FYI to all Progressives and Medicare for All supporters:
The coalition that fought Obamacare repeal has fragmented as the party tries to follow through on campaign promises.
FYI to all Progressives and Medicare for All supporters:
The coalition that fought Obamacare repeal has fragmented as the party tries to follow through on campaign promises.
Well, the 2018 Midterm elections are over, and the analysis is beginning as to what this all means.
For those who wanted to send a message to the Russian puppet in Washington, the election meant that the House of Representatives will be controlled for the next two years starting in January by the Democrats.
For the Republicans, it means a greater control of the Senate, with at least one race, the one in my current state of Florida undecided and headed for a recount, as per state law.
However, there were many defeats for the party of Obama, Bill Clinton, Jimmy Carter, LBJ. JFK, Truman and FDR. Andrew Gillum lost to a nobody for governor of Florida who is connected to the Orangutan by an umbilical cord. Beto O’Rourke made a valiant, if futile effort against the worse person to hold a Senate seat, Lyin’ Ted Cruz. And a few Democratic senators lost seats in Indiana, Missouri and North Dakota.
But as far as health care is concerned, the change in the leadership of the House of Representatives means that the ACA is safe for another two years. and Medicare and Medicaid will not be cut, as the Senate Majority Leader has indicated he wanted to do.
Medicaid, in particular, came out of the Midterms a little better than expected before the election, as the following posts from Healthcare Dive, Joe Paduda, and Health Affairs reported this morning.
First up, Healthcare Dive, who reported that Red states say ‘yes’ to Medicaid . Idaho, Utah, and Nebraska said yes to expansion; Montana said no.
Joe Paduda echoed that in his post, “And the big winner of the 2018 Midterms is…Medicaid“. However, Joe stated that results in Montana were not final; yet, they had decided to expand Medicaid two years ago, but the vote was temporary, and yesterday’s vote was to make it permanent.
And lastly, Health Affairs reported in “What the 2018 Midterm Elections Means for Health Care” that besides blocking repeal of the ACA, Democrats may tackle drug prices, preexisting conditions protections, Opioids, Medicare for All, Surprise bills (unexpected charges from a hospital visit). regulatory oversight, extenders such as MACRA, Medicaid Disproportionate Share Hospital (DSH) payments, and Medicaid expansion, especially since gubernatorial wins in Maine, Kansas, and Wisconsin will make expansion more likely in those states.
For nearly a year now, I have been advocating single payer health care ever since I was diagnosed with end-stage renal disease. BTW, I am doing fine, even if I have been rejected twice for access to transplant centers due to personal reasons I won’t go into here.
Today, I found an article on The Intercept.com that reported that several candidates for Congress and other offices in Hawaii and other states have secretly secured opposition to “Medicare for All” single payer healthcare, even though they have told their voters that they support it.
According to the article, the candidates in Hawaii’s 1st Congressional District, former state Sen. Donna Mercado Kim, Hawaii Lt. Gov. Doug Chin, and Honolulu City Council Member Ernest Martin are taking heat from opponents for talking to an industry-friendly group, the Healthcare Leadership Council (HLC).
The Healthcare Leadership Council seeks to advance the goals of the largest players in the private health care industry. These candidates are talking to the HLC even as public opinion is moving towards positions opposed by giant health care companies.
Kaniela Ing, a state lawmaker running for the seat on a democratic socialist platform stated that, “Democrats running in a primary election will say they support ‘Medicare for All,” but what do they say to lobbyists behind the scenes?”
In fact, the article reports, one leading candidate has campaigned on a pledge to crack down on over-priced pharmaceuticals and promote single payer, but told the consultant sent from the HLC that he would maintain drug industry friendly pricing policies and views Medicare for All with skepticism.
HLC spends over $5 million a year on industry advocacy and brings together chief executives of major health corporations, and represents an array of health industries — from insurers, hospitals, drugmakers, medical device manufacturers, pharmacies, health product distributers, and information technology companies.
HLC’s outreach in Hawaii began in January. The group told candidates, in an email obtained by The Intercept, that it was in the process of forming a coalition to “jointly develop policies, plans, and programs to achieve their vision of a 21st century system that makes affordable, high-quality care accessible to all Americans.”
This language obscures their national campaign to monitor and blunt the energy behind progressive policy reform. In an email to The Intercept, Michael Freeman, executive vice president of HLC said that they survey “congressional candidates every election cycle regarding their views on a wide range of healthcare issues.”
Former state Sen. Kim’s dossier profile said she is very pro-market, opposes any attempt at single payer, does not support price controls on pharmaceuticals and agrees that Medicare and Medicaid need to be managed by the private market.
It would seem that besides the opposition from the insurance companies and the pharmaceutical industry, single payer, Medicare for All, is under assault below the radar of most voters, if not most Democratic voters during the primaries.
Despite alleged strong support for bills such as the one Bernie Sanders introduced, lobbyists for the medical-industrial complex are fighting hard to defeat health care reform for all Americans, and no matter what the public attitude is, they will prevent at all costs, the transition to single payer.
HLC also keeps tabs on candidates who could be a threat to their agenda, such as Ing, stating that she vocally supports a single payer, public health care system.
Lobbyists have told executives in the health care industry to be vigilant about the threat of single payer.
“It would be a mistake for us to overlook the growing number of lawmakers who are supportive of measures to expand significantly government’s role in healthcare,” according to a report HLC published at the end of last year. The report went on to say that while these ideas do not have the political support to pass at the moment, the “momentum on the Democratic side of the aisle is undeniable,” They have dispatched teams of lobbyists to keep tabs on rising candidates.
So, even if you vote for a Democrat in November, chances are, that they will double-cross you when it comes to supporting Medicare for All. Which is wrong-headed on their part, especially the hospitals and pharmaceutical companies.
If more people are covered, and the government pays for their health care, hospitals will get more patients covered under the plan and thus more revenue, even if they charge lower prices than for private insurance, and drug companies will sell more drugs to these patients, even if the prices are brought under control.
What difference does it make if a patient gets their health are from a government plan like Medicare or Medicaid, as many already do, or if they get it through private insurance? The hospitals and drug companies still make money, just a smaller amount. The number of newly insured will offset any assumed loss of profit, thereby increasing profit, and just not from a select group of people who can afford health care on their own.
Advocates for single payer need to be vigilant also. Don’t buy a pig in a poke. Confront these and other candidates for office to see if they really believe in single payer, or are pigs with lipstick.
Don McCanne, former President of the Physicians for a National Health Plan posted a New York Times article that said that Americans are equally divided over support for single-payer versus private insurance.
The article also said that support for single-payer edged up 10-points from last year, and closed a 27-point gap since 2010.
This year’s survey, conducted Nov. 2-8, indicated that 48% preferred the private health insurance system and 47% preferred the government-run system.
Here is the breakdown by party:
Favor government-run system
Favor system based on private insurance
When asked if they had an opinion on “Medicare for All”, the majority said they did not have enough information.
61% Don’t know enough to say
While private insurance is still favored, if only by a percentage point, time will tell as the GOP’s tax plan takes effect and wipes out the middle class, whether that poll changes in the direction of single-payer.
As a student of American Social history, I am acutely aware that for much of the 241 years of the Republic, the majority of the American people were not what we today would call “Middle Class.”
In fact, they were cash poor, dirt farmers, tradesmen, owning very little except what they could carry on a horse, mule, or in a wagon as they migrated west in search of better opportunities.
Until the New Deal, the Middle Class as we know it did not exist in such great numbers. True, there was a middle class in the cities and towns of the East Coast and Midwest, but most of them were descendants of immigrants from the 17th and 18th centuries, and rose steadily into the middle class as the nation’s economy shifted from a mercantile to an industrial economy in the first half of the 19th century.
Consider the following quotes from three US presidents regarding the power of money and corporations. You will notice that none of them are wild-eyed radicals in the least.
“I hope we shall crush in its birth the aristocracy of our monied corporations which dare already to challenge our government to a trial by strength, and bid defiance to the laws of our country.”
“Mischief springs from the power which the moneyed interest derives from a paper currency which they are able to control, from the multitude of corporations with exclusive privileges… which are employed altogether for their benefit.”
“I see in the near future a crisis approaching that unnerves me and causes me to tremble for the safety of my country. Corporations have been enthroned, an era of corruption in high places will follow, and the money-power of the country will endeavor to prolong it’s reign by working upon the prejudices of the people until the wealth is aggregated in a few hands and the Republic is destroyed.”
So it is no surprise that the Republican Party is ramming down the throats of the American middle class, a tax reform bill that will effectively wipe out the remaining members of the middle class, and redistribute the wealth to those making over $75,000 and those at the very top, the oft-mentioned 1%.
My fellow blogger, and unsuccessful Democratic candidate for County Legislator in upstate New York, Joe Paduda, wrote a very potent analysis of the GOP tax scam legislation. Yes, I did call it a scam, but that is not my word. Others have used it in the past few days in an effort to derail and stop it from passing.
Besides destroying the middle class, it will as Joe points out, bankrupt the health care system. Then we will have to go all the way to a single-payer system just to get the whole thing working again.
Here is Joe’s piece in its entirety:
The GOP “tax reform” bill will directly and significantly affect healthcare. Here’s how.
It removes the individual mandate, but still requires insurers to cover anyone who applies for insurance. So, millions will drop coverage knowing they can sign up if they get sick.
How does that make any sense?
Here’s the high-level impact of the “tax bill that is really a healthcare bill”:
- Enforcement of the individual mandate would be repealed, saving about $330 billion, and many will drop their insurance, and
- Health insurance premiums will increase about 10 percent, and as a result
- About 13 million fewer people will have health insurance.
- Plus, the budget cuts forced by the bill will immediately force $25 billion in annual Medicare spending cuts…when this happened four years ago, many oncologists stopped treating elderly cancer patients.
- The medical expense tax deduction would be repealed, affecting about 13 million more taxpayers [update – reports this morning indicate the Senate bill MAY remove this provision, however they may have to find offsetting funds or cuts elsewhere to make up for lost revenue]
The net – healthcare providers are going to get hammered, and they’re going to look to insured patients to cover their costs.
The real net – The folks most hurt by this are those in deep-red areas where there is little choice in healthcare plans, lots of struggling rural hospitals, and no other safety net. Alaskans, Nebraskans, Iowans, Wyoming residents are among those who are going to lose access to healthcare – and lose health care providers.
Here are the details.
According to the Commonwealth Fund, “repeal would save the federal government $338 billion between 2018 and 2027, resulting from lower federal costs for premium tax credits and Medicaid. By 2027, 13 million fewer people will have health insurance, either because they decide against buying coverage or can no longer afford it.”
Most of those who drop coverage will be healthier than average, forcing insurers in the individual market to raise prices to cover care for a sicker population. This is how “death spirals” start, an event we’ve seen dozens of times in state markets, and one that is inevitable without a mandate and subsidies.
For example, older Americans would see higher increases than younger folks. Here’s how much your premiums would increase if you are in the individual marketplace.
So, what’s the impact on you?
Those 13 million who drop insurance, which include older, poorer, sicker people, will need coverage – and they’ll get it from at most expensive and least effective place – your local ER. Which you will pay for in part due to cost-shifting.
ACA provided a huge increase in funding for emergency care services – folks who didn’t have coverage before were able to get insurance from Medicaid or private insurers, insurance that paid for their emergency care.
[after ACA passage] there were 41 percent fewer uninsured drug overdoses, 25 percent fewer uninsured heart attacks, and over 32 percent fewer uninsured appendectomies in 2015 compared to 2013. The total percent reduction in inpatient uninsured hospitalizations across all conditions was 28 percent lower in 2015 than in 2013. Between 2013 and 2015, Arizona saw a 25 percent reduction in state uninsured hospitalizations, Nevada a 75 percent reduction, Tennessee a 17 percent drop, and West Virginia an 86 percent decline.
If the GOP “tax bill” passes, hospital and health system charges to insureds (yes, you work comp payer) are going to increase – and/or those hospitals and health systems will go bankrupt.
What does this mean?
It means we of the middle class had a very good run, but the ruling class has spoken, and they want us to disappear, or at least shrink to the point that we become unimportant to their pursuit of greater wealth. Why else would the donor class of the Republican Party, the Koch Brothers, the Mercer family, Sheldon Adelson, and the rest of their donors threaten members of Congress with no more funds for their re-election if they fail to pass this bill?
There is a word for that, it’s called Extortion. And we are the sacrificial lambs.
Thursday’s The Economist had the following article.
It explains what the U.S. needs to do to fix health care.
Our leaders in Congress, both Democrats, and especially Republicans should listen to what it has to say.
Medicare for All is not socialism, socialized medicine, or communism. But the status quo is health care capitalism, and has been a disaster.
Here’s a little light reading for your weekend, courtesy of Patricia Illingworth, writing today in Health Affairs blog about the Social Determinants of Health and the take on it by the current administration.
Ms. Illingworth rightly points out that those below the poverty level and without a college degree, both whites and minorities, suffer more serious illnesses such as diabetes, asthma, heart disease, as well as smoking, drinking and using illegal drugs more than those with college degrees.
She also states that cuts to education, energy, the environment, housing and urban development, among other social sectors, impacts health, and that if these social determinants are underfunded, people will need more health care. And now that the health care reform debate is stalled, the current POTUS is still trying to destroy the ACA, and has threatened members of his own party, including the Senate Majority Leader, Mitch McConnell.
Ms. Illingworth cites a study published by the Brookings Institution, that showed that “deaths of despair”—those associated with drugs, alcohol, and suicide—have risen significantly among middle-aged white non-Hispanic Americans without a college degree.
Living conditions, Ms. Illingworth reports, also affects rates of asthma, which are the leading cause of children’s visits to ER’s, hospitalizations, and absenteeism. And, it is more prevalent in poor and minority communities.
All of this is not surprising, since 1980, this nation has waged a relentless war against its poor and minority citizens. This war began the day Ronald Reagan took the oath of office and began dismantling not only the New Deal programs, but cutting back the programs created under the Great Society of the 1960’s.
With each successive Republican administration, as well as the rise of Republican power in Congress since the ascension of Newt Gingrich to Speaker of the House, and in many states, especially in the formerly solid Democratic South, poverty and illness among the poor and minority, as well as whites have increased. And the loss of manufacturing and other support services jobs associated with manufacturing have resulted in the current opioid crisis, which only yesterday was addressed as a national emergency by the POTUS.
But Democrats are not without fault here too. Failure to stand up to the Reaganite Counter-Revolution, the pursuit of a failed “free trade” policy that has outsourced jobs or allowed companies to offshore jobs, as well as paying deference to the will of Wall Street and Corporate America, has brought us the current occupant of the Oval Office.
In the recent health care debate in Washington, many placed their confidence in moderate Republican senators to defeat the repeal and replace measures, but as Andrew Sullivan wrote four years ago in his blog, The Dish, “What Moderate Republicans?”, Sullivan says the following:
“There is effectively no Republican party any more. There is a radical movement to destroy the modern American state and eviscerate its institutions in favor of restoring a mythical, elysian, majority-white, nineteenth-century past. This crisis is proving that more powerfully than even watching Fox. We need to see what is in front of our nose: a cold civil war has broken out between those properly called conservatives, defending the credit of the government, empirical reality, and adjustments to modern life and those properly called radical reactionaries declaring our current elected president and Senate as illegitimate actors, bent on the destruction of America, and therefore necessitating total political warfare, even to the point of threatening to destroy the global economy.”
The current architect of this destruction is not the man with the orange hair, but one Stephen K. Bannon, the former head of Breitbart. Bannon’s radical agenda is to destroy the “deep state”, and to create what Sullivan so rightly predicted four years ago, as he said above.
Bannon has been identified as a racist, anti-Semite, and has no business in the White House. Another member of this cabal is Stephen Miller, who a few weeks ago, revealed his true colors by openly defending restricting legal immigration, something that brought his family, and mine, as well as millions of others, to this country.
I could go on, but this post is about health care.
The main point is, we need to stop playing games with people’s health and do what other Western and developed countries provide to their citizens, health care for all.
If you don’t believe me, then maybe the words of a billionaire will convince you. Warren Buffett, one of the richest men in America, and an astute and very successful businessman, unlike a certain neophyte politician, has said the following with regard to single payer.
“…government-run health insurance “probably is the best system” because it would control escalating costs. We are such a rich country. In a sense, we can afford to do it, … In almost every field of American business, it pays to bring down costs.”
It is time to give every American health care. Then we will see a vast improvement in the social determinants of health.