May 19, 2020

Sara R. Colins et al., “New survey finds Americans suffering health coverage insecurity along with job losses,” Commonwealth Fund, Apr 21, 2020

News flash! “Health Coverage Insecurity Accompanies Job Losses.” Who knew? Also 20% of the newly unemployed had no job-based health insurance to begin with. And: “Nearly two-thirds (64%) of adults age 18 and older said the potential out-of-pocket costs would be very or somewhat important in their decision to get care if they had symptoms of the coronavirus.”

*

Andrew Perez, “Democrats are now retreating on a public option amid the pandemic,” TMI, May 5, 2020

“How even in a blue state [Colorado], health care industry propaganda and lobbying can kill a modest reform at the worst possible time.” The plan was a statewide public option, shot out of the sky by the Partnership for America’s Health Care Future Action, “a secretive new group.” Not secret to us.

*

David Sirota, “Insurance companies are not ‘selfless,’” TMI, May 18, 2020

Brilliant reframing: “Health insurance companies now want you to think they are doing you a favor by giving you the product you paid for.”

*

L.J. Dawson, “Under COVID cloud, prisons in rural America threaten to choke rural hospitals,” Kaiser Health News, May 14, 2020

Rural areas economically dependent on prisons and with weak clinical infrastructure face disaster. “Any outbreak has the potential to overwhelm our medical resources.”

*

Erin Cox & Steve Thompson, “Very few of Maryland’s coronavirus tests from South Korea have been used so far. Here’s why,” Washington Post, Apr 29, 2020

Gov. Hogan (R) had to mobilize the National Guard to keep Jared Kushner’s mitts off his state’s stash. But then Hogan the Hero started channeling Kushner: “First of all, the state is going to maintain those tests. We’re not just going to send them off to people.” Also, tests need reagents and swabs. “Without [those] things, they are sort of like paperweights.”

*

Will Dunn, “How America built the best pandemic response system in history – and threw it away,” New Statesman, Mar 24, 2020

The infrastructure included inter-agency coordination mechanisms that now have to be reconstructed. Minor budgets for disaster preparedness were slashed in 2018. Bolton then dissolved the Global Health Security team within the NSC. Chaos reigns.

*

Craig Murray, “Profiting from coronavirus,” Craig Murray [blog], May 17, 2020

Hysteria over foreign governments attempting to hack research findings obscures the fact that ALL findings should be in the public domain as part of international cooperation. “The UK and the US are attempting to hide their vaccine and treatment research results from the rest of the world to make money out of them. They are jealously guarding [their results] and each working in a bubble hoping to be the first in order to cash in.”

*

Willoughby Mariano & J. Scott Trubey, “‘It’s just cuckoo’: State’s latest data mishap causes critics to cry foul,” Atlanta Journal-Constitution, May 13, 2020

Gov. Kemp was desperate to show good pandemic numbers to justify quick re-opening. The state’s health department then produced a chart with the dates in reverse—voila! A decline! “Where does May 2 come before April 26?” In Georgia.

*

Leila Fadel et al., “As hospitals lose revenue, more than a million health care workers lose jobs,” NPR, May 8, 2020

“The very workers tasked with treating those afflicted with the virus are losing work in droves.” 1.4 million of them to date as “elective” surgeries are postponed. Meanwhile, insurance companies, with lower payouts, are cashing in. Important details to read in full.

May 14, 2020

Akela Lacy & Jon Walker, “HEROES Act delivers a win to the health insurance industry,” The Intercept, May 12, 2020

Of the three main players in healthcare delivery—hospitals, doctors, and insurance companies—only the last are thriving. Pelosi’s plan showers them with more benefits instead of recognizing that employer-based health insurance is a failed model. COBRA subsidies do nothing for people who weren’t covered at work to begin with or those who bought policies on the exchanges. “Tying health insurance to employment and therefore, ensuring a loss of insurance during times of unemployment, was a huge problem well before the crisis; the only real difference now is that it is happening to so many people at once.”

*

Lauren Coleman-Lochner, John Tozzi & Jeremy Hill, “Virus pushes America’s hospitals to the brink of financial ruin,” Bloomberg, May 8, 2020

Especially hospitals already on the ropes. Also, private equity ownership of hospitals has “left some facilities hamstrung with debt”—just like PE wrecked Sears and Toys R Us. Expect hundreds more hospital closings, especially in underserved areas.

*

Emily Shugerman, “The hospital CEOs keeping seven-figure salaries as frontline workers go without pay,” Daily Beast, May 2, 2020

And yet: “Thousands of health-care workers across the country have had their wages cut and hours slashed. But some executives don’t seem willing to share in the suffering.” The average hospital CEO’s salary increased 93 percent in the decade between 2005 and 2015 while the average provider’s salary increased just 8 percent.

*

Tim Dickinson, “The four men responsible for America’s COVID-19 test disaster,” Rolling Stone, May 10, 2020

How the Federal Government acted like a deer in the headlights while the virus spread out of control. Staggering details.

*

E. J. Dickson, “Judy Mikovits, disgraced doctor at the center of ‘Plandemic,’ has a bestselling book on Amazon,” Rolling Stone, May 12, 2020

Reminiscent of the HIV-denialist movement, which persisted despite mountains of solid debunking evidence. The anti-vaxers will flog this for years. The book “features a forward by noted anti-vaccine huckster Robert F. Kennedy Jr.”

*

Caroline Lewis, “Cuomo won’t back down on Medicaid cuts—even if it means spurning billions in coronavirus aid,” Gothamist, Mar 31, 2020

“Cuomo has made it clear that he is determined to cut Medicaid in the midst of a massive public health crisis—even if it means risking federal funds designated to provide relief.” The state is giving up $6.7 billion as Cuomo tinkers with Medicaid eligibility. Expect more crying poverty to justify state austerity measures, such as cuts to the indigent care pool.

*

Sydney Lupkin, “Gilead lobbying rose as interest in COVID-19 treatment climbed,” NPR, May 2, 2020

Handy chart

*

Associated Press, “Schumer calls on VA to explain use of unproven drug on vets,” May 10, 2020

About 28% of veterans who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. Thank you for your service! “A whistleblower complaint filed this past week by former HHS official Rick Bright alleged that the Trump administration, eager for a quick fix to the onslaught of the coronavirus, wanted to ‘flood’ hot spots in New York and New Jersey with the drug.” [see story below]

*

Sharon Lerner, “Whistleblower details how Trump’s bureaucrats refused to secure N95 masks as pandemic loomed,” The Intercept, May 7, 2020

“Though officially tasked with quickly mobilizing a national response to public health crises, [Robert] Kadlec, the assistant secretary for preparedness and response and formerly Bright’s boss, is described in the report as a petty tyrant who ignored, mocked, and thwarted Bright’s repeated efforts to address the imminent shortage of masks and other personal protective equipment in January and February as the virus began spreading across the country.” Also, “Kadlec had repeatedly pushed Bright to award government contracts to politically connected companies, including one tied to Trump’s son-in-law, Jared Kushner. Prior to that, Kadlec had served on the staff of Sen. Richard Burr, R-N.C., who is now best known for dumping his stocks while assuring the public about the coronavirus.” [And whose home was raided by the FBI this week]

*

Elisabeth Rosenthal, “We knew the coronavirus was coming, yet we failed 5 critical tests,” Kaiser Health News, May 11, 2020

“Our system requires every player — from insurers to hospitals to the pharmaceutical industry to doctors—be financially self-sustaining, to have a profitable business model. As such, it excels at expensive specialty care. But there’s no return on investment in being primed and positioned for the possibility of a once-in-a-lifetime pandemic.” Which is why language like “return on investment” has no place in health care.

*

David Quammen, “Why weren’t we ready for the coronavirus?” New Yorker, May 4, 2020

Comparisons with the successful response to SARS, ignored as the threat was dismissed. “A smoke alarm doesn’t work when the battery has been removed.”

*

Sarah Owermohle, “The nation’s supply chain isn’t anywhere close to ready,” Politico, May 11, 2020

An interesting dip into the many aspects of getting a vaccine into billions of people that go far beyond the scientific confirmation of efficacy—if that ever comes. “Meeting the overwhelming demand for a successful coronavirus vaccine will require a historic amount of coordination by scientists, drug-makers and the government. The nation’s supply chain isn’t anywhere close to ready for such an effort.” Glass vials, rubber stoppers, refrigeration units, etc., not to mention the U.S. insistence on autarky while the rest of the world works together.

*

Meredith Deliso, “Oklahoma city reverses face mask requirement amid threats of violence,” ABC News, May 3, 2020

Show up with guns and get your way (white people only). “Stillwater (OK) had required customers to wear masks in stores and restaurants. But the mayor quickly amended that policy on Friday afternoon after employees were ‘threatened with physical violence and showered with verbal abuse.’”

*

And finally, some non-COVID news:

Merrill Goozner, “Why are patient groups silent on high drug prices?” Washington Monthly, April/May/June, 2020

A neat hustle: Pharma funds patient groups, which then defend or at least remain silent on price-gouging. “Drugmakers also buy goodwill through funding programs that provide help to poorer patients who can’t afford their co-pays and deductibles.” The author says patient organizations have to look beyond their disease silos.

May 8, 2020

David Sirota, “A coronavirus cover-up is already starting,” TMI, May 7, 2020

Democrats move quickly to ensure that we learn nothing from the debacle and permit Trump to drive the narrative. “The call for bipartisanship is the last refuge of scoundrels who don’t want to be held accountable for anything.” Key figure in this maneuver: South Carolina’s James Clyburn, the CBC power-broker who saved Biden’s campaign. The enthusiasm for George W. Bush’s kumbaya moment fits neatly here.

*

Anna Russell, “The underground efforts to get masks to doctors,” New Yorker, May 7, 2020

“With supply chains gone haywire and the government doing little, ordinary citizens have organized to keep health-care workers protected.” Starve the state; point to its incompetence; privatize; rinse and repeat. Surreal tales of doctors shipping equipment around in unmarked trucks like drug dealers to avoid seizure by FBI agents working on behalf of Kushner. On the other hand, consider the organizing potential of all the pop-up hyper-local groups forming to respond to the emergency.

*

Angus Liu, “Fair price for Gilead’s COVID-19 med remdesivir? $4,460, cost watchdog says,Fierce Pharma, May 4, 2020

“The drug was initially developed as part of a collection of hepatitis C drug candidates, and Gilead has already recouped those costs by successfully selling other treatments in the area.” So, there is no need for Gilead to make anything more than a modest profit on production costs, which are about $10 per 10-day course of treatment.

*

Lee Fang, “Private hospitals, now demanding bailouts, lobbied to defeat cost-saving health reform as coronavirus crisis grew,” The Intercept, Apr 28, 2020

“Private hospital mega-chains have maneuvered in recent months to defeat the expansion of low-cost health insurance coverage, while demanding unprecedented bailouts over the coronavirus crisis.” The Partnership for America’s Health Care Future concentrated on M4A during the presidential primary season, now aims at any threats of state action with a special focus on Colorado. “True West Strategies, a company recently registered by a former aide to former Gov. John Hickenlooper, was also paid by the campaign.” Recall Hickenlooper’s prominent anti-M4A role in the debates. Also: “The chairman of PAHCF, Chip Kahn, the chief lobbyist for the [investor-owned] Federation of American Hospitals, disclosed that his team worked to secure emergency funding for hospitals as part of the nearly $3 trillion in recent federal spending.” A neat pivot: feed at the public trough and while insisting that states “can’t afford” single-payer. Worth reading in full to grasp the level of looting underway.

*

Theodore Hamm, “As virus spreads in nursing homes, Gov. Cuomo’s big donors are immune from liability,” The Indypendent, Apr 23

The liability protection, “tucked away inside the budget bill,” benefits Cuomo’s five-figure donors who own nursing homes. “The Greater New York Hospital Association took credit for writing the legislation.” And here I thought we had an elected legislature.

*

Ese Olumhense, “Family of Bronx woman who died in childbirth gets $2K hospital bill,” The City, May 5, 2020

“Amber Isaac died just days after tweeting that she wanted to write a ‘tell all’ about the ‘incompetent doctors at Montefiore.’” She was pushed into a tele-medicine instead of in-person visit despite a low platelet count. Anecdotal but disturbing.

*

J. David McSwane, “How profit and incompetence delayed N95 masks while people died at the VA,ProPublica, May 1, 2020

This one is beyond belief: “It’s unclear why the VA gave Stewart’s fledgling business — which had no experience selling medical equipment, no supply chain expertise and very little credit — an important [no-bid!] contract. Or why the VA agreed to pay nearly $5.75 per mask, a 350% markup from the manufacturer’s list price.” Chaotic incompetence is a prerequisite for corruption.

*

Josh Wingrove, Daniel Flatley & Shira Stein, “Kushner airlift moves millions of masks, but details are secret,Bloomberg, May 1, 2020

“A program created by Donald Trump’s son-in-law Jared Kushner has airlifted millions of gloves, masks and other coveted coronavirus supplies into the U.S. from overseas — but it isn’t clear who’s getting them and at what price or how much private-sector partners are earning through the arrangement. The U.S. government provides the air transportation for free to speed the arrival of the products. The six distributors keep the profits, if any.” NB: Trump has already said congressional oversight is a joke and ignored impeachment-related subpoenas.

*

Yasmeen Abutaleb & Ashley Parker, “Kushner coronavirus effort said to be hampered by inexperienced volunteers,” Washington Post, May 5, 2020

More on Kushner’s amateur hour. A feature not a bug as corruption first requires chaos and incompetence.

*

Jordan Fabian, “Trump outbid governors on coronavirus supplies after telling them to buy their own,” Bloomberg, Mar 19, 2020

The background for those who came in late.

*

Dan Gorenstein & Leslie Walker, “Coronavirus conundrum: How to cover millions who lost their jobs and health insurance,” WBUR [Boston], May 04, 2020

Why Nancy Pelosi’s proposal to subsidize COBRA is a lousy idea. As usual, the NPR affiliate never considers single-payer as an alternative approach.

*

Rachel Roubein & Dan Goldberg, “States cut Medicaid as millions of jobless workers look to safety net,” Politico, May 5, 2020

State budgets are in freefall, so Medicaid, a large expense, is under threat just as need explodes with millions of newly unemployed. Democrats handed Trump trillions while not insisting on protecting it, now will complain.

*

Jon Asplund, “Ill. nursing home workers offered raise ahead of planned strike date,” Modern Healthcare, May 06, 2020

Direct action is all we have left.

May 4, 2020

Patrick Kennedy, “CEO pay watch: UnitedHealth’s David Wichmann made more than $52 million last year,” [Minneapolis] Star Tribune, Apr 26, 2020

A national emergency won’t get in the way of mega-payouts for the leaders of health finance companies, e.g., total 2019 compensation for David Wichmann, UnitedHealth Group’s CEO was $52,098,104; CEO-to-median employee ($54,322) pay ratio there: 348 to 1.

*

Angela Hart, “Newsom’s ambitious health care agenda crumbles in a ‘radically changed’ world,” Kaiser Health News, Apr 9, 2020  

California governor had planned to “expand the pool of undocumented immigrants covered by Medicaid, enable California to manufacture its own generic drugs, pour billions into the Medicaid program to address chronic homelessness, and dramatically increase mental health and addiction treatment statewide.” Now the state’s budget is in shambles, but some of the plans to get aggressive on costs will make more sense than ever.

*

Arielle Kane, “COVID-19 makes it clear: Medicaid block grants will make everyone worse off,” The Hill, Apr 4, 2020

“COVID-19 demonstrates why block grants are irresponsible and hurt the most vulnerable.” A pre-set fixed dollar contribution from the feds makes no sense in a huge medical emergency. Also, Medicaid is counter-cyclical, meaning that when the economy tanks, Medicaid spending goes up, and the fresh injection of federal dollars helps sustain purchasing power. Oklahoma and Tennessee push ahead with block grants anyway.

*

Susannah Luthi & Rachel Roubein, “White House still scrambling to cover virus treatment for the uninsured,” Politico, Apr 20, 2020

Talk is cheap, but the bills keep coming. “The White House pledged [in early April] to cover coronavirus treatment for uninsured Americans — but the administration still doesn’t have a plan for how to do it.” Meanwhile, Democrats insist that federal funds be funneled through for-profit insurers. And hospitals don’t know where to send the bill.

*

Laurie McGinley, “FDA did not review many coronavirus antibody tests flooding the market,” Washington Post, Apr 19, 2020

Here are the four tests that have been rigorously examined and authorized: Cellex, Chembio Diagnostic Systems, Ortho Clinical Diagnostics and Mount Sinai Laboratory. The other 80-plus on the market also might work—or not. Also, the degree of immunity—if any—indicated by an antibody-positive test is unknown.

*

Carmen Heredia Rodriguez, “COVID tests are free, except when they’re not,” Kaiser Health News, Apr 29, 2020

Labyrinthine rules for when a provider can order the test, when a patient is covered, and how much the insurer has to pay.

*

Isaac Arnsdorf, “Health insurers to investors: We’re good. Health insurers to lawmakers: Please help,” ProPublica, Apr 28, 2020

Brilliant juxtaposition of what insurers say to Wall Street analysts and what they say to Congress when lobbying for subsidies.

*

Susannah Luthi, “The unlikely alliance trying to rescue workplace health insurance,” Politico, Apr 28, 2020

“Big businesses and powerful Democrats are aligning around a proposal to bail out employer health plans.” What’s unlikely about that? Democrats have been more enthusiastic than Trump about keeping insurance companies in the financing loop. The hospital-insurance-union lobbying group pushing this is called “Families USA.” Aww.

*

Daniel Horn, Wayne Altman & Zirui Song, “Primary care must be saved from being devastated by covid-19,” STAT, Apr 29, 2020

“Most [primary care practices] rely on an outdated payment model: each in-person visit with a patient generates a payment. Without in-person visits, there is little to no revenue. To prevent the spread of Covid-19, practices are actively discouraging patients from coming into the office.” And Medicare compensates telemedicine visits at half the usual rate. Sixty thousand independent practices may collapse. The authors propose capitation payments as an alternative to fees-for-service.

*

Daniella Silva, “Health care experts say coronavirus exposes major flaws in medical system,” NBC, Apr 29, 2020

Amazing that such an astute, critical examination of the problems facing our current healthcare delivery system can totally omit single-payer as a conceivable solution. Self-censorship or ideological blinders?

*

Ivana Kottasová, Tami Luhby & Valentina Di Donato, “She was asked to pay thousands for her coronavirus treatment, he got a free ride. She’s American. He’s Italian,” CNN, May 1, 2020

“Leah Blomberg and Marco Paolone both called an ambulance when their coronavirus symptoms worsened. Both spent time in intensive care, both were unconscious for days, and both were on a ventilator.” He paid zero; she’s on the hook for $2000 just for the ambulance. “The evidence so far suggests that more centralized, publicly funded systems with universal coverage and a solid chain of command and control have been weathering the crisis better.” Really?

*

Arman Azad, “Remdesivir: US government will decide where drug goes amid coronavirus pandemic, Gilead Says,” CNN, May 3, 2020

Hardly reassuring to put the decisions about treatments in the hands of Jared Kushner and Trump as they openly retaliate against critics. Will New York get any?

Apr 28, 2020

Charles Duhigg, “Seattle’s leaders let scientists take the lead. New York’s did not,” New Yorker, Apr 26, 2020

Today’s must-read, no paywall. Why Washington State is way down the list of corona hotspots while New York buries hundreds per day. Lesson 1 from epidemic experts: don’t put politicians on camera every night.

*

Vale Disamistade, “No, Italy is not the case against Medicare for All,” The Nation, Apr 14, 2020

In fact, just the opposite: “When Covid-19 reached Italian shores, it found a country in the midst of a private-sector transformation that has been turning the country’s single-payer health care system into an Italian version of Biden’s beloved ‘public option.’” Italy’s system was being Americanized through austerity and the simultaneous decision to rip open the healthcare field to private competition.

*

Marc A. Thiessen, “Why this pandemic is an indictment of socialized medicine,” Washington Post, Apr 14, 2020

Playbook: (1) cut public services, drown government in the bathtub, wreck the bureaucracy; (2) point at how awful things are; (3) privatize; (4) hire PR shills to tout the superior private sector; (5) rinse and repeat. The article is a (4). “Contrast the incredible job our private health-care system is doing today with the utter incompetence of the federal government in preparing for today’s pandemic.” Thiessen is a right-wing hack from the American Enterprise Institute and wrote a book defending torture.

*

Siddhartha Mukherjee, “What the coronavirus crisis reveals about American medicine,” New Yorker, Apr 27, 2020

A deep dive into the problems COVID has unearthed from the supply chain folly of outsourcing to the destruction of doctor notes by Electronic Medical Records (“Because notes are used to bill, determine level of service, and document it rather than their intended purpose, which was to convey our observations, assessment, and plan. Our important work has been co-opted by billing.”) Twitter works better. The only shortcoming of the article is its assumption that those in charge must want government to work efficiently, instead of recognizing their deep, structural attachment to its failure [see previous article].

*

Angela Hart & Anna Maria Barry-Jester, “The inside story of how the Bay area got ahead of the COVID-19 Crisis,” Kaiser Health News, Apr 21, 2020

“[Public health authorities] were able to move swiftly because they had a secret weapon: a decades-long alliance seeded in the early days of the AIDS epidemic that shields them from political blowback when they need to make difficult decisions.” The Bay area’s stay-at-home order came days before any of the states took action. Also, “County health officers in California have immense power to act independently in the interest of public health, including the authority to issue legally binding directives. They don’t need permission from the governor or mayors or county supervisors to act.” Politicians had to take a back seat.

*

Isaac Arnsdorf, “Medical staffing companies cut doctors’ pay while spending millions on political ads,” ProPublica, Apr 20, 2020  

The companies behind the ads, TeamHealth and Envision Healthcare, are owned by private equity firms KKR and Blackstone. Their astro-turf vehicle, called “Doctor Patient Unity,” [aww] spent $57 million on ads since June 2019. They also demand bailout money.

*

Karl Evers-Hillstrom, “Congress invests big in pharmaceutical, tech stocks,” opensecrets.org, Apr 27, 2020

“In the most recent financial disclosures filed last year, lawmakers reported holding tens of millions of dollars in tech and pharmaceutical stocks.”

*

Anna Case & Angus Deaton, “American health care is an engine of inequality,” New York Times, Apr 14, 2020

Case & Deaton introduced the concept of “deaths of despair” as a byproduct of modern capitalism. “The first step to reform is to change the way we think about the health care system. Many Americans think their health insurance is a gift from their employers — a ‘benefit’ bestowed on lucky workers by benevolent corporations. It would be more accurate to think of employer-provided health insurance as a tax.”

*

Cathy O’Neil, “10 reasons to doubt the Covid-19 data: The pandemic’s true toll might never be known,” Bloomberg, Apr 13, 2020,

How to read the numbers.

*

Anita Kumar & Gavin Bade, “States still baffled over how to get coronavirus supplies from Trump,” Politico, Apr 13, 2020

Tragicomic incompetence and playing favorites based on who lavishes praise on Trump.

*

Jay Hancock, Phil Galewitz & Elizabeth Lucas, “Furor erupts: Billions going to hospitals based on Medicare billings, not COVID-19,” Kaiser Health News, Apr 10, 2020

“States such as Minnesota, Nebraska and Montana, which the pandemic has touched relatively lightly, are getting more than $300,000 per reported COVID-19 case in the $30 billion. On the other hand, New York, the worst-hit state, would receive only $12,000 per case.”

Apr 24, 2020

Shelby Livingston, “Health insurer CEOs score big paychecks despite public scrutiny,” Modern Healthcare, Apr 22, 2020

Insurance execs doing fine. “UnitedHealth Group CEO David Wichmann’s total compensation reached $18.1 million [$25.1 million with stock options].” Glad to see my premiums are doing God’s work!

*

Susan B. Glasser, “How did the U.S. end up with nurses wearing garbage bags?” New Yorker, Apr 9, 2020

“A fragmented procurement system now descending into chaos.” Gory details of why states have to take matters into their own hands. One source describes “a government failure by design—not a problem to be fixed but a policy choice”—an important insight: make it fail, then demand privatization.

*

Sheelah Kolhatkar, “How private-equity firms squeeze hospital patients for profits,” New Yorker, Apr 9, 2020

Private equity firms Blackstone and KKR bought up doctors’ practices, then jammed out-of-network bills on powerless consumers. Congress acquiesced. The multiple COVID-19 bailouts have not fixed this.

*

David Willman, “Contamination at CDC lab delayed rollout of coronavirus tests,” Washington Post, Apr 18, 2020

“The failure by the Centers for Disease Control and Prevention to quickly produce a test kit for detecting the novel coronavirus was triggered by a glaring scientific breakdown at the CDC’s central laboratory complex in Atlanta.” Logical conclusion to the government-is-the-problem, let’s-drown-it-in-the-bathtub approach. “Where was the adult supervision?” a former CDC lab chief said.

*

Michael Grabell, Bernice Yeung & Maryam Jameel, “Millions of essential workers are being left out of COVID-19 workplace safety protections, thanks to OSHA,” ProPublica, Apr 16, 2020

“Even as the federal worker-safety agency has been inundated with complaints, it has rolled back safety standards and virtually eliminated non-health care workplaces from government protection.” OSHA is not represented on the White House Coronavirus Task Force. However, strikes have had some effect.

*

Katharine Gammon, “How the anti-vaccine community is responding to covid-19,” Undark, Apr 16, 2020

When and if there is a vaccine, count on these Trumpian activists to undermine its effectiveness.

*

Jeanmarie Evelly, “Decades of shrinking hospital capacity ‘spelled disaster’ for New York’s COVID response,” City Limits, Apr 15, 2020

Pushback on big hospital chains’ moves to eliminate community hospitals as they prefer costlier specialty procedures. Result: we need a Navy ship to handle an emergency. “They have been prioritizing same-day surgery and other profitable services and trying to abandon lower-income communities, where patients are predominantly people of color.” Details on the shutdown of Mount Vernon Hospital.

*

Howie Klein, “There are worse governors than Andrew Cuomo, but none who are personally responsible for as many coronavirus deaths,” Down with Tyranny, Apr 13, 2020

“In the midst of the pandemic response he botched so badly, Cuomo just forced through a budget that drastically cuts healthcare funds to [minorities with high COVID death rates].” Also reports that Maggie Moran, Cuomo’s top political operative (“the one not currently serving a prison term”) is helping organize and fundraise against AOC. But he speaks so nicely!

*

Dan Ming, “We talked to an ICU nurse working in an overwhelmed coronavirus ward,” Vice, Apr 14, 2020

Moving testimony about conditions and a broader view of healthcare delivery 2020.

*

David Dayan, “Unsanitized: The mystery of Donna Shalala’s unreported stock sales,” American Prospect, Apr 21, 2020

No accident that former Obama cabinet officer Shalala was Pelosi’s choice for the corporate bailout oversight panel. Shalala’s chief of staff, Jessica Killin, previously spent ten years as the top lobbyist for a bank.

*

David Lim & Brianna Ehley, “Inside America’s testing snafu,” Politico, Apr 22, 2020

“The problem with the federal plan is that it is not a federal plan,” said Jeremy Konyndyk, a former USAID official who worked on Ebola response during the Obama administration. “It’s a list of things they think the states should do.” Yet, mass testing and contact tracing are supposed to part of the back-to-work strategy.

*

Fenit Nirappil, Erin Cox & Gregory S. Schneider, “Maryland buys 500,000 coronavirus test kits from South Korea, Hogan announces,” Washington Post, Apr 20, 2020

Maryland’s (Republican) governor wangled a purchase of 500,000 tests from South Korea through his Korean wife. The Trump administration “made it clear over and over again that states have to go out and do it ourselves.”

*

Ed Kilgore, “What Biden can do about pressure to embrace Medicare for All,” New York, Apr 13, 2020

“Whether or not this approach appeals to him, Biden needs to start making serious concessions to the left on health-care policy or let it be known quietly that he’s gone as far as he can. . . . The key would be recognition of a single-payer system like Medicare for All as an ultimate goal.” Erroneously assumes facts not in evidence, i.e., that Biden and the corporate wing want to sideline the for-profit insurance companies.

*

Justine Coleman, “New York nurses’ union sues state, hospitals over coronavirus working conditions,” The Hill, Apr 20

Montefiore Medical Center, Westchester Medical Center and the state DoH.

*

Justine Coleman, “Chile to issue world’s first ‘immunity passports’ to people who have recovered from coronavirus, The Hill, Apr 20, 202

This presumes that antibodies = immunity, which has not been demonstrated. Chile’s right-wing government is fully in the Trumpian mode of saving the economy, even if kills the workers

Joseph Zeballos-Roig, “Fed Chair Jerome Powell calls out massive US health spending, says Americans are ‘getting nothing’ in return,” Business Insider, Feb 12, 2020

A curious additional voice calling out the dysfunction in U.S.-style health care. “We spend 6% to 7% of GDP more than other countries. That’s a lot of money that you are effectively spending and getting nothing.” This business paper called the statement “brutal.”

*

Eoin Higgins, “Why the unnecessary 6?: Medicare for All advocates warn Biden that lowering age to 60 solves nothing,Common Dreams, Apr 9, 2020

Not a U-turn as it refuses to touch the role of for-profit insurance in the financing of health care. Also, is there any evidence that this incremental change wouldn’t be opposed just as ferociously as M4A?

*

Rachel Roubein, “Rural hospitals shut out of stimulus loans face financial crisis,” Politico, Apr 14, 2020

“Government-owned hospitals [are] in danger of running out of money just as the virus hits the heartland.” Democrats now “plead” with Trump to fix the problem with an exception—why didn’t they demand it before saying yes? Dems can veto anything but choose not to.

*

Rosie Collington, “Who benefits when the price of insulin soars?” Institute for New Economic Thinking, Apr 16, 2020

“Contrary to pharmaceutical company claims, revenue from high insulin prices are [sic] going to shareholders, not R&D.” Nothing new.

Apr 20, 2020

C. Jason Wang, Chun Y. Ng & Robert H. Brook, “Response to COVID-19 in Taiwan,” Journal of the American Medical Association (JAMA), Mar 3, 2020

“Taiwan has 23 million citizens of whom 850,000 reside in and 404,000 work in China. In 2019, 2.71 million visitors from the mainland traveled to Taiwan. . . . COVID-19 occurred just before the Lunar New Year during which time millions of Chinese and Taiwanese were expected to travel for the holidays.” Nonetheless, Taiwan has almost NO cases of COVID-19. Why? “Taiwan quickly mobilized and instituted specific approaches for case identification, containment, and resource allocation to protect the public health. Taiwan leveraged its national health insurance database and integrated it with its immigration and customs database to begin the creation of big data for analytics; it generated real-time alerts during a clinical visit based on travel history and clinical symptoms to aid case identification.” Other fascinating details of how a real public health system works. We’re light-years away from anything comparable.

*

Clio Chang, “Democrats big coronavirus idea is to subsidize health insurers,” Vice, Apr 14, 2020

Democrats’ response to the collapse of employer-based health insurance: keep private gatekeepers in charge by paying 100% of COBRA premiums. Opens up room for Trump to run to the left of the Democrats as the White House floats the idea of paying hospitals directly for COVID care.

*

Natalie Shure, “The Democrats’ COBRA proposal is an insurance industry bailout,” In These Times, Apr 17, 2020

“Private insurance firms require public funding to perform basic functions less satisfactorily than their peer programs in the public sector.”

*

Donald Shaw, “Dems’ health insurer bailout follows bundled checks from the industry’s lobbyists,” Sludge, Apr 15, 2020

Why do it this way? “Health insurance lobbyists have collected nearly a quarter of a million dollars for the DCCC so far this cycle.” The COBRA-reimbursement plan “mirrors a recommendation put forward recently by the health insurance industry.” Good return on investment: a million bucks in exchange for billions in fresh cash.

*

David Sirota, “Will big Pharma fleece us on a COVID treatment that we helped fund?” Too Much Information, Apr 18, 2020

Gilead: the company that “raked in billions in profits from exorbitantly priced Hepatitis C medications that were developed with taxpayer dollars, then shifted those profits to offshore tax havens where it dodges U.S. taxes.” COVID drug Remdesivir had ample government funding in its early stages, so no, drug companies should not be compared to Jonas Salk.

*

Carol D. Leonnig, Jonathan O’Connell & Michelle Ye Hee Lee, Washington Post, “Behind the scenes, private equity angles for a piece of stimulus,” Washington Post, Apr 6, 2020

Private equity sausage getting made at the White House. “The private-equity industry is pushing to qualify for various pots of stimulus funds, arguing that companies with investors should not be left out of the relief effort.” Note the bipartisan lobbying effort on behalf of the plutocrats.

*

Michael Sainato, “U.S. for-profit healthcare sector cuts thousands of jobs as pandemic rages,” Guardian, Apr 14, 2020

In March alone, 43,000 health care jobs were lost because they were engaged in high-return activities that suddenly shut down. “We have a healthcare system where you excel in normal times by stressing what’s needed the least, and then when we have an emergency and the need is greatest, you’re in financial trouble.”

*

Rachana Pradhan & Lauren Weber, “The COVID-19 bailout that’s left every hospital unhappy in its own way,” Kaiser Health News, Apr 16, 2020

Unequal per-patient compensation, vast differences in patient populations and disparities among states, rural v/s urban realities, and a single $100 billion pot for hospital support, plus “complete discretion” on who gets it by Trump’s top health officials—what could go wrong? (Indiana did well.)

*

Mira B, “Detroit nurses ordered to leave hospital after refusing to work,” The Source, Apr 8, 2020

Work stoppages as a last resort: “We had two nurses the other day who had 26 patients with 10 ventilators,” [ER nurse Sal] Hadwan shared. “The nurses need extra help because for three straight weeks they’ve had more than 110 patients in the ER.” Where’s the political support—anyone?

*

Luke Kenton, “‘Land of the free!’ Healthcare workers are heckled by anti-lockdown protesters as they stand in front of their cars in Colorado and more demonstrations erupt across the US,” Daily Mail, Apr 19, 2020  

Additional comment superfluous.

Apr 14, 2020

Supply chain follies

*

Andy Kroll, “Absolute clusterf–k’: Inside the denial and dysfunction of Trump’s Coronavirus Task Force,” Rolling Stone, [advance of publication] May 2020

VP Pence’s official Task Force v/s Kushner’s insiders committee. [Sen. Chris Murphy (D-Conn.)] says, “I walked away from that conversation scratching my head, like, ‘Who’s in charge?’” Possible answers:  the White House, DOD, FEMA, HHS, and Jared Kushner’s father-in-law. Tragicomic story about Chicago mayor Lightfoot’s attempt to find out what her airport was supposed to do.

*

Brent Korson, “‘This is going to be constant from this point on’: As coronavirus surges, tracking the PPE shortage storm in some states, and the calm before, in others,” Tarbell, Apr 10, 2020

“Like being on eBay with 50 other states” in a bidding war.

*

Jonathan Allen, Phil McCausland & Cyrus Farivar, “Behind closed doors, Trump’s coronavirus task force boosts industry and sows confusion,” NBC News, Apr 7, 2020

The Federal Government, under Trump’s new emergency powers, can take control of orders, divert shipments, and decide which private entity gets to profit, i.e., excellent conditions for corrupt insider-dealing. Also clarifies Kushner’s statement that “it’s supposed to be our stockpile, it’s not supposed to be states’ stockpiles.” Also: “Controlling the flow of goods at a time of scarcity and need gives Trump tremendous leverage to reward allies and punish enemies, including governors, mayors and executives at companies.”

*

Geoff Mulvihill, “U.S. state shares, get creative in hunt for medical supplies,” Associated Press, Apr 9, 2020

“President Donald Trump told governors to take care of their own needs. States said they were trying but that bidding in a global marketplace for the supplies was highly competitive and expensive, pitting states against each other, their own hospital systems and other countries, including the U.S. government.” And red states get priority: “Alaska and Wyoming, for example, received more than 300 respirators for every confirmed case, while hard-hit New Jersey received just six per case.”

*

Noam N. Levey, “Hospitals say feds are seizing masks and other coronavirus supplies without a word,Los Angeles Times, Apr 7, 2020

“The federal government is quietly seizing orders, leaving medical providers across the country in the dark about where the material is going and how they can get what they need to deal with the coronavirus pandemic.” Equipment purchases can’t get answers. No one is in charge, but don’t dare criticize.

*

Lydia DePillis, “Lessons learned from running ICUs in disaster zones,” ProPublica, Apr 11, 2020  

“Hospitals are starting to look less like part of a wealthy country’s medical system and more like the makeshift clinics in disaster zones or the developing world.” Tips for the USA from Rwanda and Guinea.

*

Jacqueline Charles & Alex Harris, “Caribbean nations can’t get U.S. masks, ventilators for COVID-19 under Trump policy,” Miami Herald, Apr 11, 2020

“In the past week, three Caribbean nations —the Bahamas, Cayman Islands and Barbados —have all had container loads of personal protective equipment purchased from U.S. vendors blocked from entering their territories by U.S. Customs and Border Protection.” Including 8 ventilators headed for the Cayman Islands. Eight.

*

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

Don’t seek help from FEMA, HHS, or the CDC. Try the FOT instead (Friends of Trump).  

*

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

Cities and states scramble to get supplies as the Federal Government flails about and the Jared commission cooks up deals. Says one logistics VP, “From our perspective, it’s this unbelievable place we find ourselves in — realizing we have a vulnerable supply chain.” Translation: I never knew we bought all our stuff from China!

*

Greg B. Smith, “An insane situation: Inside the chaos at Bellevue Hospital,The City, Apr 13, 2020

Official optimism and 7:00 o’clock cheers v/s reality in the hospitals.

*

And finally . . .

Charles Rabin & Aaron Leibowitz, “Private island bought coronavirus tests for every resident,” Miami Herald, Apr 13, 2020

“Fisher Island — an exclusive enclave of multimillion-dollar condos and homes and one of the wealthiest ZIP codes in the country — has purchased thousands of rapid COVID-19 blood test kits from the University of Miami Health System for all of its residents and workers.” The rest of Florida has a 1% testing rate.

Apr 12, 2020

Rachel Cohrs, “HHS to use coronavirus relief funds to pay for care for uninsured,” Modern Healthcare, Apr 3, 2020 

Trump floats the idea of moving toward single-payer for COVID-19, suggesting that the Federal Government might pay hospitals directly, bypassing insurers. Says one expert: “It is astounding that the Trump administration would prefer that people remain uninsured, with the federal government picking up the entire tab for COVID treatment, than enroll in private health insurance.” Only if you think Trump is constrained by ideology. Also, non-Medicaid-expansion states like Texas would get more money this way. Weirder things have happened. After all, the innovation of universal, state-funded healthcare came from Bismarck.

*

Ezra Klein, “It’s time to move past employer-based health insurance,” Vox, Apr 9, 2020

Klein, a middle-of-the-roader, admits that “Tying health insurance to employment is now, and always has been, a disaster” and that now it will get worse. He disses the Biden plan and offers as an alternative Medicare Extra, “the middle ground that this moment demands.” He doesn’t explain why the industry that will do anything to stop M4A would be any happier with this.

*

Adriana Belmonte, “Coronavirus and the U.S. health insurance system is ‘a recipe for disaster,’” Yahoo Finance, Apr 10, 2020

Nothing much new in this article except that it comes from the financial media and focuses on the crushing payouts facing the insurance industry. Estimates of next year’s premium increases range up to 40%.

*

Adam Gaffney, “Eight needed steps in the first against COVID-19,” Boston Review, Apr 3, 2020

From PNHP. Most of the 8 are political 180s and unlikely for now. But (1.) “Immediately protect patients from medical costs due to COVID-19” and (6.) “Stabilize hospital financing while protecting patients from hospital costs” are doable even for ideologically straitjacketed Republicans.

*

Susannah Luthi, “’Surprise’ billing fix could hitch ride on next coronavirus relief bill,” Politico, Apr 9, 2020

Still no resolution on how much of COVID care will hit patients’ pocketbooks as confusion abounds in the multi-payer system. Deaths go unrecorded as people avoid treatment. “[A]bout 30 percent of emergency departments are run by private equity-backed physician groups — including some companies currently being investigated by Congress for their billing practices.”

*

Blake Farmer, “Long-standing racial and income disparities seen creeping into COVID-19 care,” Nashville Public Radio, Apr 6, 2020

Findings: “Doctors may be less likely to refer African Americans for testing when they show up for care with signs of infection.” And in Nashville, “Most of the testing in the region took place at walk-in clinics managed by Vanderbilt University Medical Center, and those are primarily located in historically white areas.” Most localities are not disaggregating data by race/ethnicity.

*

Isaac Scher, “The Trump administration issued a new rule that blocks guaranteed paid sick leave for 75% of American workers,” Business Insider, Apr 3, 2020

Trump & Co. immediately drive their tank through a loophole to punish workers trying to get sick leave. Secretary of Labor: Eugene Scalia, son of late Supreme Court Justice Antonin Scalia.

*

Eileen Appelbaum & Rosemary Batt, “Hospital bailouts begin…for those owned by private equity firms,” American Prospect, Apr 2, 2020

Step (1): acquire a hospital through a leveraged buyout (LBO), loading up the hospital with new debt; (2) run the hospital’s finances into the ground by selling its real estate and forcing it to pay rent, plus the new debt; (3) apply for a bailout from the CARES slush funds, threatening to close the hospital if no pay-off materializes. Voilà, the “emergency” COVID-19 funding fattens the bank accounts of the super-rich.

*

Ray M. Poses, “During the pandemic, follow the money: Hospitals and health care provider organizations put money ahead of clinician and patient safety, public’s health,” Health Care Renewal, Apr 2, 2020

“Most hospitals, like other health care organizations, are in the grip of managerialism, which makes short-term revenue the first priority of all organizations and undermines the health care mission.”

*

Isaac Arnsdorf, “A major medical staffing company just slashed benefits for doctors and nurses fighting coronavirus,” ProPublica, Mar 31, 2020

They are employed by Alteon Health, backed by private equity outfits Frazier Healthcare Partners and New Mountain Capital.

*

Harris Meyer, “Utah suspends Medicaid work requirement due to COVID-19,” Modern Healthcare, Apr 2, 2020

Utah bows to reality as 16 million U.S. jobs disappear in less than a month. Oklahoma, on the other hand, plows forward with its Medicaid work requirement, premiums, and copays. “The punishment will continue until morale improves.”

*

Saurav Upadhyay, “The problem with saying we’re ‘at war’ with the coronavirus,” American Friends Service Committee [Quakers], Apr 8, 2020

Cautionary words about the use of war metaphors. We went through this with HIV. It’s not helpful.

Apr 6, 2020

Today’s focus is on market economics as a way to provide healthcare.

*

Maria Cramer, “Philadelphia hospital to stay closed after owner requests nearly $1 million a month,” New York Times, Mar 27, 2020

Five hundred beds gone. But see below: even without the hospital deal, the new owner is set to get a big tax break.

*

Akela Lacy, “A private equity baron sitting on an empty Philadelphia hospital is in line for huge tax gift in the COVID-19 stimulus,” The Intercept, Apr 1 2020

The bill retroactively change real estate depreciation rates plutocrats can use to avoid taxes. “Former Vice President Joe Biden, a Pennsylvania native whose campaign headquarters is in Philadelphia, has not taken a position on the issue.”

*

Peter S. Arno & Philip Caper, “Medicare for All: The social transformation of U.S. health care,” Health Affairs, Mar 25, 2020

Corporatization of healthcare: “The problem is not that these corporate entities are doing something they shouldn’t. They are simply doing too much of what they were created to do—generate wealth for their owners. . . . The cultural changes accompanying these trends have affected every segment of the US health care system, including those that remain nominally not-for-profit.” The top 7 investor-owned health insurance corporations control $913 billion of national health-related spending.

*

Meagan Day, “Decades of hospital closures led to this disaster,” Jacobin, Apr 4, 2020

“Desperate times call for desperate measures. But these times didn’t have to be so desperate to begin with. New York City has lost nearly twenty hospitals, and tens of thousands of hospital beds, in the last two decades.” Man of the Hour, Austerity Andrew Cuomo, watched this process benignly as the failing “businesses” were shuttered.

*

Mark Brown, “Illinois adjusts on the fly to meet medical supply needs in a coronavirus ‘Wild West,’” Chicago Sun-Times, Apr 3, 2020

Free-market tragicomedy: a state official raced to hand-deliver a check to beat out the competition for N95 masks. “When they find what they need, they have to move immediately to complete the purchase before losing out to another bidder — even as the competition causes prices to jump.”

*

Peter Slevin, “Illinois confronts a chaotic White House approach to the Coronavirus,” New Yorker, Apr 4, 20020

The Keystone Kops’ “Emergency Preparedness” training film: “What I’m hearing from mayors across the country [says Chicago Mayor Lightfoot] is this little bit of the allocation that they’re getting is essentially worthless. It’s product that is expired and, worse, that is really in poor condition and disintegrating.” Laugh & cry details abound.

*

Kim Willsher, Julian Borger & Oliver Holmes, “US accused of ‘modern piracy’ after diversion of masks meant for Europe,” Guardian, Apr 3, 2020

Bare-knuckles slugfest in the best of all possible free-market worlds. Cuomo: It’s “like being on eBay with 50 other states.” Meanwhile, Trump orders 3M not to sell to Canada or Latin America.

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.”

*

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.

*

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.”

*

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.  

*

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.

*

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.

*

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.

*

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.”

*

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).

*

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.

*

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.]

*

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.

*

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.”

*

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?)

*

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.”

*

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.”

*

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!  

*

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.

*

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.”

*

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.

*

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.

*

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!

*

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).

*

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.”

*

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.

*

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.

*

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).

*

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.

*

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.

*

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.

*

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?”

*

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.

*

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.

*

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?

*

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.

*

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.

*

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.”

*

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.

*

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.”

*

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.

*

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.”

*

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.

*

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.

*

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.

*

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.”

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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?

*

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.

*

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.

*

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.”

*

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.

*

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.

*

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?

*

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.

*

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.

*

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.”

*

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.

*

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.

*

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.”

*

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.

*

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.”

*

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.”

*

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.

*

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.

*

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.

*

[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.

*

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.

*

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.

*

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.

*

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?

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.”

*

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.”

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.

*

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.”

*

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.

*

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.

*

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.

*

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.

*

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.

*

Bryce Covert, “How Medicaid expansion is transforming politics as we know it,” The Nation, Jan 6, 2020

Medicaid expansion, i.e., enrolling people in a simplified, single-payer system without expensive premiums, deductibles, and co-pays, is extremely popular across all political viewpoints. Who knew?

*

Michael Brady, “States can do more to make healthcare affordable, report says,” Modern Healthcare, Jan 7, 2020

Oregon has done best in cramming down costs through “efforts to increase price transparency, creating a permanent organization to oversee healthcare spending, establishing all-payer spending benchmarks and building out claims data for all payers.”