JFK and Healthcare for All in 1962

[David Andrews]

Two worthwhile articles on the failure of US health insurance, and the medical industry threat to Britain's NHS:

https://www.theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt

https://www.theguardian.com/society/commentisfree/2019/nov/05/nhs-precious-ill-us-big-pharma-costs-healthcare

Apparently the insurance and medical industries want us robbed and killed.

[Cory Santos]

Yes he does nothing all day.  

Blinders people blinders.

https://www.wsj.com/articles/trump-administration-releases-transparency-rule-in-hospital-pricing-11573825649?fbclid=IwAR0hdZ07GunZ0dSVoz2YN8qfwukeE5pOyx9TeI30pwGubAtoT9NxLEBsTnc

[Ron Bulman]

3 hours ago, Cory Santos said:

Yes he does nothing all day.  

Blinders people blinders.

https://www.wsj.com/articles/trump-administration-releases-transparency-rule-in-hospital-pricing-11573825649?fbclid=IwAR0hdZ07GunZ0dSVoz2YN8qfwukeE5pOyx9TeI30pwGubAtoT9NxLEBsTnc

Blinders?  Take yours off.  This was a political ploy to appear transparent to his followers regarding some of his biggest supporters.  What does it really change?  Is it progress towards healthcare like most developed nations on earth have had for years?  Not something JFK would have done.  Did you watch his speech in Jim's link?

[W. Niederhut]

22 hours ago, David Andrews said:

Two worthwhile articles on the failure of US health insurance, and the medical industry threat to Britain's NHS:

https://www.theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt

https://www.theguardian.com/society/commentisfree/2019/nov/05/nhs-precious-ill-us-big-pharma-costs-healthcare

Apparently the insurance and medical industries want us robbed and killed.

David,

These private industries want PROFITS.   It's about for-profit systems vs. the public sector.  Both systems have obvious virtues and flaws.

When I was a medical intern, (36 years ago) I worked part of the year at a fairly posh private hospital, and part of the year at a local VA and inner city hospital.  I used to joke that my experiences that year made me a believer in capitalism.  The private hospital services were very efficient, and of high quality.  At the VA, it was difficult to do my job.  For example, I had to do my own phlebotomies on the patients and retrieve lab results from a hand written ledger in the basement of the hospital, because there were no phlebotomists or staff to retrieve results for the wards.  I even had to wheel my patients down to X-ray and assist the X-ray tech to get chest X-rays at night, because there were no orderlies around to help us out on the wards.

The advantage of a public sector, Medicare type single-payer system is that; 1) it eliminate the siphoning of healthcare funds (about 15-20% in some estimates) by private insurance corps, and 2) it reduces costs by enabling the single-payer to negotiate lower prices for drugs and other services.

The trade off is that there is a reduced incentive for efficient, high-quality services.  When I retired last year, I was one of the few private psychiatrists in town who was still participating in Medicare.  It was very difficult to find providers for my Medicare patients.

This article in yesterday's WaPo describes some of these issues fairly well, IMO.

 

Americans have questions about Medicare-for-all. Canadians have answers.

https://www.washingtonpost.com/health/americans-have-questions-about-medicare-for-all-canadians-have-answers/2019/11/18/7971c78e-d4d6-11e9-9610-fb56c5522e1c_story.html

Yasmeen Abutaleb 

 

November 19, 2019 at 5:30 a.m. MST

HINTON, Alberta — When Bryan Keith was diagnosed with prostate cancer three years ago, he underwent a blizzard of tests, specialist consultations, a month of radiation treatment and a surgical procedure.

His out-of-pocket costs? Zero.

“I’ve never had to reach into my wallet for anything other than my health-care card,” said Keith, 71, who is now in remission.

In this picturesque mountain town of about 10,000 people, Keith’s experience is the norm — and the model often cited by Sens. Bernie Sanders and Elizabeth Warren as they promote Medicare-for-all as an antidote to some of the problems afflicting U.S. health-care consumers.

No one in this mostly working-class community agonizes over whether they can afford to see a doctor, or take their child to the emergency room. No one faces bankruptcy, or loses their home, because of medical debt. Most residents of Hinton have had babies delivered, broken bones set and cancer treatments provided without ever seeing a bill.

But there are also drawbacks: Some wait months for knee or hip replacements or to see certain specialists. Most also pay premiums for private insurance to cover prescription drugs and other services not included in their government plan.

As middle-class Americans express growing anger about skyrocketing drug prices and mounting co-pays, premiums and deductibles, the Canadian health-care system has emerged as a shadow player in the 2020 Democratic presidential primary contest — offering a window onto a parallel reality where 37 million people’s health-care needs are largely covered from birth to death.

The stories of real people here in rural Alberta show how the health-care system functions in their daily lives — and underscore Canadians’ deep and widely shared belief that health care is a human right, which helps explain their overwhelmingly positive reviews of the system despite its shortcomings.

By all accounts, Canada’s system, called Medicare, is simpler, more equitable and more consumer-friendly than America’s patchwork of public and private plans that leaves millions without sufficient coverage. Every resident of Canada has guaranteed access to covered benefits through provincial- and territorial-administered public insurance plans — and pays taxes to support that system. There are no premiums, co-pays or deductibles for a broad menu of care that includes doctor visits, emergency care, hospital stays, surgical care, and maternal and newborn services.

[David Andrews]

What I'm saying, W., is that we're never going to find out.  The private system is so entrenched in US medical culture and politics that we are not going to get single-payer and find out if it works better for all, under public scrutiny, than VA worked under a smaller group of bureaucrats on a population that is, unfortunately and unfairly, sidelined in our culture.

Don't you think that if people want it, we should try single-payer?  People who are ill or dying, or aging, or just worried about their future and their family's?

Will medical costs go down under single-payer?  If not, blame the medical establishment and the insurance industry we have suffered under all these decades.

This same institutional culture is responsible for across-the-board inflationary rise in the cost of services, by example.  Think about it: not only has the cost of healthcare driven up the cost of other services directly, but also indirectly, by the psychopathy of the culture.  Now your car mechanic, your computer repairman, your contractor has "specialized knowledge" that is "worth more" than the services of other practitioners, "in the same way that a doctor's is."  This is a cultural trend that has ruined American life in combination with other causes of inflation, such as the valuation of natural resources and their goods, and the arcane valuation of international debt.

Edited November 20, 2019 by David Andrews

[W. Niederhut]

2 hours ago, David Andrews said:

What I'm saying, W., is that we're never going to find out.  The private system is so entrenched in US medical culture and politics that we are not going to get single-payer and find out if it works better for all, under public scrutiny, than VA worked under a smaller group of bureaucrats on a population that is, unfortunately and unfairly, sidelined in our culture.

Don't you think that if people want it, we should try single-payer?  People who are ill or dying, or aging, or just worried about their future and their family's?

Will medical costs go down under single-payer?  If not, blame the medical establishment and the insurance industry we have suffered under all these decades.

This same institutional culture is responsible for across-the-board inflationary rise in the cost of services, by example.  Think about it: not only has the cost of healthcare driven up the cost of other services directly, but also indirectly, by the psychopathy of the culture.  Now your car mechanic, your computer repairman, your contractor has "specialized knowledge" that is "worth more" than the services of other practitioners, "in the same way that a doctor's is."  This is a cultural trend that has ruined American life in combination with other causes of inflation, such as the valuation of natural resources and their goods, and the arcane valuation of international debt.

I have believed, for many years, that the U.S. should have a single payer, non-profit healthcare administrative system.   The Canadians cover everyone, and they spend a lot loss per capita to achieve better public health outcomes, generally -- partly by eliminating insurance industry profits, and partly by having the leverage to reduce costs for goods and services.

Medicare is a shining example of how such a system could work for everyone in the U.S. (other than the 2003 Bush-Cheney Medicare Part D proviso that prohibited Medicare from negotiating with Big Pharma to reduce drug prices!)  Among other success stories, Medicare dramatically reduced senior poverty in the U.S. after 1965.

Not to make excuses for physicians, but the main driving force behind our current dysfunctional for-profit healthcare system, IMO, has been the private insurance industry.  They control the money supply, and they put a lot of energy into managing (reducing) their costs, while advertising how much they "care."  Physicians nowadays are mostly pawns in the industry game-- unless they simply cater "out-of-network" to the rich, as many do.

Not sure what it will take to break the insurance industry's stranglehold on political efforts to establish a general single payer system.

I was surprised and bitterly disappointed when Hillary Clinton's healthcare task force in the 1990s invited only private insurance industry moguls to the table, rather than sitting down with public health experts to devise the best healthcare system for the American people.

Similarly, (after waiting another 15 years for a reform effort!) the 2009 Senate Finance Committee sabotaged the crucial ACA plans to include a "public" provider option for the ACA.  It was a bipartisan sabotage effort, spearheaded by Charles Grassley, Max Baucus, and Joseph Lieberman, on behalf of the private insurance industry.

What we know, for certain, is that America's private insurance industry moguls will fight tooth-and-claw to sabotage any future legislative efforts to expand a single payer system.

The industry sabotage will include heavily funded advertising/disinformation, lobbying, and the usual YUGE financial donations to elected public officials in both parties.

 

[Sandy Larsen]

Obamacare requires that medical insurers spend at least 85 cents of every premium dollar collected on actual medical care. (80 cents for groups of less than 50, for example small employers.) The 15 cents they keep goes to pay for administration of their plans, advertising, and profit.

If an insurer collects more than 15% of premiums in a given year, they must refund the excess to the insured people. (That happened to me last year and my premium was dropped to compensate me for it.)

While it would be great to reduce or eliminate the insurance industry's 15% piece of the pie, that's not going make insurance affordable to low income people. What Obamacare does to make insurance affordable is subsidize premiums  and other medical costs for low-income people.

Obamacare is great for low income folks. Not great for others, in particular those whose premiums have been increased to pay for the subsidies.

 

[W. Niederhut]

Good article by Mark Kriedler at CommonDreams.org this week about industry-funded sabotage of U.S. public health...

Industry Seeks to Flatline Universal Health Care

A deeply funded lobbying group is out to kill Medicare for All. Its ideological roots run back to the Truman era.

https://www.commondreams.org/views/2019/12/16/industry-seeks-flatline-universal-health-care