March 30, 2020

Wendell Potter, “Millions of Americans are about to lose their health insurance in a pandemic,” Guardian, Mar 27, 2020

The irrationality of tying healthcare to employment: “The very pandemic that threatens to infect and kill millions is simultaneously causing many to also lose their health coverage at their gravest time of need.”

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Christina Jewett & Lauren Weber, “Hospital suppliers take to the skies to combat dire shortages of COVID-19 gear,” Kaiser Health News, Mar 26, 2020

“Demand is outstripping what’s available due to a damaged supply chain heavily reliant on China and a struggling Strategic National Stockpile.” No one thought of that when profits from just-in-time purchasing were high.

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Nicholas Kulish, Sarah Kliff & Jessica Silver-Greenberg, “The U.S. tried to build a new fleet of ventilators. The mission failed,” New York Times, Mar 29, 2020

Amazing story of cutthroat capitalism at its best: a federal program to produce an inexpensive ventilator was sidetracked when a competitor bought the grantee company. The authors deploy breathtaking understatement: “Private companies’ focus on maximizing profits is not always consistent with the government’s goal of preparing for a future crisis.”

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Mike Hixenbaugh, “Scientists were close to a coronavirus vaccine years ago. Then the money dried up,” NBC News, Mar 5, 2020

“There is a problem with the ecosystem in vaccine development, and we’ve got to fix this.” For-profit pharmaceutical companies can’t be bothered with projects unlikely to hit it big. Worth remembering the next time Pharma reps insist they need huge profits to fund R&D.  

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Caroline Chen, Marshall Allen & Lexi Churchill, “Internal emails show how chaos at the CDC slowed the early response to coronavirus,” ProPublica, Mar 26, 2020

One of the CDC’s core functions is to spot and track disease outbreaks. The current team didn’t know how to do that.

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Jon Walker, “The pandemic could overwhelm the insurance industry. We must expand Tricare for everybody who needs it,” The Intercept, Mar 26, 2020

Interesting. The author argues that the current system could buckle under the twin pressures of spiking treatment needs and a huge drop in revenues. To avoid a bailout of the health insurance industry, he proposes “an off-the-shelf solution” that can be deployed at a huge scale: Tricare, which covers 10 million U.S. military personnel, and Tricare Select for military families and retirees under 65. It offers full coverage, including drugs, small copays, rules against surprise billing, and roughly Medicare provider reimbursement rates. “It is exactly the kind of insurance we want people to have during this crisis, and, most importantly, it already exists.”

*

Juliet Eilperin, Michael Scherer, Josh Dawsey & Seung Min Kim, “Politicians jockeying for covid-19 tests find proximity to Trump is the fastest route,” Washington Post, Mar 25, 2020

Headline says it all. Meanwhile, “Maryland Gov. Larry Hogan (R) said this week that the state has bought coronavirus tests from China, is trying to buy them from South Korea and is ‘beating on the federal administration every day to get us more tests.’”

*

Drew Altman, “Why the U.S. doesn’t have more hospital beds,” Axios, Mar 30, 2020

“The shortage of hospital beds in the U.S. didn’t happen by accident. It’s a result of both market pressures and public policy.” To have enough for a crisis, they have to be empty at other times. MBA hospital administrators hate that.

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Carla K. Johnson & Mike Stobbe, “Sick staff fueled outbreak in Seattle-area care centers,” Associated Press, March 18, 2020

Hard evidence of the predicted effect of using low-paid workers without sick leave in jobs like nursing home aides.

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Mark Dudzic, “The labor movement must fight for Medicare for All — not employer-based plans,” Jacobin, Jan 17, 2020

From January, a look at union resistance to M4A. Perhaps now that all that great coverage disappeared along with the jobs, the terms of the debate will shift. A prescient excerpt: “This parochial perspective ignores the reality that New York unions are only one election or economic downturn away from catastrophe.”

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Isaac Stonermarch, “Saving lives should be good business. Why doesn’t that apply to finding new antibiotics?” STAT, Mar 18, 2020

A biomedical researcher and entrepreneur describes why finding new antibiotics is a money-loser (and should be directly funded by government-doh).

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Emmarie Huetteman, “Senators who led Pharma-friendly patent reform also prime targets for Pharma cash,” Kaiser Health News, Mar 24, 2020

Sen. Thom Tillis (NC), chairman of the subcommittee on intellectual property rights: $156,000; Sen. Chris Coons (DE), ranking Democrat: $124,000. “Over the past 10 years, the pharmaceutical industry has spent about $233 million per year on lobbying, according to a new study published in JAMA Internal Medicine, more than any other industry, including the oil and gas industry.”

*

Michael Ollove, “Medical groups slam Trump Medicaid rule,” Stateline, Feb 28, 2020

Trump Administration looking for ways to cut Medicaid and Medicare under the rubric of fighting fraud. “If the rule is implemented, there will be locations that will close, especially in rural areas.” Good thing rural people don’t need hospitals these days!

*

March 26, 2020

Zach Carter “Democrats are handing Donald Trump the keys to the country,” HuffPost, Mar 25, 2020

Bailout money will flow to rich people with bipartisan collusion. “The Senate coronavirus bill is not an economic rescue package, but a sentence of unprecedented economic inequality and corporate control over our politics that will resonate for a generation.” Litany of disaster: the bill permits bailed out companies to lay off up to 10% of their workforce over the next six months; Mnuchin can let all future profits accrue to the companies, not the government that saved them; restrictions on stock buybacks are weak and short-term; dividends still permitted; the “independent auditor” provision is a joke—corporations will ignore him & nothing will happen. In short: Democrats, who just impeached Trump for misconduct over funds, now hand him trillions to play with.

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Wendell Potter, “Coronavirus pandemic reveals just how devastating the greed of for-profit insurance industry has become,” Tarbell, Mar 18, 2020

From a former industry PR executive: “Behind the PR spin, they’ll be doing everything they can to deny care and maintain profits while making it look like they’re heroes.” Insurance companies happy to give you COVID testing (which the government will reimburse), but your copays for treatment will remain. [Update: Aetna and other companies announced they will drop copays for treatment.]

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Erica Werner, Mike DeBonis & Paul Kane, “Senate, White House reach $2 trillion stimulus deal to blunt coronavirus fallout,” Washington Post, Mar 25, 2020

Amid all the debate on the bill’s particulars, no one is addressing the elephant in the room: what about people who had employer-based health insurance? What do they do now? There seem to be NO provisions for that.

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Jeanne Whalen, Tony Romm, Aaron Gregg & Tom Hamburger, “Scramble for medical equipment descends into chaos as U.S. states and hospitals compete for rare supplies,” Washington Post, Mar 24, 2020

Not only is there no federal healthcare system, we just barely have a federal country. “A mad scramble for masks, gowns and ventilators is pitting states against each other and driving up prices. . . . Hospitals are requesting donations of masks and gloves from construction companies, nail salons and tattoo parlors.”

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Isaac Scher, “‘It is unclear why quality control did not detect this issue’: Early CDC tests couldn’t distinguish between coronavirus and water,” Business Insider, Mar 19, 2020

Staggering scientific incompetence from the newly installed ideologues at CDC. Supplier remains unnamed (a Kushner company?)

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Farhad Manjoo, “How the world’s richest country ran out of a 75-Cent face mask,” New York Times, Mar 24, 2020

By offshoring production and using just-in-time stocking to cut costs. Good for profits! (For emergencies, not so much.) “Two decades ago, most hospital protective gear was made domestically. But like much of the rest of the apparel and consumer products business, face mask manufacturing has since shifted nearly entirely overseas.”

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Shelby Livingston, “COVID-19 could prompt higher 2021 insurance premiums, benefit cuts,” Modern Healthcare, Mar 23, 2020

How the epidemic will further increase insurance costs if nothing is done to revamp the entire system. “Absent any federal action, those costs could prompt commercial health insurers to increase premiums between 4% to 40% in 2021.” Struggling businesses will either absorb the costs, push them onto their employer-covered workforce, or even drop coverage entirely. Major impact once the dust settles. “This is where there’s no place for insurers to hide.”

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Allyson Y. Schwartz, “Congress quietly sets a new bipartisan record on health care,” Modern Healthcare, Feb 21, 2020

Overwhelming two-party backing for creeping privatization of Medicare via Advantage supplemental policies. Allyson Y. Schwartz, president and CEO of the Better Medicare Alliance, represented Pennsylvania in the House of Representatives from 2005 to 2015. Revolving doors: the key to prosperity!  

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Christopher Baum, “New York Gov. Cuomo’s panel proposes Medicaid cuts amid coronavirus crisis,” Truthout, Mar 21, 2020

While Cuomo gets national attention for not being completely incompetent, Austerity Andrew stages a stealth strike on the state budget. Stage 1: “strengthen” the public hospitals by slashing their Medicaid payments by $186 million (which the city will have to make up). Very good on neoliberal “lean management,” i.e., “just-in-time” staffing and inventory translated to the hospital sector.

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Max Blumenthal, “The new Cold War with China has cost lives against coronavirus,” [Chicago] Reader, Mar 24, 2020  

Many examples of focusing on China’s initial cover-up rather than the lessons they could teach us. “The creator of the groundbreaking [40-minute] test, Weihong Tan, was a professor at the University of Florida’s cancer research lab until last year when the Department of Justice targeted him with a McCarthy-style investigation. Accused by a Cold War-crazed U.S. government of failing to disclose Chinese funding for his department, he returned to Hunan University, where he found ample government support for his lifesaving research.”

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Julia Conley, “‘This is a massive scandal’: Trump FDA grants drug company exclusive claim on promising coronavirus drug,” Common Dreams, Mar 24, 2020

Gilead scores again: “A pharmaceutical company with ties to the Trump administration [but also everyone else in DC] has been granted exclusive status for a drug it is developing to treat the illness—a potential windfall for the company that could put the medication out of reach for many Americans.” Gilead can now enjoy seven years of exclusive profits, “block manufacturers from developing generic versions of the drug” and get grants and tax credits. The “orphan drug” designation was designed to stimulate R&D, but the drug in question already existed, developed with government money, of course.

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Anders Fogh Rasmussen, “Taiwan has been shut out of global health discussions. Its participation could have saved lives,” Time, Mar 18, 2020

Why does Taiwan, just a few miles from China, have only 100 cases? Good public health planning, which thanks for the mainland’s hostility, gets little notice. (Not that anyone here would have paid attention.) Rasmussen was the Prime Minister of Denmark 2001-2009.

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Anna Irrera & Koh Gui Qing, “How one elite New York medical provider got its patients coronavirus tests,” Reuters, Mar 20, 2020 h

Just pay $5K a year for boutique medical care to get what you need!

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Chris Talgo, “ObamaCare: 10 years of distress and disappointment,” The Hill, Mar 5, 2020

The author is from a libertarian and conservative think tank, but the critique is devastating. “In its first decade, ObamaCare has failed to solve many of the health care problems it was supposed to address. Even worse, it has compounded many of the issues it was meant to fix.” Good overview of the broken promises: will cut premium costs by $2500 a year (premiums have doubled); will drastically reduce the uninsured population (Medicaid expansion did, but uninsured total today is 28 million and rising); you can keep your health care plan (4.7 million active policies were canceled); you will be able to keep your doctor (false).

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March 23, 2020

Shashank Benagli & Ralph Jennings, “‘A mess in America’: Why Asia now looks safer than the U.S. in the coronavirus crisis,” Los Angeles Times, Mar 20, 2020

“Suddenly, it seems, the U.S. is the basket case, an aloof, inward-looking power that had already weakened its alliances, failed to lead on global emergencies such as climate change and shrunk in a crisis.”

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Rachel Cohrs and Jessica Kim Cohen, “Senate GOP wants to suspend Medicare sequester, expand telehealth,” Modern Healthcare, Mar 19, 2020

Now that we have to test and treat massively, even (some) Republicans are pulling back from slashing Medicare and Medicaid. “The sequester, which reduced spending for most benefits by 2% starting in 2013, would be suspended from May 1 to December 31, 2020.” After that, we can get back to destroying both.

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Brooke Seipel, “US woman gets $34,927.43 bill for coronavirus treatment,” The Hill, Mar 20, 2020

Uninsured. As will be soon many of those with employment-based insurance. Cost of the COVID-19 test alone: $907.

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John Buell, “Why Americans should stop talking about “China Flu” and learn some things from China,” Informed Comment, Mar 20, 2020

“Trump’s insistence on calling the virus the China virus is not only misleading and a source and intensifier of ethnic conflict. It is also an accelerant of the pathogen.” We need cooperation, not finger-pointing (though criticism of the Chinese response is legit).

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Jill Burcum, “Coronavirus pandemic: What’s ‘normal’ now? What’s next? An interview with Michael Osterholm,” [Minneapolis] Star-Tribune, Mar 22, 2020

“None of this was really that difficult. It was pretty straightforward right in front of us. People who knew health care knew that health care [had been] carved down to the bone for which there was no resiliency of any substantial nature, no excess capacity, no monies to stockpile large volumes of protective equipment.” But no one was listening. Of interest: he notes that school closings apparently had no effective on the epidemic in Hong Kong.

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Robin Young & Allison Hagan, “While some wait for COVID-19 tests, the wealthy cut the line,” WBUR (Boston), Mar 19, 2020  

Queue-jumping by rich people. “One concierge doctor who stocked up on virus swabs is organizing drive-through testing in Silicon Valley for his clients only.” Harvey Weinstein got a test in prison.

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Maureen Callahan, “‘We should blow up the bridges’ — Coronavirus leads to class warfare in Hamptons,” NY Post, Mar 19, 2020

The rich are not like you and me. “A wealthy Manhattan woman who tested positive called tiny Southampton Hospital to say she was on her way and needed treatment. The woman was told to stay in Manhattan. Instead, she allegedly got on public transportation, telling no one of her condition. Then she showed up at Southampton Hospital, demanding admittance.” Southampton has four ICU units and but only one guillotine.

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David H. Freedman, “Is Bernie Sanders right about Medicare for All? How government-run health care actually works,” Newsweek, Mar 16, 2020

Cover story and excellent corrective to the “government takeover” talking point: guess what, it already exists. “It’s taken on the care of millions of some of America’s most challenging patients, including residents of isolated rural communities and older patients who need long-term care. It trains most of America’s doctors. It is a leader in telehealth, electronic health care records, precision medicine and many other important, forward-looking technologies. It earns quality-of-care ratings that most hospitals would envy. It keeps costs generally below average and charges most patients little or nothing. The system is the Veterans Health Administration. . . . If that’s not socialism, what is?”

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Lee Fang, “Banks pressure health care firms to raise prices on critical drugs, medical supplies for coronavirus,” The Intercept, Mar 19, 2020

How to profit from a catastrophe. Forgot toilet paper hoarders, these are the real sociopaths. Remdesivir is the hands of Gilead (which did not discover it), the same company that has made billions on marketing a Hepatitis C treatment that it also didn’t discover. U.S. Pharma has not been particularly interested in low-profit vaccine development, unlike peers in Germany, China, and Japan.

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By Jordan Fabian, “Trump told governors to buy own virus supplies, then outbid them,” Bloomberg, Mar 19, 2020

The Federal Government is “not a shipping clerk,” said Trump.

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Whitney Webb, “U.S. intel agencies played unsettling role in classified coronavirus response plan,” Mint Press, Mar 13, 2020  

How classifying top-level meetings on domestic coronavirus response as “top secret” hampered the response. “The classification decision prevented key experts from participating in meetings and slowed down the ability of HHS and the agencies it oversees” while shifting responsibility to the military and spooks, probably so that they could use the crisis against Iran and China. Meanwhile, they all knew the epidemic would explode and let Trump deny it.  *

And finally, one non-corona story:

John Horgan, “The cancer industry: Hype vs. reality,” Scientific American, Feb 12, 2020

Lots of healthcare spending, marginal benefits to patients.

March 13, 2020

Shelby Livingston, “CMS encourages Medicare Advantage plans to remove barriers to COVID-19 care,Modern Healthcare, Mar 11, 2020

“Encourages”? Why can’t the government order them to provide the service in the midst of a national emergency?

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Sarah Karlin-Smith, “How the drug industry got its way on the coronavirus,” Politico, Mar 5, 2020

“Industry lobbyists successfully blocked attempts this week to include language in the $8.3 billion emergency coronavirus spending bill that would have threatened intellectual property rights for any vaccines and treatments the government decides are priced unfairly.” So the government ponies up $3 billion for the pharmaceutical companies to take over marketing and profits once the vaccine exists. Meanwhile, promises of “access” to treatment are as meaningful as “access” to the Ritz Carlton. Pelosi is okay with it.

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Christopher Rowland & Peter Whoriskey, “U.S. health system is showing why it’s not ready for a coronavirus pandemic,” Washington Post, Mar 4, 2020

Hospitals and doctors “improvise emergency plans daily, even as they remain uncertain how bad the crisis will get.” States take action but not the MIA federal government. And no gowns or masks from China, where we have outsourced production. Meanwhile, many nursing home employees get no sick leave.

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Vera Bergengruen & W.J. Hennigan, “‘Doomed from the start.’ Experts say the Trump Administration’s coronavirus response was never going to work,” Time, Mar 5, 2020

“Everything is under control” has a comforting ring, but wishing doesn’t make it so. “COVID-19 has likely been spreading in Washington state since mid-January, weeks before the U.S. implemented travel and quarantine measures.”

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Jennifer Wright, “Four disastrous mistakes that leaders make during epidemics,” Washington Post, Mar 3, 2020

(1) Deny the disease exists or, if it exists, say it’s not a big deal; (2) suppress scientific information; (3) blame vulnerable minorities; (4) say anyone who gets sick had it coming. Trump is 4 for 4.

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Trudy Lieberman, “Thinking about health: Generic drugs not always equivalent, sometimes dangerous,” Tarbell, Mar 2, 2020

“We are dependent on distant drug manufacturers yet have little visibility into their methods.” FDA oversight is light, and “no law requires a drug maker to disclose the country of origin for either the ingredients or the manufacturing of the drug itself.”

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John Buell, “Will DC’s neoliberal model of drug costing finally kill us all?” Informed Comment, Mar 9, 2020

Why is there even a debate on how to pay for an eventual vaccine? The polio vaccine was developed by a nonprofit and distributed for free.

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Jay Hancock and Elizabeth Lucas, “VCU Health halts 30-year campaign that seized patients’ wages, put liens on homes,” Kaiser Health News, Mar 11, 2020

VCU [Virginia Commonwealth University] slammed by bad publicity, finds Jesus, asks for forgiveness for trying to seize patients’ homes. Debt jubilees were an essential part of the ancient Babylonians’ rule—we could try catching up to them. “Forgive us our debts as we forgive our debtors.”

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Abha Bhattarai & Peter Whoriskey, “Companies are putting out hand sanitizer. But for years, many have campaigned against sick pay,” Washington Post, Mar 9, 2020

“At least a dozen states, including Florida and much of the Southeast, have passed legislation since 2011 to block efforts to require medical leave. Stopping Orlando’s sick pay requirement, former governor Rick Scott (R) said at the time, was ‘essential to ensuring a business-friendly environment.’” Any regrets? New fun term: “contagious presenteeism.”

March 9, 2020

Mary T. Bassett & Natalia Linos, “The coronavirus could hit the U.S. harder than other wealthy countries,” Washington Post, Mar 2, 2020

What makes us especially vulnerable: low trust in institutions, disdain for science, “truthiness,” officials making stuff up, and of course the skewered healthcare financing system. How many people will avoid seeking care for a fever due to cost? Not mentioned: dismantling of public health departments to save money for finer things.

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Anonymous, “Statement by a quarantined nurse from a northern California Kaiser facility,” California Nurses Association/National Nurses United, Mar 5, 2020

Real-life incompetence at the top: a nurse treating a coronavirus patient gets sick, can’t get “authorization” from the CDC for a test. Meanwhile, South Korea, a first-world country, performs 10,000 tests a day at ten-minute drive-throughs.

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Robinson Meyer & Alexis C. Madrigal, “The strongest evidence yet that American is botching coronavirus testing,” The Atlantic, Mar 6, 2020

Former CDC director Friedan: “I don’t know what went wrong this time.” As the data on total tests performed is incomplete and perhaps not even gathered, we have no idea of the denominator to calculate positives/total tests. Louisiana’s governor helpfully provided his state’s: 0 positive out of 5 tests. Reassuring.

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Ben Conarck, “A Miami man who flew to China worried he might have coronavirus. He may owe thousands,” Miami Herald, Feb 24, 2020

Probably a lazy “taker” just trying to get healthcare for free at the expense of hard-working Americans. “Azcue [who had signed up for a junk plan to save on premiums] said he heard from his insurer that he would also have to provide three years of medical records to prove that the flu he got didn’t relate to a preexisting condition.”

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Yves Smith, “Mr. Market loses it over coronavirus risk: Oil tanks, S&P futures trades halted on limit down overnight, gold jumps,Naked Capitalism, Mar 9, 2020

Scroll past the financial round-up to Smith’s review of the unfolding nightmare in Italy and the likely incapacity of the U.S. healthcare system to cope.

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Craig Murray, “Momento Mori – Unpopular thoughts on corona virus,” craigmurray.org.uk, Mar 7, 2020

“Consider this: 100% of those who contract coronavirus are going to die. 100% of those who do not contract coronavirus are also going to die.” Welcome perspective.

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Rachel Cohrs, “Colorado public option fight kicks off as hospitals push alternative,” Modern Healthcare, Mar 5, 2020

The state is pushing a weak-tea version of the “public option” alternative to M4A, described as a “privately administered public insurance option in the individual market.” That should be complex and confusing enough to satisfy most centrist corporate lobbyists, but alas, the state’s hospital association opposes the program because it might actually give the state some say over pricing.

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MSNBC, “Trump response to coronavirus compared to Wilson and ‘Spanish Flu,’” Mar 8, 2020

Fascinating look at how Woodrow Wilson covered up the “Spanish” flu to pursue war aims, leading to millions of deaths. War-time censorship empowered him to do so. BTW, a more accurate name for it would be “American” flu. Spain got the blame because as a neutral country in WW1, it did not hide its numbers.

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Ben Schreckinger, “James Biden’s health care ventures face a growing legal morass,” Politico, Mar 9, 2020

Another Biden relative (James, “sometimes business partner” of nephew Hunter) emerging from the swamp. Rich targets abound.

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Liucija Adomaite & Mantas Kačerauskas, “27-hour hospital stay leaves parents of a killed one-year-old not only in grief but also in $175K of medical debt,” Bored Panda, Feb 27, 2020

Today’s horror story.

March 5, 2020

Toluse Olorunnipa, Josh Dawsey & Yasmeen Abutaleb, “Pence seizes control of coronavirus response amid criticism of his qualifications,” Washington Post, Feb 27, 2020

All statements on the outbreak must pass through the White House and, presumably, reflect Trump’s Pollyannish spin.

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Monique O. Madan, “Immigration officials vow not to raid hospitals as coronavirus spreads,” Miami Herald, Mar 4, 2020

Great way to make sure people don’t report to healthcare facilities when they feel sick—induce fear of deportation. Immigrants are over-concentrated in service roles, meaning they tend to have contact with large numbers of people. Does anyone trust the Trump Administration to rein in ICE raiders? HIPAA protects medical privacy, but will any hospital openly state they will not cooperate with ICE and risk Trump’s wrath sooner or later?

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Jonnelle Marte & Heather Timmons, “Fragile safety net leaves U.S. economy vulnerable to coronavirus hit, Reuters, Mar 4, 2020

Workers who cannot take sick days are more likely to go to work sick and infect others. This is not hard. In a survey, “54% [of all workers] said they were not financially prepared to handle a contagious disease that may limit their ability to work for weeks.” Also, those laid off in ten states will find their unemployment benefits skimpier than after the 2008-09 bust.

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Noah Smith, “Coronavirus might make Americans miss big government,” Bloomberg, Mar 4, 2020

Tragicomic list of all the ways the U.S. has bungled the response.

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Gavin Yameymarch, “A coronavirus vaccine should be for everyone, not just those who can afford it,” STAT, Mar 5, 2020

Appalling and disgraceful that we even have to discuss this. “[D]espite taxpayer funding of these [vaccine development] efforts, Azar speculated that vaccines might not be affordable to all.”

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Sara R. Collins & David Blumenthal, “Why the coronavirus crisis proves we need universal healthcare,” Los Angeles Times, Mar 5, 2020

The epidemic may generate pressure to reverse some of Trump’s Medicaid cuts.

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Yvette Stephens, “I work at the airport in the eye of the coronavirus without health insurance,” USA Today, Mar 3, 2020

Thousands of airport workers are uninsured. The author got a pay raise and lost Medicaid eligibility, recounts hair-raising personal stories among her co-workers. However, her proposed solution is a band-aid to protect workers like herself rather than a universal coverage plan.

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Lev Facher, “Trump’s tone toward pharma shifts, as he looks to drug makers to help with coronavirus response,” STAT, Mar 2, 2020

From a scolding over drug pricing to happy talk about a coronavirus vaccine with Pharma “geniuses.” Next: will Trump break with the anti-vaxxer crowd?

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Eion Higgins, “‘What more do you need to know?’ Health insurance stocks drive Wall Street rebound on Biden Super Tuesday wins,” Common Dreams, Mar 4, 2020

Cigna up 10%, UnitedHealth Group 12%, Anthem 14%.

Feb 20, 2020

Adrienne M. Gilligan, et al., “Death or debt? National estimates of financial toxicity in persons with newly-diagnosed cancer,” American Journal of Medicine, Oct 2018

Fascinating concept: “financial toxicity.” A representative sample of cancer patients showed that the average hit to net wealth was $92,098 with 42% experiencing “complete asset depletion,” academic-speak for total wipe-out, after two years. Financial burden “worsened with improving diagnosis,” so if the cancer doesn’t kill you, the bills will. The impact on morbidity is so severe that these clinicians treat financial aspects as part of their duties of disease management.

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Michael Hiltzik, “Trump’s budget proposal shreds Social Security and Medicaid benefits,” Los Angeles Times, Feb 10, 2020

Dismantles the official talking points about the Trump budget to expose the class war underneath.

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Ben Conarck, “Miami woman doing 35 years in prison for bilking Medicare gets sentence commuted by Trump,Miami Herald, Feb 18, 2020

Keep in mind the next time a Trump Administration official insists that cutbacks in Medicaid or food stamps are designed to “reduce fraud.”

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Matt Bruenig, “The Culinary [Union’s] health insurance is not that great,” People’s Policy Project, Feb 13, 2020

The reports on this dust-up between the big Las Vegas union and Bernie Sanders has not included detail about the supposedly great employer-based insurance that the union has won for its members. Here are some surprising facts about the insurance-everyone-loves.

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Michael Sainato, “‘We can’t afford healthcare’: US hospital workers fight for higher wages,” Guardian, Feb 17, 2020

Hospital employees organize to improve pay, working conditions, and yes, health insurance that they can actually use.

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Alison P.Galvani, et al., “Improving the prognosis of health care in the USA,” Health Policy, Feb 15, 2020

Another academic study endorsing the single-payer approach as fairer, cheaper, and “would save more than 68,000 lives and 1·73 million life-years every year compared with the status quo.”

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Elisabeth Rosenthal, “Who’s profiting from your outrageous medical bills?” New York Times, Feb 14, 2020

Hospitals, doctors, and insurance companies are in a “three-way competition for your money.” The jockeying over legislation reflects the relative strength of each sector’s lobbyists, meaning that the victims of this gouging are a distant fourth.

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Igor Derysh, “American health care system costs four times more than Canada’s single-payer system,” Alternet/Salon, Feb 15, 2020

The U.S. spends $812 billion per year in health administration, or 34% of all health-related spending. On a per capita basis, it is $933 per American (versus $196 in Canada). “The increase in costs was driven in large part due to private insurers’ growing role in administering publicly-funded Medicare and Medicaid programs.”

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Meris Lutz, “Marietta [GA] sues drug company over medicine that went from $40 to $39,000,” Atlanta Journal-Constitution, Feb 18, 2020

Amazing that Pharma gets away with stunts like this, usually after paying a cost-of-doing-business fine. “Marietta says Mallinckrodt has been able to keep Acthar’s price artificially high by acquiring and then shelving the rights to a cheaper synthetic alternative.”

Feb 18, 2020

Caitlin Oprysko, “Nevada culinary union lays into Sanders supporters after health care backlash,” Politico, Feb 12, 2020

The union slammed M4A, then called the pushback “vicious.” The online bio of the union official cited here, Geoconda Argüello-Kline, notes that she “fled” Nicaragua in 1979 as a political refugee, which strongly suggests that her family backed the Somoza dictatorship. Might explain her hostility to “socialism.”

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Russell Mokhiber, “NPR and the escalating attack on single-payer health care,Counterpunch, Feb 14, 2020

Beltway hack Mara Liasson coins the term “Mandatory” Medicare for All in an NPR report since people will have to be coerced into not paying for their healthcare. Anticipate NPR’s next attacks on “mandatory clear air” and “mandatory garbage removal.” No discussion of Buttigieg’s “voluntary” coverage that will cost $7,000 in fines if you don’t sign up.

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Roy M. Poses, “What the heck happened to surprise billing legislation?” Health Care Renewal, Feb 10, 2020

A review of how hospital-friendly corporate Democrats blocked a late 2019 deal to end surprise medical bills.

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Peter Sullivan, “Ex-HHS chief threatens to vote ‘no’ on surprise medical billing measure,” The Hill, Feb 7, 2020

For example, here’s Rep. Donna Shalala (D-Fla.), Obama’s secretary of Health and Human Services, lining up with hospitals and doctor groups controlled by private equity.

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[No author], “Appeals court rebukes administration’s attempt to force work requirements, other barriers on Medicaid program,National Health Law Program, Feb 14, 2020

A welcome judicial veto to the Trump Administration’s attempts to gut Medicaid, which, however, will continue.

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Ian Hill, Emily Burroughs & Gina Adams, “New Hampshire’s experiences with Medicaid work requirements: New strategies, similar results,” Urban Institute, Feb 10, 2020

Yet again, a state’s Medicaid work requirement is shown not to improve entry into the workforce among beneficiaries. However, if the real purpose is to make access to healthcare harder and push people out of the program, then it might be deemed a success.

*

Harris Meyer, “Employer health plan spending jumped 4.4% in 2018,” Modern Healthcare, Feb 13, 2020

How long can the beloved employer-based health insurance system sustain these increases? Four percent a year is more than double core inflation and well above the average pay raise. Average per-person spending for someone with a single chronic condition was $9,187 in 2018.

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Lauren Weber, “Patients stuck with bills after insurers don’t pay as promised,” Kaiser Health News, Feb 7, 2020

This week’s horror story: “retrospective denial.” When your insurer says yes, then retracts after the bills come in.

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Catherine Rampell, “On health care, is Trump malicious or just incompetent? Yes,” Washington Post, Feb 3, 2020

“Republicans appear to remain laser-focused on taking insurance away from as many Americans as possible.” While gaslighting the public with a menu of falsehoods.

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Phil McCausland, “‘On the brink’: Trump’s push for Medicaid transparency could worsen rural hospital crisis,NBC News, Feb 15, 2020

Another example: the Trump Administration’s “financial transparency” rule change designed to further squeeze struggling hospitals, especially those in rural areas. Note that powerful hospital chains are successfully resisting surprise billing legislation while these poorer players are on the chopping block. “The closing of rural health care facilities increased the mortality rate in those populations by 5.9 percent.” Is that a bug or a feature?

Feb 11, 2020

Jess Mason, “Trump slashes foreign aid, cuts safety net programs in new budget proposal,” Reuters, Feb 9, 2020

Cuts to Medicaid, Medicare, disability, and other safety-net programs would total $4.4 trillion over 10 years. In response, will the Dems (1) refuse to succumb to deficit panic; (2) exercise their veto over the runaway war budget; or (3) accept social spending cuts in principle, insist on a little less, then claim they did the best they could?

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Jonathan Cohn, “The Trump Administration is coming for Medicaid again,” HuffPost, Jan 30, 2020

Block grants offer “flexibility” to help states cut coverage and dump beneficiaries, described by the Trump official in charge as “providing better care at a lower cost.” Also includes user fees and lots of talk of “sustainability,” meaning cuts now or cuts later. Plus, states can keep money in block grants not spent on healthcare, so they will have an incentive to grab the cash for other projects.

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Amy Goldstein, “Trump administration’s Medicaid block-grants option touches off ideological fight,” Washington Post, Jan 30, 2020

The Trump block grant proposal targets “able-bodied” beneficiaries, code for nonwhite people who sit around inventing healthcare needs. Broader attacks on other undeserving poor people will follow.

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Doktor Zoom, “Utah flies public employees to Mexico to fill prescription and isn’t that normal?” Wonkette, Jan 06, 2020

RX tourism—expect to hear more about it! “The cold equations mean that it’s literally far cheaper, by thousands of dollars, to fly teachers and office workers—plus a friend!—from Salt Lake City to San Diego, then drive ’em to Hospital Angeles, in a nice upscale part of Tijuana, instead of paying what US pharmaceutical companies would charge.” State of Utah saved $225,000 so far on only ten employee beneficiaries. Next stop: a Vancouver airport pharmacy. This is not excerpted from a science fiction novel.

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CBS NEWS [no byline], “‘You wouldn’t think you’d go to jail over medical bills’: County in rural Kansas is jailing people over unpaid medical debt,” Feb 9, 2020

Local lawyer figured out a new business plan: force medically indebted folks to show up in court every three months for a public shaming, then put them in debtors’ prison if they don’t.

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Dan Primack, “Health care VCs haven’t made plans for a Bernie Sanders win,” Axios, Feb 5, 2020

VC=venture capitalist, the guys who scratch around the economy for quick payouts. They’re not worried since Bernie can’t win.

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Martha E. Gaines, Austin D. Auleta & Donald M. Berwick, “Changing the game of prior authorization: The patient perspective,” JAMA (Journal of the American Medical Association), Feb 3, 2020  

Significant that the AMA is questioning pre-authorization abuse, including the (incredible) “retrospective denials” that saddle patients with bills after they have obtained the go-ahead.

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Megan Messerly, “Culinary Union suggests Sanders, Warren asking union members to trade health plans for ‘promises,’” Nevada Independent, Feb 7, 2020

Union officials say they support the right to healthcare but want to preserve their 130,000 members’ high-end plan, provided “through a special trust fund.” The trust fund must be enormous. Does the union run it in-house? Incidentally, the Nevada Independent is the originator of the tale of the 2016 caucus chair-tossing incident that never happened and marked the onset of the “Bernie Bro” narrative.

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STATE WATCH: GEORGIA

Steven Findlay, “Feds slow down but don’t stop Georgia’s contentious effort to ditch ACA marketplace,” Kaiser Health News, Feb 7, 2020

Georgia proposes to bar residents from the federal Obamacare health insurance exchange in favor of forced enrollment with private companies. Cost savings plan includes the possibility of a waiting list if the pre-set spending cap is reached. Insurers could also sell plans that don’t comply with ACA requirements. “For example, one proposed type of plan could cover just half of a consumer’s costs for care, as opposed to the 80% to 90% levels of ACA’s silver and gold plans. Such a plan would have lower premiums but sharply higher out-of-pocket costs.”

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STATE WATCH: TEXAS

Mitchell Schnurman, “Will voters revolt over health care prices? Texans have plenty of reason to push for change,” Dallas Morning News, Feb 9, 2020

“A growing number of Americans who have health insurance are finding it too expensive to use.” This category (the “underinsured”) is now 25% of all Americans; in Texas it’s almost 50%. “Most Americans are saying they’re ready to give up on the private sector,” said Den Bishop, president of Holmes Murphy, an insurance brokerage and consulting firm. “We’re absolutely at a tipping point.”

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STATE WATCH: OHIO

Cathy Candisky, “Cause for alarm: Thousands more Ohio children have lost health insurance,” Columbus Dispatch, Jan 6, 2020

Rates of uninsured children are creeping up, despite the low unemployment. Reasons are people earning too much to qualify for Medicaid and a “time-consuming and cumbersome” annual renewal process, plus cuts in federal outreach and enrollment assistance.

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STATE WATCH: OHIO

Laura Hancock, “State reveals $1.2 billion Ohio Benefits system riddled with defects a year out from Medicaid work requirements,” cleveland.com, Jan 16, 2020

Another software debacle. System doesn’t work; meanwhile, Ohio is gearing up to add work requirements, guaranteeing further dysfunction.

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STATE WATCH: CALIFORNIA

Melody Gutierrez, “California eyes selling its own brand of generic prescription drugs to battle high costs,Los Angeles Times, Jan 9, 2020

California would become the first state to sell its own brand of generic prescription drugs. The proposal also includes merging all state providers to negotiate drug prices as a bloc.

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STATE WATCH: TENNESSEE

Nathaniel Weixel, “Democrats warn against Tennessee Medicaid block grant,” The Hill, Jan 14, 2020

What are the chances that “vigorous oversight” will happen or be effective in the face of the huge incentive to save Medicaid block-grant money and spend it elsewhere? Block grants are inconsistent with the original Medicaid legislation, but interpretation will depend on Trump-appointed judges.

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STATE WATCH: IOWA

Jeff Stein, “Most Iowa Democratic caucus-goers support a single-payer health-care plan,” Washington Post, Feb 3, 2020

These polls bring in wildly divergent results, usually attributable to differences in phrasing of the question.

Feb 3, 2020

Terri Wilder, “Oral arguments in antitrust case against HIV drug companies began last week. Plaintiff Peter Staley explains the case,” The Body Pro, Jan 28, 2020

This week’s must-read: a lawsuit aims to discover whether Gilead illegally kept generic HIV medications off the market through a secret deal. ACT UP stalwart Staley is a plaintiff, and the article includes background on how activism scored earlier successes against Pharma. Many useful insights.

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Michael Elsen-Rooney, “Queens College professor says he fears financial ruin over cost of crucial HIV drugs under CUNY union’s healthcare plan,” New York Daily News, Nov 13, 2019

Local professor finds that a loophole in his coverage puts him on the hook for tens of thousands of dollars for his HIV medication. “I always thought having a full-time job at a big-time institution meant I had a certain kind of security around things like healthcare,” he said. ACT UP is on this.

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Rachel Cohrs, “Healthcare industry launched lobbying blitz ahead of year-end spending deal,” Modern Healthcare, Jan 24, 2020

Pharma, hospitals, and doctors spent big and scored big. “The Greater New York Hospital Association, an influential force in Senate Minority Leader Chuck Schumer’s (D-N.Y.) home state,” threw in hefty bags of cash. Schumer coincidentally intervened against the surprise billing legislation, which had bipartisan support but tanked at the last minute. Tax repeals amounting to $400 billion of lost revenue did pass, so the companies are getting huge returns on their paltry investments in elected officials.

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Jake Johnson, “Medicare for All ‘is what patients need’: New Harvard study shows even those with private insurance can’t afford care,” Common Dreams, Jan 27, 2020

Sicko by Michael Moore made the same point in 2007. The Harvard study shows financial obstacles among the insured “no improvement in unmet need for physician services.” In fact, their data indicates things have got worse.

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Rachel Cohrs, “States could be next trailblazers for policy regulating hospital costs,” Modern Healthcare, Jan 18, 2020

“The healthcare industry is worried enough that a national coalition has spent six figures advertising against [the Colorado public option] proposal.” State-level fights may be the best tactic for now in the absence of federal action. Note that the ferocious opposition is against a plan that would be run by private insurers, i.e., any change to the status quo will be resisted.

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Luke Darby, “Health-care CEOs made an infuriating amount of money last year,” GQ, Apr 8, 2020

From April, in case we had forgotten: “Last year, 62 CEOs of health-care companies made a combined total of $1.1 billion in compensation.” Or about $17 million each. Or more than the CDC spends on disease control.

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Shannon Brownlee & Judith Garber, “Fragmented health system contributes to medication overload for seniors,” Modern Healthcare, Jan 30, 2020

How overprescribing by specialists not communicating with each other endanger elderly patients.

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Melissa Healy, “US health system costs four times more to run than Canada’s single-payer system,” Los Angeles Times, Jan 8, 2020

Medical admin and insurance company employees “who play no direct role in providing patient care” cost every American man, woman and child an average of $2,497 per year. In Canada, the equivalent cost is $551 per person.

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Sam Finkelstein, “Buttigieg backed by Pharma lobbyist who sought drug price hikes in poor countries,” Sludge, Jan 30, 2020

Touting his seasoned foreign policy team, Mayor Pete failed to vet a top Pharma lobbyist on his list.

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Jake Johnson, “’Cruelty is the point’: Trump takes aim at Medicaid with plan that could harm millions,” Common Dreams, Jan 24, 2020

Trump ramping up the block grant idea to indirectly slash Medicaid.

Jan 22, 2020

Jon Queally, “In historic shift, second largest physicians group in US has new prescription: It’s Medical for All,” Common Dreams, Jan 20, 2020

A huge move toward single-payer from a major group of MDs despite a glaring inconsistency: they simultaneously endorse single-payer AND a public option, which are incompatible.

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Jonathan Cohn, “‘Medicare For All’ has real trade-offs. So does the public option,” Huffington Post, Jan 22, 2020

A fair summary of the current debates although laughably gullible on the “public option” pushed by some candidates, both in terms of its operations and its political viability. The author also slips fully into the canard that taxes must cover federal spending in the face of overwhelming contrary evidence. The conclusion is incoherent.

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Harris Meyer, “Q&A: Kansas Hospital Association CEO praises bipartisan Medicaid expansion deal,” Modern Healthcare, Jan 14, 2020

Red-state Kansas is on the verge of Medicaid expansion after years of official self-harm. “The expansion is expected to ease the rural hospital crisis in his state, where five hospitals have closed since 2010 and another 29 are on the financial brink.” Interestingly, Kansas Republicans did not insist on a punitive work requirement, citing administrative and legal obstacles. But it did include a “work readiness questionnaire” to make sure lazy & undeserving poor people don’t get a free ride.

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Luke Darby, “72 percent of all rural hospital closures are in states that rejected the Medicaid expansion,” GQ Jul 30, 2019

Background from earlier last year. Fun fact: Utah was the only red state to say yes to Medicaid expansion and has had no rural hospital closures.

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Shelby Livingston, “UnitedHealthcare expects big Medicare Advantage gains in 2020,” Modern Healthcare, Jan 15, 2020

For-profit companies eagerly infiltrate Medicare: “Given Medicare Advantage’s rapid growth and support from the federal government, it’s no wonder health insurers are clamoring for a piece of the lucrative market.”

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Dylan Scott, “Taiwan’s single-payer success story — and its lessons for America,” Vox, Jan 13, 2020

“In the 1990s, Taiwan did what has long been considered impossible in the US: The island of 24 million people took a fractured and inequitable health care system and transformed it into something as close to Sen. Bernie Sanders’s vision of Medicare-for-all as anything in the world.” Read in full for the many fascinating details, including problems of physician burnout. “A majority of people in Taiwan disapproved of the single-payer plan when it took effect,” but today, approval is 80%, and spending as a percentage of GDP is flat.

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Rachel Cohrs, “CMS rejects Wyoming plan to lower air ambulance costs,” Modern Healthcare, Jan 16, 2020

The Trump Administration suddenly discovers federal law and finds a way to prevent a state from providing a universal benefit.

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Priyanka Dayal McCluskey, “State seeks to rein in largely unregulated urgent care industry,” Boston Globe, Jan 20, 2020

New for-profit players in the health field dig in their heels against regulation.

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Ana B. Ibarra, “For 2020, California goes big on health care,” California Healthline, Jan 17, 2020

California might take the lead on forcing drug price negotiations and halting surprise bills. Howls of outrage follow.

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Alex Gangitano, “Progressives raise red flags over health insurer donations,” The Hill, Jan 16, 2020

So far in the election cycle: $4.5 million from four companies although the numbers come from not only the industry and its PACs but also “employees and their immediate families.” So it is not the same as lobbyist cash and may reflect the diverse nature of these insurers’ workforces. Nonetheless, the amounts are a reflection of the health industry’s huge role in the overall economy (currently 18% of GDP).

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.

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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?

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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.”