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Tuesday, May 5, 2020

Health Care Reform Articles - May 5, 2020

Arguing with Zombies review: Paul Krugman trumps the Republicans

The Nobel-winning economist and New York Times columnist is at the top of his game in eviscerating those who have dragged America down
 
by  Charles Kaiser - The Guardian - May 3, 2020
 
The New York Times columnist Paul Krugman has four essential rules for successful punditry:
  • Stay with the easy stuff
  • Write in English
  • Be honest about dishonesty
  • Don’t be afraid to talk about motives
Those maxims have consistently made Krugman the most intelligent and the most useful New York Times pundit, at least since Frank Rich wrote his final must-read column 11 years ago. A new collection of Krugman’s pieces, therefore, is a timely reminder that actual knowledge and ordinary common sense are two of the rarest qualities in mainstream journalism today.
Krugman’s enemies are the “zombie ideas” of his book’s title, especially the belief that budget deficits are always bad and the notion that tax cuts for the rich can ever benefit anyone other than the plutocrats who never stop pleading for them.
The same tired arguments in favor of coddling the rich have been rolled out over and over again, by Republican presidents from Ronald Reagan to Donald Trump, even though there has never been a shred of serious evidence to support them.
These relentless efforts over five decades culminated in the Trump tax cut, memorably described by the political consultant Rick Wilson as a masterwork of “gigantic government giveaways, unfunded spending, massive debt and deficits, and a catalogue of crony capitalist freebies”.
Wilson also identified the billionaires’ effect on the nation’s capital. Washington, he wrote, has become “the drug-resistant syphilis of political climates, largely impervious to treatment and highly contagious”.
Krugman’s columns act like a steady stream of antibiotics, aimed at restoring the importance of the economic sciences that have been so successfully displaced by brain-dead Republican ideology.
Very few political columns are worth reading 12 months after they are written – the New York Times grandee James Reston accurately titled one of his collections Sketches in the Sand. But Krugman’s book proves that he, a Nobel-prize winning economist, shares two rare qualities with George Orwell, the novelist who also wrote much of the best journalism of the 20th century: deep intelligence and genuine prescience.
Krugman is at his Orwellian best here: “When you’re confronting bad-faith arguments, the public should be informed not just these arguments are wrong, but they they are in fact being made in bad faith.”
It’s “important to point out that the people who predicted runaway inflation from the Fed’s bond buying were wrong. But it’s also important to point out that none of them have been willing to admit that they were wrong.”
Krugman also writes that “even asking the right questions like ‘what is happening to income inequality’” will spur quite a few conservatives to “denounce you as un-American”. And it’s worse for climate scientists, who face persecution for speaking the truth about our continued dependence on fossil fuels, or social scientists studying the causes of gun violence: “From 1996 to 2017 the Centers for Disease Control were literally forbidden to fund research into firearm injuries and deaths.”
The history of the last half-century is mostly about how the unbridled greed of the top 1% has perverted American democracy so successfully, it has become almost impossible to implement rational policies that benefit a majority of Americans.
To Krugman, an “interlocking network of media organizations and think tanks that serves the interests of rightwing billionaires” has “effectively taken over the GOP” and “movement ‘conservatism’ is what keeps zombie ideas, like belief in the magic of tax cuts, alive.
“It’s not just that Trump has assembled an administration of the worst and the dimmest. The truth is that the modern GOP doesn’t want to hear from serious economists, whatever their politics. It prefers charlatans and cranks, who are its kind of people.”
  
Even now, as the incompetent kleptocrats who have filled up the White House and every federal agency confront the greatest worldwide health emergency of modern times, they have maintained their laser-like focus on the interests of the rich. As the Guardian has reported, “Millionaires and billionaires are set to reap more than 80% of the benefits from a change to the tax law Republicans put in the coronavirus economic relief package … the change will allow some of the nation’s wealthiest to avoid nearly $82bn of tax liability in 2020.”
And as the great labor reporter Steven Greenhouse pointed out this week, with Trump’s latest executive order to keep meatpacking plants open regardless of the consequences to their employees, the president is literally “marching many meatpacking workers off to slaughter”.
Never before in modern American history has the plutocracy so blatantly embraced the idea that profits matter much more than people – especially when the idiotic reopening of the economy weeks before health experts say it’s safe will clearly kill more poor people than anyone else.
When I was 15, I acted as the translator for my uncle Jerry’s family on a tour of the grand chateaux of the Loire Valley. As we traipsed through one spectacular example of conspicuous consumption after another, my deeply progressive uncle kept repeating the same question: “What took them so long to start the revolution?”
If our present calamity is finally enough to force the climate-change-denying, poor-people-hating Republican party from the White House and the Senate, one can only hope the popular imagination will be stirred as it was in Paris in 1793.
 
https://www.theguardian.com/books/2020/may/03/arguing-with-zombies-review-paul-krugman-trump-republicans

Physician Burnout, Interrupted

Pamela Hartzband, M.D. and  Jerome Groopman, M.D. - New England Journal of Medicine - May 1, 2020

Before the onset of the Covid-19 pandemic, each day seemed to bring another headline about the crisis of physician burnout. The issue had been simmering for years and was brought to a boil by mounting changes in the health care system, most prominently the widespread implementation of the electronic health record (EHR) and performance metrics.1 Initially, the prevailing attitude was that burnout is a physician problem and that those who can’t adapt to the new environment need to get with the program or leave. Some dismissed the problem as a generation of “dinosaur” doctors whining and pining for an inefficient, low-tech past. But recently, it has become clear that millennials, residents, and even medical students are showing signs of burnout. The unintended consequences of radical alterations in the health care system that were supposed to make physicians more efficient and productive, and thus more satisfied, have made them profoundly alienated and disillusioned. The problem has become even more urgent with the realization that it’s costing the health care system approximately $4.6 billion a year.2
Solutions have largely targeted the doctor, proposing exercise classes and relaxation techniques, snacks and social hours for decompressing, greater access to child care, hobbies to enrich free time, and ways to increase efficiency and maximize productivity. There is scant evidence that any of these measures have had a meaningful impact, as shown by a recent meta-analysis of 19 controlled studies evaluating a total of more than 1500 physicians.3 These data lead to the inescapable conclusion that currently proposed solutions do not address the underlying problem: a profound lack of alignment between caregivers’ values and the reconfigured health care system. A largely neglected field of organizational psychology provides an explanation and a roadmap for ameliorating physician burnout.
Seminal work by Gagné and Deci examined motivation in the workplace.4 The researchers classified motivation as intrinsic or extrinsic: people may perform an activity because they find it interesting and derive spontaneous satisfaction from the activity itself (intrinsic motivation); or they may receive a tangible external reward, so that satisfaction comes not from the activity itself but from that reward (extrinsic motivation). One might imagine that intrinsic and extrinsic motivators would have additive or even synergistic effects. But Gagné and Deci showed that tangible extrinsic motivators, such as monetary rewards, can paradoxically undermine intrinsic motivation. Such unexpected effects occur particularly among professionals who undertake complex tasks requiring cognitive flexibility, creativity, and problem solving.
Medicine is in many ways unique. Doctors, nurses, and other health care professionals have traditionally viewed their work as a calling. They tend to enter their field with a high level of altruism coupled with a strong interest in human biology, focused on caring for the ill. These traits and goals lead to considerable intrinsic motivation. In a misguided attempt to improve the medical system, health care reformers put into place various positive and negative extrinsic motivators, without realizing that they would actually erode and destroy intrinsic motivation, eventually leading to “amotivation” — in other words, burnout.
Reformers are perplexed that monetary incentives haven’t worked to prevent or remedy burnout. Using a monetary reward as a central motivation strategy seems practical and appealing. However, in a recent survey of more than 15,000 doctors in 29 specialties (Medscape National Physician Burnout and Suicide Report 2020), half the doctors said they would give up at least $20,000 in annual income in order to reduce their work hours; these doctors included millennials, who are among the lowest earners. It’s important to emphasize that money in and of itself is not toxic; Gagné and Deci observed that an increase in yearly salary or a bonus does not diminish intrinsic motivation. But bringing money to the fore in each individual patient interaction — by translating physicians’ work into relative value units, for example — does.
Gagné and Deci posit that there are three pillars that support professionals’ intrinsic motivation and psychological well-being: autonomy, competence, and relatedness.3 All three have been stripped away as a direct result of the restructuring of the health care system.1
Autonomy, according to Gagné and Deci, means having the right to act with a sense of volition and having the experience of choice. Physicians now endure a profound lack of control over their time and even language. The amount of time we spend with a patient, what is discussed (even to the point of uniform scripts), and how a visit is documented are all frequently mandated. We are further controlled by surveillance in the form of time and motion studies and timing of our use of the EHR.
Competence was once viewed as having a deep fund of medical knowledge and exercising clinical judgment appropriately with each patient. Under recent health care reforms, it has been redefined as compliance with various metrics, many of which are not evidence-based. Competence has also become a matter of checking off boxes in the EHR and satisfying insurers’ demands by quickly placing a note in the record for billing purposes, even if it’s incomplete or erroneous. In defense, many doctors now add a disclaimer that the note has not been proofread and to “disregard any errors.”
Relatedness is the psychological feeling that one belongs, has interpersonal attachments, and is connected to the social organization. Doctors want to give patients the time and support they need, and they want the system to value and recognize their efforts to provide this kind of care. While much lip service is given to “patient-centered care,” many doctors feel that the system is increasingly driven by money and metrics, with rewards for professionals who embrace these priorities.
Medicine’s daily tasks have become Sisyphean. Physicians recognize that it’s impossible to satisfy the current system’s demands. If you surrender, the joy of engaging with your patients is diminished and ultimately lost. If you resist, you incur the system’s wrath. Doctors are finally expressing the pain they feel. Emily Silverman, a hospitalist at the University of California, San Francisco, recently bemoaned in the New York Times “the relentless reminders of tasks we haven’t completed, supplications to correct our documentation for billers, and daily, jaundiced reminders: You are currently deficient.”
Burnout is toxic for patients as well as physicians, because it’s associated with loss of empathy, impaired job performance, and increases in medical mistakes.5 Family and friendships also suffer as the EHR’s demands invade doctors’ homes and consume the time once enjoyed in vital relationships, worsening emotional exhaustion.
The problem of burnout will not be solved without addressing the issues of autonomy, competence, and relatedness. Evidence from the meta-analysis of controlled interventions supports the restoration of autonomy; giving doctors flexibility in their schedule to allow for individual styles of practice and patient interaction was one of the few system solutions that reduced burnout.3 Flexibility in scheduling recognizes that both patients and doctors are individuals, and some interactions simply take longer than others. The EHR, initially lauded for its potential as a repository of patient information, has become a tyrannical, time-consuming billing tool; it must be reconfigured to work for physicians rather than forcing physicians to work for it.
Competency can be restored by purging the system of meaningless metrics while maintaining a core of evidence-based measures, allowing for clinical judgment, and honoring individual patient preferences. Relatedness should be authentic, aligning the system’s values with those of physicians, nurses, and other health care professionals who chose their careers out of altruism. Restoring these three pillars will support the return of intrinsic motivation.
With the Covid-19 pandemic, medicine is at a crisis point. Health care professionals are responding with an astounding display of selflessness, caring for patients despite the risk of profound personal harm. Our efforts are recognized and applauded. During this interlude filled with uncertainty, there has been a sense of altruism and urgency that has unexpectedly catalyzed the restoration of some elements of autonomy, competency, and relatedness. Indeed, the whole medical system, including hospital administrators and insurers, among others, has rallied to support the caregivers. But will these positive changes be sustained? Tectonic shifts are at work as hospitals and clinics suffer grave financial losses and the workforce is diminished by illness and exhaustion. As the current crisis ultimately abates, we need to remember the lesson that the system can be reset. It is time to evaluate what has worked and what hasn’t in health care reform. We must not return to the former status quo.
https://www.nejm.org/doi/full/10.1056/NEJMp2003149?query=RP

The unlikely alliance trying to rescue workplace health insurance

As millions lose employer health plans, powerful Washington groups are uniting behind a bailout of the popular coverage.

Big businesses and powerful Democrats are aligning around a proposal to bail out employer health plans in the wake of staggering losses to the insurance industry, as some worry that a surge in uninsured Americans could give new life to a stalled push for “Medicare for All.”
The business and labor interests, who have strong economic motives to keep the current system of employer-based care, are rallying behind a Democratic effort to subsidize temporary extensions of newly unemployed Americans’ workplace health plans in Congress’ next coronavirus rescue package.
But to some progressives who cheered Bernie Sanders' (I-Vt.) Medicare for All plan, the crisis has exposed what they see as the folly of tying employment to health coverage. Sanders, who's advocating for an emergency version of his health plan during the pandemic, ripped the idea of propping up an expensive employer system in a POLITICO op-ed Tuesday.
"Not only would health insurance corporations make massive profits off the plan—profits that come at the cost of the American taxpayers—but it would still leave tens of millions uninsured or underinsured," the former Democratic presidential candidate wrote. "And during this pandemic, a lack of insurance means more Covid-19 transmissions and more deaths."
America’s health care system since World War II has relied on the increasingly costly employer insurance market. But with 26 million people rapidly losing their jobs amid a massive health crisis, the idea of tying coverage to the workplace is facing its biggest stress test yet.
Employers, health care groups and unions badly want the employer system to emerge from the health crisis unscathed, believing it would ward off any new expansion of government health care. Joe Biden’s rise to becoming the presumptive Democratic nominee was a relief to the health care industry, which has spent the past two years attacking Medicare for All. Health care groups also oppose other more incremental government expansions, like a public option Biden and other moderate Democrats support.
“This crisis will be over — not soon enough, but it will be over — and we need to fundamentally keep that highway back to jobs and job-provided health care open,” said Ilyse Schuman, senior vice president of health policy for the American Benefits Council, which represents major employers. “That’s what Congress needs to do now, and employer-sponsored insurance plays a big role in that.”
Experts estimate the job-based insurance market has likely already lost millions of customers as unemployment skyrockets, and a growing number of insurers hoping to retain business are offering grace periods on premium payments. Few people losing their jobs sign up for temporary workplace insurance, known as COBRA plans, unless they desperately need the coverage. And it's both complicated and extremely costly, since it comes without employer subsidies that typically cover the lion’s share of monthly premiums.
Newly unemployed people losing health insurance can often find cheaper or even free coverage through the Obamacare insurance markets or Medicaid. However, President Donald Trump’s refusal to broadly reopen the Obamacare markets or make enrollment easier for those eligible may limit the safety net’s reach. Many of the poor won't be eligible for Medicaid in the remaining 14 states that have not expanded the programs under Obamacare.
While the health industry and Democrats still want to bolster Obamacare, an unusual bloc is pressuring Congress to fully subsidize workplace premiums for the uninsured. Corporations would benefit because the employer-based system supplies a big tax break for benefits they can use as a recruiting tool. Unions would keep the generous coverage they have negotiated with corporations. And hospitals and doctors could maintain the big payouts from private insurance, which are far higher than the Medicare and Medicaid rates paid by government.
Such an idea could hit the political sweet spot on Capitol Hill. Workplace plans, which covered an estimated 160 million Americans before the pandemic, remain popular. Democratic leaders in Congress know Republicans have little appetite for broadly expanding government coverage, and Biden has endorsed temporarily subsidizing workplace plans. Republicans, despite railing against insurer “bailouts” in Obamacare for years, are friendlier to employer-based insurance and may be more receptive to a deal that could prevent millions of people joining the Medicaid rolls.
The health care industry is spooked by a widely circulated projection that between 12 million and 35 million people could lose their employer health plan in the economic fallout from coronavirus. The same analysis from consulting group Health Management Associates predicts the uninsured ranks could swell from 28 million to 40 million people, while Medicaid rolls in expansion states would also grow. That prospect worries the hospital industry, which endorsed COBRA aid on Tuesday, since the safety net program typically pays much less than Medicare.
Meanwhile, the health care industry is also trying to win back Americans’ trust about the affordability of the system, just months after hospitals and physician groups helped derail an effort to ban exorbitant “surprise” medical bills. Big insurance companies are waiving deductibles and copays for their commercial plans and the Trump administration is offering Medicare payments to hospitals so they don’t charge uninsured coronavirus patients.
Industry experts downplay the idea the pandemic poses an existential threat to employer insurance, noting that once the economy rebounds the same dynamics that have made the market attractive will remain unchanged.
Still, the market has already taken a hit. Additionally the yearslong trend of small businesses dropping employee coverage will likely accelerate, either because they will have shuttered or need to cut costs.
Ultimately, the future of employer-based insurance will be steered by large corporations that are the backbone of the market, said Linda Blumberg of the Urban Institute. The uncertain prospects for recovery from this crisis, however, remain a wild card.
“I think a lot remains to be seen with regard to how strongly the labor market bounces back and how long it takes,” she said.
Unions, major insurers, hospitals and the consumer advocacy group Families USA have banded together through a group called the Alliance to Fight for Health Care, and are lobbying Congress to subsidize COBRA through the next stimulus package.
Supporters said COBRA aid would provide a backstop to hospitals and physicians, whose finances have been hurt by the cancellation of elective procedures during the crisis. Congress has already approved $175 billion to health care providers with few strings attached.
“Hospitals and providers are seeing tremendous expense and increase in uncompensated care and uninsured individuals coming in, while also seeing drops in elective procedures, so I think it’s money well spent in protecting employees in a time of crisis,” said Katie Mahoney, vice president of health policy for the U.S. Chamber of Commerce.
House Speaker Nancy Pelosi first pitched COBRA subsidies a month ago in a proposed alternative to the $2.2 trillion CARES Act that was ultimately approved by Congress. House Education and Labor Chairman Bobby Scott (D-Va.) and Rep. Debbie Dingell (D-Mich.) earlier this month unveiled standalone legislation fully subsidizing employer premiums for laid-off or furloughed workers.
Support from unions puts pressure on progressive Democrats, the driving force behind Medicare for All, to back the policy.
Unite Here, representing mostly service workers, said Congress must subsidize workplace plans. The union’s international president, D. Taylor, estimates 95 percent of its members are unemployed during the crisis.
“The health care crisis of a lifetime requires full emergency health care coverage for those millions of hardworking Americans who, through no fault of their own, have become unemployed," Taylor said.
But the effort has raised eyebrows among some liberal policy experts, who say Democrats are overlooking the health care law they’ve spent the past 10 years defending. They said Democrats should be trying to expand that safety net at a time when health coverage independent from a workplace is more important than ever.
The law’s individual market plans are expensive but are still ultimately cheaper for the government to subsidize than employer coverage. Medicaid plans, which offer full coverage for lower-income adults in expansion states, are cheaper still. And analysts question whether the subsidies would be money well spent when they only buy temporary certainty for workers and their families, who may ultimately have to turn to the Affordable Care Act if the economy is slow to recover.
“At a time when you don’t know if people are going back to work, or where they’ll go back to work, getting them better ACA coverage would be more expedient,” said Arielle Kane, director of health policy at the Progressive Policy Institute.
Moreover, experts note, COBRA subsidies come with a huge price tag and ultimately help the middle- and higher-income people, rather than lower-income people more likely to work retail and service jobs affected by shutdowns.
“Almost no matter the employment outlook or time horizon, COBRA subsidies are unlikely to be the most cost-effective way of expanding coverage or relieving financial hardship,” said Matt Fiedler, former chief economist of the Council of Economic Advisers under the Obama administration. “They’re just not targeted on the right people.”
Congress subsidized COBRA in the last recession, before Obamacare was passed. The aid had limited reach — only about one-third of those eligible for subsidies signed up for coverage, according to a 2015 Labor Department review. Congress at the time agreed to a 65 percent premium subsidy. This time, groups are pushing to cover the entire amount.
Tom Leibfried, a health care lobbyist for AFL-CIO, acknowledged some progressives would rather expand government coverage through the crisis, but he stressed that it would be easier to work within the existing system to deliver faster relief.
“So as happened in 2009, during the Great Recession, it’s just more practical to turn to existing institutions and use those to make sure people get the care they need and don’t face financial hardship,” he said.
 
https://www.politico.com/news/2020/04/28/washington-groups-fight-for-bailout-employee-health-insurance-215981 
 
 

Here’s How to Cover Uninsured Americans During the Pandemic

Empowering Medicare to cover our health needs is comprehensive and cost-effective.
As the coronavirus continues to spread, and the United States climbs closer to 1 million cases and nearly 60,000 deaths, we face an unprecedented economic and health care crisis that demands an unprecedented response. While we work toward an economic solution that keeps people on the payroll, Washington is also in the midst of a crucial argument over how to help cover the costs of testing, treatment and all other essential care for the millions of people who are now uninsured or soon will be as the country faces record levels of job loss. This pandemic makes even more clear that we are all only as safe as the least-insured in our country.
Last week, the White House said it would give an unspecified amount of federal aid directly to hospitals to cover the costs of treating uninsured Covid-19 patients, but details have not been released, and the proposal leaves out all non-Covid-19—but still crucial—medical care. The week before, a handful of Democrats proposed spending hundreds of billions of dollars on expanding subsidies for COBRA—the program that allows those who have lost their jobs to continue, on a temporary basis, paying out-of-pocket for the health insurance coverage they received from their previous employer.
But there’s another, better way to guarantee that everyone in America gets all the health care they need, without cost, for the duration of the pandemic: Empower Medicare to pay all of the health care costs for the uninsured, as well as all out-of-pocket expenses for those with existing public or private insurance, for as long as this pandemic continues. Our Health Care Emergency Guarantee Act is more comprehensive than Trump’s vague proposal and less expensive than the Democrats’ COBRA expansion.
Let’s be clear: Even before this crisis began, 87 million Americans were uninsured or underinsured—struggling to get to a doctor when they needed to. Now the situation is much worse.
There is no doubt that the health care crisis we are facing right now is an emergency. Already, an estimated 9.2 million workers have lost their employer-sponsored insurance, and as many as 35 million people might lose coverage by the end of the crisis. Meanwhile, the cost of hospital treatment for the coronavirus amounts to tens of thousands of dollars, and patients struggling with the disease are desperately worried that they cannot afford treatment or might go bankrupt if they get it. To make matters worse, some of the communities hit hardest by the coronavirus, such as the undocumented, largely do not have any health insurance coverage at all.
Yet, unbelievably, in the midst of this horrific pandemic, Republicans in Congress have only continued their cruel and single-minded focus on repealing the Affordable Care Act. Further, Republican governors, like Greg Abbott in Texas, continue to fight against Medicaid expansion, leaving many of the most vulnerable people in their states desperate and sick.
While almost all Democrats understand the severity of the crisis and the need to act, too many of them are proposing a totally inadequate response that would simply lock in place the dysfunction and waste of our current health care system.
Subsidizing COBRA, as they have suggested, would be both expensive and ineffective: Not only would health insurance corporations make massive profits off the plan—profits that come at the cost of the American taxpayer—but it would still leave tens of millions uninsured or underinsured. And during this pandemic, a lack of insurance means more Covid-19 transmissions and more deaths.
Expanding COBRA during the pandemic would do nothing to cover those who already lacked insurance. It also won’t help the many Americans who continue to receive employer-provided health care but are still prevented from going to the doctor by massive deductibles and co-pays. In fact, the average family with employer-provided insurance faces $4,700 in out-of-pocket costs every year. The deductible alone for the average low-income worker is $2,600 a year. Maintaining the status quo does nothing to address these extraordinary costs, made worse during the pandemic economy.
Further, COBRA subsidies will only cement the inequities of our current health insurance system. Right now, low-wage workers are, on average, enrolled in plans with low premiums but higher deductibles. On the other hand, higher-wage employees, often professionals, have platinum plans with much higher premiums and far superior coverage. Expanding COBRA, which subsidizes only premiums, would treat high-income workers who lose their jobs far better than low-wage workers who do, even though the latter have suffered the brunt of the economic damage wrought by the pandemic.
The Health Care Emergency Guarantee Act would treat all people equally. For the duration of this crisis, under the act, Medicare will cover all medically necessary health care, including prescription drugs, for the uninsured, whether those who have recently lost their jobs or those who have been long without insurance. It is simply irresponsible and dangerous to the public to allow millions of people in this country to go without health coverage as a pandemic rips through our communities.
Medicare, under our plan, would also temporarily cover the copays, deductibles and other out-of-pocket costs for all medically necessary health care for those who are already insured. Here is how this simple and efficient plan would work: When people go to the hospital or doctor, they provide their insurance information. If they have insurance, their provider will bill Medicare for the out-of-pocket costs; if the individual is uninsured, the provider will bill Medicare for the entire cost of care. The patient will not be forced to pay any bills for their treatment.
This proposal would prevent insurance companies from decreasing coverage and ban surprise billing so patients don’t get unexpected charges later. It would also prevent price gouging by pharmaceutical companies by making sure the government pays the same lower price for prescription drugs as the Veterans Health Administration.
Allowing Medicare to cover out-of-pocket health care expenses during the pandemic isn’t just the right thing to do, it’s actually less expensive for taxpayers because, unlike COBRA, the government would not be covering the cost of expensive monthly premiums to insurance corporations.
The numbers make this clear. If 35 million Americans lose their employer-provided coverage, as estimated by Health Management Associates, subsidizing premiums to health insurance corporations through COBRA would cost $157 billion over four months, or as much as $472 billion over a year. And even then, these figures don’t include the outrageously high deductibles that many people would still have to pay. Meanwhile, the conservative Committee for a Responsible Federal Budget estimates that allowing Medicare to cover out-of-pocket expenses for everyone would cost around $150 billion over four months, or only $400 billion over a year. In other words, the Health Care Emergency Guarantee Act provides comprehensive coverage to far more Americans while saving taxpayers money.
The American people deserve a health care response to the pandemic that’s simple, easy to understand and doesn’t require them to fill out complicated forms or deal with an already stressed bureaucracy in order to receive care. Under this proposal, everyone in the United States, regardless of insurance coverage or immigration status, would be able to walk into a doctor’s office to receive the care they need without worrying about the cost.
At a time when many American families are waiting hours in food lines and are often unable to afford groceries, whatever amount of money is left in their pocket must be saved for the basic needs of their families, not exorbitant health care bills. When so many of our people are struggling economically and are terrified by the possibility of becoming sick with the coronavirus, the government must take the burden of health care costs off the backs of working people. The Health Care Emergency Guarantee Act would do just that.
https://www.politico.com/news/magazine/2020/04/28/covid-health-care-proposal-uninsured-medicare-212973


The pandemic has made the US healthcare crisis far more dire. We must fix the system

Before the pandemic, 87 million were uninsured or underinsured in the US. We must finally guarantee healthcare to everyone as a human right
by Bernie Sanders and Pramilla Jayapal - The Guardian - May 2, 2020

When it comes to our current healthcare system, the waste, cruelty and dysfunction was glaringly obvious even before the horrific pandemic we are now experiencing. Today, as millions of Americans lose their jobs and their healthcare benefits that come with them, it is now virtually impossible for any rational person to defend a system – unique among wealthy countries – that ties healthcare to employment, and is designed only to make huge profits for the insurance industry and drug companies, while ignoring the needs of ordinary Americans.
Before the pandemic, 87 million people were uninsured or underinsured in our country, and more than 30,000 people died every year because they couldn’t get to a doctor when they needed to see one. More than half a million families declared bankruptcy each year because of medically related debt. One out of five Americans could not afford the outrageously priced prescription drugs their doctors prescribed to them. And our healthcare outcomes, from maternal deaths to life expectancy to infant mortality, lagged behind most other industrialized nations.
And for all of that, the United States still spends nearly $11,000 on healthcare for every adult and child – more than twice the average of other major countries.
That was before the pandemic. The situation is far more dire now.
Over just the last five weeks, more than 26 million Americans have lost their jobs and now face a crisis unique among advanced countries: for most of them, their healthcare was tied to their jobs. In America, unlike any other major country, when you lose your job, you lose your healthcare. As a result, up to 35 million Americans are estimated to see their health coverage disappear in the middle of this Covid-19 nightmare. And premiums for those who retain their health insurance in this crisis could increase by up to 40% . As horror stories circulate of $34,000 coronavirus medical bills, the uninsured remain terrified of going bankrupt just to get tested and treated for Covid-19. In many cases, they just cannot afford to go to a doctor or the hospital.
But it’s not just the high cost and growing number of uninsured that expose the irrationality of the current system. It’s that the current “system” makes absolutely no sense to anyone. It is an incredibly byzantine and complicated collection of independent entities without a common purpose – except greed. Think about it: In the midst of the worst healthcare crisis in modern American history, with thousands of doctors and nurses and other medical personnel becoming infected and sometimes dying, hospitals and clinics have, for financial reasons, been forced to lay off thousands of medical workers at a time when they are needed most.
Further, our public health system is incredibly weak, in part because of consistent federal disinvestment and austerity that have decimated too many public health agencies. In most states, we lack the capability to significantly increase the level of coronavirus testing and contact tracing we need to begin to safely reopen the economy.
Price-gouging and profiteering has affected everything from hand sanitizer to respirator prices which, in some cases, have more than quintupled – virtually overnight. Cities, states and hospitals continue to fight over scarce gloves, gowns, masks and ventilators. Four out of five frontline nurses don’t have enough protective equipment. In the richest country in the history of the world, nurses caring for coronavirus patients have resorted to wearing trash bags as makeshift protective gear. That is an international embarrassment.
The current crisis has also exposed, to a horrific degree, how the massive level of income and wealth inequality in America magnifies healthcare inequities, and financially ravages our most vulnerable people. Rural hospitals and community health clinics, which often treat the poor, are on the verge of going bankrupt and shutting down. Major outbreaks are attacking our Black, Hispanic, Native American and undocumented communities, as well as the incarcerated and the homeless.
State and local data show that more than 30% of reported deaths have been African American, even though they only make up less than 15% of the population. The perverse irony of our broken for-profit healthcare system is that black, brown, rural and low-income people are most likely to be uninsured or underinsured, delaying or forgoing the costly necessary treatments or prescription drugs that could prevent the very conditions that make them most susceptible to the virus. It is no coincidence that the poor, the working class, the sick and the elderly disproportionately make up America’s 1m reported coronavirus infections and over 57,000 deaths – the largest figures of any country on Earth.
If there is any silver lining in this unprecedented moment that we find ourselves in, it is that we must use this time to reassess the foundational institutions of American society and determine how we go forward into a better future. With tens of thousands of Americans dying and millions losing their jobs, how sad it would be if we learned nothing from all that we have done wrong.
Do we really want to continue the current expensive and cruel system that ties healthcare to our jobs? Or do we need a simple, comprehensive and cost-effective system that understands that healthcare is a human right for all of our people – employed or unemployed, young or old, rich or poor?
Do we really want to continue being ripped off by the pharmaceutical industry that charges us, by far, the highest prices in the world for prescription drugs? Or do we want a system that negotiates drug prices like every other country on Earth?
Do we really want to continue the complicated, wasteful and bureaucratic system in which virtually every visit to a doctor or hospital requires the filling out of endless forms in order to determine how much of our deductible we have paid, what percentage of our procedure is covered, and whether we got sick in the appropriate “network”? Or do we want a simple system in which we go to any doctor we choose and never see a bill, because the system is publicly funded?
Do we really want to continue having a woefully inadequate primary healthcare system because medical and nursing school graduates, faced with huge student debt, often gravitate to communities where they can make big bucks? Or do we want to make sure we have an appropriate number of medical personnel in the locations where they are most needed?
The good news is that a growing number of Americans – especially in the face of this pandemic – believe that this dysfunctional and wasteful healthcare system must be replaced. A poll conducted this month, for example, indicated that 69% of all Americans – including 68% of independents and 88% of Democrats – support providing Medicare to every American.
The bad news is that the healthcare industry, which made more than $100bn in profits last year and provides their CEOs with huge compensation packages, will do everything possible to maintain the status quo. And don’t be fooled: they will lobby just as hard against any lesser proposal as they will against Medicare for All, buying politicians with campaign contributions and spending endless amounts of money on lobbying and advertising.
There is no question that this will be an enormous challenge – but we can win this struggle if we engage people in the political process in a way we have never done before. We are all in this together. In this unprecedented moment in American history, let us stand united and harness the solidarity and compassion that so many are now demonstrating. Let us, finally, guarantee healthcare to all our people as a human right.
https://www.theguardian.com/commentisfree/2020/may/02/us-healthcare-system-coronavirus-pandemic-bernie-sanders-pramila-jayapal

A firm that employs doctors at 2 bankrupt Maine hospitals may seek bankruptcy itself

A staffing firm that employs some of the doctors in three rural Maine hospitals — including two that are now in bankruptcy and suing the federal government for stimulus funding — is reportedly considering filing for bankruptcy itself as a result of steep revenue shortfalls related to the coronavirus.
Just as those hospitals have lost considerable revenue after preparing to handle the pandemic, Envision Healthcare Corp. is struggling to pay off $7 billion in debt after the crisis forced medical systems all across the U.S. to delay lucrative elective services, according to Bloomberg.
As a result, Envision — which provides staffing to hospitals across the country — has hired restructuring advisors and considered seeking Chapter 11 bankruptcy protection to help manage its debts, Bloomberg reported. It based the report on information from unnamed sources who said the situation was fluid and subject to change.
Envision, one of the largest physician staffing firms in the country, employs the ER doctors of Calais Regional Hospital, Penobscot Valley Hospital in Lincoln and Down East Community Hospital in Machias. It also employs the doctors, known as hospitalists, who see admitted patients at Penobscot Valley Hospital.
An Envision spokesperson, Aliese Polk, did not directly respond to a request for confirmation of the Bloomberg report or an explanation of how a bankruptcy proceeding would affect its services at the three Maine hospitals.
“As clinicians who live and work in the Washington and Penobscot communities, we are focused on caring for our neighbors and supporting our hospital partners,” Polk said in an emailed response. “Envision Physician Services is treating COVID-19 patients and working to mitigate the spread of the virus while continuing to provide care to all patients seeking emergency care in the communities it serves.”
In general, companies usually continue operating during Chapter 11 bankruptcy, but it gives them protections while they try to reorganize their debts and return to profitability, according to the U.S. Securities and Exchange Commission. Some companies continue to operate after the process, while others end up being liquidated.
All three Maine hospitals that use Envision doctors run on thin or negative operating margins. In the last year-and-a-half, Calais Regional Hospital and Penobscot Valley Hospital have both sought Chapter 11 bankruptcy protection to help restructure their millions in debts. The Calais and Machias hospitals began using Envision to staff their emergency rooms in recent months.
As part of their bankruptcy cases, the Calais and Lincoln hospitals have both just filed lawsuits against the federal government because they were denied access to a relief program meant to help small businesses keep their staff employed during the coronavirus, but that has interim rules barring applicants who are in bankruptcy. The hospitals have said that restriction is unlawful and that they could have to close their doors by the end of June if they don’t receive more stimulus funds.
A Calais Regional Hospital spokesperson referred any questions to Envision, and Penobscot Valley Hospital CEO Crystal Landry said that she had not heard reports that the company may file for bankruptcy.
Julie Hixson, a spokesperson for Down East Community Hospital, said: “We don’t have any real information on this and feel it would be imprudent to prematurely speculate on their possible bankruptcy protection filing. Regardless, it will play no part in our ability to stay safely staffed or our ability to care for the people who come to our emergency department.
“The people in this community have enough to deal with right now,” Hixson added. “We want them to know that DECH and all our provider practices are here to take care of them. We also want them to know that Envision is committed to taking care of patients at DECH; they have assured us of that.”


The COVID-19 Pandemic Exposes Deep Flaws In America’s Broken Healthcare System


The coronavirus crisis is demonstrating why it’s time we replaced a system that exists purely for profits with one that puts public health first.

When it comes to the number of Covid-19 cases and deaths, the United States is off the charts compared to other countries. Although the USA comprises five percent of the global population, 32 percent of Covid-19 cases and 25 percent of deaths worldwide are there. By contrast, China, where the novel coronavirus originated, has one-tenth of the number of cases and deaths, despite having a population that is four times larger.
A disaster scenario is playing out across the United States, particularly in New York City where scores of refrigerator trucks have been brought in to hold the dead, hundreds of people are dying in their homes without medical attention every day, mass graves are being used to store bodies while mortuaries are overwhelmed, and health professionals lack basic personal protective equipment (PPE), ventilators, and dialysis machines.
Dr. Mike Pappas, a doctor there, has described the difficulties he and other health professionals are facing. The shortage of PPE means doctors and nurses are reusing masks and gowns and are sometimes working without them. They are wearing trash bags over their bodies to protect themselves and their patients from becoming infected. In an interview, Dr. Pappas spoke about the stress of not having enough staff, having to clear hallways and the cafeteria to make bed space, and the reluctance of hospital administrators to buy more ventilators.
As people in America struggle to wrap their heads around the twin crises of the rampant pandemic and collapsing economy, it is easy to blame the Trump administration for its failures to take rapid and effective action to contain the spread of infection and provide financial support. In reality, the roots of the crises precede Trump. The US would have fared poorly during a pandemic under any president.

It’s the system, stupid

The current disaster exists in large part because the US healthcare system is the opposite of what is needed. It is fragmented, discriminatory and designed for corporate profits, not the wellbeing of the public. Even before the pandemic, the United States had the highest number of preventable deaths compared to other wealthy nations and a declining life expectancy.
Nearly every facet of the system, which is twice as expensive as other developed countries, is designed to extract profit whether it is the hundreds of private health insurers that compete for the healthiest enrollees while avoiding those with health conditions, or the pharmaceutical corporations that charge whatever the market will bear. Even hospitals are shutting down essential departments such as obstetrics and pediatrics to make space for more lucrative areas like cardiology and orthopedics.

Two-thirds of US bankruptcies are caused by medical bills

There are now more than 30 million people without health insurance. In the past five weeks, as more than 26 million people filed for unemployment benefits for the first time, five million of them lost their health insurance. The number of uninsured is expected to rise by more than 13 million by June. On top of that, tens of millions of people with health insurance can’t afford care because of the thousands of dollars in out-of-pocket costs they must pay before their insurance benefits begin.
Even if a person has health insurance, there may not be anywhere to go for care. Over the past 45 years, as the US population grew by over 100 million, the number of hospital beds shrunk by about 600,000. Hospitals closed in rural areas because they could not bring in enough revenue to keep their doors open. Another 453 rural hospitals are teetering on the edge of closure out of the 1,844 that remain. In cities, hospitals that served poor communities for over 100 years are being shuttered to make way for luxury housing or retail space in gentrifying areas.
Another flaw that has been exposed by Covid-19 is the supply chain for goods and equipment. In February and early March, when patients went to hospitals with symptoms of the virus, there were few to no tests for diagnosis because the US chose to create its own tests rather than purchasing them from the World Health Organization. There have been severe shortages of protective gear. States have been fighting with each other to get basic kits as suppliers raise prices by as much as 1,000 percent.
This situation has made the call for a national improved Medicare for All healthcare system grow louder. If the US already had Medicare for All, many of the problems being experienced would not exist. Under the Medicare for All system, as defined by the congressional bill in the House of Representatives, every person in the US would be covered from birth to death without requiring payment before care is given.
This would alleviate the real fear Americans experience of financial ruin. For example, in March a nurse sought care and testing for Covid-19 symptoms and subsequently received a bill for $35,000 even though she was never admitted to the hospital. Two thirds of personal bankruptcies in America are because of medical bills.

Put people before profits

There’s a more fundamental case for a more socialized approach: it works better. A look at healthcare systems around the world that have performed well during the pandemic finds universal coverage, central planning, and the principle of health over profit are essential features. Even countries that are suffering from economic sanctions are doing a better job of containing the spread of infection than the United States.
Under a national improved Medicare for All, hospitals would not be closing their doors or shutting down departments that don’t generate high revenues in favor of more lucrative ones. Every hospital and health facility would receive a budget to cover operating costs and capital expenses. The days of investment companies buying up hospitals, running them into bankruptcy and leaving them stranded would be over.
Another key feature would be that the federal government would purchase pharmaceuticals and medical supplies in bulk to lower the cost and ensure states have what they need. Bidding wars and price gouging would cease to exist.
The US is an outlier in this pandemic in terms of the number of Covid-19 cases and deaths, and an expert predicts the next winter will be even worse as the flu season begins. But the US has been an outlier for a long time for spending the most on healthcare and still having poor health outcomes. Around the world, the countries that have handled the pandemic well, such as China, South Korea, Cuba and Venezuela, share common features of their healthcare systems: central planning, universal coverage and a focus on public health.
Whether America finally adopts a similar system depends on what people do to demand it, but there certainly has not been a more opportune time to make that demand.
https://popularresistance.org/the-covid-19-pandemic-exposes-deep-flaws-in-americas-broken-healthcare-system/

Two Medical Systems, Two Pandemic Responses

by Ian Austen - NYT - May 2, 2020

After lamenting in a recent Canada Letter about my inability to find an expert who could offer an informed comparison of how the medical systems in Canada and the United States were responding to the coronavirus pandemic, I soon heard from Prof. Peter Berman.

He is particularly well placed for such an assessment, after spending 25 years teaching at Harvard, most recently as a professor of global health systems and economics at the T.H. Chan School of Public Health. Professor Berman is now based in Vancouver as the director of the school of population and public health at the University of British Columbia’s medical school.
I’ll begin the comparison with some numbers. Massachusetts, the previous home of Professor Berman, has a population of 6.8 million and British Columbia has slightly over five million residents. But the toll of the pandemic on the two areas has been significantly different. As of Friday afternoon in Massachusetts, there have been more than 62,000 reported cases and 3,562 deaths, or 52 fatalities for every 100,000 people. In B.C., there have been just 2,112 reported cases and 111 deaths or just two victims for every 100,000 residents.
Professor Berman cautioned that those numbers reflect a wide variety of factors outside the medical system like the demographic makeup of different cities and regions.

But he noted that near his old office at Harvard “there must be thousands of the world’s best hospital beds and there are three top international top hospitals within a couple blocks.” So with resources like that, why is there such a great disparity with British Columbia?
Part of the answer, for Professor Berman, can be found in how hospitals are funded and managed by the public health care systems of Canadian provinces.
“The kind of system we have in Canada — and I think in British Columbia we have a pretty well-run version of it — allows the public health authorities to essentially commandeer the hospital system. It’s a command and control thing, it’s not a coordination thing,” he said.
In the United States, Professor Berman said, hospitals are largely private institutions without any overall control.
The effect of having these different systems plays out in many ways.
“In British Columbia, the province just said: ‘We need to get ready for this, we need to free up 30 percent of the hospital beds,’” Professor Berman said. “And they instructed the health authorities to do it.”

 

But in Massachusetts, he said, not only was there no one to tell hospitals to clear out beds, the economics of the system work against such steps.
“If you have a private hospital where all the beds are paid for by patients and by insurance, when you have an empty bed, you have no revenue,” Professor Berman said. “So there’s a strong incentive for the hospital managers, especially in trying economic times, to be reluctant to cooperate. And then you end up with this kind of panicky atmosphere that has been happening in the U.S. where people are saying: ‘We don’t have enough beds, we don’t have enough this, we don’t have enough that.’”
By contrast, Canadian hospitals have fixed funding. The number of full or empty beds has no effect on their budgets.

The structure in the United States leads to other problems. Few American hospital administrators got together to do things like moving medical supplies and patients around between their institutions, Professor Berman said.

“They have a strong disincentive not to do that and in addition there is no one who can make them do that without a pretty heavy duty expression of police powers of the state, which we haven’t really seen happening,” he said.
Professor Berman also noted that while the American system has vast medical and scientific expertise, there’s little national coordination. Instead, responsibility has been fractured among a variety of long established agencies like the Centers for Disease Control, the National Institutes of Health and the coronavirus task force established by President Trump.
“So you see these different agencies being brought in to weigh in with their opinions without any sense of who’s really the spokesperson,” he said. In Canada however, “at a national level, Theresa Tam is doing that and then at the provincial level, we have people like Bonnie Henry doing that. I think in the U.S., no one’s been allowed to do that.”
None of this means that Canada’s approach to the crisis and the structure of its medical system is perfect. Among other things, Professor Berman said that Canada’s health systems, which effectively treat doctors as private contractors, sometimes leads to disconnections between primary health care and the hospital systems. He also said that the country has been slow to push testing for the virus out into communities.
But none of that has led to the sort of response he’s seeing back in the United States.
“I’m a health economist,” Professor Berman said. “So the argument is always given in the United States that we have a lot of innovation, the system is very efficient and so on. But this is the other side of the argument.”

https://www.nytimes.com/2020/05/01/world/canada/america-canada-coronavirus-comparison.html   

 

 
 

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