a finding of payments for referrals is completely inaccurate.” Meaning that the settlement was based upon a finding of payments for referrals. The whistleblower got $6 million—should be enough for bodyguards.
Nov 16, 2019
Yves Smith, “HHS investigates Google-Ascension secret medical records projects for millions of patients; concrete evidence of HIPAA violations,” Naked Capitalism, Nov 13, 2019
This is a gigantic scandal that should be attracting much bigger headlines and will cost Google billions if there is anything like real HIPAA enforcement. Google brazenly broke a crystal-clear law that patient confidentiality may NOT be ignored in pursuit of non-medical (read commercial) goals. Texas had to pay $1.6 million over 6,000 breached records; this case may entail 50 million. It will be interesting to see if hospital-friendly Democrats defend the culprits while Silicon Valley-unfriendly Trumpians lower the boom. (Coverage in the business press highlights Google’s claim that everything was legal; it wasn’t.) I hope an entire division of sleazy personal injury lawyers rides this over the mountains like a herd of screeching Valkyries.
Harris Meyer, “With no national reporting system, volume of medical errors is still unknown,” Modern Healthcare, Nov 9, 2019
On the other hand, here’s a situation where NO records of any kind are wanted or kept. Is the number of patients who die each year due to preventable medical errors in U.S. hospitals 40,000 or 400,000? The Institute of Medicine’s 1999 estimate was 44,000-98,000. No data mining to be performed here that could be monetized into targeted ads, upcoding for higher reimbursement, or sale back to brokers and insurance companies for policy tweaking and avoidance of coverage.
Phil Galewitz, “Verma attacks critics of Medicaid work requirement, pushes for tighter eligibility,” Kaiser Health News, Nov 12, 2019
Verma sees court challenges as those affected by Trump’s actions “weaponizing” the legal system. So much for the judicial branch of government. Meanwhile . . .
Shelby Livingston, “Georgia unveils Medicaid expansion plan with work requirement,” Modern Healthcare, Nov 4, 2019
Georgia dribbles out Medicaid coverage for a few “deserving” (i.e. not lazy, good-for-nothing) poor people who will be on notice that they must “work, job train, volunteer or pursue education” for at least 80 hours a month—AND convince the state bureaucracy that they did so.
Roy M. Poses, “The managers’ coup d’état in health care appears complete: A study of top health care ‘influencers,’” Health Care Renewal, Nov 8, 2019
Interesting background on a decades-long scheme to shift power over the practice of medicine from doctors to corporate managers.
Dan Witters, “Millions in U.S. lost someone who couldn’t afford treatment,” Gallup, Nov 12, 2019
Stunning statistics: “More than 13% of American adults—or about 34 million people—report knowing of at least one friend or family member in the past five years who died after not receiving needed medical treatment because they were unable to pay for it.”
Stephanie Goldberg, “Chicago not-for-profit hospitals forced to defend hundreds of millions in property tax breaks,” Crain’s Chicago Business, Nov 11, 2019
The tax exemptions are explicitly “in return for providing free or discounted services to poor and underinsured people.” They should either do that or be prepared to pay up.
Raymond Feierabend, “Where physicians and patients split on single payer health care,” Tarbell, Nov 13, 2019
An insight into the effect of the current two-tier system and how it generates resistance to M4A from those on the most privileged end of the spectrum.
Tom Simonite, “A health care algorithm offered less care to black patients,” Wired, Oct 24, 2019
“Software guiding care for tens of millions of people systematically privileges white patients over black patients.” Using data to show that data itself can reflect racial biases.
Libby Watson, “Elizabeth Warren retreats from Medicare for All,” New Republic, Nov 15, 2019
Warren has taken most of the heat for single-payer recently, especially about the pay-go debate. Yet she now seems poised to backtrack on timing.
Sarah Kliff, “What if the road to single-payer led through the states?” New York Times, Nov 8, 2019
Simplifies one aspect of a state-led M4A plan like the New York Health Act: mandates ease of transferring all Medicare/Medicaid dollars into the statewide insurance pool.
Nov 12, 2019
Laura Davison & Misyrlena Egkolfopoulou, “Warren left $30 trillion short of paying for her health plan,” Bloomberg, Oct 17, 2019
Before Warren unveiled her plan, the business press hit her for being “vague” on financing. “Her team hasn’t yet figured out how to pay for it.” Once the detailed plan was published, the attacks shifted to how her plans were inaccurate or unrealistic.
Ezra Klein, “Elizabeth Warren’s plan to pay for Medicare-for-all, explained,” Vox, Nov 1, 2019
Here’s a run-down of the Warren plan’s main elements. Not clear why both Klein and the plan itself accept the Urban Institute’s assumptions about increased healthcare utilization, which are contested.
Glenn Kessler, “Warren’s plan to pay for Medicare-for-all: Does it add up?” Washington Post, Nov 5, 2019
Fact-checking: “If one believes the provider cuts are too steep or the administrative savings are unrealistic, then the cost side of the equation is higher than estimated. And if the revenue raisers are suspect, such as the money obtained from better tax enforcement, then the expected revenue falls short.” All true, except that the underlying assumption is erroneous: federal revenue does not fund federal spending.
Lindsay Koshgarian, “We don’t need to raise taxes to have ‘Medicare for All,’” New York Times, Oct 17, 2019
A refreshing op-ed from the left-leaning Institute for Policy Studies that shows vast areas of potential savings from bloated war spending. However, the author sidesteps the fact that none of these enormous spending commitments ever generate the question, “How are we going to pay for it?” or, to use debate-moderator language, “To fund [invading Iraq, new H-bombs, etc.], will taxes go up on the middle class?” This is because for those activities, the U.S. Treasury simply issues a check to cover the costs, and no one says anything further about it.
Danielle Kurtzleben, “Bernie Sanders won’t yet explain details of how to pay for Medicare for All,” NPR, Oct 29, 2019
Sanders takes a different approach by refusing to get into the weeds on financing M4A. “I don’t think I have to do that right now,” he says, suggesting that the resources are obviously there given what we pay for health care and that therefore we can look at the details later.
Elisabeth Rosenthal, “Elizabeth Warren throws down the gauntlet,” New York Times, Nov 4, 2019
Rosenthal demands that people not only focus on Warren’s plan but insist that the others move beyond “30,000-foot concepts” to explain their own blueprints—if they have any. However, the author assumes good faith among the media/Beltway class, rather than a desire to knock out M4A proposals.
Andy Slavitt, “2020 Democrats, you’re doing it wrong on health care. Stop arguing and show leadership.” USA Today, Oct 8, 2019
Meanwhile, look over here! Slavitt, a former insurance executive and Obamacare architect, says the debate over whether the for-profit sector should exist is “not very important.” Slavitt has a perch at the Bipartisan Policy Center, a Beltway think tank that celebrates “viable consensus solutions” backed by both Republicans and Democrats and that enjoys health industry, pharmaceutical, and other corporate support. He outlines the secondary topics that will serve as distractions as the insurance intermediaries fight for their profits.
Nov 2, 2019
Adam Gaffney, “The hospital under Medicare for All,” Jacobin, May 10, 2019
A terrific response to oppo from hospitals: “Our goal shouldn’t be to lower hospitals’ prices, but to eliminate them entirely.” Also lays out a brilliant comparison between multi-payer healthcare and what multi-payer education would look like. If you read one thing this week, make it this!
Abigail Abrams, “A new generation of activist doctors is fighting for Medicare for All,” Time, Oct 24, 2019
A major shift is taking place within the medical profession.
Jocelyn Wiener, “California nursing home residents told to find new homes,” California Healthline/Sacramento Bee, Oct 29, 2019
“Managed care” of the elder-care system: what could go wrong? “The typical nursing home population in California is about two-thirds Medi-Cal, and many have given up everything — their apartments or mobile homes, their furniture, their burial insurance — to qualify, said Lonnie Golick who has received a number of complaints about coverage terminations. ‘They gave up their whole life, and then they’re told, “It’s time to go.”’”
Ady Barkan, “Elizabeth Warren’s plan is a massive win for Medicare for All movement,” The Intercept, Nov 1, 2019
Barkan celebrates the Warren plan as a milestone in answering the cost questions.
Lambert Strether, “Elizabeth Warren releases #MedicareForAll “Pay For” plan, with ‘no new taxes’ on the ‘middle class,’” Naked Capitalism, Nov 2, 2019
This is a more critical take on the Warren plan that questions the regressive nature of the Warren tax proposals as well as the entire package’s dependence on a series of ancillary actions. Fundamentally, the author asks, Why are we asking the “Pay For” question? “A suspicious mind might even conclude that ‘how you gonna pay for it?’ is a question asked in bad faith, with a view toward ensuring that we can’t have nice things.”
Peter Sullivan, “Biden aide: ‘Alarming’ that Sanders won’t release details of paying for ‘Medicare for All,’” The Hill, Oct 30, 2019
Like clockwork, Biden trots out lines from the GOP playbook. Sanders: if we pay double any other country now, then the money is there.
Justin Volz, “Why your health insurer doesn’t care about your big bills,” ProPublica/National Public Radio, Oct 9, 2019
How insurers make profit even when letting hospitals and providers gouge them. “It’s as if a mom told her son he could have 3 percent of a bowl of ice cream. A clever child would say, ‘Make it a bigger bowl.’”
Alex Kotch, “Super PAC backing ‘middle-class Joe’ is led by lobbyists, corporate consultants, and Democratic fundraisers,” Sludge, Oct 30, 2019
Biden will go for the big donor bucks now that his fundraising among the 99% has tanked. Interesting info on the lobbyists and insiders involved in his super PAC. For example, Larry Rasky, Treasurer, is CEO of Rasky Partners, which lobbies for health insurer Harvard Pilgrim Health Care, medical robotics company Myomo, defense contractor Raytheon, border security technology company Andiscern, and a weapons company.
Oct 29, 2019
Trudy Lieberman, “Be wary of the complex pros and cons of Medicare plans,” Tarbell, Oct 29, 2019
Creeping privatization of Medicare through government promotion of Advantage plans.
Peter D. Salins, “If Democrats want universal coverage, they need to abandon the ‘Medicare for all’ fantasy,” Los Angeles Times, Oct 4, 2019
The author identifies himself as a professor at SUNY Stony Brook but elides another affiliation: as a fellow at the Koch-funded Manhattan Institute. This is a clever twisting of facts (and some lies with statistics) to kneecap M4A in favor of improving the ACA with “eminently feasible reforms” that the insurance industry can then undermine.
Alex Kotch, “This Pharma-backed astroturf group wants to keep your drug prices high,” Sludge, Oct 10, 2019
Always useful to keep up with the proliferating oppo groups popping up with generous dollops of industry cash, ready to dig in their heels against any reforms (including the “pragmatic” halfway measures favored by many candidates).
Rachel Corbett, “Medicaid’s dark secret,” The Atlantic, Oct 2019
Horror story of Medicaid users forfeiting assets like the family home in exchange for care under Clinton’s Medicaid Estate Recovery Program of 1993. Since homeownership is a key vehicle for upward mobility, this practice destroys working families’ equity in the name of preventing the undeserving poor from getting freebies.
Rachel Z. Arndt, “No end in sight: EHRs hit hospitals’ bottom lines with uncertain benefits,” Modern Healthcare, Oct 13, 2018
The switch to electronic medical records was supposed to be the great technical (as opposed to political) fix to healthcare. A doctor begs to differ: “We’ve made this enormous investment, and in the end, I’m not sure the care I’m providing is any better or less expensive than if I were doing it on paper.”
J.B. Silvers, “This is the most realistic path to Medicare for All,” New York Times, Oct 15, 2019
This former industry exec argues that M4A will just happen “with a whimper, not a bang” because for-profit insurance isn’t viable as a business in the long term. It’s a curious erasure of the political fight that brought about Medicare/Medicaid in the 1960s and implies we needn’t engage in one today.
Wendell Potter, “Health care debate shows the lies I told for insurance companies about ‘Medicare for All’ worked,” NBC Think, Oct. 16, 2019
A run-down of the anti-M4A arguments from someone who helped formulate them (and now atones for it). “After watching the first three Democratic debates and accompanying media coverage, I find that the industry strategy has been more effective in manipulating journalists and pollsters than I could have ever predicted.”
Paul Demko, “What we don’t know about Bernie’s favorite healthcare idea,” Politico, Sept 12, 2019
Here is an excellent example of a purportedly balanced, “informative” article that adopts anti-M4A terminology and talking points invented 40 years ago in the fight against the failed Clinton healthcare reform proposal.
Samantha Liss, “As Medicaid work requirements cost taxpayers $408m, government watchdog calls for more oversight,” Health Care Dive, Oct 11, 2019
Therefore, imposing complex work requirements for Medicaid coverage is an expensive failure, right? Not if the purpose is to harass and punish beneficiaries, thus discouraging them and tossing them out of the program.
Carl Gibson, “Pharma & insurance gave $43m to the 130 House Democrats not backing Medicare for All,” GritPost, Mar 7, 2019
From March, good background on the oppo camp. [Since this was written, Jeffries has (sort of) endorsed M4A.] Top “earners”: Neal (MA) $3.2m; Hoyer (MD) $2.6m; Kind (WI) $2.4m; Pallone (NJ) $1.9m; Eshoo (CA) $1.8m; Clyburn (SC & Congressional Black Caucus) $1.5m; Pascrell (NJ) $1.1m; Pelosi (CA) $1m. Also, Dems from CT (HQ of Aetna, Signa, Hartford Financial) are no slackers: Larson $2.1m; Himes $1.3m; Courtney $582k; De Lauro $414k
Oct 18, 2019
Anna Maria Barry-Jester, “Even people insured by their employer are worried about rising health care costs,” FiveThirtyEight, Oct 5, 2019
“People with employer-sponsored insurance are nearly as worried about paying their medical bills as are the public as a whole.” Deductibles of $2000 or more now affect ¼ of all employer-covered families, up from 1/10 a decade ago.
Donald M. Berwick, “Elusive waste: The Fermi Paradox in U.S. health care,” [editorial], JAMA, Oct 7, 2019
Estimated at 25-35 percent of total expenditures or in the $1 trillion range. The authors ask why this “market-based” system isn’t busily finding ways to cut the fat. Their answer: “What some call ‘waste,’ others call ‘income.’”
Linda J. Blumberg et al., “From incremental to comprehensive health reform: How various reform options compare on coverage and costs,” Urban Institute, Oct 16, 2019
As the momentum builds to put an end to insurance companies’ control over our healthcare, there is a surge of “moderate” and “pragmatic” proposals to tinker with the ACA while preserving the role of rent-seeking intermediaries that provide no medical services. These proposals are couched in progressive-sounding language about the need to “move toward” universal coverage and to curb unsustainable price increases. As the next article notes, their skewered conclusions are “hidden under layers of elaborate calculations, charts and tables.”
David U. Himmelstein & Steffie Woolhandler, “The Urban Institute’s single payer cost estimate: False assumptions false conclusions,” Physicians for a National Health Program, posted 18 Oct 2019
Detailed take-down of the Urban Institute report.
Jenny Deam, “United Healthcare terminates contract with Houston Methodist; 100,000 plan members affected,” Houston Chronicle, Oct 10, 2019
Godzilla vs. King Kong as mega-companies slug it out over who gets the skim from healthcare dollars. An interesting development in the for-profit insurance world given the argument that M4A would be “disruptive.”
Naomi Zewde, “Why we need to design health care reform that puts patients before profits,” Roosevelt Institute, Oct 17, 2019
Points out a glaring shortcoming of Obamacare that the advocates of incrementalism downplay: high co-pays and deductibles make policies bought on the state exchanges useless for many potential buyers. As a result, ACA policies were a money-maker for hospitals but provided zero financial relief for many citizens forced to purchase them.
Andrew Perez, “Documents reveal hospital industry is leading fight against Medicare for All,” The Intercept/MapLight, Oct 15 2019
Hospitals tend to have strong links with Democrats, e.g., “Bob Kerrey, a former Democratic governor and U.S. senator from Nebraska who now serves on [hospital group] Tenet’s board of directors.”
Trudy Lieberman, “Congress may move to lower drug prices later this year or next,” Tarbell, Oct 10, 2019
Despite the ample flows of industry cash, elected officials—including Republicans—are starting to see pikes and pitchforks. But some of the proposals are weak tea: limiting annual drug costs to $3000 a year?
Lindsay Koshgarian, “We don’t need to raise taxes to have ‘Medicare for All,’” New York Times, Oct 17, 2019
An interesting comparison of what our spending priorities are v/s what they could be. But it still falls into the old trap of assuming that federal revenue has to equal federal spending (a.k.a. “Pay-Go”). This is not true, and the GOP is well aware of the fact when it runs up deficits to provide massive tax breaks for the rich or to set off on foreign wars of conquest. Federal spending is limited only by resource constraints, and if there are doctor or hospital shortages after M4A, I suspect someone will quickly move to fill them. Articles like this set up a false debate over what has to be axed to “pay for” socially beneficial spending.
Oct 12, 2019
Libby Watson, “The plot against Medicare for All,” New Republic, Oct 8, 2019
Discusses how the Trump-Pelosi-Biden attacks on M4A pit seniors—who enjoy a form of single-payer—against everyone else. “The absurd ‘keep your government hands off my Medicare’ line that we’ve heard for at least 25 years takes on a new spin. It’s not just keeping the government’s hands off Medicare: It’s keeping your neighbors’ hands off it, too.”
Akilah Johnson, “They’re retired. They’re insured. The government pays for it. And Trump loves it,” ProPublica, Oct 3, 2019
Well-off white retirees love single-payer, but only for themselves. Trump is their guy.
Nausicaa Renner, “Massachusetts unions vote to vet presidential candidates on Medicare for All, breaking with labor’s top brass,” The Intercept, Oct 9 2019
Trumka and Weingarten looking out of touch with membership. “This came from our rank and file who all have health care but wanted to make sure there was health care for everyone.” Solidarity was once a key principle of unionism.
David U. Himmelstein & Steffie Woolhandler, “The ‘public option’ on health care is a poison pill,” The Nation, Oct 7, 2019
The authors (from PNHP) outline how the for-profit insurance industry can and will game any attempt by the government to compete with them via a public option: obstruct high-cost care, select healthy (cheap) clients while pushing sicker (expensive) ones to the government program; systematically upcode diseases to extract higher reimbursements; lobby for bonus payments and free, state-funded advertising. Also explains why the German use of health management companies isn’t comparable to keeping for-profit U.S. insurers in the system.
Julie Hollar, “Corporate journalists push tax attack on Medicare for All,” Fairness and Accuracy in Reporting (FAIR), Oct 2, 2109
I hope I live long enough to hear Bernie or a surrogate say to one of these TV talking heads: “Yes, George/Jake/Erin, you make $5 million a year, so you will indeed pay higher taxes.”
Eileen Appelbaum, “How private equity makes you sicker,” American Prospect, Oct 7, 2019
Step 1: Buy a strategically located urban hospital with borrowed money. Step 2: Shift the debt burden onto the hospital; (extract hefty fees for this “service”). Step 3: Force cost-cutting measures to boost the hospital’s ability to pay “its” debts. Step 4: Close the “failing” hospital. Step 5: Sell the prime real estate at a hefty profit. Step 6: Use profits to repeat the process elsewhere.
Tara Bannow, “Drug list prices climb 8% annually in California,” Modern Healthcare, Oct 8, 2019
The state legislature passes a law; pharma mostly ignores it.
Stefanie Dodt & Jan Lukas Strozyk, “Pharmaceutical companies are luring Mexicans across the U.S. border to donate blood plasma,” ProPublica/ARD German TV, Oct 4, 2019
No militarized border control if you need to wreck your health for a medical corporation’s profits. Just don’t ask for asylum!
Naomi Martin, “As vaping became widespread with little known about its health effects, US government delayed key regulations,” Boston Globe, Sept 28, 2019
Not directly single-payer related, but a good look at (bipartisan) regulatory capture.
Oct 7, 2019
Chris Casteel, “Republican former House speaker endorses Medicaid expansion for Oklahoma,” The Oklahoman, Oct 2, 2019
Signs of retreat by GOP ideologues: a crimson-state legislator’s views have “evolved,” now thinks Medicaid expansion might be a good idea. “When people are healthier, it tends to improve the quality of life,” he said. Um, yes.
Kent Kaiser, “Pelosi’s prescription drug ‘negotiations’ would harm Americans and benefit China, Russia,” The Hill, Oct 1, 2019
The Russians! The Chinese! They’re pushing for cheaper medicines to muscle aside U.S. pharmaceutical companies. Who knew? Also, cheaper drugs=dead patients. The opinion is from the Trade Alliance to Promote Prosperity (https://www.promote-trade.org) . Could that possibly be an industry think tank? Led by a member of the Federalist Society?
Jeanette Settembre, “Millions of senior citizens can’t afford food — and they’re not all living in poverty,” MarketWatch, May 19, 2019
“Even seniors with incomes above the federal poverty line struggle to afford food in the U.S. . . . due to the high cost of health care, housing, utilities and transportation, the study suggests.”
Kristin Lam, “Thousands of California seniors are ‘one disaster away’ from homelessness. What can the state do?” USA Today, Oct 2, 2019
Medical bills . . . hunger, homelessness. . . what else?
Markian Hawryluk, “Why hospitals are getting into the housing business,” Kaiser Health News/USA Today, Oct 4, 2019
And homelessness leads to excessive hospitalization. But is turning hospitals into real estate developers really the answer?
Olivia Webb, “Private equity chases ambulances,” American Prospect, Oct 3, 2019
“The transformation of ambulance services from community service to luxury good [is] complete.” Private equity=the other useless middleman. Disgusting details.
Helaine Olen, “Our health-care bills are a form of taxation without representation,” Washington Post, Sept 27, 2019
A twist on the tax debate.
David Lazarus, “She’s 82. The cost of her long-term care insurance just went up 80%,” Los Angeles Times, Oct 1, 2019
Let’s call it “increased taxes on the middle class.”
Vin Gupta, “Don’t end private health insurance, 2020 Democrats. People want more choice, not less,” USA Today, Sept. 30, 2019
An advisor to Joe Biden insists we like our insurance companies (“choice”). Also, note the ludicrous argument that our current system embodies “simplicity” and “flexibility.”
Shelby Livingston, “Trump executive order aims to encourage new Medicare benefits,” Modern Healthcare, October 03, 2019
When officials say the word “choice,” cover your wallet with both hands. This announcement, made during Trump’s visit to a Florida senior center, encourages further privatization of Medicare via “affordable” plans with high deductibles.
Taylor Sisk, “A tale of two hospitals; One survived, the other didn’t,” Daily Yonder, Sep 25, 2019
The hospital in Kentucky, a state that expanded Medicaid, is still in business. The one in Tennessee, that didn’t, isn’t. This is not hard.
Kimberlee Kruesi, “Tennessee governor says block grant opponents ‘misinformed,’” Associated Press, October 03, 2019
Public opposition is overwhelming to this GOP plan to slash Medicaid. Tennessee refused a 90%-federally funded Medicaid expansion and now claims to be concerned about saving money.
Sept 30, 2019
Excellent bar graphs illustrating things like how employee contributions to health insurance have increased by 290% in the past two decades. This is a finance/economics site that rarely touches upon the issue, so it may reflect a growing recognition that the healthcare debacle can no longer be ignored.
Rep. Brian Higgins, “Allow Medicare buy-in for older adults,” Modern Healthcare, September 21, 2019
This U.S. representative (D-Buffalo) says the premise of Obamacare was that “all Americans should have universal access to comprehensive health insurance coverage”—not healthcare itself. He further criticizes Trump for pushing more people out of “the marketplace.” Not surprising then that his solution is for another halfway measure, allowing older-but-not-yet-65 folks to join Medicare. This is a restart of the “public option” that was dangled before advocates to stave off discussion of single payer during the Obamacare debate, then jerked away. We will be told that this is the more “realistic” and “pragmatic” alternative, on the assumption that the insurance companies will be fine with losing half of their business, rather than all of it.
Libby Watson, “The fetishization of employer-provided health care,” New Republic, Sep 27, 2019
Don’t skip this framing of the resistance to a fair and equitable health system as “class warfare against the poor.” Watson writes: “The reason that Democrats are so eager to please those who have employer-sponsored insurance is that those in this cohort with decent plans tend to be wealthier, and wealthy people make up a big part of the Democrats’ path to power.”
Adam Cancryn & Rachel Roubein, “‘Medicare for All’ backers find biggest foe in their own backyard,” Politico, Sept 25, 2019
Hospitals like to toss the blame over to insurers, but both are partnering up to protect their turf. Note that this group calls Rep. Higgins’ Medicare buy-in plan [above] a “total non-starter.”
Sen. Chuck Grassley, “Let’s prescribe a dose of common sense: End spread-pricing in Medicaid,” Modern Healthcare, Sep 21, 2019
Another sign that even the GOP sees that something has to give.
Shelby Livingston, “Job-based insurance annual premiums reach $20,000 record high,” Modern Healthcare, Sep 25, 2019
More exactly: $20,576 for a family of four, of which $6,015 (or $500 a month) is picked up by the worker. On top of that, the average deductible was $1,655, double what it was ten years ago.
Ben Curttright, “Why is teachers union president Randi Weingarten attacking Medicare for All?” Jacobin,
Takes apart the nice-sounding but disingenuous rhetoric from faux-allies like Weingarten but does not answer the question posed in the title.
Wendell Potter, “Why the private health industry faces an existential crisis,” Portside, Sept 25, 2019
“Our health insurance companies are not essential. They don’t treat anyone. They don’t prevent anyone from becoming sick. They don’t take you to the hospital or make sure you take your pills. They don’t fund or discover medical innovations. They’re simply middlemen we don’t need. And in the industry, we always dreaded the day American businesses and patients would wake up to that reality. That day has come.”
Sept 26, 2019
Eoin Higgins, “‘Unfortunate but not surprising’” Sanders responds to report Biden-linked firm poll testing attacks on Medicare for All,” Common Dreams, Sep 23, 2019
Biden camp echoing GOP attacks on Medicare for All.
Bill Salisbury, “Seen those ads asking you to call Tina Smith on surprise medical bills? Here’s what they are about,” Twin Cities Pioneer Press, Sep 20, 2019
Corporate doctors in Minnesota cooked up breathtakingly dishonest ads to slam a member of Congress for supporting measures to curb surprise hospital bills. These tactics are sure to proliferate and will require massive truth squads to counter them.
Michael Brady, “Doctors and patients tired of insurance hassles, Verma says,” Modern Healthcare, September 24, 2019
Extraordinary. A top Trump official warns insurers to get behind cosmetic changes or face public wrath. She called the recent close AMA vote to endorse single-payer a warning of the “growing chorus to eliminate your industry entirely.”
Samantha Liss, “Insurers’ message on ‘Medicare for All’: We’re part of the answer,” Healthcare Dive, May 3, 2019
From a few months ago, this is an insight into how the insurance industry will frame its plea for survival: we have “a role to play” in healthcare delivery, such as in Medicare Advantage plans and Medicaid managed care. Look for comparisons with German or Dutch systems where some administrative functions are outsourced.
Naomi Jagoda & Jonathan Easley, “Warren comes under new pressure over Medicare for All and higher taxes,” The Hill, Sept 23, 2019
Both Warren and Sanders fall into this trap by laying out counter-balancing revenue proposals. Correct answer to the How Do We Pay for It? question: “The same way we pay for the F-35 fighter plane: we send a check from the U.S. Treasury.” Then ask the questioner: “Will taxes go up on the middle class if we attack Iran? Why don’t you ask?” (On the other hand, NYHA does need a revenue stream since New York State does not issue dollars.)
Emmarie Huetteman, “Hill Hodgepodge: Pelosi draws from Democrats, GOP and Trump for drug plan,” Kaiser Health News/USA Today, Sept 20, 2019
What’s in Pelosi’s plan? A mandate that the HHS secretary (currently a former Pharma executive) negotiate prices of at least 25 drugs per year; inflation-linked limits on price increases; a Part D cap of $2000/year.
Burgess Everett, “McConnell warns Pelosi’s drug-pricing plan is DOA,” Politico, Sept 19, 2019
That was fast.
Alex Pareene, “Do Democrats actually want to make drugs cheaper?” New Republic, Jun 3, 2019
From June when this writer, addressing an earlier draft of the Pelosi plan, already was predicting posturing over content: “Mind you, this was not a plan actually to lower the costs of drugs. No, it was a plan to pass a bill about high drug prices.” And: “Like many seemingly intractable problems in American society, the problem of out-of-control drug prices is only ‘complex’ and difficult to solve because the easy solutions are forestalled by our plutocrat-captured political system.”
Meanwhile. . .
Michele Cohen Marill, “Three ways to fix the drug industry’s rampant dysfunction,” Science, Sep 18, 2019
A new company tests medicines for bioavailability and safety. It rejects 10 percent of the samples.
Sept 21, 2019
Rachel Madley, “Does anyone really ‘love’ private health insurance?” New York Times, Sep 17, 2019
A terrific op-ed from a member of our UPA committee—we can all learn from Rachel how it’s done, combining compelling personal details with clear advocacy. I love the line about “working a second shift” to fight her insurance companies for her needs.
Rachel M. Cohen, “The biggest strike in America is about how much bosses can gut your healthcare. This is the new normal,” Vox, Sep 18 2019
A major factor behind the strike is GM’s attempt to push more healthcare costs onto workers.
Tara Golshan, “How the GM workers strike makes Bernie Sanders’s case for Medicare-for-all,” Vox, Sept 18, 2019
“Joe Biden argued Medicare-for-all would be bad for unions. Then General Motors cut health benefits to striking union workers.”
Bob Bryan, “Amazon-owned Whole Foods’ decision to drop health benefits for hundreds of part-time workers reveals how promises to workers like CEO Jeff Bezos’ recent pledge are worthless,” Business Insider, Sep. 13, 2019
Bezos either has no PR sense or doesn’t care.
Matt Bruenig, “Medicare for All would cut poverty by over 20 percent,” People’s Policy Project, Sep 12, 2019
Handy bar graphs. Note that the poorest spend an average of 22 percent of their income on medical expenses. “This makes M4A one of the most potent anti-poverty programs proposed thus far in the current presidential race.”
Libby Watson, “Pete Buttigieg’s health care plan is the worst yet,” New Republic, Sep 19, 2019
This digest has avoided delving too deeply into the details of the various candidates’ plans, but this take-down is epic: “It is a faux-technocratic fantasia soaked in the utterly meaningless jargon of Access and Affordability that won’t even accomplish the things it pretends to want.” Aside from the specifics, it makes a crucial political point: “Buttigieg’s plan falls prey to the belief that significant conflict with the various bad actors in the health care system can be avoided.”
Raymond Feierabend, “TennCare doesn’t care: The unraveling of a state Medicaid program,” Tarbell, July 15, 2019
Tries to answer the question of why Tennessee would forego billions in federal funds and apply Medicaid work requirements that don’t work. (Short answer: to punish poor people.) Now, the state has applied for permission to turn Medicaid into a block grant, which would make it easier for the federal government to starve the program in the future in the name of austerity or reducing the deficit (see NHS under the Tories in Britain).
Dena Bunis, “House leaders unveil bill to lower prescription drug prices,” AARP, Sep 19, 2019
Lev Facher, “Democrats still have questions about Nancy Pelosi’s drug pricing plan,” Stat, Sep 19, 2019
Pelosi kept fellow Dems in the dark, but “lobbyists and reporters” had an advance copy of the proposal.
Liz Highleyman, “Advocates say Gilead broke antitrust laws,” Bay Area Reporter, Sep 18, 2019
Interesting even though there is little appetite for antitrust in any sector of our economy these days—which dates back to the deregulation frenzy begun under the Carter Administration.
Alex Kacik, “Lopsided urban hospital markets spark cost concerns,” Modern Healthcare, Sep 17, 2019
Hospital prices, the “main driver of U.S. healthcare spending inflation,” increase with hospital concentration, yet no one is acting to rein in mergers.
Sept 15, 2019
Alex Kacik, “Price hikes, upcoding drive Massachusetts inpatient spending,” Modern Healthcare, Sept 12, 2019
Hospitals manipulate patient data to claim higher reimbursements for the same conditions. Result: more spending for less care.
Marshall Allen, “We asked prosecutors if health insurance companies care about fraud. They laughed at us,” ProPublica, Sept 10, 2019
For-profit insurers have incentives to ignore fraud. “To protect their networks and bottom lines, health insurers don’t aggressively pursue widespread fraud, making it easy for scammers. Then they pass the costs off to you.”
Jay Hancock and Elizabeth Lucas, “‘UVA has ruined us’: Health system sues thousands of patients, seizing paychecks and putting liens on homes,” Washington Post, Sept 9, 2019
“UVA Health System stands out for the scope of its collection efforts, pursuing poor as well as middle-class patients for almost all they’re worth. It garnished thousands of paychecks, largely from workers at lower-pay employers such as Walmart [including the hospital’s own employees], where UVA took wages more than 800 times.” Note that UVA is a NONPROFIT hospital. Now see below for news of where a successful UVA financier is going next.
Shelby Livingstone, “UVA Medical Center CEO heads to New York-Presbyterian,” Modern Healthcare, Sept 10, 2019
“University of Virginia President James Ryan said Sutton-Wallace’s departure ‘is in no way related’ to a Kaiser Health News story that exposed UVA Health’s aggressive billing and collection tactics.” That’s reassuring.
Michael Simon, “A provider’s perspective on the surprise medical billing debate,” Modern Healthcare, Sept 11, 2019
Here’s the argument from the outfit making millions off surprise bills. Note the repeated references to “what is best for patients,” (including, we presume, those in comas).
Shelby Livingston and Susannah Luthi, “House committee throws spotlight on prior authorization burden,” Modern Healthcare, Sept 11, 2019
One witness described “the chaos of having to deal with 35 different health insurers that all have their own prior authorization processes and drug formularies that change regularly.” Interesting figures on these administrative costs for a typical MD. The insurance companies oppose this legislation arguing that prior authorization reduces “misuse.” So why are they uninterested in fraud? [see above]
Libby Watson, “How greedy hospitals fleece the poor,” New Republic, Sept 11, 2019
The author surprisingly comes out for single-payer as a solution, rather than incrementalism or targeted fixes. Not sure if the generally centrist New Republic has taken this position previously.
Eion Higgins, “Progressives explode after ABC panel featuring Chris Christie and Rahm Emanuel launches attack on Medicare For All,” Common Dreams, Sept 8, 2019
Hilariously obvious bias of a panel comprised of both the Republican and the Democrat sides of the healthcare issue, both coincidentally anti-single payer. No point in getting annoyed at these corporate tactics, which will accelerate as they get more desperate.
Sept 11, 2019
Sydney Ember, “Bernie Sanders went to Canada, and a dream of ‘Medicare for All’ flourished,” New York Times, Sep 9, 2019
Ember is surprisingly even-handed in probing Sanders’ family history, including the premature death of his mother, which Sanders doesn’t discuss.
Alex Kotch, “DSCC raked in cash from health care and fossil fuel lobbyists before endorsing Hickenlooper,” Sludge/Maplight, Aug 29, 2019
Hickenlooper, the “moderate” Democrat who spent his brief presidential campaign hating single-payer with GOP talking points, now wallows in cash from pharmaceutical and insurance industry lobbyists for his Senate run.
Tim Marchman, “Joe Biden: It would be an insult to my dead son for everyone to have healthcare,” Vice, Aug 27, 2019
Biden’s weaponizes his dramatic personal story to reinforce the idea that healthcare should be “affordable,” that is, a marketplace commodity.
Robert Draper, “How Medicare for All went mainstream,” New York Times, Aug 27, 2019
Great historical review, including the story of Hillarycare, another attempt at a “pragmatic,” middle-of-the-road reform that was politically toxic.
Josh Cook, “Health care industry spending millions in Iowa to preserve profits,” Iowa Startling Line, Aug 26, 2019
The industry lobby is attacking early in a key presidential state.
Eileen Appelbaum & Rosemary Batt, “Private equity tries to protect another profit center,” Center for Economic and Policy Research,” Fall 2019
This review of what has come to be known as “surprise medical billing” is quite dense and detailed but important to understand as it shows how financiers (private equity) have moved into medicine to extract rent. They will propagandize in their own favor by attacking the insurance companies, which may sound plausible until we realize that they themselves are just as bad or worse. Schwartzman’s Blackstone Group is a major culprit, so remember that when you go to the 42nd Street public library named after him.
Steven Findlay, “States pass record number of laws to reel in drug prices,” Kaiser Health News, Sept 9, 2019
A federal purchasing agency with real bargaining clout would cut through all these piecemeal efforts, but meanwhile states are becoming more pro-active with oversight boards, price monitoring, and authorizing purchases from Canada.
Sept 6, 2019
Danielle Keeton-Olsen, “Endo International’s Ohio opioid settlement is microscopic compared to crisis cost and Endo’s earnings,” Tarbell, Aug 26, 2019
How to deal drugs, get caught, pay off the court. Endo’s stock jumped nearly 30% after the settlement.
Merrill Goozner, “Editorial: Who benefits from private equity buyouts?” Modern Healthcare, Sept 5, 2019
An important insight into the role of financial manipulation—a long-time culprit in the destruction of the U.S. industrial base—now moving into medicine.
Peter Sullivan, “House Democratic Caucus chairman announces support for ‘Medicare for All,’” The Hill, Sept 4, 2019
A partial victory: the pressure on Jeffries moved him to endorse M4A, but read to the end where he hedges by saying he also supports the non-M4A alternatives. So it’s a shift of rhetoric without much substance. Still, it’s important to have pushed him this far.
Lauren Weber, “Groupons for medical treatment? Welcome to today’s U.S. health care,” Kaiser Health News, Sept 6, 2019
If medicine is a marketplace commodity, why not Groupons? At least you get a clear statement of the costs up front. Maybe they can cut deals with the private equity owners of doctors’ practices. “Groupon also offers discount coupons for expectant parents looking for ultrasounds, sold as ‘fetal memories.’” Copay for engraving.
Emmarie Huetteman, Jay Hancock & Elizabeth Lucas, “Pharma cash rolls into Congress to defend an embattled industry,” Kaiser Health News, Aug 27, 2019
Get ready for the tsunami of cash from Pharma protecting its profits while the recipients insist they are “fighting” to contain costs (but, sadly, losing). Kaiser has a handy database with the details. Top Senate beneficiaries: Chris Coons (D-DE), and Thom Tillis (R-NC), “leaders of a Senate subcommittee on intellectual property working on legislation to overhaul the patent system.” The official PAC dollars are only the tip of the iceberg as they do not include individual donations.
Rebecca Kolins Givan, “Unions shouldn’t use their health insurance as a weapon against universal coverage,” Washington Post, Aug 28, 2019
An op-ed from a professor of Management and Labor Relations: “Imagine a world where elementary school attendance was limited to those children who had a parent whose job offered, or whose union had negotiated, this benefit. While this scenario is patently absurd, it’s exactly the policy we’ve accepted for access to health care.” Good arguments for the dialogue with organized labor.
Drew Altman, “Health care costs as much as a new car,” Axios, Aug 23, 2019
And that’s for the lucky ones covered at work.
Aug 28, 2019
ZDoggMD, “What I saw on rounds made me sick,” ZDoggMD, Aug 22, 2019 [VIDEO]
Articulate and impassioned criticism of how the dictatorship of EMR (electronic medical records) is trashing medical practice. Unfortunately, he does not draw the link to payment modalities.
Bob Herman, “Doctors bring in a bevy of lobbyists on surprise billing,” Axios, Aug 20, 2019
Surprise-you’re-bankrupt! doctors have their own lobbying team.
Barbara Feder Ostrov & Lauren Weber, “The collapse of a hospital empire—and towns left in the wreckage,” Kaiser Health News, Aug 20, 2019
Vulnerable rural hospitals and vulnerable localities are prime targets for financial fraudsters. Note that all are in non-Medicaid-expansion states.
Michael Braga, Jennifer Borresen, Dak Le & Jonathan Riley, “‘Leaving billions of dollars on the table’: Rural hospitals foundering in states that declined Obamacare,” GateHouse Media, Jul 28, 2019
“Rural America is in the midst of a deep and prolonged crisis that resulted in 106 hospital closures since 2010. Nearly 700 more are on shaky ground, and nearly 200 are on the verge of collapse right now.” Handy map of the Confederacy where state governments refused Medicaid expansion.
Alice Mirando Ollstein & James Arkin, “Senate battleground Dems shun ‘Medicare for All,’” Politico, Aug 25, 2019
They propose halfway measures that will attract the same ferocious opposition from the industry, thus producing both disappointing results and political poison. Recall that Obamacare’s passage led to a Dem loss of 60 House seats.
William Rivers Pitt, “Insulin prices killed Josh Wilkerson. Now his mother is taking on big Pharma,” Truthout, Aug 24, 2019
State-sponsored murder by price-gouging.
Gabriel Levitt, “PharmacyChecker vs. Big Pharma front groups and allies,” Pharmacy Checker blog, Aug 16, 2019
How Google helps big Pharma block access to cheaper alternatives.
Michael McAuliff, “Keeping international pharmacies under a cloud,” Tarbell, May 2, 2018
Background on the above: Pharma claims cheaper drugs from overseas are “unsafe.” Plenty of help from the Obama White House.
Philip Longman, “Time to fight healthcare monopolization,” Democracy: A Journal of Ideas, Fall, 2016
This is an older piece that highlights another important issue: how industry consolidation is undermining the possibility of controlling costs. “It is naive to expect that government regulators won’t become even more captured than they already are if economic, and therefore, political power becomes ever more concentrated in the industry they are supposed to regulate. . . . [O]ne-third of the money Americans spend on health care is pure waste or worse, going for treatments that have no clinical benefits or that are harmful to patients.”
Aug 23, 2019
Peter Sullivan, “American Medical Association leaves coalition fighting ‘Medicare for All,’” The Hill, Aug 15, 2019
Not to endorse M4A but finding itself uncomfortable with the industry lobby’s opposition to everything. The AMA is split nearly down the middle with a recent vote to endorse M4A losing 47%-53%.
Joseph Zeballos-Roig, “The 4 Democratic presidential candidates who cosponsored Bernie Sanders’ Medicare for All Senate bill either no longer support it or won’t say if they do,” Business Insider, Aug 20, 2019
Harris backtracks at a Hamptons fundraiser. Bernie notes the optics.
Michael Kolber, “Could next year be the beginning of the end of traditional employer-sponsored health insurance?” The Hill, Aug 20, 2019
A potentially deep shake-up to the employer-based insurance model. One strong incentive is the relative simplicity of being signed up through one’s job—this new model will throw the responsibility back onto each individual to navigate complicated options with a huge gotcha! potential from insurers trying to charge more and provide less. This “tax on time” element is an unacknowledged flaw of Obamacare. From the article: “Brokers and tech vendors will need to help employees navigate increasingly complex coverage decisions.” All these “brokers and tech vendors” will add to costs while contributing zero to health care.
Michelle L. Price & Ricardo Alonso-Zaldivar, “For Democrats, a shift toward the middle on healthcare,” Associated Press, Aug 23, 2019
This sounds so reasonable: we all want M4A, but let’s preserve good employer-based insurance and move there gradually through things like the “public option” and expanded Obamacare. Then check out the next headline.
Sahil Kapur, “All the Democratic health-care proposals have one big problem: Even their most moderate plans aren’t likely to get past the health-care industry,” Bloomberg, Aug 23, 2019
Paywalled, but the title summarizes: the proposed halfway measures will generate the same ferocious industry opposition.
Alice Miranda Ollstein & Holly Otterbein, “Fact check: Did Bernie just backtrack on Medicare for All?” Politico, Aug 22, 2019
No. But the coverage of his tweak to reassure union members isn’t likely to be as fair as this article (although check out the grumpy-grandpa photo they chose to use of Bernie).
Harris Meyer, “Alaska governor signs sharp Medicaid cuts as hospitals sue,” Modern Healthcare, Aug 20, 2019
Slash and burn by a fanatic GOP governor who now faces a recall petition. The goal is to eliminate all vestiges of the safety net.
Fran Quigley, “‘If Grandma is on the table, no one will blink at the price’: A former drug company manager talks about price-setting,” Faith in Healthcare, July 4, 2019
Always interesting to hear from people who know a situation from the inside.
Aug 19, 2019
Merrill Goozner, “Editorial: Big Pharma nears another big win,” Modern Healthcare, Jul 18, 2019
A roundup of the steady defeats of attempts to rein in pharmaceutical prices.
Tim Higginbotham, “The 5 biggest lies Joe Biden is telling about Medicare for All,” Jacobin, Jul 18 2019
“Biden claimed Medicare for All will throw millions off of their insurance, scrap Obamacare, end Medicare as we know it, cause a hiatus in coverage, and cost more than his own plan.” All the industry’s talking points in one (Democrat) package.
Marshall Allen, “Health insurers make it easy for scammers to steal millions. Who pays? You,” ProPublica, Jul 19, 2019
How private insurance enables fraud: “It is surprisingly easy for fraudsters to gain entry, and it is shockingly difficult to convince insurance companies to stop them.”
Kristina Gaddy, “Why would cancer patients stop treatment? Money,” OZY, Aug 11, 2019
Nothing new: having insurance is no guarantee against bankruptcy because that “great” policy collapses when one actually needs coverage. New term: “financial toxicity.”
Susannah Luthi, “Rural hospitals take spotlight in coverage expansion debate,” Modern Healthcare, Aug 7, 2019
This industry-funded study only makes sense if Medicare reimbursement rates stay exactly the same under a new, universal system. It doesn’t address why so many rural hospitals are closing NOW. However, expect to hear this study cited repeatedly to generate doubts about single-payer.
Taylor Knopf, “Legislators offer lifeline to rural hospitals drowning in debt,” North Carolina Health News, June 27, 2019
It’s not as if rural hospitals are thriving under the current system. Stories like this are daily fare.
Wendell Porter, “’Don’t touch my Medicare!’” Tarbell, Aug 5, 2019
A 2016 piece with excellent background on the origins of Medicare and the stealth privatization pushed by both parties as well as detail on how the for-profit sector games Medicare reimbursements.
James G. Kahn, “Medicare for All and private insurance: It is like mixing oil and water,” Tarbell, Jul 19, 2019
A crucial distinction about how “private insurance” works here versus Germany or Switzerland.
Ed Weisbart, “Think twice when you hear the words ‘public option’ health insurance,” St Louis Post-Dispatch, Jul 4, 2019
Why adding optional Medicare won’t work and isn’t an alternative to straight-on single-payer.
Aug 11, 2019
Marisa Iati, “Couple dead in apparent murder-suicide left notes saying they couldn’t afford medical care, police say,” Washington Post, Aug 10, 2019
No comment needed, if any were possible.
Dr David Ray, “Misinformation is poisoning the debate over health care,” Albany Times-Union, Jul 29, 2019
An excellent op-ed, written in response to the campaign’s call for same by members.
Michael Hiltzik, “Health insurance companies are useless. Get rid of them,” Los Angeles Times, Aug 5, 2019
Hiltzik, a highly respected finance journalist, dismantles the industry’s justifications for its existence.
Jon Queally, “Sanders demands drug and insurance industries explain the hundreds of millions they seem willing to spend to defeat Medicare for All,” Common Dreams, Aug 10, 2019
“You made $100 billion in profits last year—how much of that are you going to spend to protect your profits?” Bernie’s strategy to fend off the tsunami of oppo advertising sure to come: call it out and immunize people against its messages.
T J. David McSwane & Tom Benning, “Are Trump’s top Medicaid regulators ignoring major problems? Insurance giant’s tense meeting with a senator adds to growing concern,” Dallas Morning News/ProPublica, Aug 6, 2019
A round-up of systematic negligence by federal regulators over for-profit Medicaid contractors.
“Hurry up and wait: Docs say insurers increasingly interfere,” Associated Press, Jul 29, 2019
Insurer-created interference in care: “The insurance has been great until I got to a point that I really needed something for survival,” said a patient. Or to put it another way, until she needed the health insurance she had been paying for.
Jake Johnson, “Sanders and Warren defend Medicare for All from moderates and media,” Truthdig, Jul 31, 2019
Blatant tipping of the scales by industry ads during the presidential debates. Candidates get 60 seconds each; pharma and insurance companies then pay for 90 seconds X 3. The “moderates” apparently were okay with it as CNN cashed in.
Jake Johnson, “Union leaders rebuke centrist Democrats for claiming Medicare for All would harm workers,” Common Dreams, Aug 2, 2019
Pro-M4M unions push back against the claim that “unions” want to preserve private coverage.
Simon Davis-Cohen, “Iowa privatized Medicaid: It has been a disaster. Here’s why.” Tarbell, Apr. 25, 2019
Privatization was peddled as a money-saver, which it hasn’t. But, predictably, the for-profit companies boost claim challenges, forcing hospitals and doctors to bug them for payment. This is not rocket science.
Christopher Rowland, “Pfizer had clues its blockbuster drug could prevent Alzheimer’s. Why didn’t it tell the world?” Washington Post, Jun 4, 2019
How our perverse drug patent system stymies medical research. You have to read through a lot of smoke and mirrors to get to the salient fact: that the patent was going to expire, so Pfizer had no financial motive to find that the drug worked.
Aug 5, 2019
Tara Bannow, “UHS’ stock price up more than 10% after $127M DOJ settlement news,” Modern Healthcare, Jul 25, 2019
Insurer fined for misconduct; stock soars: an admirably clear demonstration of how cost-of-doing-business fines for reimbursement fraud are baked into the business. On the other hand, criminal charges against top corporate officers (dropped by DoJ in this case) would hurt the corporate image and be much more effective.
Walter Tsou, “A for-profit company bought, then closed, a Philadelphia hospital. Medicare for All could have saved it,” Tarbell, Aug. 1, 2019
A city hospital sits on prime downtown real estate. It’s more valuable as an empty lot.
Ezra Klein, “How ‘Medicare Extra’ gets to universal coverage without single-payer,” Vox, Jul 23, 2019
Sanders reset the healthcare debate so that centrists now have to support M4A in theory while finding ways to retain the role of private insurance. The question they don’t answer: why would complicated roadmaps to “eventually” marginalize Aetna and Blue Cross have any better chance of enactment? Also, “universal” coverage is the new normal, i.e. Obamacare lacks full-throated apologists.
Collin Anderson, “Iowa Dem hits Ernst for taking Pharma money, takes Pharma lobbyist money,” Washington Free Beacon, Jul 23, 2019
Hard to denounce your opponent for being in the pocket of lobbyists when you are also covered in lint.
Paul Heideman, “The Democratic debate showed the left is winning,” Jacobin, Jul 31, 2019
A concise recap of the Sanders-Warren domination of the healthcare debate.
Wendell Potter, “Senator Harris: You really need to rethink your plan to put private insurers in charge of Medicare,” Tarbell, Jul 31, 2019
Takedown of Harris’s public-private healthcare hermaphrodite. If it works, private insurers will dump enrollees. If it doesn’t work, they’ll come back to reap hefty profits from government payouts and perfect their reimbursement scams.
Osita Nwamevu, “How Bernie Sanders changed the health-care debate,” New Yorker, Aug. 3, 2019
“Perhaps even more notable than the stridency of Sanders’s and Warren’s defenses of the plan were the barbs from moderates who have been forced by widespread enthusiasm for Medicare for All to put forward plans that are well left of the Affordable Care Act.” Sanders is “strident” while defenders of for-profit healthcare are “moderate” or sometimes “pragmatic.”
Carly Stern, “Forced to divorce: Americans with disabilities must pick marriage or health care,” OZY, Apr. 25, 2019
How “pragmatic” healthcare forces people to divorce. But don’t get all “strident” about it!
July 24, 2019
Jim Hightower, “The other Mexican migration,” Hightower Lowdown, Jul 16, 2019
Americans fleeing from U.S. health costs to Mexico.
Dean Baker, “It’s not an accident Medicare doesn’t cover retirees overseas: No one in the media supports free trade!” Beat the Press, Jul 18, 2019
Baker’s sarcasm exposes the rhetorical inconsistency between the constant mediatic praise of “free trade” and the highly protectionist posture of most domestic politicians (and pundits) vis-à-vis U.S. professionals (medical, finance, lawyers, etc.) who enjoy the benefits of our immense trade barriers against potential competitors.
Fred Schulte & Lauren Weber, “Insurers running Medicare Advantage plans overbill taxpayers by billions as feds struggle to stop it,” Kaiser Health News, Jul 16, 2019
How the infiltration by private insurance into Medicare has incentivized fraud.
Alex Gangitano, “Rick Scott: PhRMA hasn’t provided ‘A single answer’ on lower drug prices,” The Hill, Jul 15, 2019
While the corporate Democrats tut-tut Bernie for being too radical, a half dozen GOP senators launched a broadside against the pharmaceutical lobby. Recall that Trump attacked HRC from the left—cynically, opportunistically, successfully.
Erin C. Fuse Brown & Elizabeth Y. McCuskey, “Could states do single-payer health care?” Health Affairs, Jul 22, 2019
The authors review the legal obstacles to establishing single-payer state by state, but they note the Canadian precedent and the utility of allowing a variety of experiments (“laboratories of the state”) to explore how best to make the transition.
Suzanne Delbanco “Commentary: As healthcare prices are revealed, hospitals face hard choices,” Modern Healthcare, Jul 20, 2019
“Why can some hospitals charge higher prices than others? Market power.”
Michael Hiltzik, “New data show that failing to expand Medicaid has led to16,000 unnecessary deaths,” Los Angeles Times, Jul 22, 2019
ACA expansion of Medicaid–a single-payer program—is consistently credited with a large portion of improved outcomes.
Mattie Quinn, “After midterm wins in red states, GOP lawmakers slow Medicaid expansion’s momentum,” Governing, Jul 1, 2019
Good round-up of the state of play. Voters speak for expanded Medicaid; lawmakers dawdle or undermine it.
Melinda Deslatte, “After thousands booted from Medicaid rolls, Louisiana will spend $400m less under program’s projections,” Associated Press, Jun 13, 2019
Work and eligibility confirmation requirements, popular with conservatives, enable states to push people off Medicaid coverage and spend the money elsewhere. This clever adjustment was requiring quarterly rather than annual proof of eligibility.
Andy Marso, “Missouri Democrats want investigation of Medicaid drop,” Kansas City Star, Jul 23, 2019
Republicans: improving economy means people don’t need it; Democrats: bureaucratic red tape and computer error pushes people off the rolls. Result: state saves money.
Tribune News Service, “For the uninsured there’s a lot at stake,” News & Record [Greensboro NC], Jul 21, 2019
Republicans dig in their heels to block Medicaid expansion, Democrat governor insists on it.
Sean Maguire, “Alaska Health Care Association sues state of Alaska over Medicaid rate cuts,” KTUU-TV, 7/17)
Alaska governor’s burn & pillage strategy to dismantle Medicaid.
Brett Kelman & Mike Reicher, “At least 220,000 Tennessee kids faced loss of health insurance due to lacking paperwork,” Nashville Tennessean, Jul 14, 2019
“The analysis indicates TennCare representatives, using this paperwork process, were rarely able to determine if kids were actually eligible or not.” So the state’s own employees couldn’t figure out the system, but Medicaid recipients are supposed to be able to.
Mark Hayward, “Deadline for Medicaid work requirement extended as state goes door to door seeking the noncompliant,” New Hampshire Union Leader, Jul 8, 2019
“[Gov] Sununu said outreach efforts have included four direct mailings, radio ads, information booths and grocery and retail stores, 50,000 telephone calls, and text messages.” How about dropping the whole silly exercise and saving a few million?
Ariel Hart, “Cut from Georgia Medicaid rolls, patients run into bureaucracy,” Atlanta Journal-Constitution, Jun 14, 2019 h
First we cut off your benefits; then we make it impossible to get them back. The system works!
David McSwane, “Texas’ Medicaid system hurt vulnerable people as insurers got rich; now major reforms head to Gov. Abbott,” Dallas Morning News, May 5, 2019
Surprising headline for a red state paper. The article applauds “reforms” to a dysfunctional system.
July 18, 2019
Paul Walden, “Joe Biden proposes radical leftist health-care plan,” Washington Post, Jul 15, 2019
This is a curious piece: the author is not hostile to either M4A nor the Biden plan (despite the headline). He argues that Biden’s Obamacare 2.0 will be attacked by the industry in any case because the public option could outperform for-profit insurance and pave the way for M4A. Whether or not you buy that, these halfway measures will attract the same virulent opposition as M4A, so it’s hard to see the political advantage in pushing them. (An electoral advantage, maybe—which is different.) But Biden’s plan has all the elements that caused the backlash to Obamacare: a huge boost in outlays, tax increases (or rescinding of cuts), an increased government role, continued hyper-complexity including unfairness tiers, and lack of universality. And with the industry invited to tinker with the details, we could anticipate a final hybrid that retains high out-of-pocket payments and shoves the sickest patients to the public sector.
Tara Golshan, “Bernie Sanders made Medicare-for-all mainstream. Now he’s trying to reclaim it,” Vox, Jul 17, 2019
Describes the array of confusing interpretations of M4A and assumes, incorrectly, that this is an accident.
Ed Weisbart, “Think twice when you hear the words ‘public option’ health insurance,” St Louis Post-Dispatch, Jul 4, 2019
Excellent take-down of the public option non-solution.
Alice Miranda, “Sanders swipes at rivals, makes a case for ‘Medicare for All'”, Politico, Jul 17, 2019
Emphasizes Bernie’s insistence that the industry must be confronted head-on and that industry-funded candidates can’t—or won’t—fight its interests.
Burgess Everett, “Republicans ready to dive off a cliff on Obamacare,” Politico, Jul 14, 2019
The early reporting on this lawsuit downplayed the possibility that it would succeed. However, now it appears that the federal judges are open to abolishing the entire ACA. Not much to do with all the speculation, but it could change the parameters of the debate as the Supreme Court challenge probably would occur in the thick of election season 2020.
Drs. James G. Kagan & Elliot Marseille, “Medicare for All: A voter’s cheat sheet,” The Hill, Jul 17, 2019
A handy, brief glossary from M4A supporters.
Fred Schulte & Lauren Weber, “Insurers running Medicare Advantage plans overbill taxpayers by billions as feds struggle to stop it,” Kaiser Health News, Jul 16, 2019
Corruption and waste in the for-profit system: note regulatory capture and industry resistance to being audited effectively via extrapolation of error rates.
Alex Kotch, “Donna Shalala opposes Florida drug import bill, and so do her pharma lobbyist donors,” Sludge, Jul 12, 2019
Legalized bribery in full, shameless flower. Note that Shalala, a cabinet secretary under Clinton, is to the right of the Florida GOP on this.
Harris Meyer, “CMS seeks to reduce state reporting on Medicaid access, pay cuts,” Modern Healthcare, July 11, 2019
This may seem like an insider-baseball issue. But the Trump Administration consistently takes actions to enable states to weaken Medicaid coverage as well as to undermine any data that might demonstrate such weakening [see climate science].
Kenneth Dolkart, “In health care, the free-market model has failed,” Valley News (West Lebanon NH), Jun 15, 2019
Interesting to see pro-M4A opinion columns such as this one in a small-town newspaper.
Lefty Coaster, “Red States that refused to expand Medicaid under the ACA are seeing their rural hospitals close down,” Daily Kos, Jun 30, 2019
Rural areas cannot sustain hospitals under the present payment system.
Jim Hightower, “The obvious reason Congress is in no rush to make health care universal,” Truthdig, Jul 8, 2019
His answer: the Office of the Attending Physician (OAP), “a secretive medical center located right in the U.S. Capitol building that provides a full-blown system of — shhhhh — health care socialism to our governing elites. . . . our lawmakers don’t personally feel the financial pain and emotional distress that are inflicted on millions of regular Americans.”
Beth Mole, “879% drug price hike is one of 3,400 in 2019 so far; rate of hikes increasing,” Ars Tecnica, Jul 2, 2019
Despite public and political pressure, the average price hike was 10.5% in an essentially zero-inflation environment.
Samantha Liss, “Trump admin opens door to fundamental changes in healthcare benefits,” Healthcare Dive, Jun 17, 2019
If successful, further undermining the current employer-based insurance model.
Tina Bellon & Nate Raymond, “U.S. judge strikes down Trump administration rule requiring drug prices in TV ads,” Reuters, Jul 8, 2019
The judge said Congress could authorize it, so why not go to Congress to pass a law? Also, note the irony of the White House blaming the ruling on an “Obama-appointed judge” when it is simultaneously trying to scotch the entire ACA.
July 7, 2019
Jessica Corbett, “Medicare for all sponsor Rep. Jayapal challenges Biden’s comments on labor unions and health insurance,” Common Dreams, Jul 6, 2019
Unions “broke their necks” to get good health care, says Joe. He doesn’t explain why anyone should have to do that. Also: Biden insists that buying into Medicare is the best pathway to achieve single-payer. So why wasn’t that part of the ACA package ten years ago? (Hint: they could ignore M4A more easily back then.)
Jessica Corbett, “Rising enthusiasm for Medicare for All has provoked dramatic surge in industry-backed lobbying: Report,” Common Dreams, Jun 28, 2019
Sign of the times: overall number of anti-M4A lobbyists has increased ninefold.
Samantha Liss, “Insurers’ message on ‘Medicare for All’: We’re part of the answer,” Healthcare Dive, May 3, 2019
A shifting national discourse on healthcare has forced the for-profit industry to find more credible talking points: this one comes from the tobacco industry, which always seeks to be “part of the dialogue” on how to reduce harm (while protecting their business). Interesting that some companies opt to remain silent, which suggests that anything they say will boomerang. Also: “universal coverage” does not = single-payer: the difference is who pays, who collects, and where the transaction takes place.
Andrew Perez, Abigail Luke & Tim Zelina, “Journalists, pundits and retired politicians put on a show for lobbyists,” Maplight/Tarbell, July 2, 2019
How to sidestep anti-corruption restrictions: “buckracking”. Note the heavy presence of reporters who cover health issues among the beneficiaries of industry largesse.
Dean Baker, “Replace patent monopolies with direct public funding for drug research,” Truthout/Beat the Press, Jul 1, 2019
Public-sector drug research with results posted in the public domain: another surprising idea given how we are used to leaving the development of medicines to for-profit companies.
Dr. Raymond Feierabend, “Mergers, COPAs, and healthcare, oh my!” Tarbell, Mar. 18, 2019
Monopolization of the hospital sector and its impact on the care system. If competition and the role of the private sector are so important for maintaining the quality of healthcare, why is this a good thing?
Tara Bannow, “Healthcare consolidation goes beyond usual players,” Modern Healthcare, Jun 10, 2019
Amazing data about concentration in all aspects of the healthcare business as all parties seek economies of scale. Logically, a single purchaser would have similar clout.
Shefali Luthra, “Delaney’s debate claim that ‘Medicare For All’ will shutter hospitals goes overboard,” Kaiser Health News, Jun 27, 2019
Sky will not fall although M4A would alter payment practices and outcomes. How, exactly, no one can safely predict. Capital spending is handled separately in the Jayapal bill, so the perceived need for those extra-high margins to cover expansion would not be relevant.
Salvador Rizzo, “Would Medicare-for-all mean hospitals for none?” Washington Post, Jul 3, 2019
Emphasizes the worst-case scenarios: “Some could close. Others might find themselves flush with new revenue. Some hospitals could take a financial hit, lay off staff, close a wing or two, but remain open. The government, meanwhile, could step in to control rates if needed.” The last sentence is key: nothing says that Medicare reimbursement rates would have to remain static. Also, one cited expert says: “[T]he prices hospitals currently receive from private insurers are excessive, and there is room to reduce those prices.”
Richard Eskow, “Medicare for All is coming, no matter what they say,” Moyers & Co./OurFuture.org, July 13, 2017
From 2017, still spot on. Love the concept of the “world-weary” oppositional style.
Jon Walker, “What can be learned from Democrat and Republican delusions on Obamacare,” Shadowproof, Nov. 13, 2018
This is from last year, but he makes good points on the politics of selling a healthcare plan to voters.
July 1, 2019
Osita Nwanevu, “The Democratic divide on the future of health care,” New Yorker, June 28, 2019
Outlines how Bernie has moved the debate on health care. Good summary of the confusion around the policy and the competing approaches. One question: if the Medicare buy-in (or “public option”) is such a great way to get to universal coverage, why wasn’t it included in the ACA a decade ago?
Jeff Stein & Yasmeen Abutaleb, “Democratic presidential candidates dive into complicated health policy with mixed results,” Washington Post, June 28, 2019
Argues that the debates tried to simplify something that is just too darn complex for people to understand. Debunks some of the dumber arguments, and illustrates how some candidates want to be seen as M4A backers and still hedge their bets (Booker, Gillibrand).
Ilana Novick, “Why are Democrats afraid to end private health insurance?” Truthdig, Jun 27, 2019
Waffling and bafflegab are getting harder for candidates.
Paul Waldman, “Do the 2020 Democrats really want to ‘abolish’ private insurance?” Washington Post, Jun 28, 2019
A sober account of the varying roles of private insurance in mostly single-payer countries.
Shefali Luthra, “Health care gets heated on Night 2 of the Democratic presidential debate,” Kaiser Health News, Jun27, 2019
Fact-checking various arguments.
Andy Slavitt, “Democrats can beat Trump on health care if they focus on high costs and economic security,” USA Today, Jun 26, 2019
A run-down of the political arguments for preserving for-profit health insurance: Obamacare is a success, Trump loses when he attacks it, don’t give him ammo with M4A. Note one curiosity: the main achievements Slavitt attributes to the ACA are due to Medicaid expansion, i.e., a single-payer program. [P.S. Slavitt is a “former health care industry executive” and senior advisor to the Bipartisan Policy Center. In 2018 Slavitt and two partners launched the venture capital firm Town Hall Ventures “to invest in healthcare technology and services companies that impact care delivery for vulnerable populations.”]
Sara R. Collins, Herman K. Bhupal, and Michelle M. Doty, “Health insurance coverage eight years after the ACA: Fewer uninsured Americans and shorter coverage gaps, but more underinsured,” The Commonwealth Fund, Feb. 7 2019
Obamacare eight years later: fewer uninsured completely, but more under-insured: “the greatest deterioration in the quality and comprehensiveness of coverage has occurred among people in employer plans.” Inadequately covered = 45% of ALL adults under 65(!) In the weeds: ACA benefits to middle-income citizens are not available to those in slightly higher brackets. Politically, this is deadly as people do not see everyone getting the same advantages, so government intervention looks unfair (and is).
Guy Boulton, “Health care costs for the typical family of four top $28,000 this year, despite slower increases,” Milwaukee Journal Sentinel, Jun 4, 2019
Average costs (out-of-pocket plus employer premiums and worker contributions) for a family of four: $28,000 a year and rising by $100 a month. People love this system so much they’ll demand to preserve it [snark].
June 25, 2019
Andrew Perez, “Obama alums tell health insurance lobby ‘Medicare for All’ won’t happen,” Tarbell/MapLight, Jun 22, 2019
Axelrod and several other Obama officials shilling at the insurer’s trade conference. Ka-ching! Their rhetoric is all about what is and is not “possible,” according to the Very Serious People (VSP), erasing the inconvenient detail that leaders who actually lead influence that.
Ilana Novick, “Skyrocketing drug prices have Americans taking desperate measures,” Truthdig, June 17, 2019
The current system that our VSPs think only needs a little tweaking.
Robin Feldman, “Why do Americans pay more for drugs?” MarketWatch, Apr. 25, 2019
Explanation of the perverse incentives in the pharmaceutical industry that keep prices high and all the players cashing in.
Tim Higginbotham, “Elizabeth Warren has a plan for everything — except health care,” Jacobin, June 11, 2019
We’ve been going easy on candidate stuff, but this one highlights an important anomaly about Warren the policy maven.
Alex Kacik, “Rising prices drive estimated 6% medical cost inflation in 2020,” Modern Healthcare, Jun 20, 2019
In a virtually zero-inflation environment, healthcare costs continue to spiral upward. “Deductibles for employer-sponsored plans have tripled between 2008 and 2018.” This is the coverage that American workers supposedly love.
Merrill Goozner, “The latest attack on Obamacare,” [editorial], Modern Healthcare, Jun 20, 2019
Making sure that the lower classes have crappy insurance that either can’t be used at all (due to high deductibles) or doesn’t work when you need it. Uninsured rate nationwide is up substantially (“an additional 7 million Americans without coverage despite the economy being at full employment”).
Harris Meyer, “More Arkansans uninsured, unemployed post-Medicaid work requirement,” Modern Healthcare, Jun 19, 2019
Medicaid work requirements are a failure at getting people into the workforce. But if their real purpose was to punish Medicaid enrollees and enable politicians to distinguish between the deserving and undeserving poor, they are a great success!
June 17, 2019
Lisa Schencker, “‘Medicare for All’? American Medical Association says no, drawing protest in Chicago,” Chicago Tribune, Jun 10, 2019
But the vote was quite close (53%-47%). And the AMA did not defend the current system: “We cannot continue to spend this quantity of money and create bankruptcies just because someone gets sick.”
Barbara G. Ellis, “Canvassing the 55 percent of rural voters wanting Medicare for All,” Truthout, Jun 11, 2019
Interesting suggestion: focus on the plight of rural populations facing hospital shutdowns and poor healthcare options. Also: “If House Speaker Nancy Pelosi or Sen. Chuck Schumer had been leading a Democratic Congress in the 1960s, . . . Medicare would never have become law.”
Merlin Chowkwanyun, “How red-baiting in medicine did lasting harm to Americans’ health care,” Washington Post, Jun 12, 2019
This is really fascinating: how McCarthyism purged the medical professions of progressive tendencies and critical voices.
Walter McClure, Alain C. Enthoven & Tim McDonald, “Universal Health Coverage? Why?” Health Affairs, July 25, 2017
A 2017 article by (mostly) pro-M4A health economists arguing that the current debate mislabels the options and sidesteps the issue of runaway costs in both public and private care. The problem, they argue, is “a malstructured health care system that greatly rewards excessive medical services but impedes and penalizes efficient care . . . [and] rewards those who run up costs regardless of quality.” Worth a read for the discussion of how to create incentives for efficiency.
Dena Bunis, “Florida governor signs prescription drug importation bill,” AARP, June 11, 2019
Despite foot-dragging, Colorado, Vermont, and Florida—the latter two headed by GOP governors—have agreed to permit imports and now await HHS approval.
Donald Shaw, “Richard Neal tells colleagues not to say ‘Medicare for All’ after taking checks from the health industry,” Sludge, Jun 12, 2019
Enter the Fudge Brigade, amply lubricated with industry cash.
Jennifer Henderson, “As N.Y. dispute-resolution bill advances, hospitals ramp up opposition,” Modern Healthcare, Jun 7, 2019
Slugfest between insurance companies and hospitals/unions breaks out in New York over who gets saddled with cost-containment.
Susannah Luthi, “Physician, hospital groups gear up for fight on surprise medical bills,” Modern Healthcare, Jun 11, 2019
Same fight at the federal level.
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.
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).
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!
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?
Alyssa Fisher, “TV producer shares tragic story of father’s death to shed light on mental health crisis,” Fast Forward, Jun 4, 2019
Click on the Twitter box to read the whole thread.
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.
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.
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.”
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.
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!
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.
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.
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.
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.
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.
Raymond Feierabend, “Why I worry about the health care merger craze,” Tarbell, May 30, 2019
Consolidation in rural areas and its impacts.
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.
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?
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.
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.
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.”
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.
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.
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.
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.”
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.
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.
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.
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.”
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.
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.”
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.
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!
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.
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.”
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!
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.
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.
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.
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.
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’.
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.
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.
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.”
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.
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?
Susannah Luthi, “House lawmakers throw down gauntlet for Medicare for All,” Modern Healthcare, Apr. 30, 2019
“Industry jitters” indeed.
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.
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.
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!
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.
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.
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.
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.
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.
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!
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?
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.”
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.
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.
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?
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.”
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?
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.”
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.”
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.”
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.
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.
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!
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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].
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.
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.
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?
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.
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.
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.
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.”
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.
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.
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.
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.
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.
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!
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.”
Ralph Nader, “25 ways Canadian health care system is better than Obamacare” Eurasia Review, Dec. 31, 2018
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?”
Julie Appleby, “Short-term health plans hold savings for consumers, profits for brokers and insurers,” Kaiser Health News, Dec. 21, 2018
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.
Bruce Japsen, “Medicare at 55 could gain momentum in 2019,” Forbes, Dec. 30, 2018
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.”