Category Archives: Health Insurance

Whistleblower Reveals Effort of Employer to Crush Medicare for All

An employee at the insurance giant UnitedHealthcare leaked a video of his boss bragging about the company’s campaign to preserve America’s for-profit healthcare system.

“I felt Americans needed to know exactly who it is that’s fighting against the idea that healthcare is a right, not a privilege,” the anonymous whistleblower told the Washington Post‘s Jeff Stein.

UnitedHealthcare CEO Steve Nelson boasted at an employee town hall about how much his company is doing to undermine Medicare for All, which is rapidly gaining support in Congress.

So begins an article from Common Dreams.org by staff writer Jake Johnson.

Naturally, UnitedHealthCare is not the only insurance company that is actively seeking to thwart the move towards Medicare for All, but this is the first time that an insider actually provided the media with proof that their leaders are engaged in such activities.

As I wrote in my post, By What Right?, these individuals believe they can supersede the right of all Americans to have decent, affordable health care that does not force them into bankruptcy, or to go without because they cannot afford treatment for serious illnesses or diseases, or expensive medications.

Like the individuals I cited in that post, Mr. Nelson and his colleagues at other insurance companies are defending a turf that is indefensible. Their only motive is greed and profit at the expense of those who suffer from disease or life-threatening illnesses.

They are protecting their companies bottom-lines and their investors’ money, and don’t care about the people who need medicines and treatments that can extend their lives or save their lives.

How much longer will we let the Steven Nelson’s dictate to the American people what form our health care takes, and who gets to decide who gets covered and who doesn’t. He shouldn’t, and neither should anyone else in the medical-industrial complex.

Why Medicare for some is the wrong idea | TheHill

From the Overnight News Desk:

Diane Archer wrote in The Hill Monday on why half measures on Medicare for All, so-called “Medicare for Some” is not the answer to our current health care crisis.

In her article, she takes aim at the very root of the problem, commercial health insurance. This article should serve as confirmation of the issues I raised in previous posts, By What Right? and Health Care Is Not a Market.

The “pragmatists” she speaks of, naturally are many of you out there who have criticized the push towards Medicare for All, simply because you have a personal, financial and career stake in the status quo.

It is high time you put aside your personal and professional interests, and put the interests of the American people ahead of all other considerations. Doing so will improve your value as health care and related industries professionals, because you will be serving a higher cause than yourselves.

Here is Ms. Archer’s article:

The American people deserve a frank conversation about how we can guarantee access to health care as a right in this country. That conversation does not begin with Medicare for some. It begins – and ends – with Medicare for all.

Source: Why Medicare for some is the wrong idea | TheHill

By What Right?

In the annals of Western history, two courageous men stood up and challenged the establishment of their nations to act to change history or to right a grievous wrong done to an innocent man.

The first individual was Patrick Henry when he gave his “Give me liberty, or give me death” speech, and the second was Émile Zola, who wrote “J’Accuse…!,” which he wrote in defense of Alfred Dreyfus, imprisoned falsely on Devil’s Island for treason.

These, of course were not the only instances where men of good intention, rallied people to a just and rightful cause; but it was the two instances that came to mind after reading another health care expert poo-poo Medicare for All on social media.

The individual commented on an article in Healthcare Dive.com that I had discussed some days ago. The article was about how kidney care in the US was being revamped, and the individual claimed that Medicare for All would damage the care dialysis patients are currently receiving.

What this person is doing is trying to scare people with propaganda that is akin to saying Medicare for All is “Socialism.” We know that none of the countries that have such a system are Socialist. They are Capitalist. The scare tactic being used here is rationing of care. It so happens that my clinic company is a European company, and I don’t believe people in their home country are rationed dialysis care. And they have a single payer system.

In the past few days, I have seen several comments made by men and women in occupations related to, or in the health care industry. These comments generally have attacked the very idea of Medicare for All for a variety of reasons. Many of these individuals are either a part of the medical-industrial complex, or they are lawyers, employee benefits consultants, or other types of consultants to specific areas of health care. They are defending a turf.

These individuals believe they can supersede the right of all Americans to have decent, affordable health care that does not force them into bankruptcy, or to go without because they cannot afford treatment for serious illnesses or diseases, or expensive medications.

Those of you who have been reading my blog of late, know that I have been very passionate about enacting Medicare for All, either because a fellow blogger has written so eloquently about it, or for personal reasons.

So, I have decided, like M. Zola did, to declare openly: By What Right?

By what right do you have to deny millions of Americans health care? By what right do you have to even suggest that Medicare for All is too expensive, would do more harm than good, or any of the other remarks made on social media to attack the very notion of health care for all?

By what right do you have to consign others to a broken, complex, complicated, bloated, and out of control health care system, whose true aim is to line the pockets of insurance companies, pharmaceutical companies, device manufacturers, hospitals, Wall Street investors, or the shareholders of these and other companies?

I don’t mind constructive criticism of this plan or that plan put forth by any number of Congressmen or Senators, but to outright state that it won’t work, or should not work, is to deny the rest of the nation the same kind of health care that the members of Congress receive.

By what right do you have to tell the millions of uninsured and under-insured, “sorry, we don’t believe in Medicare for All, so you will just have to suffer, so that we can keep our jobs, and collect our fat paychecks.”

I have yet to hear a logical answer to why the US should be the only Western nation to not provide its citizens with universal health care. Some say it is too expensive. Do you mean, it is more expensive than spending taxpayer money on weapons of war? Or on a wall on our Southern border? Or a space force?

Do you mean that it would raise taxes, first on the wealthy and corporations, and later everyone else? Well, maybe the rich and the corporations should pay more in taxes. Polls seem to indicate that as much lately.

Another line of attack says that providers would be hurt. Do you mean that certain very wealthy physicians, surgeons and specialists, would see their incomes cut in half? Do you mean that hospitals could not buy each other up and become larger conglomerations that raises health care costs, instead of lowering them?

I thought medicine was a calling, not a get-rich quick scheme.

Oh, and what about the pharmaceutical industry that uses Americans as a cash cow while the same drugs, manufactured overseas, by the same companies, cost a fraction of what they do here, and have made men like current Federal pen occupant, Martin Shkreli, a wealthy man. Why not allow Americans to import those very same drugs from Canada, the UK, Israel, Mexico, etc. so that they can have their insulin and other life-saving medications without having to cut the dosages in half or go without altogether.

By what right do you have to defend the status quo? To make huge and obscene profits? As I wrote in Health Care Is Not a Market:

“…they are deciding that they have the right to tell the rest of us that we must continue to experience this broken, complex and complicated system just so that they can make money. And that they have a right to prevent us from getting lower cost health care that provides better outcomes and does not leave millions under-insured or uninsured.”

“…not all these individuals are doing this because of their jobs. Some are doing so because they are wedded to an economic and political ideology based on the free market as the answer to every social issue, including health care. They argue that if we only had a true free market, competitive health care system, the costs would come down.”

“…the free market companies have jacked up the prices simply because they can, and because lobbyists for the pharmaceutical industry have forced Congress to pass a law forbidding the government from negotiating prices, as other nation’s governments do.”

Instead of trying to tear down Medicare for All, why not offer your expertise and knowledge to improving the Medicare for All bills introduced to Congress, as well as other plans, especially the proposal by the Physicians for a National Health Program (PNHP)?

Those of you who are not familiar with the legislative process, something that at times has been compared to the production of sausages, it isn’t pretty. There is a lot of negotiating and horse-trading that occurs before a bill is passed and signed into law. Unfortunately, given a Republican President, and his lapdog, Republican Senate, none of the introduced pieces of legislation will pass the Senate, even if the House passes it.

So, consider this, by what right do you have to step in the way of progress for all Americans to get health care? By what right do you have to put your economic interests ahead of the health needs of others? By what right do you have to be cruel and inhumane, to let people die, get sick, and suffer needlessly, just so that you can sleep at night?

I hope that once you do consider this, you won’t sleep at night, because it would mean that you are not just greedy little cogs in the medical-industrial complex, but rather, kind and compassionate human beings who are motivated more out of love, than out of what’s in it for you if things don’t change.

By what right do you have to tear down something that has not even been passed and implemented? Why don’t we enact Medicare for All, and see if all the criticisms you have will come true or not? Could it be because you know deep in your heart it will, but are afraid to say so for fear of what your colleagues would say?

And finally, by what right do you have to play God with other people’s lives? You have already predicted that Medicare for All will fail, so why even bother? You are basing your opinions on what you have been told by free market ideologues, academics, business leaders, Conservative media, and politicians.

So, who cares if the poor die, if the elderly die, if children born with crippling illnesses and diseases die, if young people stricken down in the prime of life die, etc., as long as someone can make a hefty profit off of adverse selection, and the outrageous cost of desperately needed medications that they cannot afford?

I know what you are going to say to yourselves, and to me. That I don’t know what I am talking about, that I am wrong on so many levels, that I don’t have the experience in health care that you do. Well, I really don’t care what you will say. Do you have compassion and concern for your fellow citizens, or are you minions of a heartless, soulless Capitalist system that grinds people down for profits and wealth?

Patrick Henry stirred a people to revolution against a tyrant, Émile Zola rallied a nation to free a man unjustly accused and sentenced to hard labor in the most horrible prison ever constructed by Western man.

You can do what is right. You can defend Medicare for All, and even improve on what has already been proposed, but don’t attack it. Doing so will only cause more pain and suffering to millions of Americans, and will make investors, stockholders and providers and industry leaders wealthier, and the rest of us, poorer. Both spiritually and materially.

You are better than this.

Provider Reimbursements under Medicare for All

Yesterday, Healthcare Dive.com posted an article outlining the various proposals for a public health insurance program.

While it did not cover new ground, there was one part that made me curious as to why it was a big deal. It had to do with provider reimbursements under Medicare and Medicaid being lower, and if a single payer system was enacted, providers would see less in reimbursements.

Here is what Healthcare Dive said:

“Providers are already taking up arms against any expanded public health plan. Since Medicare and Medicaid tend to pay less than private payers, more government reimbursement would mean less money in hospitals’ coffers.”

Really?

Excuse me if I sound a little confused, but if you expand the number of persons covered for health insurance, even though you are being paid less under such a plan, won’t you still make more money than if the number of persons covered was smaller?

So for example, if x number of Americans are covered by Medicare and Medicaid, and the providers are reimbursed at a high amount without a single payer plan, wouldn’t covering all 300+ million Americans under single payer, mean that providers would make just about the same, or maybe even more than before single payer?

If providers were paid $1,000 for each of 200 covered individuals in the current system, totaling $20,000 for example, then by raising the number of covered under Medicare for All to let’s say, 3000, providers would be paid $800 for each covered person, then they would make $2.4 million. And for arguments sake, if there were fifty providers, then without MFA they each would make $400 each, but with MFA, they would make $48,000 each. Not bad.

So why are providers up in arms? Could it be that they are engaged in a financial version of adverse selection by wanting to only take private insurance reimbursements, and not single payer?

Or maybe that is part of the problem with our health care system? Pure, unadulterated greed.

Health Care Is Not a Market

For the next twenty-one months, there will be a national debate carried on during the presidential campaign regarding the direction this country will take about providing health care to all Americans.

However, to anyone who reads the articles, posts and comments on the social media site, LinkedIn, that debate is already occurring, and most of it is one-sided against Medicare for All/Single Payer. The individuals conducting this debate are for the most part in the health care field, as either physicians, pharmaceutical industry employees, hospital systems executives, insurance company executives, and so on.

We also find employee benefits specialists and other consultants to the health care industry, plus many academics in the health care space, and many general business people commenting, parroting the talking points from right-wing media.

That is why I re-posted articles from my fellow blogger, Joe Paduda last week and yesterday,  who is infinitely more knowledgeable than I am on the subject, and has far more experience in the health care field, that not only predicts Medicare for All (or what he would like to see, Medicaid for All), but has vigorously defended it and explained it to those who have misconceptions.

For that, I am grateful, and will continue to acknowledge his work on my blog. But what has caused me to write this article is the fact that most of the criticism of Medicare for All/Single Payer is because those individuals who are posting or commenting, are defending their turf.

I get that. They get paid to do that, or they depend on the current system to pay their salaries, so naturally they are against anything that would harm that relationship.

But what really gets me is that they are deciding that they have the right to tell the rest of us that we must continue to experience this broken, complex and complicated system just so that they can make money. And that they have a right to prevent us from getting lower cost health care that provides better outcomes and does not leave millions under-insured or uninsured.

However, not all these individuals are doing this because of their jobs. Some are doing so because they are wedded to an economic and political ideology based on the free market as the answer to every social issue, including health care. They argue that if we only had a true free market, competitive health care system, the costs would come down.

But as we have seen with the rise in prices for many medications such as insulin and other life-saving drugs, the free market companies have jacked up the prices simply because they can, and because lobbyists for the pharmaceutical industry have forced Congress to pass a law forbidding the government from negotiating prices, as other nation’s governments do.

Yet, no other Western country has such a system, nor are they copying ours as it exists today. On the contrary, they have universal health care for their citizens, and by all measures, their systems are cheaper to run, and have better outcomes.

None of these countries can be considered “Socialist” countries, and even the most anti-Socialist, anti-Communist British Prime Minister, Winston Churchill said the following, “Our policy is to create a national health service in order to ensure that everybody in the country irrespective of means, age, sex or occupation shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.”

Notice that Sir Winston did not say, free market competition. He knew that competition is fine for selling automobiles, clothing, food, and other goods and services. But not health care.

He also said that you can always count on Americans to do the right thing, after they have tried everything else. We’ve tried the free market in health care, and drug prices and other medical prices are through the roof.

However, another thing they have not done, and I believe none of the other OECD countries have done about health care, is to divide the “market” into silos such as the elderly with Medicare, the poor with Medicaid, children with CHIP, veterans with the VA, and their families with Tricare, etc.

No, they pay for all their citizens from a global budget, and do not distinguish between age level, income level, or service in the armed forces.

And their systems do not restrict what medical care their people receive, so that no only do they have medical care, but dental care, vision care, and hearing care. It is comprehensive. And if they have the money to pay for it, they can purchase private health insurance for everything else.

In the run-up to the debate and vote in the UK on Brexit, the point was raised that while Britain was a member of the EU, their retirees who went to Spain to retire, never had to buy insurance because the Spanish providers would bill the NHS.

However, once Britain leaves the EU, they will have to buy insurance privately, because the NHS won’t pay for it. But not all retirees can afford private insurance, so many British citizens will have a problem.

As I have mentioned before in this blog, I was diagnosed with ESRD, and am paying $400 every three months for Medicare Part B. I was doing so while spending down money I received after my mother passed away in 2017. My brother and I sold her assets and used that money to purchase property so that she could go on Medicaid, and eventually into a nursing home when the time came for her to be cared for around the clock.

Since my diagnosis, and prior, I was not working, so spending $400 every three months, and paying for many of my meds, has been difficult. I am getting help with some of the meds, and one is free because my local supermarket chain, Publix gives it for free (Amlodipine).

I hope to be on Medicaid soon, but would much rather see me and my fellow Americans get Medicare for All, and not have to pay so much for it. (a side note: we have seen that Medicaid expansion has been haphazard, or reversed, even when the government is paying 90% of it)

So why are we not doing what everyone else does? For one thing, greed. Drug companies led by individuals like Martin Shkreli, who is now enjoying the hospitality of the federal government, and others are not evil, they are following the dictates of the free market that many are advocating we need. No thanks.

For another, Wall Street has sold the health care sector as another profit center that creates a huge return on investment by investors and shareholders in these companies and hospital systems. Consolidation in health care is no different than if two non-health care companies merge, or one company buys another for a strategic advantage in the marketplace.

There’s that word again: market. We already have a free market health care system, that is why is it broken. What we need is finance health care by the government and leave the providing of health care private. That’s what most other countries do.

So those of you standing in the way of Medicare for All/Single Payer, be advised. We are not going to let you deny us what is a right and not a privilege. We will not let you deny us what every other major Western country gives its people: universal, single payer health care.

Your time is nearly up.

What’s all this about Single Payer and Medicare For All? – Managed Care Matters

Once again, my fellow blogger, Joe Paduda hits it out of the ballpark in explaining Single Payer and Medicare For All.

Most of what you hear comes from politicians and a few billionaires, one running for President and one not; one a former barista, the other a former big city mayor.

But there is also a lot of misinformation and wrong information on the Internet, especially on social media sites like LinkedIn, where the professionals in the health care or insurance space spout off their opposition to Single Payer/Medicare For All mostly because it will disrupt their businesses and may even cost them their jobs. But never mind that millions of Americans can’t afford insurance, or have very little insurance to protect them in case of severe illness or disease.

These individuals are not physicians, nor are they executives with insurance companies, or hospitals; but rather, they are consultants and analysts who offer their services to the health care industry.

But not all commenters are in the health care field, many are just average business people or citizens who put their two cents into the discussion threads, without knowing what they are talking about, or without any facts to back up their argument.

One common refrain is that Single Payer/Medicare For All is government-controlled health care. It isn’t, it’s government financed health care, but to their minds, any time the government pays for something, they “control” it.

So, Joe’s article today is sorely need to clear up any misconceptions.

Here it is:

It’s the worst kind of government over-reach. It’s an easy solution to a huge problem that will cost nothing. And everything in between. Between now and Election Day you are going to hear a lot about Medicare for All and … Continue reading What’s all this about Single Payer and Medicare For All?

Source: What’s all this about Single Payer and Medicare For All? – Managed Care Matters

Surveys Say Health Care More Expensive for US Workers

A post on LinkedIn by Jaimy Lee, Health Care Editor at LinkedIn, reported Thursday that a pair of surveys indicated that health care is getting more expensive for many workers in the US.

Ms. Lee states that,

“Of the roughly 50% of Americans who get their health insurance from their employer, the cost of the average single premium rose 3% and the average family premium jumped 5% from 2017 to 2018, according to the Kaiser Family Foundation. That means premium rate increases are rising faster than inflation, which rose 2.5% during the same period.”

In addition, the Kaiser survey reported that:

  • The average annual premium last year for one person was $6,896 and $19,616 for a family in 2018. (Workers have to pay for, on average, between 18% and 29% of their premium.)
  • The average deductible amount for single coverage in 2018 was $1,573. That’s similar to 2017.

And that a separate survey stated that, 45% of Americans between the ages of 19 and 64 years old were underinsured — meaning they have health insurance but their out-of-pocket costs exceed at least 10% of their household income — in 2018. [Emphasis added]

And, in a blow to those who would like to keep the current employer-based system and not move towards an improved and expanded Medicare-for-All system, a growing number of the underinsured are people who get their health benefits through their employers. That’s up 20% over the last four years. (Traditionally the underinsured are adults who buy insurance on the individual market.)

Ms. Lee closes her post on employer-based health care underinsured workers with the following from Vox:

“In a great historical irony, the evident faults of employer-sponsored insurance are helping fuel a new appetite for Medicare-for-all, a single-payer system where everybody gets health coverage from the government,” writes journalist Dylan Scott. “Shifting 160 million people from the coverage they currently get through their jobs to a new government plan is a lot of disruption — and disruption, especially in health care, has historically made a lot of Americans nervous.”

They may be nervous at first, but it would be much better to be fully insured and nervous for a short time, than to be uninsured and nervous worrying about how they will afford ever increasing costs of insurance.

Medicare-for-All is the only way to provide such piece of mind.