Healthcare – the posts

I listened to Senator Slotkin’s response to Trump’s diarrhea of lies before Congress last night. Fortunately, it was only a bit over ten minutes long. She spent the first nine minutes on the three shared beliefs all Americans hold: the middle class is the engine, strong national defense is primary, and democracy is wonderful, American exceptionalism. She touched on the need to bring prices down, make more things in America through union jobs, provide certainty —>> read more –>>

A reader of my recent post, “Bernie Sanders got much right about our current situation….” commented: “Thank you Mark for validating what we know to be true with real data. Now what do we do about it?” My perspective on our situation has shifted because I have come to recognize that American life has been transformed over the past 50 years. The Trump era, following 2016, marks the culmination of a long campaign by the —>> read more –>>

Background Cerberus Capital, a private equity firm, began buying several hospitals in Massachusetts in 2010. In 2015, Cerberus sold most of its hospitals’ property to other investors for $1.25 billion. This suddenly added significant lease (rent) costs to the hospitals’ budgets. Other cost-cutting practices were applied. The hospitals then provided worse patient care, more falls, hospital-acquired infections, and patient readmissions. In May 2024, the entire nationwide Steward Healthcare system of hospitals declared bankruptcy. The state —>> read more –>>

Over several decades, there has been increasing discussion of the role of ultra-processed foods in our health. Globally, surging levels of diabetes, hypertension, obesity, and other chronic illnesses. Developing scientific levels of proof of the connection between the increasing consumption of industrial foods and these illnesses has not been easy.15 Today, various analyses claim that between 50% and 69% of the calories in the American diet come from ultra-processed industrial foods. This is a non-trivial —>> read more –>>

The present Medicare Advantage (MA) offerings by private insurance began in 1999 as an alternative to traditional Medicare health insurance for seniors. Today, over half of all Medicare recipients are enrolled through this system. The funds that support MA comes from Medicare. “We estimate that Medicare spends approximately 22 percent more for MA enrollees than it would spend if those beneficiaries were enrolled in traditional Medicare, a difference that translates into a projected $83 billion —>> read more –>>

From a recent email from Bernie Sanders with this byline: “Yes. In the wealthiest country on earth let us Make America Healthy Again.”, I extracted these headline proposals. Medicare for All. Lower the cost of prescription drugs. Paid Family and Medical Leave. Reform the food industry. Raise the minimum wage to a living wage. Lower the work week to 32 hours with no loss of pay. Combat the epidemic of loneliness, isolation and mental illness. —>> read more –>>

How might we summarize the War on Drugs launched in 1970 under President Nixon20 and supported by every President and Congress since? Now, 54 years have elapsed. It began as a cynical political maneuver and has continued to be just that. “The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and Black people,” Ehrlichman said. “You understand what I’m saying? We knew we couldn’t make it —>> read more –>>

The other day I was poking around in TikTok to see what it is all about. Came across a quote from Karl Marx that struck a chord. “There must be something rotten in the very core of a social system which increases its wealth without diminishing its misery.”24 Here we are 164 years later and this observation is perhaps even more telling. This is particularly so because we are a very rich country. The US —>> read more –>>

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We’ve argued here numerous times that the state of the US healthcare system is an outrage. We spend almost double per capita what every other developed country spends, except Switzerland, which comes in at 70% of our per capita spending. An NPR report this morning (3.29.2023) (‘Live free and die?’ The sad state of U.S. life expectancy) grinds through the numerous failings of American healthcare. The report reminds us that solutions are not a mystery. We —>> read more –>>

Yesterday as I was taking a walk up and down Warren St. here in Hudson I realized that I had become actively angry about the state of the US and the world. I walked past hotels where a single room would set you back $400 for a night or you could go for the suite that is a mere $1300. This in a country where 32% of the people can’t pay an unexpected $400 bill.25 —>> read more –>>

“A 30-Year Campaign to Control Drug Prices Faces Yet Another Failure Democrats have made giving government the power to negotiate drug prices a central campaign theme for decades. With the power to make it happen, they may fall short yet again.”36 This is the headline with its tagline in today’s NYTimes. Nothing more need be said about the extent to which the rich and corporations control our political parties and government institutions. This is what —>> read more –>>

Trump and his Republican enablers – the Trumplicans –  are responsible for the pandemic in the US and the nearly 200k deaths that have occurred to date. Comparing the US response with the rest of the world makes it clear that this catastrophe is the direct result of Trumplican policies.

It is absolutely clear that Trump and Republicans (Trumplicans) are to blame for the state we find ourselves in. Trump and Republicans can talk all they want about “Wuhan virus” and other racist slurs. There is no other explanation for the tremendous surge in COVID-19 cases across the southern belt of the US. It is their policies that have created this monster. There has been no coherent Federal policy to drive an effective response to —>> read more –>>

Tightrope provides a well-written description of the American crisis through personal stories and hard data. Unfortunately it falls flat in its call for action.

The decline of the US has become so marked over the last few decades that the stories and numbers no longer shock. From a country with an enormous middle class we have become a country with rich, super-rich and big corporations at the top while the vast majority, more than 80%,  are either homeless, very poor, poor, or a paycheck or two from poor. If you want an introduction to the state of our society, —>> read more –>>

In our continuing effort to find varied sources to illustrate the power of marketing and the costs of unregulated capitalism we return to John Oliver’s show Last Week Tonight for his segment on sugar in food. The food industry continues to put sugar in nearly every processed food and fights efforts to reveal how much of this dangerous additive is in each bite.

Roosevelt’s 1944 State of the Union called for a second bill of rights, an economic bill of rights, that resonates loudly today.

“We therefore estimate that Medicare for All could reduce U.S. Health Consumption Expenditures by about 9.6 percent while also providing decent health care coverage for all U.S. residents” The Medicare for All movement gained some new support from a study released last week. The research report, “Economic Analysis of Medicare for All”,37 provides an analysis of the lower costs and improved healthcare outcomes to be expected from the implementation of Medicare for All. Here is —>> read more –>>

Since corporations have reason not to worry about safety and efficacy, we do need the government to represent us. Common sense and ethics suggest that a company establish the safety and efficacy of products and services BEFORE selling them. In a world better balanced to the needs and interests of the vast majority this would be a required step. Heart stents and tricycles are examples of the failings of our current system.

We have argued here repeatedly that the US healthcare system is not about healthcare all. No one anywhere here gets paid for keeping you healthy. The system is designed from top to bottom to produce as many prescriptions, tests and procedures as possible. And the prices for these are completely in the hands of the providers. There is no market that sets prices based on supply and demand. And there is no way to create —>> read more –>>

These corporate giants are “disrupting” healthcare or so the headlines say. Despite the media flurry we should not expect much. The structure of US healthcare defies little nibbles at the periphery. As noted many times here, we need to look to our developed country competitors for their proven approaches to how to set up a world-class healthcare system at world standard costs.

Opioids and White Privilege The arrival of opioids as a national concern might focus your attention on the role of drug companies, doctors, and hospitals in creating this new addiction path. In the October 30 New Yorker Patrick Radden Keefe provides a through introduction to this in his piece, “The Family That Built an Empire of Pain: The Sackler dynasty’s ruthless marketing of painkillers has generated billions of dollars—and millions of addicts”. But taking another —>> read more –>>

Nearly 9 Million children are loosing their health insurance as states run out of funds. The Congress, controlled by the vicious Republican Party that is more focused on getting a sexual predator elected in Alabama than worrying about mere children, has not appropriated any new funds.

The US has the worst maternal mortality rate by far of any developed country in the world.

An American Sickness by Elisabeth Rosenthal is important and disappointing. Despite all of the information about the failings of our market-based healthcare system Rosenthal abandons her analysis when it comes to treatment.

Recent NYTimes article broadly acknowledges what every other developed country has recognized for decades, healthcare is not a good candidate for market control.

Certainly if all of these countries, Canada, UK, France, Germany, Australia (and others not included in this study) have figured out how to deliver much better healthcare at half the cost we need to demand that our government do at least as well. Obamacare is not the solution to our healthcare problems of access and cost.

Mirror, Mirror 2017:International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care from Commonwealth Fund.

A consistent chattering point in American discussions of healthcare is the claim that if we can only bring transparency and competition to healthcare we will drive prices down and bring sanity to healthcare. The rest of the world knows that this is not the answer but we seem to remain in the thrall of universal free-market thinking. To answer this question lets start with an example of a market that works reasonably well and which —>> read more –>>

The Democratic Party must absorb the reality of our situation. We need to develop and express some outrage at the current healthcare providers. None of this will happen as long as Democrats are taking money from the rich and corporations. If there is a single lesson from the Bernie Sanders campaign it is that with messages and programs that reflect the needs of the vast majority of Americans, you can raise enough money to fight —>> read more –>>

None of the failings of our healthcare system outrages the vicious Republicans. They hate poor and middle class people, the hate black and brown people, the hate government, the love to make the rich richer. That is the essence of the Republican Party.

from the New York Times an article that covers some earlier history of the US healthcare industry. How Did Health Care Get to Be Such a Mess? By CHRISTY FORD CHAPIN “The problem with American health care is not the care. It’s the insurance. Both parties have stumbled to enact comprehensive health care reform because they insist on patching up a rickety, malfunctioning model. The insurance company model drives up prices and fragments care. Rather than rejecting this —>> read more –>>

The solution to our healthcare problems cannot be clearer. Look at Canada, Germany, France, Japan, Australia, Netherlands, UK, Denmark, Sweden, and others. Plenty of healthcare systems with decades of operational experience producing much better outcomes for very single person in these countries at less than half the cost!!

The solution to our healthcare fiasco is first to recognize its true nature and then to face down those who are consuming a fifth of our economic output while producing profoundly bad results.

Trump loves Australia’s universal healthcare: Speaking to Australian Prime Minster Trumbull, Trump said, “We have a failing healthcare. I shouldn’t say this to our great gentleman and my friend from Australia, because you have better healthcare than we do.” A day later Trump repeated his praise for the Australian healthcare system, “Of course the Australians have better healthcare than we do – everybody does,” he wrote on Twitter. “Obamacare is dead! But our healthcare will soon be —>> read more –>>

Using a variety of tools and institutional arrangements every other developed country controls prices and healthcare budgets. They do not allow a one-sided market to focus on delivering as many procedures and prescriptions as possible without any systematic focus on health. To put the outrage of American healthcare in its true global setting: US healthcare spending compared to other developed countries and health outcomes relative to other developed countries. As the chart below demonstrates, the —>> read more –>>

Dan Udell videotaped a presentation on the US healthcare system by Rob Bujan on 3/25/17. I could not attend so I watched Dan’s YouTube video –   The discussions towards the end of this presentation (about minute 50) concerning single-payer systems would have been more vigorous and perhaps useful with a little international context. We live in a world where every other developed country has universal healthcare and has had for decades. So, there is plenty —>> read more –>>

Mr. Faso, Your promise to voters and citizens of your district, including me, should be to improve the conditions of country. The proposed AHCA fails on three counts.

To put the situation in sound bite language we spend twice as many healthcare dollars as almost all of our competitor nations and get developing country results. That Mr. Faso is your challenge.

WE DO NOT HAVE THE BEST HEALTH CARE IN THE WORLD – IN FACT WE ARE NOT EVEN REALLY COMPETITIVE WITH OUR PEERS IN THE DEVELOPED WORLD “The United States was number 1 in terms of health care spending per capita but ranked 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy.”

Mitt Romney’s defense of the Massachusetts health care reforms was politically self-serving. It was also true. Despite all of the bashing by conservative commentators and politicians — and the predictions of doom for national health care reform — the program he signed into law as governor has been a success. The real lesson from Massachusetts is that health care reform can work, and the national law should work as well or even better…….

There is much to applaud in Obama’s speech: control of nuclear weapons, assertion of human and civil rights, multilateralism in conflict resolution and enforcement, denial of religion as a justification  for oppression of others. But, we come to a significant claim, one that the US government has asserted for my entire lifetime,  and which the US media and populace would support:  “Whatever the mistakes we have made, the plain fact is this: the United States —>> read more –>>

The Obama administration is touting the action taken this week against Pfizer for illegal promotion of several of its drugs. The $2.3 billion sounds like a lot of money to me, and I suspect most people. Is it really a lot of money or just an annoyance to a large company, just another cost of doing business?

Acknowledge the basic facts about how the healthcare system is working today. Yesterday in a radio interview, “How to conquer health care challenges”, with Professor Glenn Melnick  from the Rand Corporation and USC, we were again offered up “expert” opinion that does not even acknowledge the basic facts about how the healthcare system is working today. Here are a couple of examples from the interview lead by Kai Ryssdal: “RYSSDAL: Well, let me make sure I understand —>> read more –>>

The healthcare crisis in the US is growing in severity and yet is not the subject of any real public debate. More than 44 million Americans are without health insurance, and almost 65 million will experience a lack of coverage during the year. Emergency rooms are the primary care provider of necessity. All of this despite the fact that, as a nation, we spend more than any other country in the world; 11% more than —>> read more –>>