39 Comments
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John T. Cullen's avatar

It is astonishing that we (U.S. voters) put up with this. As long as the oligarchs keep us divided (maga versus smart people) this will be our fate in life, unless we can overcome Trump's insane regime and ride a center/left progressive wave to a much better future. I have hope.

JTC

Breezy's avatar

It's not something we just tolerate tho.. people get force fed misinformation and are aching with confusion.. We've been systematically lied to by the best propaganda machine money can buy.. while our government has been so corrupted by corporate money it rubber stamps whatever the lobbyists want..

John T. Cullen's avatar

Well said! I've lived in Europe and experienced their universal health care... it is like oxygen & sanity in contrast with the methane & darkness we in the US take for normal. If US people only realized!

Candace Lynn Talmadge's avatar

I lived in England between 1968 and 1972, when I was a teenager. I experienced the British NHS. Lots to like about it and always room for improvement. The NHS dentists would tell me my teeth were fine. When I returned Stateside, the dentists found and filled cavities. You might just toss it off as profit motivated except when I lived in England, most adults wore dentures because they did not get adequate teeth care. Improved Medicare for all is the way I want to go, with Medicare Advantage and managed Medicaid revoked entirely.

Patient to Purpose's avatar

We need single payer and there is a difference.

Susananda's avatar

Nice and with M4A employers will be happily revoked from managing individuals health.

𝓙𝓪𝓼𝓶𝓲𝓷𝓮 𝓦𝓸𝓵𝓯𝓮 (𝓜)'s avatar

🤣😂🤣

Just like Roe, the Democrats had 50 fucking years to secure universal healthcare and chose not to deliver it. 50 fucking years. It's never going to happen.

Candace Lynn Talmadge's avatar

A lot of smart people are MAGA, and I share some (not all) of MAGA's concerns. Mainly about the allopathic model of healthcare. It has been thoroughly corrupted and bent to the benefit of investors. It also does not actually heal people. If we want to break the current healthcare mess, then we walk away from allopathic medicine--especially for chronic ailments. The allopathic model works for acute/emergency care, but a lot of acute care would not be needed if we had better nutrition and used models such as homeopathy and traditional Chinese medicine. The very processed food most American eat is utterly devoid of nutrients due to factory farming and chemical additives. Widen your lens here. There is far more corruption than just in healthcare that negatively impacts our health.

John T. Cullen's avatar

My added thought: how many men, women, and children has our national wealth scare industry (laughingly called 'health care') killed so far today... people who could have lived & prospered. Amazing too that so many people (in a head fog) think we are a Kristian Nation. If it wasn't so insane and tragic, I would roll on the floor laughing (ROFL). // JTC

Susananda's avatar

Thanks and with passage of Medicare for all Act we can have good healthcare results. At the same time let employers be free of making healthcare choices for their employees.

Susananda's avatar

Congress is not curious nor interested. They created this profit.

Nurse Kitty's avatar

Thank you for sharing this information. As an RN, business owner, DPC entrepreneur, and corporate healthcare refugee—I want to offer a perspective on how to change this abominable situation. Support your local doctors and nurses. And mental health professionals. People like myself, and my business partner, a family physician, have struggled for years in trying to escape the beast of corporate healthcare. It took us over 18 months to start our direct primary care business—not because we lack experience- but because as moms, divorced women, and healthcare professionals, there was little to no real financial support or business planning support for us in creating a viable primary care practice outside of our corporate medicine jobs. If you want to learn more about how to support the clinicians who are stuck inside this system and wanting to make it better for our country to have real, affordable, accessible healthcare…it’s possible. I’m happy to share more about my story. We need more people to wake up to the giant opportunity that is building a system outside of the traditional insurance model. Because it’s possible. We’re doing it. But it isn’t easy or fast and there is a surprising lack of funding available for clinicians who want to build something better.

Susananda's avatar

We are healing the ozone layer and for sure we have a better lightbulb! It’s time we have M4A, single payer and or universal healthcare.

Susananda's avatar

Hi Wendell Potter. I’m thinking gouging Is same as rigging.

Suzy Wraines's avatar

I don't use insurance for this very reason. I pay cash for preventative visits and use private practice holistic providers who don't take insurance on purpose. There isn't a need for preventative insurance when the deductibles and co-pays cost more than paying a private provider cash.

Maybe's avatar

You don't have a high deductible plan for hospitalization, surgery?

If you have any assets, like a house ... Good luck if you have a real medical problem.

An arm or leg fracture requiring surgery - even hand surgery - you're looking at 15K to 100K or more.

Cancer requiring much care.. 20K, 50K, 300K easy - if not much more.

Patient to Purpose's avatar

That person doesn't plan to die from anything.

Breezy's avatar

Sure, if you can buy your way out of the system, by all means.. but paying cash doesn't protect you if you have an emergency, are at end of life, have any kind of chronic condition, or need long-term care or hospitalization. Our system needs a hard reset asap.

Suzy Wraines's avatar

I do believe it needs a reset. I'm saying we can have both. A good system and private care that is cost-effective. When the system costs more than private, there's an issue for sure.

eg's avatar

You can’t solve a systemic problem via individual action — fallacy of composition

Lindsay Clarke-Youngwerth's avatar

The problem is insidious, and for those of us who are benefits consultants for employers who are the ultimate payers of our healthcare, and can change it, we were trained and educated by insurance companies. And for those of us who are intent on changing the status quo and disrupting the system, it is an uphill battle because the narratives of how healthcare works are so embedded in our cognition, trusting that the alternative strategies are valuable, will help, and create sustainability feels like trying to jump over the Grand Canyon. We not only face the insurance companies using counterarguments and silencing us, but they also use relationships and incentives with large corporate agencies like Gallagher (Sponsor of Wrigley Field) to upend our efforts, because if we are successful, they will all lose an obscene amount of revenue. It's not just insurance companies, PBMs, and hospitals that gain from the lack of transparency. The very advisors making the health plan recommendations to your employers stand to lose millions if the rules are changed.

(It must be noted that Medicare and Individual health Insurance policies are fixed revenue products, and those advisors are paid very little, from $15 to $20 per policy and $0 on many Medicare products, without the ability to ask for additional fees. These big revenue numbers are specific to employer health plans.)

When the referee owns the team, the game is rigged.

Check this out:

https://www.businessinsurance.com/school-district-sues-gallagher-over-insurer-selection-commissions/#:~:text=The%20Osceola%20County%2C%20Florida%2C%20School,federal%20court%20in%20Orlando%2C%20Florida.

Or this:

http://blog.riskmanagers.us/breaking-whistleblower-lawsuit-exposes-alleged-drug-rebate-scheme-at-assuredpartners/

Citizens can do something about this. Healthcare is the most bipartisan issue - Colorado and Oklahoma have made significant strides.

https://hcpf.colorado.gov/hospital-price-transparency

PSchicchi's avatar

Again, I must repeat myself. If there are only seven big players in the healthcare industry, then it should be very easy for universal healthcare coverage to happen. The government buys them all out in one big, beautiful healthcare bill for its citizens. The government will control the healthcare market and they can eliminate all deductibles, coinsurance, copays, and out of pocket expenses. The government will pay only X amount of dollars to doctors, hospitals, and pharamacies. Yes, our taxes will go up, but all Americans will receive healthcare and they will never have to worry about ever going bankrupt. End of story.

Susananda's avatar

Also research Physicians for a national Health Program (PNHP)

Timothy Duffy's avatar

Once again I will be the contrarian in this discussion. Profit (of any size) is bad. We should let the US government take over health care, collect massive amounts of taxes and give us free health care. Then the government can decide who gets what services. The 70 year old with stage 4 cancer, just keep them comfortable as there's no upside wasting money on them. The premature baby, again keep the new born comfortable , extending no additional effort and expense as their earning years won't begin for awhile (remember Ezekiel Emanuel Complete Lives System). And best of all, the US government does an excellent job with every other entitlement under its control.

100% probability that someone in this thread will comment: "What about Medicare?" Of course it works well, it's a dollars in, dollars out system. Although the dollars going out far exceed dollars coming in. With the continued low birth rate this will become even worse over the next 10 years.

Which brings me to "Medicare For All". What a solid idea! NOT! Let's transfer the balance of Americans currently covered under an employer or individual plan to Medicare. Americans will save money, right? Or will they? After the shift in financial responsibility, won't employers increase employee compensation? Maybe, maybe not. Even though Americans will pay much higher taxes to cover the cost, can we expect better care at a lower cost? Maybe, maybe not. As the cost of care continues to rise over the years, taxes will need to rise. At what point do the politicians decide they can't continue passing along tax increases? Will coverage and care suffer? What about R&D for new medical procedures and drugs? U.S. companies are the pioneers of the world when it comes to R&D as well as bringing this all to market.

While many will see a rosy upside, no one is paying attention to the downside, which is huge! Remember people, there is no free lunch! Be careful what you wish for. Faced with the smallest percentage of success, terminally ill patients see a 5% survival rate as 95% survival. When the government says you're not worth the effort to save, how will you feel then?

Susananda's avatar

National Nurses United prefer we fund care not billionaires.

Timothy Duffy's avatar

Curious, how many nurses are members of the NNU?

eg's avatar

And yet every OECD nation other than your particular collection of idiots manages this — and with better aggregate health outcomes with a smaller outlay of GDP no less.

What is wrong with you?

Patient to Purpose's avatar

That guy constantly trolls this substack. I really wish Potter would block him.

Timothy Duffy's avatar

75% of the US population is obese, greater than any other developed country. US cancer survival rates are higher than any other developed nation. What sucks is our primary care, which is worse than other developed nations. Our wait time for many services is short in comparison. In Canada the wait for joint replacement is as much as 18 months. Lot of suffering goes on during that time frame. I live in the Detroit area. Many Canadians come here for their care. The majority of nurses in Detroit hospitals are Canadian. Many have asked me if they can purchase health insurance. Not possible as they commute from Windsor and are covered under the Ontario health system. On a daily basis, ambulances are transporting Canadians with emergency medical issues to Detroit hospitals as there isn't enough ER docs in Windsor to handle the load, not to mention a lack of cardiologists. The steady stream of Canadian license plates driving south and north on Interstate 75 is because they don't have enough medical facilities in northern Ontario (they don't have a major highway that allows travel to the more populated areas of southern Ontario). So Canadians have a days travel to get an MRI, not to mention the return trip to their home. Imagine having to take almost 2 days just for an MRI. There would be medical anarchy in the US.

By the way EG, these are not my idiots. Clearly there is a better way than how we are doing it now. Primary care should of the utmost priority. Living healthier lifestyles would also help. What we have here in the US is unfettered entitlements of Medicare and Medicaid, not to mention the local NGO organization that provide community health care. Please show me the preventative programs offered Medicare and Medicaid that encourage a healthy lifestyle or assist those in these entitlements with developing a healthy lifestyle. There aren't as these plans are just dollars in, dollars out.

Lastly, if the government completely takes over health care (like it has education, and to a certain extent housing and transportation) then beaurocrats will decide who gets what. And what if you don't like a decision that goes against what you think you should be receiving? Tough cookies pal, their decisions are for the good of the people and population at large. You don't think cost containment will surface with government controlled health care? Think again. All other countries with socialized medicine employ cost controls to the detriment of its citizens. Remember, socialism is for the people NOT the socialists.

eg's avatar

It's your anecdotes vs my OECD health data -- the US is an unmitigated disaster, all the way from its inexcusable infant mortality rate right up to its falling -- that's right, FALLING life expectancy rates. In the richest and most powerful country in the history of the world. Inexcusable.

Go ahead and believe what you will -- the numbers don't lie. And whose fault, exactly, is the lack of preventative care in the US? The "socialists" hiding under your bed?

Timothy Duffy's avatar

Well eg I guess you have been missing what is going on with the mayoral races in NY, Minneapolis and a few other cities. Avowed socialists are running for mayor and they have a good chance of winning. So no they are not under my bed, they are front and center with plenty of platforming from a compliant press! Even moderate Democrats are holding their noses.

Regarding your comment on infant mortality, my previous reply indicated that our primary care is horrible. But that's only part of the equation. Infant mortality is high amongst the poor. Even with access to adequate prenatal care, many times the mother continues smoking and/or drinking and/or drugs. Even in a rich nation like ours, no one can fix that except the mother.

It's not just the insurance companies. It's the medical associations, the hospital systems, the trial lawyers and many others. No one wants their ox to be gored. Hospital systems have been acquiring doctor practices to negotiate higher reimbursement from the government and health insurers, yet most of them are inefficient and not willing to reform. Even the so-called nonprofits are greedy for ever higher revenue so they can pay the executive staff high salaries and bonuses. I don't hear anyone demanding they be reformed.

The US health care system is far from a "unmitigated disaster". Does it need reforming, yes! However, the government is not the answer.

Jack's avatar

Thanks. Please reconcile the above data with the report from the NAIC which shows substantially lower profits from Health Insurance in 2024. That is, Health Insurer profits are not the same as profits from Health Insurance, or are they?

https://content.naic.org/sites/default/files/2024-annual-health-industry-commentary.pdf

I suspect you are looking at profits for each firm ... not so much profits from health insurance alone. Remember, most people with employer-sponsored coverage are now enrolled in a self-insured plan where these large insurers likely serve as an Administrative Services Only organization, not as an insurer. Or, perhaps they provide stop loss coverage to the plan sponsor of the self-insured plan.

George Shay's avatar

As a lapsed Catholic who very recently returned to the church, I highly recommend it.

Parenthetically, I am from Pope Leo’s hometown, Dolton.

I agree that business and commerce need to be informed by what I call Abrahamic spiritual values, if for no other reason than the logic of enlightened self-interest. Managed care is digging its own grave by alienating patients, providers, and payers

We part ways on two issues:

-With all due respect to the Pope, compensation is a matter for the shareholders and is often miscategorized as salary when it is actually performance-based compensation.

-Your lesson about Guatemala was improperly taught. Land redistribution is communism. Communism has proven to be a failed system with no winners.

Ed Weldon's avatar

I am so glad we have Kaiser in California. Lucky me.

Patient to Purpose's avatar

And it's going to get worse...

eg's avatar

It’s economic rents all the way down — not that most people brainwashed by garbage neoclassical orthodox Economics 101 have any idea what those are, just as they have no clue about the obvious distinction known to the Classical political economists between earned and unearned income … 🤨

Jean Santa Maria's avatar

Phenomenal reporting. I remember when CVS was a drug store. Now that it is a bunch of billionaires, CVS is closing 24 more stores. Have you tried to shop there? It’s awful, yet my insurance (Aetna, go figure), only covers my meds if get them there. Or Walgreens. Please keep broadcasting your findings. This is outrageous. We’re so duped. And good luck getting Congress to pay attention. Bravo.

Susananda's avatar

Yes CVS to me stands for creepy Value Stores.