Single Payer News – 2017
Dec. 31, 2017
Aaron E. Carroll & Austin Frakt, “The Leap to Single-Payer: What Taiwan Can Teach,” New York Times, Dec 26, 2017
A short article relevant to our recent discussion about gradual v/s all-at-once systemtic change. “Taiwan is proof that a country can make a swift and huge change to its health care system, even in the modern day.”
Natalie Shure, “The feminist case for single payer,” Jacobin, Dec. 8, 2017
How single payer would free women from dependence on spouses and alleviate the burdens of home care now mostly performed by (unpaid) women.
Michael Gorbach, MD, “How opaque healthcare pricing mechanisms rip off consumers,” WolfStreet, Dec. 25, 2017,
Interesting insight into the irrational extra charges imposed by hospitals for outpatient services.
Ian Johnston, “Unhealthiest US counties made ‘dramatic’ switch from Obama to Trump in 2016, study finds,” The Independent, Oct. 2, 2017
Not providing people with the basic means to live and thrive actually has consequences. Dems forget that and paid the price (as did we all).
Dec. 7, 2017
Nathaniel Wexell, “Ryan pledges ‘entitlement reform’ in 2018,” The Hill/Healthcare, Dec. 6, 2017
Well, that didn’t take long: now that hundreds of billions are ready to be shoveled to the ultra-rich, GOP leaders are back to worrying about The Deficit. Note Orrin Hatch’s blaming of blaming of anyone daring to expect their Social Security payments.
James A. Morone, “How to think about ‘Medicare for All,’” New England Journal of Medicine, Dec. 7, 2017
A surprisingly upbeat assessment in one of the leading medical journals in the country. Monroe compares our campaign with the process that led to Medicare’s original creation. “Medicare for All is, first and foremost, an exercise in moral persuasion. It will become a serious policy proposal if it creates a major surge in public opinion.”
Steve Brozak, “3 takeaways from the CVS-Aetna merger,” Forbes, Dec. 4, 2017
A good summary of how the flow of health dollars is pulling these large corporate players in a variety of directions to survive the cutthroat competition.
Roy M. Poses, “One barely noticed settlement by Pfizer suggests the futility of polite protests about health policy,” Health Care Renewal, Dec. 4, 2017
“Pfizer provides an amazing example of a huge health care corporation that just marches along, settling or otherwise resolving case after case of over-charging, anti-competitive behavior, deception, sometimes fraud, bribery, and various other unethical and potentially illegal behaviors, without ever too greatly inconveniencing the managers and top executives who have been profiting from this behavior.” Note that the recent settlements result from private legal action, not government regulatory enforcement.
Nov. 25, 2017
Drew Altman, “The biggest health issue we aren’t debating,” Axios, Nov. 22, 2017
Simple chart showing how many U.S. families could not come up with the (relatively modest) deductible if they needed to use their supposed insurance.
Anna Chorniy, Janet Currie & Lyudmyla Sonchak , “The role of Medicaid managed care in the rise of common chronic childhood conditions,” VoxEU, Nov. 24, 2017
Describes the role of perverse incentives in distorting diagnosis and prescribing patterns.
Laurie Laybourn-Langton, “The movement to replace neoliberalism is on the ascendancy—where should it go next?” Open Democracy, Nov. 25, 2017
This interesting discussion, while not specific to health care, is germane in that the entire edifice of insurance-based access stems from the reigning neoliberal worship of market solutions. The author describes how the neoliberal camp prepared itself to take advantage of a crisis to shift the paradigm and impose its philosophy and proposes that the time is ripe to do the same.
Michelle Cortez, “Thirty million Americans just got high blood pressure,” Bloomberg Nov. 13, 2017
The research looks solid, but the temptation to increase prescriptions and ignore the lifestyle advice is likely to be enormous.
Kevin Menes, Judith Tintinalli & Logan Plaster, “How one Las Vegas ED saved hundres of lives after the worst mass shooting in U.S. history,” Emergency Physician Monthly, Nov. 3, 2017
How health professionals can pull off miracles when the focus is on providing care. Inspiring despite the grim background.
Nov. 15, 2017
Lambert Strether, “Alex Azar: Can there be uglier scenarios than the revolving door?” Naked Capitalism, Nov. 15, 2017
Good insight into how the new HHS chief can do real damage and why the Dems are unlikely to offer serious resistance.
Donald Moulds & Shawn Bishop, “Why tax reform could be a serious threat to health care,” To the Point, Nov. 8, 2017
Ways to undermine the ACA through changes in tax law.
Emily Mullin, “Why HPV vaccination rates remain low in rural states,” MIT Technology Review, Sept. 1, 2017
Use of the vaccine faces reluctance due to physician shyness, institutional inertia, parental (and physician) opposition to a vaccine related to sex, and (coming soon!) the anti-vaxer movement.
Todd Datz, “Millions of suburban residents in U.S. lack health insurance,” Harvard School of Public Health, Oct. 2, 2017
Rebuts the assumption that the suburbs are doing better than cities, especially if you factor in the long distances people often have to travel for basic or specialist care. This is a good example of the arbitrariness of the ACA in terms of who gets access. The story is based on an academic journal article (Health Affairs) that is paywalled, but the abstract is here.
Nov. 5, 2017
Patrick Radden Keefe, “The Family That Built an Empire of Pain,” The New Yorker, Oct. 30, 2017
The story of the philanthropists whose fortune came from the epidemic that kills 145 people in overdoses per day: “Most of the questionable practices that propelled the pharmaceutical industry into the scourge it is today can be attributed to Arthur Sackler.”
Katie O’Conner, “Professor aims to change opioid prescribing practices,” Richmond Times-Dispatch/AP, Aug. 28, 2017
One story of thousands, but it gets personal.
Don Quijones, “Global banks sabotage Uruguay’s efforts to legalize marijuana,” Wolf Street, Sept. 3, 2017
Compare the opioid crisis (driven by legal drugs), the heroin/meth/cocaine traffic (illegal) and the marijuana business (semi-legal). As the article points out, the banks putting the squeeze on Uruguay are the same ones that have been caught red-handed laundering billions for the major heroin and meth narcos. They are probably responding to pressure from the anti-pot fanatics now in charge in Washington.
Carolyn Thompson, “New opioid court uses rigorous intervention methods to address epidemic,” Associated Press, July 10, 2017
A reassuringly humane approach to drug-related misdemeanors. Interesting how common this type of account has become now that drug use is affecting mainstream populations—note the references to “legitimate” entry into drug use via prescriptions, “minor offense,” “not a career criminal,” etc.
Oct. 22, 2017
Adam H. Johnson (FAIR), “There are 3 types of single-payer ‘concern trolls’ — and they all want to undermine universal healthcare,” Los Angeles Times (op-ed), Sept. 21, 2017
He defines “concern trolls” as those “who disingenuously expresses concern about an issue with the intention of undermining or derailing genuine discussion.”
Bill Quinliven, “North Country looks at single payer,” Adirondack Almanac, Oct. 7, 2017
Excellent account of how the message on New York Health was brought in concrete detail to an upstate community.
Ruth Ford, “Understanding New York’s public hospitals crisis,” City Limits, Oct. 18, 2017
H&H gets squeezed by the private hospitals, stiffed by Albany (Cuomo) and has to take on the bulk of charity care. What could go wrong?
Roy M. Poses, “Worst health care revolving door case so far, version 2.0? From president of Lilly USA to US Secretary of Health and Human Services?” Health Care Renewal, Oct. 19, 2017
Fox guarding henhouse is now routine.
Oct. 13, 2017
Gazette Editorial, “Is it time for health care for all yet?” Charleston Gazette-Mail, Sept. 17, 2017
Answer: Yes. And quotes Bernie approvingly with the word “Bravo.” (This in a state carried by Trump 69-27.) “We hope the project draws huge public support and becomes unstoppable.” Carry this datum in your head when nervous Democrats argue that only safe, “centrist” policies will make their candidates competitive.
Lauren Weber & Andy Miller, “A hospital crisis is killing rural communities. This state is ‘Ground Zero.’” Georgia Health News/Huffington Post, Sept. 27, 2017
Another aspect of the dysfunctional U.S. health system: market-based health care is leaving underpopulated areas in the lurch.
Alex Koma, “House candidates back single-payer healthcare plan in Virginia,” Inside NOVA, Oct. 2, 2017
Pols in another state are taking up single-payer efforts despite the obstacles. While it seems unlikely to occur any time soon, the announcement provides airtime for statements like these: “Within the political class, this may be something new, but people are ready for it.”
Ryan Blethen, “Washington state’s health-exchange rates to jump 24 percent,” Seattle Times, Sept. 29, 2017
This entirely typical announcement came before the latest Trump order, i.e., the ObamaCare “death spiral” was already happening.
Ziad Jilani, “On heels of progressive wave, Rhode Island expands sick leave to 100,000 workers,” The Intercept, Sept. 21, 2017
A little-noticed victory by a slew of candidates from the Working Families Party narrowly defeating incumbent conservative Democrats. The shock apparently jolted a few others into supporting a progressive reform.
Lukas Mikelionis, “Democrat Duckworth not sold on Bernie Sanders’ Medicare for All plan,” Fox News, Sept. 22, 2017
By contrast, here come the tinkerers seeking the ever-illusive compromise with GOP crazies. “I just don’t think we are in a time right now where we should be taking these very strong stands,” says Duckworth. Of course, when Obama swept into power with huge majorities in Congress and a national mandate for radical change, that wasn’t a time for “taking strong stands” either, was it?
Zaid Jilani, “Single payer opponents say the transition process would be too difficult. But 10,000 people do it every day,” The Intercept, Oct. 9, 2017
A good point of discussion: should we go straight into universal coverage or adopt the gradual expansion of Medicare as outlined in Sanders’ bill?
Krim Krisberg, “Gun control laws can impact death rates. But we need more research to find what works,” The Pump Handle, Oct. 5, 2017
[Not single payer, but hard to ignore.] Although the GOP has blocked much research into gun safety in the U.S., there is a lot of data from other countries about what works.
Robert Centor, “It’s time to ban productivity from medicine,” Kevin MD, Sept. 25, 2017
Another aspect of commercialized medicine and how applying the Dismal Science (economics) doesn’t cut it.
Timothy Jost, “Administration’s ending of cost-sharing reduction payments likely to roil individual markets,” HealthAffairs blog, Oct. 13, 2017
A quick summary of the latest executive action to undermine ObamaCare and likely next steps.
Oct. 9, 2017
Corey Fawcett, “The difference between doctors and roofers? Not much,” Kevin MD, Oct. 6, 2017
How debt burdens, corporate models for hospitals, and doctor shortages create distortions and increase costs.
Lambert Strether, “Trump Adminstration doubles down on efforts to crapify the entire health care system (unless you’re rich, of course),” Naked Capitalism, Oct. 8, 2017
Run-down on the three strategies coming from the Trump White House to wreck the ACA and undermine Medicaid from the guy who predicted the Obamacare launch debacle.
Hooman Norchashm, “Evidence-based medicine”: Corporate medicine’s corrupted instrument,” Medium, Oct. 6, 2017
This article could have benefited from a couple of illustrative examples, but the basic idea is there: medicine should not be based only on probabilities without attention to individual risk/benefit considerations. Also, it does not highlight the perverse incentives to doctors to do more tests and offer more treatments.
Aditya Kalra, “U.S. pressing India to avoid capping medical device prices, allow withdrawals,” Reuters, Oct. 4, 2017
A good example of how “free-trade” turns into muscling foreign countries for profit over wellbeing. But the article doesn’t address why India needs U.S. medical devices—can’t they produce their own?
Katie Keith & Timothy Jost, “Unpacking the Sanders Medicare-for-All bill,” Health Affairs, Sept. 14, 2017
Details you need!
Oct. 6, 2017
Roy M. Poses, “Latest legal settlements suggest hazards of making pharmaceutical regulation more lenient, as is apparently favored by new FDA leader,” Health Care Renewal, Oct. 1, 2017
Reviews the latest regulatory charges against pharmaceutical companies, then summarizes the importance of breaking through the network of corrupt players as part of the fight to reform healthcare.
Julie Beck, “The ‘Unfortunate Family’ of American shooting survivors,” The Atlantic, Oct. 1, 2017
What else can people do?
Ted Alcorn, “Puerto Rico’s health system after Hurricane Maria,” The Lancet, Oct. 7, 2017
The natural disaster and those policy-induced. Expect both to worsen.
Jessie Hellman, “ACLU files lawsuit against Trump administration over roll back of birth control mandate,” The Hill, Oct. 6, 2017
Legal challenges forthcoming against Trump move to permit companies to deny contraception in health coverage.
Sept. 30, 2017
Theo Anderson, “The fight for single payer has transformed the healthcare debate. Last night was proof,” In These Times, Sept. 26, 2017
Argues that the framing by Sanders has reset the terms of the debate from the Reaganesque “freedom” from regulation and government generally to inequality and corporate power.
Sarah Jaffe, “Socialized medicine has won the health care debate,” The New Republic, Sept. 28, 2017
People don’t object to Medicare nearly as much as the inequities face by those who don’t get it and are slammed with Obamacare premiums and deductibles.
Ryan Grim, “Lindsey Graham on Obamacare repeal: I had no idea what I was doing,” The Intercept, Sept. 27, 2017
As was displayed in the televised debate with Sanders, who wiped the floor with him. At least he admits it.
Erin Mershon, “HHS hints at major changes to Medicare that could mean higher costs for patients,” STAT, Sept. 23, 2017
Another front appearing in the ongoing war to preserve/destroy the core elements of Medicare as a platform for single-payer. Not clear what impact Price’s departure will have on this, but probably not much. Note at the end how hospitals are open to this kind of tinkering, which says something about where they are in the overall battle.
Sept. 26, 2017
Atul Gawande, “Is health care a right?” The New Yorker, Oct. 3, 2017
Tackles the debate and especially the conservative opposition to universal coverage from the perspectives of a series of friends from his home town, Athens, Ohio. Very nuanced and has good insight into how the oppo will try to frame it. Incidentally, I notice that Bernie talks about single-payer’s benefits for “working” people, presumably to deflect the welfare-for-lazy-people meme.
David Sirota & Lydia O’Neal, “Democratic governor hires health care industry lobbyist to push Obamacare fixes in Congress,” International Business Times, Sept. 19, 2017
Follow the money. Just a reminder that once the Graham-Cassidy nightmare is over, the real work will begin.
John Nichols, “‘Single Payer Is a Rational Health-Care System’: An Exclusive Interview With Bernie Sanders on His ‘Medicare for All’ Plan,” The Nation, Sept. 13, 2017
In case you missed it.
Elisabeth Rosenthal, “How an industry shifted from protecting patients to seeking profits,” Stanford Medicine, Spring 2017,
A recap of the history of how we got here with some lesser-known details.
Steven Rosenfeld, “Why California is Bernie Sanders’ and progressives’ big battleground for universal health care,” Alternet, Sept. 22, 2017
Interesting for the comments recognizing that the current system is wrecking the California economy and has to change.
Sept. 24, 2017
Adam Johnson, “Outlets that scolded Sanders over deficits uniformly silent on $700b Pentagon handout,” Fairness and Accuracy in Reporting, Sept. 21, 2017
An excellent point to use when the Very Serious People screw up their faces and say, But how are you going to PAY for it? This misunderstanding of the federal budget (assuming that taxes pay for spending) is only trotted out when discussing social benefits, NEVER when the armaments producers show up with their wish list.
Monica Potts, “The single-payer problem liberals don’t want to talk about,” Vice, Sept. 18, 2017
Very Serious People demanding that people engaged in the socially useless, hyper-complicated billing and collecting business must be protected while industrial workers whose communities were destroyed by globalized “free” trade must take their lumps. Similar to the argument in favor of building white elephant armaments as a good way to provide jobs.
Matt Bruening, “Single payer myths: Redundant health administration workers,” People’s Policy Project, Sept. 19, 2017
Answer to the above, Part one of what promises to be a very useful series: “Given the fact that office and administrative skills are fairly portable to other sectors (non-health care establishments employ over 19 million people in such jobs), it is not at all clear that there needs to be any special program for reallocating those made redundant by this change. But even if there does not need to be such a program, single payer proposals generally contain one”.
Unsigned, “WHO warns the world is running out of antibiotics,” MarketWatch, Sept. 21, 201
Another danger of leaving drug development in the hands of for-profit pharmaceutical companies. For example, there is now only one remaining class of antibiotics that can cure drug-resistant gonorrhea, a disease that affects 350 million people per year.
Sept. 18, 2017
David Sirota & Lydia O’Neal, “As Sanders prepared Medicare bill, health care lobbyists bankrolled Senate Democrats,” International Business Times, Sept. 11, 2017
What if we were to preface answers to criticisms of the Sanders bill by saying, “Yes, that’s what the people getting insurance/pharma money are saying. On the other hand, people not on their payroll say . . .” Would that be rude?
Matt Taibbi, “Single-payer movement shows life after Trump may not suck,” Rolling Stone, Sept. 14, 2017
Funny how people who got engaged in campaigns like Improved Medicare for All after Nov. 2016 tended not to get depressed.
Enquirer and Media Network of Central Ohio staff (60 reporters), “Seven days of heroin: This is what an epidemic looks like,” Cincinnati Enquirer, Sept. 10, 201
Graphic (jaw-dropping, really) account of what cops, first responders, social workers, judges, and concerned citizens are dealing with on a daily basis. Not directly a single-payer issue, but there is a larger point about the chaos affecting the people left behind by the purveyors of the religion of “free trade.” (See Salena Zito, “The day that destroyed the working class and sowed the seeds of Trump,” New York Post, Sept. 16, 2017, on the crushing of Youngstown—that occurred under Jimmy Carter.
Sept. 14, 2017
Miles Kampf-Lassin, “Medicare for all is now mainstream: Democrats who oppose it will be left behind,” The Nation, Sept. 13, 2017
A good summary of the amazing political shift.
Abigail Tracy, “Hillary Clinton just lost her central argument with Bernie Sanders,” Vanity Fair, Sept. 13, 2017
No need to rehash the tiresome Hillary/not Hillary arguments, but interesting that the comfortably mainstream VF describes the new scenario in these terms.
Dean Baker, “Drug company seeks to hide behind Native American tribe to protect patent monopoly,” Beat the Press, Sept. 12, 2017
“If you thought the pharmaceutical industry couldn’t possibly sink any lower in its pursuit of profits, Allergan just proved you wrong.”
Trudy Lieberman, “Who is behind FDA-weakening bill based on false premise that it restricts access to experimental drugs for the terminally ill?” Naked Capitalism, Sept. 14, 2017
A stealth proposal from creepy Ron Johnson of Wisconsin, who wants to bring us back to the wonderful days of thalidomide and radium-based elixirs. Can’t wait!
Special: Arguments against Medicare for All – attacks that will be mounted on single payer.
Sept. 8, 2017
Dylan Matthews, “The stunning Democratic shift on single-payer,” Vox, Sept. 8, 201
Headline says it all: any serious candidate for 2020 will have to at least pretend to support it.
Scot M. Silverstein, “The shame of U.S. healthcare dysfunction: Hookworm returns to Alabama,” Health Care Renewal, Sept. 7, 2017
Another New Deal achievement dismantled. Note the brilliantly punitive approach from Alabama’s wise leaders: hit poor households with huge fines for not putting in plumbing they can’t afford. So no one complains or holds health departments responsible.
Erin Mershon, “With Tom Price in charge, doctors are winning again in Washington,” STAT, Aug. 1, 2017
Had meant to include this a while ago about Price’s favoring doctors over hospitals in the ongoing slugfest about who gets the best slice of healthcare reimbursements. “All of the specialty societies and provider groups come in with long wish lists, and anything that has ever bothered them about Medicare is on the table, no matter how unrealistic.”
Betsy McCaughy, “Obamacare is making the middle class the new uninsured,” New York Post, Sept. 6 201
Yes, the Post in all its tendentious glory, but the argument is pretty close to ours on the ACA’s failings.
Sept. 6, 2017
David Montgomery, “Health insurers ask to raise Minnesota premiums by average of above 50 percent,” Twin Cities/Pioneer Press, Sept. 1, 2017
Why repeal Obamacare when the insurance market will do it for you? Price hikes of this calibre are not sustainable.
Ricardo Alonso-Zaldivar, “Frustration Mounts Over Health Care Premiums,” Truthdig, Sept. 3, 2017
“Some are expecting premiums for 2018 to rival a mortgage payment.” The unlucky categories of citizens who are not rich enough, not poor enough, self-employed, employed by small businesses, or otherwise slipping through the structural cracks of Obamacare face premium hikes of 25% on average.
Carol Paris, “Medicare for all is the only health care proposal that meets Trump’s standards,” USA Today, Sept. 2, 2017
A must-read from our PNHP president! Key section: “The fatal flaw in [incremental-fix] plans is their reliance on the profit-driven insurance industry to finance care. ‘Fixing’ the ACA means dumping more cash into the pockets of private insurers. The public option would do little for those squeezed by the skyrocketing costs of employer plans, and has no power to eliminate the waste inherent in a fractured, multi-payer system.”
Dan Polsky and Laura Yasaitis, “Why some insurance plans limit specialized treatments,” Knowledge @ Wharton, Jul 25, 2017
Breathtaking example of the logic of treating citizens as “consumers” of health insurance from the Wharton School of Business. “I think we just have to acknowledge that health care is delivered in this quasi-free market. This is a business.”
Sept. 3, 2017
Eric Levitz, “The left has made Medicare-for-All a mainstream, Democratic policy,” New York, Aug. 31, 201
Mostly interesting for the headline and first grafs, then plummets into why things will/should go back to “normal” for 2020. Despite recognizing that Hillary’s “never, ever” position on single-payer is discredited, the author refuses to entertain the notion that it could actually appeal to “conservative” or GOP/Trump voters as well as “the left.”
Kelsey Thompson, “Why ‘Medicare for all’ is the best health care plan for Syracuse women,” Daily Orange, Aug. 28, 201
The very savvy (and ambitious) Gillibrand is fully on board with single-payer, which is an excellent illustration of the shift described by Levitz above. Bernie’s 2016 campaign continues to rewrite the rules by pushing the Overton Window (“the range of ideas the public will accept”) back toward New Deal-type principles.
Bob Bryan, “Trump just took a big step in undermining Obamacare,” Business Insider, Aug. 31, 201
Cuts to the promotion budget.
Carla K. Johnson & Ricardo Alonso-Zaldivar, “Has Medicaid’s expansion fueled the opiod epidemic? New GOP theory is challenged,” Associated Press, Aug. 31, 2017 (AP
Truly pathetic and sophomoric statistical manipulation, a.k.a. tendentious bullshit. Correlation is not causation—just because two things occur together doesn’t mean one causes the other. Next up: smoking cessation causes pregnancy (women who quit smoking are pregnant more often than women who do, QED).
Scot M. Silverstein, “Information technology-naïve defense lawyers vs. ‘strident critic of electronic health records,’” Health Care Renewal, Aug. 31, 201
Interesting for the specific failings of EMR but also for the ways corporate medicine deals with criticism.
Aug. 30, 2017
Jacob Puliyel, “With pneumococcal vaccine patent, Pfizer wins on many counts,” The Wire, Aug. 25, 2017
This one is so perverse it’s hard to believe even from Pharma: the vaccine barely works, cost a fortune, and carries the risk of asthma as a common side-effect. Yet the government of India is determined to buy it. Furthermore, Pfizer got a gigantic subsidy despite not inventing the thing.
Esmé E. Deprez & Caroline Chen, “Medical journals have a fake news problem,” Bloomberg BusinessWeek, Aug. 29, 2017
Anyone in academe these days gets dozens of requests a week from these Indian journals, inviting you to submit to their “open-access” publications for a small fee. They all sound pretty much alike, just as the emails proposing windfalls from Nigerian oil princes. That said, academic publishing is an outrageous hustle in which publishers get free labor from publicly-funded researchers, then turn around and sell the results to libraries at scandalous prices.
Marisa Taylor, “Offshore human testing of herpes vaccine stokes debate over U.S. safety rules,” Kaiser Health News, Aug. 28, 2017
Peter Thiel leads the way on offshoring clinical drug trials to escape IRB review. This will not end well.
Harris Meyer, “Iowa’s ACA waiver plan would redistribute subsidies from the poor to wealthier people,” Modern Health Care, Aug. 23, 2017
An apt illustration of the no-win situation created by Obamacare instead of putting everyone into the same risk pool.
Aug. 21, 2017 [links now fixed]
Howie Klein, “DCCC & Kings Landing Consultants are instructing candidates how to deceive Democratic primary voters on healthcare,” Down with Tyranny, Aug. 19, 2017
Not to be an I-told-you-so, but . . . a political consultant finds that the mainstream Dems are actively coaching their centrist candidates to lie to voters about their stance since real single-payer is overwhelmingly popular. The tell is bad-faith promotion of a “public option”, which will preserve insurance company profits. Recall that the public option was trotted out in 2009 to deflect discussion of single-payer, then jettisoned in favor of Obamacare’s expanded insurance model.
Roqayah Chamseddine, “The neoliberal record of Kamala Harris: Reckon with it instead of attacking critics,” Shadowproof, Aug. 15, 2017
Those who push single-payer as a criterion of support for Dem candidates will be accused of demanding “ideological purity.”
Alex Kotch & David Sirota, “Who is lobbying Mike Pence and why? Health insurers and big oil seek to influence Vice President,” International Business Times, Aug. 17, 2017
Blue Cross, Pharma, banks and oil companies.
Kenneth Thorpe & colleagues, “The United States can reduce socioeconomic disparities by focusing on chronic diseases,” Health Affairs, Aug. 17, 2017
This is from an academic journal with a large trove of material on health inequities. Without the central reform of single-payer, some will argue that these proposals are mostly tinkering around the edges. [Table of contents here.] The main thesis is the unsurprising assertion that poor people have poorer health outcomes, which are exacerbated by poor access to medical services. So if you address one side of the cycle, you affect the whole thing.
Aug. 16, 2017
Joanne Finnegan, “In major reversal, survey finds 56% of physicians now support single-payer healthcare system,” FierceHealthcare, Aug. 14, 2017
Another sign of a major ideological shift with respect to healthcare access. “The results indicate a near reversal of a national survey the company conducted in 2008.”
Brian Sonenstein, “Interview with Jon Walker: Why MICA is a good plan to transition U.S. to single-payer health care,” Shadowproof, Aug. 9, 2017
We have linked to this author’s proposals before. He proposes a universal mandate but without requiring people to drop employer-sponsored insurance. Worth some close attention and perhaps further study.
Michael Tomasky, “Single payer or bust?” New York Times, Aug. 14, 2017
Starts out with the “fateful moment” of 2018 primary challenges against Democrats who oppose single-payer, the famous “litmus test.” Tomsky mourns the lack of enthusiasm for bipartisan tinkering with the current system (“improving but still inefficient”) that he prefers. Then, bizarrely, he worries that pushing Dem candidates to more progressive stances will be a losing proposition in elections (in contrast to the wonderful success they’ve had as Republicans-lite). To his credit, he clarifies that the principle is universal coverage, not the precise mechanisms.
Dean Baker, “Why is it so hard for intellectuals to envision alternative forms of globalization?” Beat the Press, Aug. 13, 2017
A key element of the huge pharmaceutical rip-off we are subjected to is the protectionist, anti-free trade measures constantly written into “free trade” treaties such as TPP and backed by both major parties. Baker has been on the warpath over this for years, but he gets no airing in the mainstream.
Kyle Steward, “McClaskey gets primary challenger,” Roll Call, Aug. 16 2017
Principal focus of challenger’s campaign: single-payer.
Aug. 8, 2017
Clio Chang, “Where are the single-payer wonks?” The New Republic, Aug. 3, 2017
Re the war of ideas: Chang argues that all the think-tank weight is on the side of single-payer opponents like Heritage or the Koch network or the liberals like Krugman or Vox’s Ezra Klein (who calls it “puppies-and-rainbows”). Adam Gaffney of the PNHP board says that “detailed policy work” is lacking, and while there are plenty of academic experts, they don’t have the same presence in media debates and in formulating “late-in-the-pipeline policy development.” Worthy of debate!
Jeff Stein, “It’s time to see if Democrats are serious about single-payer,” Vox, July 24, 2017
Instead of “never, ever” (Hillary), the Dem mainstream now says that single-payer is “ultimately” what we should have. But is this sloganeering or real? The immediate argument will be that with Dems in the minority, now is “not the time” to push for it—forgetting that when they had a huge majority in 2009, that wasn’t “the time” either.
Chase Madar, “The conservative case for universal healthcare,” The American Conservative, July 25, 2017
“Within five years, the American Right will happily embrace socialized medicine. The real obstacle may be the Democrats . . . thousands of everyday Americans [are] shouting at their congressional reps at town hall meetings clamoring for single-payer against the party’s donor base of horrified Big Pharma executives and affluent doctors.”
Wolf Richter, “What the hell is going on with generic drugs and plunging pharma shares?” WolfStreet, Aug. 5, 2017
Could this be good news? Antitrust efforts could pressure pharma price-gouging. (And Shrekeli is a convicted felon.)
Eugene Kim & Christina Farr, “Amazon has a secret skunkworks lab called 1492, dedicated to health care tech,” CNBC, July 27, 2017
Amazon (and Apple) are looking into how to monetize healthcare through mining medical records, among other things. What could go wrong?
Steven Rosenfeld, “The Essentials: 11 steps states could take to rein in healthcare costs while building toward single-payer universal coverage,” Alternet, Aug. 4, 2017
List created by Gerald Friedman, a strong single-payer advocate. Which of these actions are most likely to (1) weaken the sector’s vested interests and (2) be enacted?
David Atkins, “Bernie, Kamala, and the left’s war of mutually assured destruction,” Washington Monthly, Aug. 5, 2017
Amazing analysis that concludes that the mainstream, corporate Dems are the innocent party and the “social media warriors of the left” will lead to future losses. Here are the memes to come: we need “solidarity” among all right-thinking forces against Trump, rather than “pointless division.” Great way to divert attention from the failures while refusing to recognize or acknowledge the vast losses brought on by being Republicans-lite. The incoherence of the argument is impressive, but expect to hear it repeated often.
Rachel Roubein & Nathaniel Weixel, “States scramble to prevent Obamacare exodus,” The Hill, June 4, 2017
Insurance companies panicked over potential loss of $7 billion subsidy from Obamacare as Trump makes noises about undermining the payments. Illustrates the pitfalls of relying on for-profit insurance to sustain the healthcare “market.”
Helen Ouyang, “Where health care won’t go: A tuberculosis crisis in the Black Belt,” Harper’s, June 2017
This is a real eye-opener about what could be called the Jim Crow health system of Alabama.
Michael Corcoran, “The battles ahead: Meet the biggest opponents of single-payer,” TruthOut, July 5, 2015
Old but essential background with dollar amounts.
Kathleen O’Grady & Noralou Roos, “Five things Canadians get wrong about the health system,” Globe & Mail, Sept., 5, 2014
Even older, but good to know: Canada’s system is modified single-payer, not socialized medicine; there are 15 separate (provincial) systems; there are disparities in services from province to province; drugs are not covered so most Canadians have insurance for that (more multiple- than single-payer); user fees are (sort of) prohibited.
Aug. 7, 2017
Five stories from five states and a reminder that big data is not your friend.
Greg Hinz, “Pritzker, Pawar unveil health insurance plans,” Crain’s Chicago Business, Aug. 1, 2017
Healthcare is a major campaign issue in the race for governor of Illinois. The major Dem candidates are split between a single-payer advocate and a “public option” proponent. Note the comments about not “getting into a fight” over it—this will be the line from corporate Democrats, that we’re all (secretly) in favor of single-payer but have to stay united behind the less attractive option as the “more realistic”, the possible v/s the ideal, etc. Refusing to do so will elicit charges of “whiny leftists.” These are the folks who refused to give single-payer a hearing when the Dems controlled both houses of Congress and the presidency.
David Sirota & Josh Keefe, “Will Colorado’s health insurance industry run one of its own for governor?” International Business Times, Aug. 4, 2017
Why rely on support from the insurance industry when you can run a candidate who is the insurance industry? “Just as [Lt. Gov. Donna] Lynne was being confirmed for her state government job, her company successfully lobbied against a Democratic measure in Colorado that would have strengthened requirements for health insurers to cover annual breast cancer screenings.”
Stephanie Innis, “Health debate energizing Tucson ‘Medicare for All’ proponents,” Arizona Daily Star, July 15/Aug. 5 update, 2017
Marvelous clarity from average citizens—too bad the pundit class can’t think this well. “Many like me who supported the ACA’s modest reforms now realize that keeping for-profit insurers involved still leaves too many Americans uninsured or underinsured and prevents us from controlling our skyrocketing health-care costs,” Witte said.
Jay Cassano & David Sirota, “New York subsidy to lure Aetna benefits a Cuomo donor,” International Business Times, July 26, 2017
Dizzying revolving door of money flowing to companies-landlords-political campaigns. Much more elegant than passing briefcases full of cash Brazilian-style.
Kevin Diaz, “After failed Obamacare repeal, Democrats press for Texas Medicaid expansion,” Houston Chronicle, Aug. 4, 2017
Gradualism that makes sense: many states are still resisting the 2009 Medicaid expansion.
Cathy O’Neil, “Big data is coming to take your health insurance,” Bloomberg, Aug. 4, 2017
The data mining we are all subject to will empower insurance companies because they can predict with increasing accuracy who is going to get sick & when (& how much it will cost). Now that the healthcare debate has clarified risk pooling for more people, it becomes clear that only universal coverage mandated by government can work in the long run. Otherwise, “insurers will simply use the data to make money and deny care.”
“All kinds of incidentally collected data—shopping history, public records, demographic data—can be repurposed for assessing people’s health.”
Aug. 4, 2017
Heather Caygle & Paul Demko, “Centrist lawmakers plot bipartisan health care stabilization bill,” Politico, July 30, 2017
Reasons to be nervous about this: “centrists,” “Problem Solvers,” “Obamacare fixes,” “GOP moderates,” “bipartisan proposal,” “stabilizing the insurance market.”
Now that the GOP plan is on the ropes, count on the Blue Dog Dems to save the day for them by engineering some band-aid tinkering with the weakest parts of the ACA instead of pushing for more radical solutions. First up: they want to exempt small (<50 employees) businesses from ACA requirements instead of looking for ways to alleviate the pain entirely. One possible positive: greater “flexibility” for states—but will this include single-payer options?
Soumya Karlamangla, “Covered California premiums will rise 12.5% and Anthem Blue Cross cuts coverage,” Los Angeles Times, Aug. 1, 2017
Trump’s threats to the subsidies may be having the desired effect of gradually killing off the ACA exchanges. Another reason not to agree to tinkering.
Rachel Roubein, “GOP chairman opens door to Democrats on Obamacare,” The Hill, Aug. 1, 2017
Sen. Alexander (R-TN): “We need to put out the fire in these collapsing markets wherever these markets are.” How about getting rid of them? Or proposing to do so eventually?
Joshua Holland, “Medicare for All isn’t the solution for universal health care,” The Nation, Aug. 2, 2017
The author reviews the varieties of universal coverage in the developed world and argues for gradualist approaches: “The most important takeaway from recent efforts to reshape our health-care system is that ‘loss aversion’ is probably the central force in health-care politics. That’s the well-established tendency of people to value something they have far more than they might value whatever they might gain if they give it up. This is one big reason that Democrats were shellacked after passing the Affordable Care Act (ACA) in 2010, and Republicans are now learning the hard way that this fear of loss cuts both ways.”
Aug. 2, 2017
Rachana Pradhan, “Medicaid shows its political clout,” Politico, July 19, 2017
Collapse of the attack on the ACA may have the unanticipated result of protecting Medicaid from cuts by the anti-tax zealots. It also opens the door for Medicaid expansion as a gradual way in to single-payer (though the article doesn’t say this).
Chad Terhune & Julie Appleby, “Obamacare exchanges in limbo,” Kaiser Health News, July 19, 2017
Now that the Trump/GOP destruction of the ACA is over for the time being, attention is turning to “bipartisan” efforts to shore up the Obamacare exchanges and, indirectly, insurance companies. “In Pennsylvania, premiums next year without the subsidies would increase by an average of 20 percent, compared with 9 percent if they remained intact.” So a 9% premium increase is the good news?! Question: what will Dems give away as part of the bipartisan compromise? Medicaid caps?
Susan Jaffe, “Dismantling the ACA without help from Congress,” The Lancet, July 29, 2017
Trump’s next move to crash the ACA.
Adam Gaffney, “The case against the public option,” Jacobin, July 19, 2017
Now that momentum is building for single-payer, expect to hear much more about the counter-productive “public option,” the Dems’ fall-back strategy to protect insurance companies.
Aug. 1, 2017
Arthur Allen, “Clunky’ switch to e-health records,” Politico, June 15, 2017
Electronic medical records were supposed to be a great innovation in healthcare delivery. But their use as a billing tool is undermining their utility and harming patient care.
Robert Laszewski, “The post-Republican Obamacare market will be ‘stable’ and very profitable for health insurers,” Health Care Policy and Marketplace Review, July 18, 2017
Obamacare as really great/really awful: “If the stability and success of Obamacare is measured by insurance company profitability, things are improving. But if stability and success is measured by how the Obamacare insurance exchanges are impacting the people who have no other place to go for their health insurance, this program remains a disaster for at least the 40% of the market that are not eligible for subsidies.” The reason is that the system does not attract enough healthy enrollees to be solvent, thus relies on huge premium and deductible boosts.
Dayton Misfeldt and James C. Robinson, “Orphan diseases or population health? Policy choices drive venture capital investment,” Health Affairs, July 21, 2017
“The surge in orphan drugs is a result of public policies that influence development costs and market exclusivity, which in turn influence the prices that can be charged.” Firms research drugs with “high revenue potential.”
David Dayan, “The coalition pushing for single payer in California is fracturing,” The Intercept, July 12, 2017
Dayan has been harsh on some in the single-payer campaign in California.
RoseAnn DeMoro, “Nurses Won’t Back Down in Fight for Single-Payer in California,” TruthDig, July 14, 2017
July 26, 2017
Jon Walker, “Here’s a national single-payer health care plan that would work,” Shadowproof, July 24, 2017
Very interesting proposal to transition the United States to a single-payer health care system through a transitional phase building on employer-sponsored insurance. He calls their plan MICA (Medical Insurance and Care for All) and says, “The Affordable Care Act (ACA) was designed as a large transfer of wealth from the rich and a segment of healthy middle class individuals to the poor, the sick, and importantly, the health care industry. MICA is primarily a transfer of wealth from the health care industry to everyone else.”
Discuss! [Full legislative summary is here.]
Dan Diamond, “How hospitals got richer off Obamacare,” Politico, July 17, 2017
Good follow-up to the proposal above: non-profit hospitals rake it in as tax-exempt entities, grow their revenue thanks to Obamacare, but give back little locally despite legal obligations to benefit the communities in exchange for not paying property taxes. (NY Presbyterian is right up there.)
Roy M. Poses, “Who benefits from our current health care dysfunction? Mallinckrodt’s leadership maintains impunity after well publicized opioid settlement,” Health Care Renewal, July 20, 2017
This one really sums up everything. While Sessions pushes to re-maximize punishment for street drug possession and sales, his DoJ lets off corporate drug lords with wrist-slaps. Despite the 180,000 deaths from overdoses of prescription painkillers in the years 2000-2015, prosecution settlements let the companies involved deny wrongdoing, and of course no execs ever get prison time.
July 24, 2017
Robin Rudowitz, Larisa Antonisse and MaryBeth Musumeci, “Medicaid changes in Better Care Reconciliation Act (BRCA) go beyond ACA repeat and replace,” Kaiser Family Foundation, July 21, 2017
Good round-up with graphics on what the GOP has been pushing and where they seek to undermine Medicaid by fiddling with the finance structure. Key sentence: Both the BCRA and the AHCA go beyond repeal and replacement of the Affordable Care Act (ACA) to make fundamental changes to Medicaid by setting a limit on federal funding through a per capita cap or block grant. Good detail if and when “negotiations” (Schumer) ever start. For example, will Dems agree to discuss caps or draw the line? Will they agree to work requirements as in Clinton’s welfare rewrite?
Roy M. Poses, “Gutting the Health Care Corporate Strike Force,” Health Care Renewal, July 13, 2017
Cut from five fulltime lawyers to two part-timers. Tiny attempt to rein in healthcare costs by combating fraud thus undermined. And isn’t the GOP the party of cutting “government fraud, waste and abuse”?
Marshall Allen, “The myth of drug expiration dates,” ProPublica, July 18, 2017
Those “use-by” dates on most pharmaceuticals are meaningless but mean millions in medications are trashed.
Richard Sorian, “Is Medicaid the new ‘Third Rail?’ History suggests it has been for some time,” Health Affairs, July 20, 2017
An historical parallel: Reagan tried to turn Medicaid into block grants, which would have opened the door to slowly strangling it. But state governors and key Democrats stymied it. McConnell/Ryan’s Medicaid cap is trying to do it again.
Julie Rovner, “Millions more uninsured could impact health of those with insurance, too,” Kaiser Health News, July 14, 2017
Throwing millions off their health insurance will devastate whole communities.
July 18, 2017
David Dayan, “The coalition pushing for single payer in California is fracturing,” The Intercept, July 12, 2017
This is a fascinating peek under the covers of an ongoing battle that is highly relevant to our complex New York State politics.
Sandrine Rastello, “Quebec expects $1.2 billion in savings with new drug price deal,” Bloomberg, July 16, 2017
Imagine what the U.S. with 40X more inhabitants could do if with hard-nosed price negotiations.
Reuters and Julian Robinson, “Japanese doctor who worked until months before his death passes away at 106,” Daily Mail, July 18, 2017
He introduced elements of Japan’s post-war care system and wrote about preventing aging. The advice seems to have worked!
Suzy, Khimm, “Medicare for all isn’t sounding so crazy anymore,” New York Times, July 15, 2017
The headline suggests a good starting point, but the outline focuses on costs and disruptions. You would scarcely know that the current system is expensive and disruptive.
Matt Taibbi, “Republicans and Democrats continue to block drug reimportation – after publicly endorsing It,” Rolling Stone, Jun 2, 2017
Remember how Cory Booker got slammed for siding with big pharma on drug pricing? Then he protected his presidential ambitions with a changed vote, but his Dem colleagues make sure nothing actually happens. It’s possible to be too cynical about these leaders—but not easy.
July 13, 2017
Tim Cushing, “Hospital sends legal threats to researcher, then asks her help identifying breach victims,” TechDirt, June 13, 2017
This is interesting for the insight into how vulnerable our supposedly hyper-private medical information is. But it also provides a window into the institutional culture at Bronx Lebanon. Now try to digest this next article.
Roy M. Poses, “A $1.7 Million/ year CEO of a safety net hospital alleged to have hired a dangerous surgeon, paid unethical bonuses, and associated with organized crime,” Health Care Renewal, June 29, 2017
Good background into how abuse of the poor is not unknown in the Bronx. For a useful bit of history, have a look at this 2010 legal complaint brought by A-G Schneiderman against IDC stalwart Pedro Espada, Jr., now residing at Sing Sing Correctional Facility. I encourage you to read the full account of how he systematically ripped off his constituents.
Alan R. Weil, “Pursuing Health Equity,” Health Affairs, June 2017.
It’s short, but read all the way to the end. The shift in our national dialogue about access to health care is crucial.
Matt Taibbi, “Finally everyone agrees health care is a human right,” Rolling Stone, June 30, 2017
Yes, the Trumpcare debacle is showing how inhumane and cruel it is to leave people outside the care system. But it also challenges band-aid solutions like the ACA, which did the same to a lesser degree.
July 12, 2017
David Dayan, “California single-payer organizers are deceiving their supporters. It’s time to stop,” The Intercept, June 30, 2017
This is a must-read: he argues that there are so many unresolved issues with the California proposal that it is unfair to demagogic to denounce the Dem leadership for blocking it. Then again, since when is political rhetoric fair? And the oppos get so much health- and insurance-industry money that their arguments are suspect. Nonetheless, the details are crucial and highly relevant for us.
John Ingold, “In Colorado’s drumbeat of medical mergers, rural hospitals often trade independence for better care,” Denver Post, July 4, 2017
Interesting example of the economics of hospital consolidation, especially outside of large metropolitan areas.
Paul Waldman, “Liberals, get your story straight on single payer,” The Week, July 5, 2017
Here’s a related piece: Waldman confuses socialized medicine with single-payer, but his run-down of the varieties of universal coverage are worth learning. If we get close to passage in Albany, some of these options undoubtedly will appear as the “compromise” solution. He also doesn’t believe that a single state can go single-payer despite the Canada experience.
Josh Keefe & David Sirota, “Chris Christie attack on New Jersey health insurer could help Kushner family,” International Business Times, June 28, 2017
Old-fashioned corruption at its best. Christie’s approval rating is now 15%.
Adam Johnson, “Media boosts trumpcare promoter without asking who’s writing his checks,” AlterNet, June 27, 2017
This happens all the time: traditional media feel forced to put a Dem-Rep spin on everything and provide zero information on the spokespeople they use. BTW, media is a plural noun, “the media are”—losing grammar battle!
July 4, 2017
Mandos, “One deep reason why the USA does not have a sane way to pay for health care for all,” Ian Welsh, June 30, 2017
Canada’s original single-payer system was fought tooth and nail by local doctors in Saskatchewan—but there was a significant difference in the rhetoric.
Lee Fang, “Democratic superdelegate, in room full of health insurance executives, laughs off prospect of single payer,” The Intercept, July 1, 2017
Gephardt, a classic corporate Democrat expressing populist niceties until the time comes to cash out. Note his annual fee as board member of insurance rent-extractor Centene.
Zaid Jilani, “Cory Booker will ‘pause’ fundraising from big Pharma because it ‘arouses so much criticism,’” The Intercept, June 30, 2017
Continuing backlash from Booker’s vote against the Sanders drug importation bill. Good to see that big biz water-carriers trying to parade as progressives can get their fingers burned on corporate cash.
Ed Williams, “New Mexico health reporter: ‘I’ve yet to find a story that didn’t have its roots in poverty,’” Columbia Journalism Review, June 29, 2017
Aside from the topic alluded to in the headline, note that NM’s Medicaid expansion meant greater state expenditure, despite the large pick-up by the Federal Government under the ACA. Covering more people (i.e. those now without healthcare) will mean more spending—this is not difficult! But the per capita costs can be controlled more easily.
Candace Bernd, “How the Koch-backed effort to privatize the Veterans Health Administration jeopardizes everyone’s health care future,” Truthout, July 2, 2017
Stealth privatization against the most successful single-payer system in the U.S. Obvious potential for alliances with veterans.
June 30, 2017
Suzanne Woolley, “American health care tragedies are taking over crowdfunding,” Bloomberg, June 12, 2017
[Rant warning] When I read this sort of thing, I don’t know whether to s*** or go blind. How is it possible that we are reduced to posting appeals on Facebook to pay for needed medical services? Do the cutest children get more donations? If there an age cut-off for the sympathy quotient? We are turning into a nation of beggars holding out our rice bowls. “Crowdfunding is like crowd insurance.” Yeah, right, sort of the way a CARE package is like being the King of France. [end rant]
Dean Baker, “The meaning of Republican “cuts” to Medicaid, Beat the Press/CEPR, June 27, 2017
In our strange world of science-fiction politics, experts must explain to us what the word “cuts” means. Yes, the GOP plan entails “cuts,” despite their new talking point.
Mehda Hasan, “Memo to Democrats: You need a clear message for universal health care,” The Intercept, June 28, 2017
Following up from Baker, here’s how to win the propaganda wars: good advice!
Josh Barrow, “The formula Democrats need: less Clintonism, less Sandersism, more Warrenism,” Business Insider, June 21, 2017
The author is against single-payer (mostly because he believes winning it is politically unlikely) but presents a slew of excellent intermediate demands that would weaken the industry, e.g., banning hospital mergers, freeing nurse practitioners to perform more procedures, etc. Seems logical to support most if not all of them.
David Sirota, “Democrats help corporate donors block California health care measure, and progressives lose again,” International Business Times, June 26, 2017
Pretty good summary of what happened in California, including the dollar amounts shoveled to the main players.
Cameron Easley, “Schumer makes bipartisan pitch for health care reform,” Morning Consult, June 28, 2017
Red Alert! When Dems starts talking about “compromise” with Trump and Ryan, hide your children. What would a deal look like with these folks? Dismantle Medicaid in 20 years instead of 10? We should be highly suspicious especially if there is talk of “reducing deficits” and other Joel Ossoff/GOP-lite concepts.
June 25, 2017
Melanie Mason, “California Assembly Speaker Anthony Rendon shelves single-payer healthcare bill, calling it ‘woefully incomplete’,” Los Angeles Times, June 23, 2017
On SB562, California’s version of single-payer, stymied for now. There is a ton of industry money sloshing around Sacramento [for detail see here ], so the criticism of the bill is suspect. However, the series we circulated earlier suggested that the shortcomings are real, principally the financing issue and right behind that the need for ERISA waivers and cooperation from D.C. So CA has another year to work out the bugs—as do we!
Jerome Groopman and Pamela Hartzband, “Putting profits ahead of patients,” New York Review of Books, July 13, 2017
Review of the Elisabeth Rosenthal’s and one other book on our healthcare delivery debacle. They are quite critical of a few details but not of her overall thesis and conclude that single-payer is the logical solution.
David Nather & Lazaro Gamio, “The disappearing ACA insurance market,” Axios, June 19, 2017
Good to remember that while the GOP proposal and Trump’s rhetoric are undermining the ACA, its market was already deteriorating.
Neeraj Sood, Tiffany Shih, Karen Van Nuys, and Dana Goldman, “Follow the money: The flow of funds in the pharmaceutical distribution system,” Health Affairs, June 13, 2017
An academic study, couched in very neutral language, nonetheless concludes that of a $100 expenditure on pharmaceuticals by consumers, roughly $58 goes to the manufacturer, of which $17 is spent on drug production, and $41 is spent on marketing, R&D, or kept as net profit while the remaining $42 is captured by intermediaries. The authors thus conclude that the total net profit on $100 spent on prescrition drugs is $23, of which $15 goes to manufacturers, $3 to insurers, $3 to pharmacies, and $2 to PBMs.
However, read the comments! The first one points out that the study was commissioned by the pharameutical AMGEN, underlining a direct conflict of interest on the authors’ part. Also note that the $41 figure lumps together marketing, R&D, and profit, obscuring the relationship among these three key metrics. If R&D were a large portion of it, that figure would surely be front and center.
Annie Waldman, “Big pharma quietly enlists leading professors to justify $1,000-a-day drugs,” ProPublica, Feb. 23, 2017
Now check this backgrounder on how Pharma is hiring academic courtesans to push their agenda.
Danny Vinik, “The backdoor way the Senate health care bill rolls back Obamacare,” Politico, June 22, 2017
I generally avoid these up-to-the-minute links because things are changing so quickly. But this one looks like an important detail to harp on when we call our electeds!
June 19, 2017
Ezra Klein, “Republicans are about to make Medicare-for-all much more likely,” Vox, June 15, 2017
While GOP push to destroy the ACA continues in total secrecy, speculation abounds about what will happen if they actually decide to set fire to the barn. Klein quotes an expert saying, “Democratic politicians I never thought would utter the words have mentioned single-payer to me in a non-joking way of late.” This does not, of course, include the Great Dem Hope Jon Ossof running in GA-6, whose campaign has now burned through something like $25 million trying to capture conservative Republican votes with a 2016-redux strategy.
Tony Pugh, “Free health clinics make a comeback amid fear of what Trump will do to Obamacare,” McClatchy, June 14, 2017
Sad commentary on the current outlook for health care as well as on the shortcomings of the ACA.
Jerri-Lynn Scofield, “States launch new joint probe into company sales and marketing practices for opioids,” Naked Capitalism, June 18, 2017
Good introduction to legal moves against opioid peddlers and a reminder that the Obama DoJ had a miserable record on corporate crime (W’s was better).
Helaine Olen, “Why Won’t More American Corporations Support Single-Payer Health Care?”, The Nation, May 22, 2017
Reference to a recent Warren Buffett statement more or less endorsing single-payer. Shout out to the American Sustainable Business Council’s recent initiative, but the author concludes that big business will only climb on board at the last possible moment.
Beth Mole, “Feds probing psychiatric hospitals for locking in patients to boost profits,” ArsTechnica, April 24, 2017
Had missed this one earlier: three federal agencies are investigating Universal Health Services for keeping psych patients until the day their insurance coverage runs out. And why wouldn’t they?
“I’m a terrible doctor, and I’m proud of it,” Musings of a Dinosaur, Oct. 4, 2016
A new blog discovery: self-described family doctor (i.e. dinosaur) with tales of modern insanity known as healthcare delivery, as well as just amazing tales of practicing medicine.
June 12, 2017
Fascinating experiment by a single-payer advocate in Pennsylvania who dug past the signatures of the 113 co-sponsors of HR 676 to see if there was anything behind this surge of “support.” Disappointing results, to say the least! He has a great idea of how to push the issue in the mid-terms.
Why you really, really should NOT send away for those cool DNA tests to see if you are 2% Uzbek and 1.3% Native Alaskan. Similar details at Tim Cushing, “Cheap DNA testing is giving some insurers even more ways to deny coverage,” Techdirt, June 7, 2017
From the author of the four-part series I shared last week, this is a sobering take on the obstacles to get to single-payer in California even with the political support. Note the discussion of ERISA. Walker finds the bill as written too full of good intentions and still needs “a specific plan that includes the trade-offs necessary to make it work.”
A more optimistic view with a semi-endorsement of the “Bismarck model,” the German system of channeling payments through nonprofit health insurers.
Economist Baker relentlessly annotates the assumptions embedded in mainstream news coverage. One of his favorite targets is pharmaceutical price gouging and how reporters routinely shill for the industry.
June 6, 2017
ROAD TO SINGLE-PAYER—A 4-part series by Jon Walker, ShadowProof
This is a marvelous (and wonderfully didactic) round-up of the current situation and the political, fiscal, legal, and administrative obstacles we face in achieving single-payer.
Part 1: HOW THE US CAN ACHIEVE UNIVERSAL HEALTH CARE – http://bit.ly/2qTiRPG
Part 2: UNDERSTANDING DIFFERENT UNIVERSAL HEALTH CARE SYSTEMS – http://bit.ly/2qXsz7z
Part 3: FIGHTING FOR UNIVERSAL HEALTH CARE AT THE FEDERAL LEVEL – http://bit.ly/2szz2Tu
Part 4: OVERCOMING HURDLES AT THE STATE LEVEL – http://bit.ly/2s0rgVB
May 24, 2017
“[I]f and when one state adopts a single-payer system, it could quickly alter the national political landscape, with implications far beyond the fight for healthcare reform.”
From a former GOP local official writing in a business magazine comes the startling concept of “white socialism.” Read the argument and try to disagree!
An intemperate corrective to the argument that the primary goal must be to save ACA, rather than push for single payer.
And to conclude, this completely insane horror story.
May 23, 2017
Background on how the high-risk pools work—or don’t. Note the anecdote at the end about the lady who moved across the country solely to obtain health insurance.
Author of the book An American Sickness: How Healthcare became Big Business and How You Can Take it Back gives practical advice to doctors on how to resist dubious and/or corrupt practices by hospitals and other medical services.
A good sign! This pushback from the Murdoch paper means we are getting too close to victory for their comfort. Their main lines of attack: NYS will have to raise taxes to cover costs, and single-payer will restrict access to high-cost procedures while lowering salaries of medical professionals.
Not exactly a healthcare story, but an insight into how we collectively handle the burdens of childcare and –raising. And get a load of the corporate-headquarters-as-UFO. Apparently, children are not raised in Silicon Valley—perhaps it takes place on another planet.
May 18, 2017
The government subsidizes insurers for high-cost patients, so the companies game the system to boost people’s diagnoses into the most lucrative ones. Duh! Creating perverse incentives and then watching for-profit companies exploit them is surprising because . . .?
Note how easy it would be to monitor and fine companies doing this, but the government personnel assigned to these activities have been cut back. So there you have it: make the program lose money through corruption, then denounce it as wasteful government spending.
Very technical and a little obscure, but we may be hearing a lot of this sort of proposal for an in-between or transitional solution in the future, especially once the U.S. Senate takes up the issue.
Another one from April but great background: Pharma showcases patient suffering to strongarm its costly drugs into the reimbursed formulary: 83 percent of the 104 largest patient advocacy groups take money from the drug, medical device and biotech industries. “Envelopes in his left hand held $750 checks to help patients with a rare disease cover the cost of a whirlwind trip to the nation’s capital. The money was donated by the pharmaceutical industry.”
May 16, 2017
Baker is a wonderful antidote to tendentious economic reporting purporting to tell us why single-payer won’t work, drug prices are fair, etc.
James Howard Kunstler, “American health – a racket of rackets,” Clusterfuck Nation, Mar. 31, 2017
Quite a rant. Ends with an interesting proposal: for a new Pecora Commission, styled after the investigation into the causes of the 1929 crash, that could expose health insurance as a criminal enterprise.
David Dayen, “From processors to predators: The hidden monopolies that raise drug prices,” American Prospect, Mar. 28, 2017
How Pharmacy Benefit Managers (PBMs) extract rent through a monopoly on information.
Elisabeth Rosenthal, “How to save money at the hospital,” Tincture, Apr. 4, 2017
Practical suggestions for avoiding hospital price-gouging from the author of “An American Sickness.”
May 12, 2017
Emma Court, “American health care is so messed up that a whole industry has been created to help navigate it,” MarketWatch, May 6, 2017. “Medical bill advocates” have arisen to help people deal with the gaps, blind spots, and “errors” by insurers that jack up bills in our hyper-complicated, fragmented health care system. Note that time spent on this is a form of tax, which should be part of our response when people raise the issue of single-payer- related taxes. Of course, one can always choose NOT to spend the time and pay up.
Tom Baker & Daniel Hemel, “4 ways states can prevent the Affordable Care Act from ‘exploding,’ Vox, April 8, 2017. An old one but still relevant: aside from the pro-active measures the Trump Administration can take to undermine the ACA, the deadliest is to refuse reimbursement to insurers and indirectly collapse the system.
Sarah Klifee, “Aetna CEO in private meeting: ‘Single-payer, I think we should have that debate,’ Vox, May 12, 2017. The Bertolini approach is for the government to keep Aetna in the game by imitating the creeping privatization of Medicare and call it “single-payer.” Amazing to hear an industry titan try to head off the end of his business by co-opting the language. Sign of panic?