Category Archives: Universal Health Care

Seven Years Good Luck

Despite LinkedIn’s algorithm to the contrary, today is the seventh anniversary of this blog. It was seven years ago that I began to write about Medical Travel and Workers’ Comp.

And although it has morphed into a blog about health care issues, and more recently, about Medicare for All, it is an accomplishment that it has lasted this long.

As I am sure happens to many a blogger or writer, one runs out of things to say, so they fall back on re-posting what others have written to keep themselves in the game. Such has been my experience of late.

This is no accident. Having been diagnosed with ESRD, and attending to the protocols involved with receiving treatment and dealing with it on a daily basis, I have had to slow down the pace of writing, concentrated on other issues, or just took a break from it by not working on it period.

However, with the Democratic primary campaign heading towards its next phase, I thought it would be a good idea to review the positions of each of the major candidates now debating regarding health care for Americans.

This review is a follow-up to previous posts on this blog about the Democratic debates and Medicare for All, namely Medicare for All and the Democratic Debates and The Debate Continues.

Since then, I have concentrated on posts that single out aspects of some of the candidates positions on providing health care to more people, but each and every article posted has shown that those positions will not lead to the outcome that will provide universal health care to all Americans.

So, here are the plans for health care of each of the candidates currently still debating:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Source: https://www.npr.org/2019/09/10/758172208/health-care-see-where-the-2020-democratic-candidates-stand

Since August, five of the last eight posts I wrote addressed some aspect of why those advocating a public option or keeping private insurance are wrong, and why we have not had universal health care.

The New York Times, as part of a series of articles published in their Sunday magazine about the year 1619, included an article as to why universal health care has been rejected in the US.

The article, Why doesn’t the United States have universal health care? The answer has everything to do with Race, traces the opposition to universal health care to after the Civil War, when the South was devastated, and the Freedmen’s Bureau addressed the smallpox virus that was spreading across the South. It was argued then by white legislators that it would breed dependence.

But, other articles posted since August, have criticized calls for a public option, such as the article, Public Option A Bad Policy, which was re-posted from The Nation earlier this month.

A second article, Private Insurance Failure to Lead to Medicare for All, re-printed from The New York Times two weeks ago, was written by a former CEO of a health insurance company, and currently professor of health care finance at the Weatherhead School of Management at Case Western Reserve University.

His observations about where private insurance is leading us should be read by those who are supporting candidates who advocate keeping private insurance.

Physicians for a National Health Program (PNHP) president Adam Gaffney, in Boston Review, put it simply: “It’s the financing, stupid.

Emmanuel Saez and Gabriel Zucman, writing in The Guardian four days ago, stated that Medicare for All would cut taxes for most Americans, and that not only would universal healthcare reduce taxes for most people, it would also lead to the biggest take-home pay raise in a generation for most workers.

This is something that Elizabeth Warren has not been able to address in the debates, instead talking about how it will lower costs for people. She has not been wrong in doing so, because if the average family pays $5,000 in taxes and has medical costs twice that, moving to a single payer system will save them money, even if their taxes were to increase by a small percentage. Their medical bills would fall far below the $10,000 level. However, Warren will be releasing a plan to pay for it.

Saez and Zucman, in a chapter in their book, The Triumph of Injustice: How the Rich Dodge Taxes and How to Make Them Pay, called private insurance a poll tax.

According to Saez and Zucman,

“…private insurance premiums are akin to a huge private tax. Although most workers get insurance through their employers – and thus employers nominally foot the bill – the premiums are a labor cost as much as payroll taxes are. Just like payroll taxes, premiums are ultimately borne by employees. The only difference is they are even more regressive than payroll taxes, because the premiums are unrelated to earnings. They are equal to a fixed amount per employee (and only depend on age and family coverage), just like a poll tax. The secretary literally pays the same dollar amount as an executive.”

Listening to the candidates other than Sanders and Warren, they would rather keep the status quo so that stakeholders can profit from the dysfunction in the system than address the problem of health care head-on.

It is as if we said we wanted to go to the Moon, but opted to go part of the way, saying we will get there someday, but not now, as it is too expensive, people like looking at the Moon without knowing there are men up there and spacecraft parts, and that we shouldn’t mess with it until we clean up down here.

It is better to advocate going all the way, then not at all. If you fail, then you know you must do it again until you get what you want. Thus, was the case with passing the ACA. It did not happen overnight.

This video, from a president who knew how to speak in complete and intelligible sentences, illustrated what it took to get Medicare and Medicaid passed.

Just like President Kennedy’s call to go to the Moon in the 1960s, so too did he call for universal health care as far back as 1962 when he made this speech in New York’s Madison Square Garden.

We cannot afford to do anything less, because the stakes are that important. Medicare for All must be the one and only goal. Anything else is a half-measure destined to fail.

Why The US Doesn’t Have Universal Health Care – It Is Not What You Think

Landing Negroes at Jamestown from Dutch man-of-war, 1619.

Yesterday, The Sunday New York Times Magazine ran a series of articles titled, The 1619 Project.

According to the Times:

The 1619 Project is a major initiative from The New York Times observing the 400th anniversary of the beginning of American slavery. It aims to re-frame the country’s history, understanding 1619 as our true founding, and placing the consequences of slavery and the contributions of black Americans at the very center of the story we tell ourselves about who we are.

As a student of American history, I was fully exposed to the current literature of the time regarding slavery, slaveholders, and the impact it had on the African-American culture and people, through my introduction to such historians as Eric Foner, Eugene Genovese, Leon Higginbotham, and John Blassingame, as well as from my three African-American/Sociology courses as an undergraduate.

So, I believe that this series by the Times, is not only needed, but timely, given the racial animus we see day after day from the White House, the far right, and on the Internet.

Readers of this blog  have seen that I have advocated on behalf of Medicare for All/Single Payer, because of the many causes for our broken health care system.  However, it  is not solely based on economics, politics, or defending the profits of the insurers and pharmaceutical companies. But rather due to race, as Jeneen Interlandi writes.

According to Interlandi, the first federal health care program served freedmen after the Civil War, but white legislators argued that it would breed dependence.

This health care program, the medical division of the Freedmen’s Bureau addressed the health care crisis due to the smallpox virus spreading across the post-war South. And according to Jim Downs, white leaders were worried about black epidemics spilling into their communities, and wanted the former slaves to be healthy enough to go back to the plantation. However, they feared that free and healthy African-Americans would upend the racial hierarchy.

Interlandi describes how whenever there was some move to deal with health care, there was always some backlash or outright ignoring of the solutions to the problems facing the south in the post-war period and Reconstruction. Not only that, but when federal social programs were introduced, Southern Democrats (yes, but now they would be, and are Republicans) forced concessions to bar African-Americans from receiving the benefits of those programs, or the AMA barred black doctors, medical schools excluded black students, and most hospitals and clinics segregated black patients.

There is the story of the African-American doctor who discovered blood types, and died because he was refused admittance to a hospital because he was black. This story was brought to the attention of viewers of MASH when the subject of race was part of that episode’s plot.

In college, I wrote a paper on the Tuskegee Syphilis experiment that exposed African-American men to syphilis to observe the natural history of untreated syphilis; the African-American men in the study were only told they were receiving free health care from the United States government.[3]

So those of you who oppose single payer health care should stop and consider if being the only nation in the Western world to not provide its citizens with universal health care should continue to be based on racial prejudice or simply because you want to profit by not doing so.

No Socialists Here

Dear Insurance company execs, pharmaceutical company execs, employee benefits consultants and executives, Wall Street investors, and all other stakeholders in the current dysfunctional, broken, complex, complicated, and bloated mess called the US health care system.

You have heard many politicians, and journalists, not to mention your own peers, or even you yourselves label the push for Medicare for All as “Socialism.”

We even have the Administrator of CMS, Seema Verma, calling it, and the public option plan,  “radical and dangerous for the country” recently when she spoke to the Better Medicare Alliance’s Medicare Advantage Summit in Washington, D.C.

Her solution, and probably yours as well, is to keep selling Medicare Advantage plans, which only makes the current system worse.

So, to help you get over your fear and loathing of Socialism, and to prove to you that the only reason why the US is the only Western, industrial nation to not provide its citizens with universal health care is because you are making money off of other people’s health, or lack thereof.

You are doing so, because you are greedy. There I said it. Now I hope you will pay attention to the following graphic:

Do you see any socialist countries? Do you see any radical and dangerous regimes that are hostile to the interests of the US? Well, maybe Slovenia. After all, they did send us Melania and her illegal family.

But back to the case at hand. I defy any of you hotshots in the health care space to prove to me that all of these Capitalist, free-market countries are flaming Reds, or even a bit Pinko.

You can’t, because it is not true. You and those who call Medicare for All, Single Payer, or even the so-called “public option” radical, just don’t want the government to interfere with your looting the pockets of the American people for your financial gain.

And that is why we are the only country with an “X”, instead of a check mark below our name.

Medicare for All and the Democratic Debates

See the source image

For those of you who did not watch the two nights Democratic debate, and those like me who did, one thing is clear. Medicare for All is very popular among the audiences who attended, judging by the applause garnered each time a candidate was asked about their plan for providing every American with health care.

On the first night, the moderator asked for a show of hands to the question as to who supported eliminating private insurance, only two candidates, Sen. Elizabeth Warren and New York mayor Bill de Blasio raised their hands.

The rest of the candidates on the first night supported keeping private insurance or giving people the choice of a public option, and de Blasio and former Congressman Beto O’Rourke sparring over the issue.

This is how some of the candidates responded to the issue:

“I’m with Bernie on Medicare for All,” said Elizabeth Warren

Amy Klobuchar said she preferred a “public option”, “I am just simply concerned about kicking half of America off of their health insurance in four years,”

Former Texas Rep. Beto O’Rourke allowed that the goal should be “guaranteed, high-quality, universal health care as quickly and surely as possible.” “Our plan says that if you’re uninsured, we enroll you in Medicare,” and called his plan Medicare for America.

On the second night, the same question about abolishing private insurance was asked, and again, only two raised their hands, Vermont Sen. Bernie Sanders and California Sen. Kamala Harris.

Former Vice President Joe Biden, who defended the ACA, said that Americans “need to have insurance that is covered, and that they can afford.”

Candidates Pete Buttigieg, mayor of South Bend, Ind., New York Sen. Kristen Gillibrand, and Colorado Sen. Michael Bennet all gave their views on universal coverage, noting the importance of a transition period, and suggesting that a public option would allow people to buy into Medicare.

While the rest of the candidates from both evenings’ debates were divided against their fellow candidates who supported Medicare for All, those who spoke up for it, Sanders, Warren, Harris and de Blasio, won over the audience in the hall. What remains to be seen is how their ideas are received in the primaries beginning early next year.

According to Bloomberg, (the publication, not the former New York mayor), Medicare for All enjoys broad support: 56% of Americans said they supported such a plan in a January survey by the Kaiser Family Foundation. However, when told Medicare for All would eliminate private health insurance, 37% said they favor it while 58% said they oppose the idea.

So, supporters of Medicare for All have their work cut out for them. They need to convince more Americans that sustaining the current system of private insurance, whether they get it from their employers, or they purchase it on their own, is a big part of the problem facing the US health care system.

Another point that is forgotten in the debate is the fact that what is being proposed is not a government takeover of health care, but rather a transition from a broken system to a government financed system of health care. Candidates who support this should explain the difference, and not be led into the trap set by debate moderators or interviews of calling Medicare for All, government-run health care.

It must be made clear that the providing of care will remain private, but that paying for it will not. Sanders’ stump speech line about going to any doctor sounds reminiscent of President Obama’s promise that you can keep your doctor under the ACA, but the reality was far from that.

But the takeaway from the debates indicates that the campaign will be a long and hard fought one, and that Democrats must be very clear what it is they actually want to do on health care, know how to pay for it, and sell it as the best solution to our dysfunctional health care system, or as author Marianne Williamson called it, a sickness system.

Because already, the Orangutan has pounced on one issue raised in the debate, the support by all candidates for providing medical care to undocumented immigrants. In today’s charged political climate where racism has raised its ugly head, and nationalism is on the march, such ideas can be disastrous, especially if rejected by swing voters and independents.

Time and the primaries will tell.

Medicaid Work Requirements Are Detrimental

Previous posts in this blog about Medicaid work requirements, especially in the State of Arkansas, suggested that they would be harmful to recipients of Medicaid benefits. Arkansas was the first state to implement work requirements last June.

In an exhaustive article out today from the New England Journal of Medicine, the authors found that requiring Medicaid beneficiaries to work had a detrimental effect on health insurance coverage in the initial 6 months of the policy but no significant change in employment.

Lack of awareness and confusion, the report states, about the reporting requirements were common, which may explain why thousands of persons lost coverage even though more than 95% of the target population appeared to meet the requirements or qualified for an exemption.

The conclusion of the report found that in its first 6 months, work requirements in Arkansas were associated with a significant loss of Medicaid coverage and rise in the percentage of uninsured persons.

The authors found no significant changes in employment associated with the policy, and more than 95% of persons who were targeted by the policy already met the requirement or should have been exempt.

Since the article is quite long, I have summarized the results here, but the full report can be found by clicking here.

It would appear that the goal of forcing Medicaid beneficiaries to go back to work has more downsides than upsides, but since this is being implemented by a group of puritanical, work-obsessed, economic libertarian politicians, reality has overcome their ideological disgust at giving people social benefits without expecting something in return — namely requiring low-income people to find a job in order to be covered for health care.

Isn’t it time we leave the 17th century and its puritan ethics behind and provide every American, rich or poor, with universal health care, with no strings attached? After all, that is what every other Western democracy does.

The Free Market Utopian Fantasy

Whenever the subject of what to do about the cost of health care arises on the social media site, LinkedIn, invariably there is someone who attempts to deflect the discussion away from the logical solution of Medicare for All/Single Payer, to what I am calling the Free Market Utopian Fantasy.

Those of you who read my post, “Health Care Is Not a Market”, will understand that when it comes to health care, the rules of the market do not apply. That is why I have called the attitude and comments made by these individuals, the Free Market Utopian Fantasy. Because the free market in health care is a fantasy. It is usually the expression of economic libertarianism coming from the right-wing propaganda machine.

Simply put, the Free Market Utopian Fantasy states that if we only had a truly free market health care system, costs would regulate themselves through competition, as in other areas of the free market.

In fact, one observer recently said the following in a thread on LI: “This would not be the case IF there were created and implemented an ORDERLY market for health care services based upon free market enterprise principles whereby ALL costs are transparent to ALL parties.”

An orderly market? Are you serious? More of the same BS from the Free Market Utopians.

Then there is the idea that consumers, read that as patients, must educate themselves as to the best choice. Choice? When you are dying of a heart attack? Choice, when you only have a short time to live due to a serious illness like Cancer or Diabetes?

Folks, we are not talking about choosing between buying steak or chicken. This is not choosing to go to Italy next summer or to the Caribbean. We are talking about life and death. And the only choice is to do what will save your life, not choose between colors on a swatch.

This Free Market Utopian Fantasy has infected so many people in the health care industry, and they are trying to prevent the American people from receiving the same quality of care at lower cost than all the other Western and other nations already do for their people.

They claim that we can’t afford to do it. I ask, can we afford not to?

They cite statistics about Medicare like some cite similar statistics about Social Security, but they are wrong then, and they are wrong about Medicare for All, because it will be expanded to cover everyone and everything, not requiring separate insurance for things like vision and dental care, mental health, and long-term care.

Here is what one person said in the same thread cited above:

“We can barely afford Medicare for the 60 million current Medicare recipients. Adding another 270 million recipients would bankrupt the nation in short order. Latest data (2017) on Medicare shows an annual cost of $700 billion, and projections show the Medicare Trust Fund will be insolvent in 2026 – and by the way, Medicare actually only covers about half of the real cost because the rest is covered by supplementary insurances that have to be bought by the patient. If you assume that Medicare expansion was at the same cost rate as current Medicare, Medicare for all would cost at least $3.15 trillion in 2017 dollars. Total 2019 federal government revenue is estimated at $6.5 trillion, and estimated Medicare for all costs for 2019 would be $3.5 trillion. It is simply not feasible.”

Boy, they really know how to BS their way to keeping us the only Western nation that does not have universal health care. What they don’t realize is, there won’t be any private insurance, because it is private insurance that drives up the cost of health care with administrative costs and waste,

Well, it is high time we call BS on all of them, and their Free Market Utopian Fantasy. Until we stop listening to these folks who are protecting their careers and profits, no American will never have to worry if they or a loved one gets sick and cannot afford the needed medical care without going bankrupt or dying without ever receiving the care they so desperately need. I said as much in my other post, “By What Right”, where I took these folks to task for preventing the enactment of MFA/Single Payer.

These Free Market Utopians are not doing anyone any favors. They are only hurting millions of Americans, born or not-yet-born who will someday need a truly comprehensive, universal health care system, and it won’t be there thanks to them and their associates.

Food for Thought

All those who are opposed to Medicare for All/Single Payer, here is a meme that should open your minds to the fact that the US is wrong to deny its citizens what other nations already provides. Any excuse offered is just a cop-out, and not a very good one.