Posts Tagged ‘Medicare for All’

COVID-19 and the war on populism

September 13, 2021

Hat tip to Bill Harvey.

Thomas Frank had a good interview last week on the Breaking Points TV show.  It’s worth watching.

He talked about how failure to control the spread of the COVID-19 virus, instead of being blamed on the failed health care system, is instead blamed on people who are skeptical of established authority.

The problem is that there are good reasons to be skeptical of authority.  It was Anthony Fauci, who is nowadays considered to the voice of science, who in the early days of the pandemic said that it was not to be taken seriously, it was just like the ‘flu, and that masks were useless.

It was the Centers for DIsease Control that, in the early days, advised the U.S. government not to screen air travelers coming in from China. 

Established authority nowadays tells us that vaccination will prevent the spread of the disease, when, so far as is known, it merely suppresses the symptoms and does little or nothing to stop the spread.

Nobody is being called to account for this.  The bulk of the press, the political establishment and the medical establishment say that everything that has gone wrong, and everything that is predictably going to go wrong, is the fault of right-wingers who refuse to get vaccinated.

There are all kinds of reasons why people don’t get vaccinated.  There are medical reasons.  There are economic reasons.  There are religious reasons.

And of course there are conspiracy theorists who think the pandemic is a Democratic hoax.  I don’t share their views, of course, but conspiracy theories flourish in times like these, when established authority can’t be trusted.

Whatever the reasons people have for not getting vaccinated, ridicule and scapegoating are not good methods for bringing them around.  They are, however, good tactics for diverting blame for failure from the people in charge.

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Corporate dems oppose Medicare for all

July 1, 2021

Nina Turner, who’s running for Congress in the Democratic primary on northeast Ohio, is under attack by the corporate wing of the Democratic Party for supporting Medicare for All.

Pharmaceutical industry lobbyists are backing her main primary opponent, Shontel Brown.  So are Hillary Clinton and House Majority Whip James Clyburn, both big beneficiaries of donations from Big Pharma.

As my friend Bill Harvey says, corporate Democrats are not “moderates” or “centrists.”  Their agenda is to block the opponents of big business.

LINK

Dems Launch Proxy War on Medicare for All by David Sirota and Julia Rock for The Daily Poster.

Populism and the medical profession

August 1, 2020

Thomas Frank

Thomas Frank wrote a good article on universal health care as an example of the battle between populists and professionals.

In both the United States and Canada, the organized medical profession bitterly opposed all attempts by the public to take control of the administration of health care, either through government or voluntary co-operative organization.

But in Canada, the province of Saskatchewan in 1962, led by populist Premier Tommy Douglas, instituted Medicare for all.  The province’s medical profession responded with a general strike, which failed.

In the end, many Canadian physicians admitted they were wrong. Evidently they were motivated by mistaken opinions, not greed.  The system was rolled out nationwide in steps in 1966.  Some polls indicate that Tommy Douglas is the most admired Canadian.

President Truman proposed a universal health care system in 1948, but his plan was defeated.  So was every universal health care proposal since then.  The task force appointed by Joe Biden, this year’s presumed Democratic candidate, rejected Medicare for all.

The American Medical Association no longer wields power.  Control of medical practice has been taken over by bureaucracies, just as physicians feared.  But they are controlled not by patients or the general public, but by health insurance companies and health maintenance organizations, who are the anti-populists of today.

Frank emphasized that the original Populists and their successors in fact valued education and knowledge.  The question was and is who benefits from education and knowledge.

It is interesting that Frank’s writings do not appear on the Op Ed pages of the New York Times or Washington Post, although they deserve to be.   Frank used to be published regularly in The Guardian, but his most recent two articles appeared in the English edition of Le Monde diplomatique.  I’m not sure of the significance of that.

LINK

It’s the health care system, stupid, by Thomas Frank for Le Monde diplomatique.

American exceptionalism in medical care

July 22, 2019

Click to enlarge.

I’ve often run versions of this chart on my web log.  It shows that we Americans pay more for medical care than do people of other rich countries, and yet our health is worse, and many of our citizens lack good medical year.  Yet a lot of us are afraid to change.

As a writer for The Economist said:

Republican reluctance to embrace health care, despite the president’s best efforts, is understandable.

On the one hand, America’s health-care system is woefully dysfunctional: the country spends about twice as much on health care as other rich countries but has the highest infant-mortality rate and the lowest life expectancy.  Some 30m people, including 6m non-citizens, remain uninsured.

And yet, though costs remain a major concern—out-of-pocket spending on insurance continues to rise—Americans say they are generally satisfied with their own health care. Eight in ten rate the quality of their care as “good” or “excellent”.  Few are in favour of dramatic reform.

Source: Health spending and life expectancy – The Big Picture

I think many Americans are in the same situation I am.  I have medical insurance that I can afford, providing by a company that I don’t think is going to cheat me.  I don’t know what I’d do if I had to pay my medical bills out of pocket—partly because the insurance company can negotiate lower rates than I would have to pay as an individual.

So it is natural to fear any change, and to be skeptical of anybody who promises to take away what I’ve got and replace it with something else that supposedly is just as good.

So these fears lock me into a system in which I’m at the mercy for for-profit insurance companies whose profitability is based on maximizing what they take in as premiums and minimizing what they pay back as benefits.

In the best of cases, the insurer’s need for profit is added to the medical bill.

T.R. Reid, in The Healing of Americawritten 10 years ago, said one of the reasons why American pay more for medical care and get less than people of other rich countries is the for-profit insurance system.  At the time he wrote, only Switzerland had for-profit insurance companies.

The other reason is that the other countries negotiate drug prices on a national basis, which the U.S. government is forbidden by law to do, and that medical professionals in the U.S. get more than in other countries.  I don’t have any reason to think any of these things has changed in 10 years.

The justification for the high fees of American physicians is that they have to pay off their medical school debt.  Medical education in other advanced countries is free or affordable.  If Americans ever wanted to cap physicians’ fees, we should combine that with some kind of medical debt forgiveness.

Reid said that there are three alternatives to the U.S. system: (1) the Canadian Medicare model, in which health insurance is nationalized, (2) the British National Health model, in which medical care is nationalized and (3) the system in Germany and Japan, in which non-profit organizations, accountable to patients, provide health insurance.

I don’t think it is feasible to create a patient-run cooperative insurance system for scratch, and I don’t think we Americans have the administrative capability of duplicating Britain’s National Health, even if we wanted to.

So that leaves Medicare for All as the path forward.  And it’s not Medicare for All unless we get rid of private insurance and regulate drug prices.

LINKS

Why a “Public Option” Isn’t Enough by Benjamin Studebaker and Nathan J. Robinson for Current Affairs. The two writers conflate Britain’s National Health with Medicare for All, which is based on the Canadian system, but otherwise an excellent article.

“Medicare for All” vs “Public Option”: the 2020 Field Is Split, Our Survey Shows by Abby Goodnough and Trip Gabriel for The New York Times.  Where the Democratic Presidential candidates stand.

Repealing and replacing Obamacare

September 22, 2017

Two Democrats—Senator Bernie Sanders [1] of Vermont and Rep. John Conyers of Michigan—have proposed bills to do something that President Donald Trump promised to do, but can’t and won’t do.

That is, they would repeal and replace Obamacare with something better.

I applaud what they’re doing, and I think Sanders deserves credit for making universal health care politically possible.

Tom Price

I don’t think Sanders or Conyers can get their bills through Congress at the present time, and I think President Trump would veto them if they did.

That’s just as well.   Implementation of both programs would require the cooperation of Tom Price, the current Secretary of Health and Human Services.   He is an opponent of traditional Medicare, which he would replace with a voucher system, and favors cutbacks in Medicaid.

But under both the Sanders and Conyers bills, he would appoint the administrators of the new program, and, under the Sanders bill,

The Secretary is … directed to develop policies, procedures, guidelines, and requirements related to eligibility, enrollment, benefits, provider participation standards and qualifications, levels of funding, provider payment rates, medical necessity standards, planning for capital expenditures and health professional education, and regional planning mechanisms.

Source: Health Affairs Blog

I’m pretty sure that neither Sanders nor Conyers intends to give Secretary Price the power to sabotage and discredit their plans.   Their proposals are talking points to rally support for universal health care and encourage thinking about how to make their bills better.

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Medicare for all and its alternatives

July 28, 2017

The downside of Medicare for All is that government spending will increase.   Various studies  indicate that overall spending will be less.