We need universal health care in the USA. We are the only industrialized nation without it. We have been lied to for generations. Universal health care is far cheaper, far faster, far better than corporate for-profit medicine which we have, which (Harvard study 2009) kills over 45,000 US citizens per year needlessly due to for-profit decisions rather than taking the patient's health into account. The actual damage is far worse including lives shortened and patients maimed for life while the oligarchs sit on their yachts and laugh at us.
Just as the maga-heads are starting to wake up and realize how the Trumpsters have lied to them, so they would hopefully soon wake up and understand that getting affordable, humane health care for themselves, their families, their children is the way to go. Wake up USA! Universal Health Care Now!
First, thank you for using the term "universal health care" instead of "Medicare for All" which has a very negative connotation of being a handout to the undeserving (or, as Musk refers to those getting care under Medicaid or Medicare, "parasites"). But ask many conservatives (including elected right wingers) about "universal health care" and the response tips toward positive - except, of course, if you aim the question at a hospital or major medical clinic CEO!
In the 2016 Democratic Primary between Bernie and Hillary, Hillary made the claim that the ACA has almost got the US to Universal Healthcare. Universal Healthcare to me does not mean having to purchase Private For Profit Health Insurance with a $6,000 Deductible and having to wonder if your medical bill will be paid or not. I would prefer that the name “Single Payer Healthcare” be used instead. I read that Bernie named his bill “Medicare For All” because it polled better than “Single Payer Healthcare”. Medicare For All is Single Payer Healthcare. Bernie also meant an updated version of Medicare. Not our current Medicare System that only pays 80%, forcing people to have to purchase supplemental Health Insurance to pay the other 20%.
I completely agree regarding cutting corporate profiteering though I also believe that cuts across the board in the US healthcare system are needed. Physician wages are a part of that. As of 2021, the average physician earnings were ranked as follows:
"United States – $316,000
Germany – $183,000
United Kingdom – $138,000
France – $98,000
Italy – $70,000
Spain – $57,000
Brazil – $47,000
Mexico – $12,000
. . .
The average physician net worth (sum of all assets minus debts) was ranked as follows:
United States – $1,742,000
United Kingdom – $657,000
Germany – $441,000
France – $425,000
Italy – $269,000
Spain – $228,000
Brazil – $95,000
Mexico – $67,000"
Source: Bill Loguidice, Physicians Weekly, "How Do US Physician Salaries Compare With Those Abroad?". Sep 27, 2021
Even if we agree US physicians should make more due to the higher cost of training, it would clearly be more efficient/less costly to reduce the cost of training rather than pay 70% more in wages.
I highlight physician wages specifically because the authors or the article referenced are physicians, but the same can be said for the entire healthcare industry from insurance companies to long term care to pharmaceuticals, etc. The article referenced is unfortunately behind a paywall, but I would hope the authors agree.
From a commonwealth fund study comparing healthcare spending in the US to the average of 12 comparator OECD countries:
Component Share of excess spending
U.S. pays more in administrative costs of insurance ~15%
U.S. providers spend more on administrative activities ~15%
U.S. pays more for prescription drugs ~10%
U.S. physicians earn more ~10%
U.S. registered nurses earn more ~5%
U.S. invests more in medical machinery and equipment <5%
Sum of components estimated ~60%
Source: Ani Turner, George Miller, Elise Lowry, The Commonwealth Fund, "High U.S. Health Care Spending: Where Is It All Going?" October 4, 2023
Even if you could somehow cut the excess administrative costs and insurance down to 0 (unlikely!), you're still only cutting half of the 60% excess. The other 30% is in increased prescription drug costs, physician/nurse wages and higher equipment costs.
Thank you for your articulate examination of our health system. Care for sick should be the priority of not just doctors but administration and finance as well.
T1d on Medicare using pump & cgm, Medicare requires every 90 day in person endocrinology visit. And the paperwork required by endocrinologist for me to then obtain supplies. Seems overkill to me! Definitely need universal health care, not illness care!
Yes. Corporate profiteering is a huge reason why the United States pays more for healthcare than any other country yet gets less in positive outcomes. But the other reason is the healthcare itself. It is limited by science to the purely physical, yet the origins of all physical disease are emotional-spiritual dis-ease. Science is a box that severely restricts its concept of who and what we truly are. Unless that box expands to include all of self, healthcare will continue to fall short, especially for chronic diseases.
Candace, while you are correct, some health care providers strategize for profit (either for them or the clinic's relationship with insurers) by dismissing physical complaints as 'mental' or 'emotional' and pushing pharmaceuticals or - worse - putting negative information into permanent medical records about referring them to mental health professionals. Follow the money trail. There's usually very limited insurance coverage especially under Medicare (including supplemental and advantage plans). Meaning the patient pays out of pocket for their alleged mental and emotional shortcomings. In this way, doctors play the insurance game - again especially where there is a Medicare supplement or advantage plan in place, as the plan retains more of its capitation money from CMS, and the doctor gets rewarded for "usage management." Not surprisingly, women, the elderly, and especially elderly women and elderly women of color are the most likely to have their symptoms labeled as a mental health issue.
We need universal health care in the USA. We are the only industrialized nation without it. We have been lied to for generations. Universal health care is far cheaper, far faster, far better than corporate for-profit medicine which we have, which (Harvard study 2009) kills over 45,000 US citizens per year needlessly due to for-profit decisions rather than taking the patient's health into account. The actual damage is far worse including lives shortened and patients maimed for life while the oligarchs sit on their yachts and laugh at us.
Just as the maga-heads are starting to wake up and realize how the Trumpsters have lied to them, so they would hopefully soon wake up and understand that getting affordable, humane health care for themselves, their families, their children is the way to go. Wake up USA! Universal Health Care Now!
John T. Cullen JTC Sheep Heil!
johntcullen.substack.com
https://www.johntcullen.com
https://www.galleycity.com
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model (read half free/try-buy)
First, thank you for using the term "universal health care" instead of "Medicare for All" which has a very negative connotation of being a handout to the undeserving (or, as Musk refers to those getting care under Medicaid or Medicare, "parasites"). But ask many conservatives (including elected right wingers) about "universal health care" and the response tips toward positive - except, of course, if you aim the question at a hospital or major medical clinic CEO!
In the 2016 Democratic Primary between Bernie and Hillary, Hillary made the claim that the ACA has almost got the US to Universal Healthcare. Universal Healthcare to me does not mean having to purchase Private For Profit Health Insurance with a $6,000 Deductible and having to wonder if your medical bill will be paid or not. I would prefer that the name “Single Payer Healthcare” be used instead. I read that Bernie named his bill “Medicare For All” because it polled better than “Single Payer Healthcare”. Medicare For All is Single Payer Healthcare. Bernie also meant an updated version of Medicare. Not our current Medicare System that only pays 80%, forcing people to have to purchase supplemental Health Insurance to pay the other 20%.
I completely agree regarding cutting corporate profiteering though I also believe that cuts across the board in the US healthcare system are needed. Physician wages are a part of that. As of 2021, the average physician earnings were ranked as follows:
"United States – $316,000
Germany – $183,000
United Kingdom – $138,000
France – $98,000
Italy – $70,000
Spain – $57,000
Brazil – $47,000
Mexico – $12,000
. . .
The average physician net worth (sum of all assets minus debts) was ranked as follows:
United States – $1,742,000
United Kingdom – $657,000
Germany – $441,000
France – $425,000
Italy – $269,000
Spain – $228,000
Brazil – $95,000
Mexico – $67,000"
Source: Bill Loguidice, Physicians Weekly, "How Do US Physician Salaries Compare With Those Abroad?". Sep 27, 2021
Even if we agree US physicians should make more due to the higher cost of training, it would clearly be more efficient/less costly to reduce the cost of training rather than pay 70% more in wages.
I highlight physician wages specifically because the authors or the article referenced are physicians, but the same can be said for the entire healthcare industry from insurance companies to long term care to pharmaceuticals, etc. The article referenced is unfortunately behind a paywall, but I would hope the authors agree.
From a commonwealth fund study comparing healthcare spending in the US to the average of 12 comparator OECD countries:
Component Share of excess spending
U.S. pays more in administrative costs of insurance ~15%
U.S. providers spend more on administrative activities ~15%
U.S. pays more for prescription drugs ~10%
U.S. physicians earn more ~10%
U.S. registered nurses earn more ~5%
U.S. invests more in medical machinery and equipment <5%
Sum of components estimated ~60%
Source: Ani Turner, George Miller, Elise Lowry, The Commonwealth Fund, "High U.S. Health Care Spending: Where Is It All Going?" October 4, 2023
Even if you could somehow cut the excess administrative costs and insurance down to 0 (unlikely!), you're still only cutting half of the 60% excess. The other 30% is in increased prescription drug costs, physician/nurse wages and higher equipment costs.
Thank you for your articulate examination of our health system. Care for sick should be the priority of not just doctors but administration and finance as well.
T1d on Medicare using pump & cgm, Medicare requires every 90 day in person endocrinology visit. And the paperwork required by endocrinologist for me to then obtain supplies. Seems overkill to me! Definitely need universal health care, not illness care!
Yes. Corporate profiteering is a huge reason why the United States pays more for healthcare than any other country yet gets less in positive outcomes. But the other reason is the healthcare itself. It is limited by science to the purely physical, yet the origins of all physical disease are emotional-spiritual dis-ease. Science is a box that severely restricts its concept of who and what we truly are. Unless that box expands to include all of self, healthcare will continue to fall short, especially for chronic diseases.
Candace, while you are correct, some health care providers strategize for profit (either for them or the clinic's relationship with insurers) by dismissing physical complaints as 'mental' or 'emotional' and pushing pharmaceuticals or - worse - putting negative information into permanent medical records about referring them to mental health professionals. Follow the money trail. There's usually very limited insurance coverage especially under Medicare (including supplemental and advantage plans). Meaning the patient pays out of pocket for their alleged mental and emotional shortcomings. In this way, doctors play the insurance game - again especially where there is a Medicare supplement or advantage plan in place, as the plan retains more of its capitation money from CMS, and the doctor gets rewarded for "usage management." Not surprisingly, women, the elderly, and especially elderly women and elderly women of color are the most likely to have their symptoms labeled as a mental health issue.
Sadly mostly Republicans go with the science of corporate welfare.