‘Why Is It So Expensive?’
We Asked People From Around the
World What They Think of U.S. Health Care.
Covid-19 Vaccinations: A Shot in the Arm for Universal Healthcare?
The national vaccination program has all the features of a single-payer health care system including no copays, no premiums, no insurance company blocking payment, and universal, affordable healthcare for all.
As millions of us get vaccinated against SARS-CoV-2, we will get a first-hand glimpse of what a single-payer, Medicare-for-All approach to health care might mean, at least at the federal level. At the national level, the development and distribution of the vaccines have features of a single-payer approach to health care that set the program apart from business as usual in our private market-oriented health care system.
The vaccine is being treated as a public good, not a private commodity, and its priority process is determined by medical need, not by ability to pay.
Vaccines are not usually profitable for pharmaceutical companies. It was therefore necessary for the federal government to subsidize the development and distribution of the Covid19 vaccines, mainly through Operation Warp Speed. As a result of these subsidies, none of us have to pay to receive the vaccine. Moreover, there are no documentation requirements to show eligibility and no disputes with insurance companies before or after vaccination. According to guidelines from the Centers for Medicaid and Medicare Services (CMS), “Vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost.” Additionally, providers “may not seek any reimbursement, including through balance billing, from a vaccine recipient.” We will all be covered automatically with no out-of-pocket costs.
The national vaccination program has all the features of a single-payer health care system including no copays, no premiums, no insurance company blocking payment, and universal, affordable healthcare for all. The vaccine is being treated as a public good, not a private commodity, and its priority process is determined by medical need, not by ability to pay. Notably, given all this, the vaccine rollout has drawn no allegations of “socialized medicine” by those opposed to government-financed health care.
One cannot deny that administering the vaccine is a massive undertaking and undoubtedly it had a rocky start, but it has improved dramatically over the past few months. The question remains: will our first-hand experience of the federal response to the pandemic (delayed though it was) dispel the usual objections to single-payer health care? Or will most Americans conclude that the public health crisis caused by this pandemic is a one-off exception? Since we all need access to medical care at some point—whether because of a pandemic, a variant in our genetic code, getting hit by a bus, or being struck by cancer or heart disease—it is clearly short-sighted to regard it as an exception.
Much depends on how many of us get vaccinated and experience the desired community protection and sense of solidarity underlying a universal health care model. If the outcome is positive, increased political momentum for a single-payer health system may be one of the most important results of this horrific pandemic. We’re all in this together, and what we're learning is that government is not the problem; it's the solution.
https://www.commondreams.org/views/2021/05/04/covid-19-vaccinations-shot-arm-universal-healthcare
Opinion: Biden isn’t pursuing socialism. He’s just trying to catch up with other wealthy democracies.
by Max Boot - Washington Post - May 5, 2021
Republicans accuse President Biden of pursuing a radical agenda that will turn the United States into a failed socialist state. Sen. Marsha Blackburn (R-Tenn.), for example, tweeted a link to a 1974 article about day care in the Soviet Union and wrote ominously: “You know who else liked universal day care.”
It’s true that Biden is proposing a considerable amount of new spending that could reignite inflation: He wants $2.3 trillion for infrastructure and $1.8 trillion for child care, family leave and education. That’s on top of the $1.9 trillion in stimulus spending that was already passed. But those investments won’t turn us into North Korea, Cuba, Venezuela or the Soviet Union — all countries with government ownership of industry. They will simply bring us a little closer to the standard set by other wealthy industrialized democracies — our international peer group.
Many conservatives, of course, seem to think that, as an “exceptional” nation, we have nothing to learn from any other country. But that is hubris speaking. The coronavirus pandemic should have shattered illusions about U.S. omnipotence that not even our rapid vaccination campaign can undo. While other nations such as Brazil and India have much larger outbreaks today, the United States still has more verified covid-19 deaths (more than 576,000) than any other country. The United States remains a leader in some important areas, including our high-tech industry, our financial industry, our universities and our armed forces. But by most indexes we are an embarrassing international laggard.
The Commonwealth Fund notes that the United States spends nearly twice as much on health care as a percentage of gross domestic product than do other wealthy countries in the Organization for Economic Cooperation and Development (OECD). Yet, compared with our peers, we have lower life expectancy, higher suicide rates, higher levels of obesity, higher rates of chronic diseases and higher rates of avoidable deaths. It’s no coincidence that the United States, alone among advanced industrialized countries, does not have universal health care. The United States is also alone among OECD nations in not having universal paid family leave.
The Economic Policy Institute notes that income inequality in the United States has been worsening for years: “From 1978 to 2018, CEO compensation grew by 1,007.5%. … In contrast, wages for the typical worker grew by just 11.9%.” Our level of income inequality is now closer to that of developing countries in Africa and Latin American than to our European allies.
In other respects we are simply mediocre. The OECD reports that the minimum wage in the United States is the 15th highest in the world — well behind countries such as Germany and South Korea. The World Economic Forum rates U.S. infrastructure 13th in the world (Singapore is No. 1). The OECD found in 2018 that in an international test of 15-year-olds, the U.S. ranked 11th out of 79 countries in science and 30th in math.
While we spend more on prisons than other countries, we spend less on social services. The U.S. government’s share of GDP (37.8 percent) is considerably lower than in most other OECD countries (in France it’s 55.6 percent). Yet the United States is hardly a free-market paradise: The Heritage Foundation’s Index of Economic Freedom ranks the United States No. 20, far behind countries such as Australia, New Zealand, Canada and Denmark that have more robust welfare states.
Yes, it’s possible to combine a vibrant free market with generous social welfare spending. In fact, that’s the right formula for a more satisfied and stable society. In the OECD quality-of-life rankings — which include everything from housing to work-life balance — the United States ranks an unimpressive 10th. The leaders are Norway, Australia, Iceland, Canada and Denmark — again, all emphatically capitalist countries whose governments spend a higher share of GDP than we do.
Biden’s plans, even if fully implemented, won’t cause the United States to leap to the front of the pack in quality-of-life rankings. He doesn’t have the support in Congress to address our rampant gun crime with tougher licensing for handguns and a ban on assault rifles (as occurred in Australia and New Zealand). He is not even trying to institute universal medical care — something that every other wealthy country already has — because to do so would invite the same Republican protests against “socialized medicine” that greeted the creation of Medicare and Medicaid in 1965.
At most, with proposals such as federally subsidized child care, elder care, family leave and pre-K education — financed with modest tax increases on corporations and wealthy individuals — Biden is merely moving us a bit closer to the kinds of government services that other wealthy, industrialized democracies already take for granted. We will remain on the smaller-government, lower-tax end of the spectrum, but we will have a slightly stronger social safety net than we had before. That’s far from radical. It’s simply sensible.https://www.washingtonpost.com/opinions/2021/05/04/biden-isnt-pursuing-socialism-hes-just-trying-catch-up-with-other-wealthy-democracies/
Democrats seek to push Medicare expansion as part of Biden’s $1.8 trillion families plan, defying White House
Biden has sought to address the contentious issue separately, but his congressional allies see an opening
Congressional Democrats are planning to pursue a massive expansion of Medicare as part of President Biden’s new $1.8 trillion economic relief package, defying the White House after it opted against including a major health overhaul as part of its plan.
The early pledges from some party lawmakers, led by prominent members of its liberal wing, threaten to create even more political tension around a package that is already facing no shortage of it. The expansion push comes as Biden on Wednesday stressed in his first address to Congress that he is still committed to making health care more affordable.
Democrats specifically aim to lower the eligibility age for Medicare to either 55 or 60, expand the range of health services the entitlement covers and grant the government new powers to negotiate prescription drug prices. Party lawmakers say their approach could offer new, improved or cheaper coverage to millions of older Americans nationwide.
Roughly 100 House and Senate Democrats led by Rep. Pramila Jayapal (Wash.) and Sen. Bernie Sanders (I-Vt.) publicly had encouraged Biden in recent days to include the overhaul as part of his latest package, known as the “American Families Plan,” which proposes major investments in the country’s safety net programs. Yet Biden opted only to propose additional subsidies for Americans who purchase their health insurance, disappointing many lawmakers who still otherwise support the White House’s blueprint.
Sanders said Wednesday he would “absolutely” pursue a Medicare expansion as lawmakers begin to translate Biden’s economic vision into legislation. Sen. Ron Wyden (D-Ore.), the chairman of the tax-focused Finance Committee, similarly pledged that he would “look at every possible vehicle, and that’s starting today,” to lower drug costs.
And Sen. Richard J. Durbin (Ill.), the Democrats’ vote-counter in the chamber, said he planned to push for Medicare reforms he saw as a “game changer.” Durbin said he didn’t know why the White House ultimately chose to exclude the policies, but he predicted tough work ahead for Democratic leaders in crafting a legislative package that has sufficient support.
“I don’t presume that we have a majority going in,” Durbin said. “I think we have to listen carefully to all the members and particularly those who have some problems, trying to resolve [them].”
The early efforts reflect a broader belief among congressional Democrats that they must more aggressively seize on their narrow but powerful majorities to push policies that long have been stalled in Washington — no matter their cost. Many party lawmakers have pushed Biden at times to spend sky-high sums, sometimes even more than the president himself says he supports, arguing that they have a political mandate to pursue vast economic change.
But health-care revisions are likely to present a significant challenge, threatening to open rifts not just between the two parties but within the Democratic caucus itself. In an early sign of trouble, Sen. Joe Manchin III (D-W.Va.) told The Washington Post on Wednesday that he opposes expanding Medicare eligibility even as he supports broader adjustments to the Affordable Care Act.
“No, I’m not for it, period,” Manchin said when asked about efforts to expand the health-care entitlement.
Rethinking Medicare also risks touching off a fierce lobbying barrage on the part of health insurers and pharmaceutical giants, which have mobilized aggressively against such changes in the past. The corporate opposition could add to new political obstacles now facing one of the staple elements of Biden’s economic agenda.
In his address to Congress late Wednesday, Biden described his American Families Plan as a “once-in-a-generation” series of federal investments. And he specifically promised “in addition” to that package that he would try to lower health insurance premiums, reduce drug costs and pursue other reforms to the Affordable Care Act “this year.”
“This is all about a simple premise: Health care should be a right, not a privilege in America,” the president said in his address.
The families package as proposed touches on wide swaths of the economy: It endorses universal prekindergarten for all children, two years of tuition-free community college for adults, and hundreds of billions of dollars toward combating child poverty and improving child care nationwide.
The spending also has drawn staunch opposition from Republicans. Despite adding trillions to the federal deficit under President Donald Trump, GOP lawmakers blasted Biden on Wednesday for seeking to spend such sizable amounts — and for trying to couple the spending with proposed tax increases on wealthy families and profitable corporations. Sen. John Thune (S.D.), the Republican whip, sharply criticized the White House for putting forward “a big-government proposal financed largely on the backs of the American taxpayer.”
Rep. Virginia Foxx (N.C.), the top Republican on the House Education and Labor Committee, similarly faulted the Biden administration for pursuing community college and prekindergarten reforms she saw as pricey and ineffective.
“We can’t spend our way out of these problems,” she said.
Manchin, a closely watched swing vote in virtually all significant policy fights in the Senate, also expressed some trepidation about tax increases outlined by Biden, including roughly a doubling of the capital gains tax rate for those earning more than $1 million per year.
“That’s a heavy lift,” Manchin said. “We just can’t make ourselves noncompetitive. We have an economy that’s ready to take off and boom. We can’t put the brakes on it.”
Most other Democrats, however, did not seem deterred — and some of the party’s leading lawmakers instead said the White House should seize on its rare opportunity to pursue even larger investments across the economy as part of the new families plan.
“This is our chance to do big things on housing, and big things on infrastructure, and big things on poverty,” Sen. Sherrod Brown (D-Ohio), the chairman of a key committee that oversees housing, told reporters Wednesday.
For many Democrats, the most enticing target is Medicare, as they try to deliver on their 2020 campaign promises to make health insurance affordable and available. Biden himself endorsed a policy report after the party’s presidential primaries — part of a “unity” effort among Democratic contenders, including Sanders — that called for lowering the Medicare enrollment age and expanding the health services it covers.
But Biden opted against including any of those provisions as part of the American Families Plan on Wednesday, choosing instead to focus on extending the additional health insurance tax benefits that Congress previously adopted as part of the most recent coronavirus stimulus. The White House pointed as part of the plan to the president’s past support for a major expansion of Medicare that would lower the eligibility to age 60 and allow the government to negotiate drug costs.
Asked about the approach, a White House official said the administration had embarked on an outreach campaign in the Capitol. The aide, who spoke on the condition of anonymity, said Vice President Harris has been phoning lawmakers to get their views on the American Families Plan.
In the meantime, some Democrats pledged to address both priorities in tandem. Sanders, who had lobbied Biden before the release of his plan, said lawmakers are working “very hard” to ensure the inclusion of a Medicare expansion. His comment came just hours after he unveiled a government study that showed Americans pay between two and four times more for prescription drugs than citizens of other countries.
Citing the new data, Rep. Frank Pallone Jr. (D-N.J.), the chairman of the House Energy and Commerce Committee, also pledged to use his powerful gavel to turn to the issue in the coming weeks — stressing that tackling drug costs remains “one of my top priorities as we work to pass the American Families Plan.”
Jayapal, the leader of the Congressional Progressive Caucus, said Democrats across the Capitol are likely to intensify their political push in the coming weeks out of a belief that the president’s families plan is the most efficient route to improve Medicare — given the shrinking congressional calendar and the growing need for an overhaul.
“If we have to spend all the way through August working on the jobs and families plan[s], I don’t think we have the time,” Jayapal said about calls to tackle Medicare independently. “Everything gets harder heading into the midterms.”
https://www.washingtonpost.com/us-policy/2021/04/29/democrats-congress-biden-medicare/
Telemedicine Is a Tool. Not a Replacement for Your Doctor’s Touch.
by Elizabeth Rosenthal - NYT - April 29, 2021
Earlier in the pandemic it was vital to see doctors over platforms like Zoom or FaceTime when in-person appointments posed risks of coronavirus exposure. Insurers were forced — often for the first time — to reimburse for all sorts of virtual medical visits and generally at the same price as in-person consultations.
By April 2020, one national study found, telemedicine visits already accounted for 13 percent of all medical claims compared with 0.15 percent a year earlier. And Covid hadn’t seriously hit much of the country yet. By May, for example, Johns Hopkins’s neurology department was conducting 95 percent of patient visits virtually. There had been just 10 such visits weekly the year before.
Covid-19 let virtual medicine out of the bottle. Now it’s time to tame it. If we don’t, there is a danger that it will stealthily become a mainstay of our medical care. Deploying it too widely or too quickly risks poorer care, inequities and even more outrageous charges in a system already infamous for big bills.
The pandemic has demonstrated that virtual medicine is great for many simple visits. But many of the new types of telemedicine being promoted by start-ups more clearly benefit providers’ and investors’ pockets, rather than yielding more convenient, high-quality and cost-effective medicine for patients.
“Right now there’s a lot of focus on shiny objects — ideas that sound cool — rather than solving problems,” said Dr. Peter Pronovost, a national expert in medical innovation at University Hospitals Cleveland Medical Center, who has written about finding the value of virtual medicine. “We know preciously little about its impact on quality.”
Even so, the financial world is abuzz with investment opportunities. In the first six months of 2020, telehealth companies raised record amounts of funding, with five start-ups each raising more than $100 million.
There are now telehealth apps that target niche markets like the mental health of pregnant women. Others provide medicines, like H.I.V. prevention pills, after a virtual consultation with their doctors. You can even do a digital eye appointment, meet with your dentist virtually to monitor your oral health and orthodontic progress and send a dermatologist a photo of a suspicious mole.
With telemedicine generously reimbursed, many practices are offering — even encouraging — patients to visit virtually. But, intentionally or not, that choice becomes a revenue multiplier, adding to patient expense.
When he noticed a curious rash, a relative was first directed to a practice’s telemedicine portal and billed $235 for a five-minute video appointment. Since rashes are often hard to evaluate in two-dimensions, he was told he needed to see a doctor in person for the diagnosis and then was charged $460 more for that visit. I worry that pandemic-era reimbursement practices have taken traditionally free screening calls and rebranded them as billed visits, with no value added.
Going forward, some types of virtual visits will deserve insurance coverage. Think of follow-up appointments to check blood pressure or an arrhythmia, where measurements can now be collected at a pharmacy or at home and transmitted to the physician digitally.
For most patients, in-person visits were required in large part because it was the only way a doctor could bill. But they are colossal time sucks, and for people with disabilities they created hardship. After a head injury last April — when I couldn’t yet drive — I was grateful for some insurance-reimbursed virtual visits with doctors and physical therapists.
But there are things that virtual medicine can miss, studies suggest.
One study showed that commercial telemedicine services were much more likely to prescribe antibiotics for children’s respiratory infections as a primary care doctor at an in-person visit. That’s in part because if you can’t see into the ear to observe a bulging drum, for example, the safer course is to overtreat — even though that’s contrary to prescribing guidelines intended to prevent antibiotic resistance.
An internist depresses the tongue and looks for pus on the tonsils to detect possible strep throat. A surgeon suspects appendicitis by pushing on the belly to see if there’s pain with rapid release.
Can psychiatrists develop a therapeutic relationship with a new patient equally well over Zoom? In some cases, sure. But better diagnosing of my own post-injury gait problems required office visits with hands-on maneuvers, like checking my reflexes and feeling my joints move.
“There is still real value in being in the same room, in touch, in the laying on of hands,” Dr. Pronovost said. Studies show that such interactions build trust, increasing the likelihood that patients will comply with treatment.
Telemedicine also raises new questions of equity. Even though it promises improved access for people in rural and underserved areas, video visits require high-speed internet, which is less common among those same groups. Alternatively, will the poor get mostly telemedicine clinics (cheaper, since no front desk staff needed), while those with good insurance have easy access to doctors’ offices?
Insurers are already rolling back their willingness from earlier in the pandemic to pay for telehealth visits. And providers and insurers are battling over reimbursement levels. Is a video call worth the same as an in-person doctor’s visit? If a commercial telemedicine-only doctor determines a patient requires an in-person assessment, is the fee discounted or waived? And how is a smart referral done if that telemedicine provider is thousands of miles away?
There is much to be resolved and fast, with scientific evidence and doctors, hopefully, driving the decisions. If we allow the market to make the choice, we risk preserving those telemedicine services that make money for business and providers — or save it for insurers — and lose those that most benefit patients.
Students support Maine AllCare
Letter to the editor, Opinion -Ellsworth American - April 30, 2021
Dear Editor:
We are eight senior Bachelor of Social Work students who are writing to you in support of Maine AllCare. Social workers are trained to advocate for their clients and for social justice. This is both an issue we see for our clients and is a social justice issue, so we are speaking out to the community. Maine AllCare is collecting signatures to place a universal health care resolve on the ballot for the people of Maine to vote on. Should this be enacted, the process will begin to develop universal health care for the state of Maine.
Maine AllCare did a study in 2019 that showed that 42.3 percent of mostly insured Mainers had put off medical treatment for themselves or a family member because of the cost. A total of 52.8 percent of the study population said they had experienced a significant impact on their finances because of an unexpected medical bill. There are many benefits to taking a universal health care approach in Maine. The Maine Center for Economic Policy found that with a state model that would cover all Maine residents, the state would save $1.5 billion per year. This model would fill coverage gaps and reduce out-of-pocket costs. With a universal health care coverage plan in Maine, 80 percent of households would see an increase in income because of the money they would save on insurance and other health care costs.
Maine AllCare is in the early steps of community organization that promotes a universal, publicly funded, easily used and simpler system of health care for all Mainers. Without Maine AllCare’s proposition, the health care system would stay as it is where individuals are living in poverty and experience great financial stress because of insurance payments and medical bills. Taking action on this issue and signing Maine AllCare’s petition would mean you have taken the first step to alleviating some of the issues that Mainers face in regard to health care.
As students who will be practicing social work in a few very short weeks, we urge you to sign Maine AllCare’s petition. Maine can have universal health care and Mainers can get the health care that they need and deserve.
Delaney Dow
Ellsworth
https://www.ellsworthamerican.com/opinions/letters-to-the-editor/students-support-maine-allcare/
Op-Ed: Want a Public Option? Not So Fast, Say Health Insurers
— The industry is spending millions to keep a big competitor out of the game
by Wendell Potter - Medpage Today - May 1, 2021
The nation's biggest health insurers are making it perfectly clear to lawmakers looking to fulfill campaign promises to establish a public option: you will face a massively financed lobbying and PR campaign if you even try.
And this isn't just in Washington. The industry has unleashed campaigns in at least two states so far -- Colorado and Connecticut -- where legislators are hoping to establish state-based public option plans.
Why do insurers care so much? When the status quo is extraordinarily profitable for most of them, they don't want a new competitor that might disrupt the insurance market. As a result, they're funneling millions of dollars collected from policyholders and taxpayers into what for all practical purposes is a front group to protect their ever-increasing profits.
Just recently we learned that CVS Health, which owns Aetna, alone poured $5 million into that group -- the Partnership for America's Health Care Future -- which is funded primarily by insurers and for-profit hospital chains, and run out of the PR and lobbying firm Forbes Tate.
The legislation in Connecticut facing fierce opposition from the insurers has the backing of State Comptroller Kevin Lembo and several Democratic legislators, but Gov. Ned Lamont (D) has remained quiet on the bill so far.
To try to move the governor into their camp, the CEOs of five insurers that do business in the state, including two that are based there, Cigna and Aetna, sent him a letter this month implying they would move jobs out of the state if the public option bill became law.
This tactic worked 2 years ago when lawmakers seemed to be on the verge of getting a similar bill to the governor's desk. According to published reports quoting Lembo, Cigna CEO David Cordani threatened that the company would leave Connecticut if a public option was established -- and this was despite the fact that Cigna doesn't sell coverage on the state's exchange and has relatively few large group customers in Connecticut. Cigna acknowledged it lobbied against the bill but denied the threat.
In response to the letter to Lamont, signed by CEOs of companies like Anthem and Cigna, Lembo issued a statement noting that insurers posted record profits during the pandemic and asked, "When will enough be enough ... Are legislators going to serve their constituents or do five corporations determine what becomes law in our state?"
Lawmakers and Connecticut residents are also hearing from Connecticut's Health Care Future, an offshoot of the Partnership. The Partnership spent heavily on TV and social media ads in Iowa and other states in the run-up to the Democratic primaries and caucuses last year. The ads attacked both Medicare for All, supported by Senators Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.), and the public option, which President Biden and other Democratic contenders backed.
Consistent in all the ads were messages like the ones I used to help write for similar front groups when I led communications at Cigna and worked with my peers across the industry to squash reforms our companies didn't like. The Partnership's ads claim that Medicare for All and even a public option would lead to higher taxes, job losses, and long waits for care. Left out of the ads: any mention of the fact that people would no longer have to pay premiums to insurers if they could enroll in Medicare or a public option.
The Partnership's affiliate in Colorado, Colorado's Health Care Future, is using essentially the same messaging, even though the legislation in that state is substantially different from the Connecticut bill. The Colorado legislation would give private insurers 2 years to begin to bring down the cost of healthcare, and the public option would only go into effect if they could not achieve the benchmarks set by the bill. One of the group's claims in Colorado is that a public option would lead to the closure of rural hospitals in the state. No mention is made of the fact that one of the Partnership's funders, HCA Healthcare, recently disclosed that its Colorado hospital's profit margins were more than 40%.
For-profit insurers are bigger, richer, and more powerful than ever. Recent mergers and acquisitions have bulked these companies up to the point that CVS Health is now No. 5 on the Fortune 500 list of American companies. UnitedHealth Group comes in at No. 7.
Their growth has been primarily at the taxpayers' expense. A whopping 72.4% of UnitedHealthcare's revenues in the U.S. during the first quarter of 2021 came from their government business, primarily through Medicare Advantage, Medicare Supplement plans, and the state Medicaid programs they manage. For several quarters, those programs have been their biggest -- and often only -- source of enrollment growth.
Medicare Advantage in particular has become a cash cow for big insurers. And history shows that the companies conduct business right on the line of what is legal -- often crossing it to maximize profits. Just recently, an analysis by HHS found that Humana overcharged CMS by nearly $200 million in just a single year (2015).
Insurers spend huge amounts lobbying Congress to keep the federal spigot flowing. And they have ramped up their Washington lobbying budgets to new heights this year, not only to protect their Medicare Advantage profits and to secure tax dollars to cover laid-off workers' COBRA premiums, but also, to keep a public option at bay. America's Health Insurance Plans spent more money lobbying Congress during the first 3 months of this year -- $3.9 million -- than any prior quarter. Centene, a big player in Medicare Advantage and Medicaid, increased its first quarter lobbying spend by 80%.
The big insurers have gotten bigger and more profitable as they've figured out how to game the system to their advantage in Washington and state capitals -- and they are prepared to spend whatever it takes to maintain that advantage. They certainly do not want a new competitor in the game that might be able to change the rules they've established. The status quo -- and its emphasis on profits over care -- suits them just fine.
Wendell Potter is a former vice president of Cigna turned whistleblower against the health insurance industry. He now leads the non-profit Center for Health & Democracy. After leaving the industry in 2008, he testified before Congress about the industry's abuses and became an advocate for systematically reforming America's healthcare system.
https://www.medpagetoday.com/publichealthpolicy/healthpolicy/92368Big Pharma doesn’t want us to expand Medicare. We have to fight them
We are beginning to make progress in creating a government that works for all people, and not just the very wealthy. But we still have a very long way to go.
By now you’ve heard the big headlines about the American Rescue Plan that Joe Biden signed into law in March: the $1,400 direct payments, the massive expansion of the child tax credit, the extension of unemployment benefits and the production and distribution of tens of millions of vaccine doses that are desperately needed if we are going to crush this pandemic.
What you might not have heard is that we have made primary healthcare far more accessible by doubling funding for community health centers and tripling funding to get doctors, dentists and nurses into medically underserved areas. Kids who have been stuck at home for the past year will now be able to do activities this summer because of major new funding for summer and after-school programs.
These are major steps forward.
But in this time of unprecedented crises, it is not enough. Joe Biden knows that, I know that and you know that.
The agenda the president laid out in his speech on Wednesday gives Congress a good road map, but we need to go further if we are going to seriously combat the enormous economic, social, health and environmental crises facing our country.
As chairman of the Senate budget committee, I’ll take an active role in helping to draft much of this new legislation. There are a number of critical areas we will address including our nation’s crumbling infrastructure, the need to combat climate change and provide childcare for every American family. But right now, I wanted to talk to you about one area I will be especially focused on.
It is outrageous that more than 50 years after Medicare was enacted seniors still do not receive basic hearing, vision and dental coverage. Many seniors are unable to read a newspaper because they can’t afford eyeglasses, they can’t talk with their grandchildren because they can’t afford hearing aids and they have trouble eating because they can’t afford dentures.
It is also time to acknowledge that we must lower Medicare eligibility for the millions of older workers who are in desperate need of healthcare.
This pivotal moment in American history is the time for a Democratic president and a Democratic Congress to do what the American people want. We must expand Medicare benefits and lower the age of Medicare eligibility. Using our majority to take this step is not only the right thing to do for the American people – it’s good politics as well.
These steps might seem expensive, and they are. But here is something amazing. We can pay for the entire cost of these additions to Medicare by allowing the program to negotiate the cost of prescription drugs.
As incredible as it sounds the Medicare program is not allowed by law to negotiate with drug companies over the cost of medications seniors purchase. The lobbying power of the big drug companies means they are ripping off the government and charging the American people any price they want. Not only that. Because of the power of the pharmaceutical industry all Americans are forced to pay, by far, the highest prices in the world for prescription drugs. This absurdity must end.
Negotiating drug prices is what every other major country on earth does. The Veterans Administration does it. Only Medicare is prohibited from taking this obvious step.
What we are fighting for now is the very definition of a win-win-win situation. Seniors pay lower prices for prescription drugs and receive hearing, vision and dental care. Millions more Americans become eligible to participate in the Medicare program. And we lower prescription drug costs for all Americans.
It’s almost insane to think that we would have to fight for these commonsense policies that are supported in overwhelming numbers by he American people. But it comes as no surprise that the pharmaceutical industry will use all of their power in Washington DC to try to stop them from taking place. From 1999 to 2018 drug companies spent $4.7bn lobbying the federal government. That is $233m every year. That is in addition to more than $400m in campaign contributions to federal candidates and committees and $900m to state candidate and committees.
The pharmaceutical industry, the most powerful lobby in Washington, believes that their wealth and power can prevent Congress and the president from taking action to expand Medicare and lower prescription drug prices. Well, I disagree. I believe that in the days and weeks ahead, if all of us make our voices heard we can show how powerful the American people can be when we stand together and fight back. We will not allow the greed of the pharmaceutical industry to stand in the way of Americans getting healthcare and reasonably priced prescription drugs.
As a nation we are now beginning to make some real progress in protecting the interests of the working class. Not surprisingly, the Establishment and defenders of the status quo are resisting. But, in this pivotal moment, if we have the courage to educate, organize and go forward, we will win this struggle. At the end of the day a strong grassroots movement of millions of Americans fighting for justice can and will defeat the power of Organized Money.The Potter Report
Biden's Big Chance
by Wendell Potter - Tarbell - May 3, 2021
In last week’s speech by President Biden, something stood out to me that was overlooked by many pundits: the president spoke of the NEED to fix sky-high health insurance deductibles immediately. It's not the sexiest topic, but here's why it matters.
Many think that the only ones suffering in this health care system are those without insurance. They're struggling big time, but know who else is? People with BAD insurance. The fact is, millions of Americans can’t use their coverage because their deductibles are so damn high.
These millions of Americans with bad plans don't go to the doctor or get the care they need, like cancer treatments that could save their lives. Why? Because they don’t have enough money to cover their deductible: the amount you have to pay out of pocket before coverage kicks in.
Democrats are talking about providing an extra $200 billion to subsidize premiums people pay for Obamacare plans. Insurers love that idea of course. To get that money, insurers should be forced to slash or eliminate deductibles.
High out-of-pocket costs have become an American scandal. For now, insurance companies and their shareholders are laughing all the way to the bank. Forcing us to pay through the nose means they pay far fewer of our medical bills. It’s no wonder insurers posted record profits last year.
Paying high deductibles and copays is like paying a massive bill for the right to use Netflix, and then still having to pay for each minute of each episode of "Tiger King" (or whatever the hell they're showing these days). And oh yeah, it's for basic health care to keep you alive.
The system is a total mess that's bankrupting and killing millions of Americans. And the insurance companies are hoping we won't notice. I know because I used to work for them. The bad news for them is the President Biden has taken notice. If he acts on this, it could save a lot of lives.
https://mailchi.mp/7059271221e4/the-potter-report-10138301?e=cd732898d4
Commentary: Making health care work for Maine families like mine
Nobody with diabetes should have to ration vials of insulin. A new package would hold drugmakers accountable and make medications more affordable.
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