Medicare For All podcast

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In case you’ve been asleep or under a rock for the past six months, we need to let you know two things: First, Kendrick won his beef with Drake , and second, there is a presidential election coming up. Like any presidential election year, everyone’s so focused on the big showdown at the top of the ticket, but that means that a lot of the local and state races, congressional races, and referenda that will make up most of your ballot are getting ignored. Just because Anderson Cooper isn’t covering your city’s mayoral contest or your state’s Railroad Commissioner race doesn’t mean those elections aren’t critically important in determining the immediate future of your community and getting important issues like healthcare on the table! So for this episode, we’re going to leave the speculation about Donald and Kamala to Anderson and take our own 360 view of why we all need to get in on the down-ballot action and how we bring healthcare justice to the forefront of our election conversations. https://www.youtube.com/watch?v=eY6SAa8LU9c Show Notes We have two guests who know their way around a Get Out the Vote Drive! Jasmine Ruddy is the Assistant Director of Campaigns for National Nurses United . She helps lead NNU’s political campaigns from Medicare for All to electoral work and more! Her background is in the climate justice movement and campus/student organizing in her home state of North Carolina Jonathan Cohn is the Policy Director at Progressive Massachusetts , which does multi-issue advocacy work. Jonathan wears many hats in the political space in Massachusetts and has been active in many progressive issue and electoral campaigns over the past little over a decade. Jasmine describes the local campaign that got her hooked: as a campus organizer for climate justice she helped win ballot measures to pass a regional transit tax. It was a concrete and tangible way to make an impact on the climate justice movement. Jonathan cut his political teeth on the Obama 2012 campaign, and got the local politics bug when Boston Mayor Tom Menino retired. Twelve candidates came forward for the first open mayoral race in 20 years. He was especially interested in public school policies and funding. He volunteered for mayoral candidate and City Council Member Felix Arroyo Jr. Ben confesses that while he loves democracy, he hates elections (#relatable). But he does find more hopefulness at the local level. He also got started in a mayoral election in Boston, but the most exciting campaign he worked on was for state house. He lived in one of the most progressive districts in the state but their state representative was a powerful, well-funded right-leaning Democrat. Ben’s candidate, Nika Elugardo, a true progressive beat him despite all those advantages. Picture it: New Jersey, 1990s, tween Gillian lives in a suburb (North Plainfield) seeking to change its name to distance itself from the majority Black and Brown city of Plainfield. During a town-wide debate on the ballot measure, young Gillian spoke against renaming the city. She was quoted on the front page of the local paper: “North Plainfield shouldn’t change its name. Stonybrook is just a dirty brook that divides our town, just like this issue is doing right now.” The anti-name change side won and our star was born. We discuss the additional influence a voter can have when working on a local election. When races can be won or lost by a few dozen votes, the candidates care a lot more about each individual. They may knock on your door or call you seeking support, which is a great opportunity to insert the issues you care about into the election. Once your candidate gets elected, they’ll remember the folks who helped them get there and you’ll have more influence when lobbying them on the issues you care about. (You may even end up with a job.) Jonathan’s personal philosophy is “Boo and Vote.” He never liked Obama’s catchphrase “don’t boo; vote” because it implied the two are mutally exclusive; he believes activists have every right to boo, criticize, and protest failures, bad actions, and inactions of elected officials (both our enemies and friends). Yet he will also vote and get others out to vote. The work of democracy and making change has to include both booing and voting. Booing our friends sounds counterintuitive, but is still important. Just because we supported a candidate’s election, we have to hold them accountable to do the right thing after they’re elected. Maybe we don’t criticize them as harshly as an opponent, but we have to demand they live up to the values of the people who put them in office. Elected officials are often most responsive to these demands during an election. Organizing tactics and accountability look different during an election. Jasmine tells us about the Patients Over Profits Pledge , calling on candidates to reject campaign contributions from the corporate healthcare industry (inspired by the No Fossil Fuel Money Pledge from the climate justice movement.) During peak times when candidates are seeking donations and support is the perfect time to make these demands. Even with a federal issue campaign like Medicare for All, the Patients Over Profits Pledge has a role in local elections. It gives activists a great opportunity to remind candidates that healthcare is an important issue in their local area. Corporate healthcare already has too much influence over our democracy and elected officials, and this is our opportunity to toxify that relationship, making it unsavory for candidates to take their dirty money. Local elections are also important as a pipeline: your city councillor today could be your Congressperson next cycle, with a lot of sway on healthcare policy. (Post-pod fact check: VP Candidate Tim Walz wasn’t a state legislator, but in his first race for Congress he was indeed funded by many individuals employed by Mayo Clinic in Rochester, MN and by PACs representing the healthcare industry.) It’s really important that we not allow candidates’ views on healthcare to be shaped only by those in corporate healthcare. Supporting pro-M4A candidates or starting to talk about healthcare justice with candidates when they’re running for local office means that if they run for higher office you’ll already be an influence on how they perceive the healthcare industry. Jasmine describes how activists use the Patients Over Profits Pledge to have conversations and build relationships with candidates up and down the ballot. Any voter can ask candidates in their community by asking them to sign the pledge. As more and more candidates sign on, our movement to toxify corporate healthcare grows stronger. Reach out to Jasmine’s team to get active yourself! Follow, Like & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on your favorite podcast platform! You can listen to Medicare for All on Apple Podcasts , Google Podcasts , or visit our website here . This show is a project of the Healthcare NOW Education Fund ! If you want to support our work, you can donate at our website, healthcare-now.org .…

Medicare for All

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Medical Debt in the I.O.U.SA 7:16

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The United States is unique among industrialized nations. Lucky for us, we can accumulate medical debt! Most industrialized and some developing nations have national healthcare programs that guarantee care to their residents. But we in the richest nation in the world have the freedom to get insurance through the free market, and go into debt when it doesn’t cover the care we need! USA USA USA! According to the Kaiser Family Foundation ( KFF ), while over 90% of Americans have health insurance, we owe at least $220 billion in medical debt. Approximately 14 million people owe more than $1,000, and about 3 million owe more than $10,000. When the debt is cast more widely to those who have put medical bills on their credit cards or borrowed money to pay them, KFF found that 41% of adults have healthcare debt. According to the US Census Bureau in 2021, Black and Latinx households are disproportionately affected by medical debt. Today we’ll dive into the topic of medical debt: who has it, who profits off it, and what can we do about it? https://www.youtube.com/watch?v=dZPd1kFbEuE Show Notes What causes medical debt? Believe it or not, our freewheeling use of the healthcare system is not to blame. In the US medical debt is caused by the high prices charged by hospitals, pharmaceutical companies, and insurance companies. While most industrialized nations have some means of controlling prices, in the United States the healthcare industry sets prices more or less however they want. As a result, a ccording to a nationwide poll in 2022 , over a five year period more than half of US adults report going into debt because of medical bills. Debt is preventing Americans from saving for retirement, paying for college, or buying a home. The 2022 poll found that 1 in 7 people reported being denied care due to unpaid bills. Two-thirds of those polled reported putting off necessary care due to cost. This is all despite the Affordable Care Act expanding insurance coverage to more Americans than ever before. Insurance companies increasingly shift costs onto patients, with higher deductibles and more claim denials. According to the 2022 KFF poll, 61% of insured Americans had medical debt in the previous five years. What makes medical debt so dangerous? We know health systems are denying care to patients who have unpaid bills. And we know people put off care so they don’t incur more debt. Those barriers to care make us sicker, and they disproportionately impact people with higher rates of chronic conditions. T he Commonwealth Fund found that 54% of people with employer coverage who skipped or delayed care reported getting sicker; 61% in individual market plans and 63% with Medicare reported the same. A 2024 study published in the Journal of American Medical Association found that medical debt is associated with higher mortality and premature death. What happens when you can’t pay your medical debt? When you think about all the real people on the end of those medical debts, that makes it all the harder to swallow a fact that gets relatively little attention in the broader conversation. Medical debt collection is a for-profit business. In many cases, non-profit hospitals sell debts to for-profit medical debt collections agencies. Some health systems even operate their own for-profit debt collection arms. Think of it: They set the prices for their services as high as they want, and on the other end of the equation, they’re making money off debt collection. Dr. Luke Messac of Brigham and Women’s Hospital testified at a July hearing of the Senate Health, Education, Labor and Pensions Committee that he learned that his and many other hospitals as well as collection agencies report sick, vulnerable patients to credit bureaus, garnish wages, seize bank accounts, and seek warrants for their arrest. And again, we have to highlight the evil practice of hospital systems that restrict patients from getting needed follow-up treatment until their debt is paid. These are not just a few bad apples. Aggressive debt collection tactics are widespread: a KHN investigation in 2022 examined billing and financial aid at 528 hospitals across the country and found : more than ⅔ sue patients or take actions like garnishing wages. About ⅔ report patients to credit rating agencies, which negatively affects their credit scores and hurts their ability to get housing or jobs. A quarter of hospitals sell patient debts to debt collectors About ⅕ deny care to people with outstanding debt Medical debt doesn’t always go on your credit rating: Unpaid medical debt that is sent to collections can be reported to credit bureaus after one year, then remains on your credit report for seven years. As of a rule that went into affect April 11, 2023 , medical debt can only impact your credit rating if it’s over $500. CPFD’s new rule would prevent debt of any amount from appearing. WATCH: If you need a moment of levity, a few years ago, J ohn Oliver did a segment about the “grimy business” of debt collection . How do we fix this? Until we have a Medicare for All system that takes the profit motive out of healthcare, controls prices for care, and gives patients access to treatment with no cost at the point of delivery, we will continue looking for new and creative ways to help people survive in our messed up healthcare system. Fortunately, many Americans and even some of our elected officials are good at coming up with creative ways to help each other in times of crisis. Some solutions would be relatively simple for Federal, state or even local governments to enact: Charity Care Eligibility: We have to hold non-profit, tax-exempt hospitals responsible for providing what’s known as “charity care.” In exchange for their tax-exempt status, non-profit hospitals are supposed to provide care and help patients determine if they’re eligible for free or reduced cost care or Medicaid. One problem is that charity care standards are vague; as a result, KFF found that charity care costs represented 1.4% or less of operating expenses at half of hospitals in 2020 . Another barrier to access is that hospitals make applying for this kind of assistance overly complicated, something a patient in a health crisis rarely has the capacity to do. One solution is for the IRS to use existing authority to allow hospitals to verify patient income in real time, so they can access financial assistance or Medicaid. Hospitals could use software that’s widely available to “cut off medical debt at the source” and ensure that eligible patients receive assistance when they walk in the door for care. But they aren’t currently required to do this by federal law. Buying and Forgiving Medical Debt: We’ve all contributed to GoFundMes to help people with medical bills by now. Another way to crowdfund medical debt: for ten years, an organization called Undue Medical Debt (formerly known as RIP Medical Debt) has offered Americans an easy way to buy up and forgive other people’s medical debt for pennies on the dollar (without lining the pockets of a corporate crowdfunding platform). Any individual can buy up medical debt for pennies on the dollar and go to sleep at night knowing they helped ease the burden on a fellow American. Taking that idea to a new level, some cities and counties like St. Paul, Minnesota and Wayne County, Michigan have used federal ARPA dollars to buy up the medical debt of some of their residents. St Paul, MN with a population of just over 300,000 erased $100 million in medical debt for 43,000 residents. We know that when debt is erased, especially for lower-income families, that leaves more money for rent, groceries, and the other things needed to lift people out of poverty. While this doesn’t address the root cause of medical debt, Medical Debt Cancellation Act of 2024: In May of this year, Representatives Ro Khanna of California and Rashida Tlaib of Michigan, and Senators Bernie Sanders of Vermont and Jeff Merkley of Oregon introduced legislation to eliminate $220 billion in debt, wipe it from credit reports, and limit the accrual of future debt . The bill create a grant program within the Department of Health and Human Services to to cancel medical debt, prioritizing vulnerable populations and debt owed to safety net hospitals. Consumer Financial Protection Bureau rulemaking to remove medical debt from credit reports: A proposed r ule change by Biden Administration/Consumer Financial Protection Bureau announced on 6/11/24 would prevent almost any medical debt from appearing on credit reports. State Efforts: according to a 2023 Commonwealth Fund analysis , 20 states have financial assistance standards, and 27 have community benefit standards. The strength of these standards vary, as does eligibility to receive financial assistance, but several states have robust protections: 8 states have laws limiting or prohibiting interest that can be charged on medical debt. However, the laws don’t extend to third party debt collectors, who hospitals often engage. 3 states limit hospital or debt collectors’ ability to sue patients for debt. Illinois prohibits lawsuits against uninsured patients who demonstrate inability to pay. 11 states prohibit or set limits on liens or foreclosures for medical debt. California and New Mexico prohibit liens and foreclosures for low-income populations. New York and Maryland fully prohibit them. 21 states have wage garnishment protections that exceed federal standards. California prohibits all wage garnishment for low-income populations, and New York fully prohibits wage garnishment to recover medical debt. In July we learned about North Carolina’s new plan to give hospitals additional Medicaid dollars if they forgive the debt of around 2 million residents. CMS approved the plan. In June of 2024 Minnesota passed the Debt Fairness Act, pushed by Attorney General Keith Ellison (an M4A champ who was our chief author in the House during his terms in Congress) that will Ban providers from withholding necessary care due to unpaid debt Eliminate the automatic transfer of medical debt to a patient’s spouse Establish protections from unethical medical debt collection Require providers to publish their debt collection practices Create a new process to help people dispute coding and billing errors The Republican plan: Surely Donald Trump and JD Vance have a plan to address this crisis. Just kidding. Literally nothing comes up if you Google their names plus medical debt. Conclusion Medical debt is a shameful part of our broken healthcare system. Relieving medical debt isn’t the solution. It is the right thing to do to relieve millions of Americans from immediate stress and hardship so they can focus on their health. But the real solution is a national health plan with price controls for providers based on what it costs to provide care, and low-to-no cost at the point of care, so patients can get care when they need it, without worrying about the debts afterward. With the patchwork of limited protections and relief on top of a system that allows unfettered profiteering by the healthcare industry, medical debt will continue to be a problem for Americans until we address the PRICE of care. Until then, we’ll keep you posted on mutual aid efforts that help Americans survive our healthcare hellscape. Do you have a story about the way your community is coming together to support people who need healthcare? Please share it by emailing us at info@healthcare-now.org . Follow and Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org . Don’t forget to like this episode and subscribe to The Medicare for All Podcast on your favorite podcast platform!…

Medicare for All

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Episode 102: Committable 43:31

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Usually on the Medicare for All Podcast, we talk about people who want healthcare but can’t get it, but today we’re talking about people getting healthcare they have specifically refused: folks who have been involuntarily committed. For plenty of our listeners, the idea of being held against your will at a psychiatric institution feels like a nightmare from another time – something out of gothic fiction or horror movies set far in the past. But for folks struggling with mental illness in 21st century America, the terrifying prospect of psychiatric commitment is alive and well. In fact, a 2020 UCLA study found that in the 25 states where they actually keep data on this, the numbers of involuntary psych detentions have been sharply rising in recent years. Today, we’re joined by two experts in this dark corner of our healthcare system to talk about why so many people are getting committed and who is reaping the benefits. https://www.youtube.com/watch?v=qjXjCSIM_2E Show Notes Originally from Massachusetts Jesse Mangan has experienced a few different psychiatric hospitalizations and has spent over two decades struggling with the impacts of those experiences, so now he produces a podcast about mental health laws called Committable . Rob Wipond is a freelance journalist who writes frequently on the interfaces between psychiatry, civil rights, policing, surveillance and privacy, and social change. His articles have been nominated for seventeen magazine and journalism awards. He is also the author of the 2023 book Your Consent Is Not Required: The Rise in Psychiatric Detentions, Forced Treatment, and Abusive Guardianships. Jesse shares how he came to have so much (unwanted) expertise in psychiatric commitments, and how he turned that experience into a podcast, Committable . He was involuntarily committed and held longer than the standard of care dictated, past the date his insurance ran out. He was finally discharged with no real discharge plan and a big bill. Rob tells us he’s been writing about mental health for a couple of decades. He says that the media typically portrays people who have been committed as really out of touch with reality, but he’s found that they’re far more like the rest of us. He watched his dad – who had no history of mental illness – go through a catastrophic health crisis that led to a depressive episode. Rob tells us that his dad was held and treated against his will for months. This happened in Canada where healthcare is guaranteed, so it’s a more complex problem than just enacting the right financing system. A lot of people tend to think of psychiatric commitment as a barbaric tactic from the bad old days – like Nurse Ratchet in One Flew Over the Cuckoo’s Nest – but this is obviously a practice that continues to this day. It’s more common now for people to be held for a few days, rather than months or years on end. We only have data on these commitments from 25 states, but they show that these kind of commitments are rising dramatically. Jesse explains that due to disability rights activism and investigative journalism, a number of federal cases in the 1970s established some basic due process standards for patients. At the same time the mental health system became increasingly privatized and our understanding of mental health changed dramatically. The expense of due process became a factor – as soon as a case reaches a court hearing, private providers become more likely to release the patient because of cost. State mental health laws have given a lot of authority to law enforcement and providers to detain patients on an emergency basis without a due process check until the point the facility wants to hold the patient beyond the emergency period (in many states 72 hours). The justification for holding these patients are often very vague and broad, posing a risk to many Americans. Mental healthcare in this country isn’t a clearly defined system. Providers are often driven to be more conservative about holding patients because of a fear of liability if they don’t. The profit motive is certainly involved, but there are other motives as well: it’s widely accepted that forced treatment helps and is good for the patient. There’s also a social tendency to isolate people we deem dangerous from the rest of society. Jesse highlights that we spend a lot of public resources on the court process for outpatient commitment as well. There are some resources that are only available to people on a court order, which incentivizes family and clinicians to seek a court order to get those resources. Advocacy on behalf of people with mental illness tends to be dominated by families and groups with more “respectability” leading to a generally paternalistic approach to mental health laws. Because the US doesn’t have a federal healthcare system of any kind, those of us in the Medicare for All movement tend to attribute a lot of failings to that patchwork of coverage. Rob tells us that the same critiques (“chaotic” and “patchwork”) happen in Canada because systems are run provincially. The real elephant in the room is that there’s no evidence to support involuntary mental health treatment. There’s nowhere in Canada or the US where outcomes of involuntary commitment are tracked. Money is thrown at whatever the advocates or healthcare corporations claim will work, without any scientific evidence informing a consistent standard of care across the country. Jesse also notes that there are interactions between the mental health system and the criminal justice system that Medicare for All won’t solve. In many cases patients are committed in order to restore their competency to stand trial (rather than to restore them to wellness). As soon as they are restored to competency and relased from the mental health facility, they are returned to the criminal justice system where they won’t receive treatment and may deteriorate again. Financing won’t solve mass incarceration and perverse incentives for treatment. While we continue to advocate for Medicare for All, in order to make mental healthcare truly equitable, our guests stress that we need to make sure the system covers more than just medicalized treatments, and we need to… Q6: This seems like one of those problems with US healthcare that M4A can’t solve on its own – as we fight for universal healthcare, what other changes do we need to be fighting for to make mental healthcare truly equitable? Follow and Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org .…

Medicare for All

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Project 2025 Will Kill Us All 58:02

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If there’s one thing everyone is talking about these days, it’s JD Vance’s affinity for couches. But if there are two things everyone is talking about, it’s Vance’s couches and Project 2025. You may be wondering, what is this mysterious project, and what does it have to do with me? Well, it turns out, a lot! Project 2025 is the right-wing map to a terrifying future, and if its proponents have their way, the future of healthcare is especially grim. Today, we’re doing a deep dive into what this thing is and how it could change healthcare as we know it. https://www.youtube.com/watch?v=a4kYQ-Hh5pY Show Notes Gillian Mason, Healthcare-NOW’s Executive Director, has read Project 2025 so you don’t have to. P25 is the brainchild of the Heritage Foundation, the think tank founded in 1973 because conservative businessmen thought Richard Nixon was too liberal (remember that Nixon created the EPA and advocated for a better national health plan than Obamacare, so they weren’t all wrong). They really hit their stride during the Reagan administration when they wrote his policy playbook, which they called the “Mandate for Leadership” — Reagan implemented or initiated about 60 percent of the 2,000 policy changes they recommended. They do this Mandate for Leadership report now every presidential cycle, and it’s been pretty influential whenever a Republican wins. These people are unabashed fascists. We use that term a lot kind of casually but these guys literally fit the Merriam-Webster Webster dictionary definition : “a political philosophy, movement, or regime that exalts nation and often race above the individual and that stands for a centralized autocratic government headed by a dictatorial leader, severe economic and social regimentation, and forcible suppression of opposition.” The Heritage Foundation’s whole deal is consolidating all authority in the office of the president so he can implement severe economic and social regimentation based on nationalism and barely-veiled-when-it’s-not-just-blatant racism. Project 2025 It’s the “Mandate for Leadership” for this election season, so it’s supposed to be a template for Trump’s next four years. Although reading Project 2025 would make you think it was a room full of monkeys at typewriters type situation, it was actually written by a room full of Trump’s cronies. Hundreds of people contributed to writing and researching this thing, and a hefty percentage were former Trump appointees and employees of the administration. Also, VP pick JD Vance just wrote the foreword for an upcoming book by Kevin Roberts, the head of the P25 team. Vance has also been a mouthpiece for some of the wilder shit in P25. Trump claims he really doesn’t know much about P25. But it’s still worth talking about because COINCIDENTALLY it turns out that a lot of his policies are the same as the ones in P25. The Premise: The liberals in Washington, in cahoots with Chinese Communists and the “totalitarian cult known today as ‘The Great Awokening’” have put “the very moral foundations of our society are in peril.” (This is not an exaggeration— it’s literally all on the first page) P25 has 4 main goals: Restore the family as the centerpiece of American life and protect our children. Dismantle the administrative state and return self-governance to the American people. Defend our nation’s sovereignty, borders, and bounty against global threats. Secure our God-given individual rights to live freely—what our Constitution calls ‘the Blessings of Liberty.’” All the recommendations are laid out systematically according to the different areas of the federal government they want to control (The Executive Office, Department of Homeland Security, Intelligence Services, Media Agencies, etc.) We’ll mainly be focusing on healthcare today but context is important so here are a few highlights of what they’re planning to give you some flavor: Reclassify most federal employees as appointees Mass arrests and deportations of undocumented immigrants Defund PBS Reinstate work requirements for the Special Supplemental Nutrition Program for Women, Infants & Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP). Get rid of protections for trans folks in Title 9. Roll back regulations on the production of baby formula So what do these policy geniuses have to say about healthcare? Their overall goals are: “Protecting Life, Conscience, and Bodily Integrity”: in a nutshell, a freakout about sex and gender and scientific research that bothers the consciences of conservative Christians. “Empowering Patient Choices and Provider Autonomy”: more free market competition gobbledegook about healthcare. We know that health isn’t a commodity. We don’t make decisions on health the same way we do when buying a tv or car. You can’t diagnose yourself and shop for bargains, or keep using that old busted kidney until Best Buy has a new one on sale. You also can’t comparison shop for health insurance. Markets just don’t work in healthcare. When they talk about choices, they want you to have the choice to create more profit for insurance companies. Their philosophy is that government programs like Medicare and Medicaid victimize poor people by making them depend on the state, therefore having more “choices” of private insurance are inherently better for poor people, or something. “Promoting Stable and Flourishing Married Families”: they are very worried about fatherless families, government subsidization of single-motherhood and disincetivization of work. This section also includes 50 Ways to Stop an Abortion including bringing back the Comstock Act of 1873. “Preparing for the Next Health Emergency”: they are still so mad about the COVID-19 pandemic, they are dying to make sure we do absolutely nothing. “Instituting Greater Transparency, Accountability, and Oversight”: This one is kind of interesting – they’re mad at Big PhRMA because vaccines are bad, so they want to stop private corporations, including Big PhRMA, from “capturing” federal agencies by putting their money into public-private partnerships. They also proclaim “we must shut and lock the revolving door between government and Big Pharma. Regulators should have a long “cooling off period” on their contracts (15 years would not be too long) that prevents them from working for companies they have regulated. Similarly, pharmaceutical company executives should be restricted from moving from industry into positions within regulatory agencies.” This sounds pretty good to us, actually. Unfortunately they also want to stop government negotiations over prescription drug prices. So our takeaways: ever since the GOP tried to overturn the ACA, they haven’t had a coherent health policy. Project 2025 really doesn’t move the needle. It’s mostly culture war nonsense that does not project any kind of vision of what they want to see in the future. While most opinion polls show that healthcare costs are still a major issue for American voters, they don’t touch on the topic in Project 2025. They would privatize all of our public programs, making more profits for insurance companies and putting fewer resources into patient care. Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org .…

Medicare for All

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“Hot Virus Summer”: The Next Pandemic 37:30

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It’s our 100th episode folks, and we are celebrating the only way we know how – by sharing our predictions of the grim, apocalyptic future that surely awaits us if we fail to get our healthcare system together! That’s right, we’re talking about the next pandemic, and if experts are right, it’s coming sooner than we think. In addition to several somewhat less familiar pathogens on the rise this summer, COVID is back, and this time it’s FLiRT y. Today we’ll go into some of the outbreaks currently threatening to explode into our next global disaster and explore how prepared our for-profit healthcare system is to keep us safe. Spoiler: It isn’t. https://www.youtube.com/watch?v=ErXbxe4U-QQ Show Notes This emerging new pandemic situation is pretty serious, and more people should be taking it seriously. Forbes healthcare reporter Alex Knapp called this: “Hot Virus Summer.” First, COVID is up! Again! It’s important to point out that COVID never really left – in 2023 75,000 people died from COVID 19, nearly 1 million were hospitalized, and plenty of people are still suffering from Long COVID. Now we have the new FLiRT variants — sexy! There are a lmost 34,000 new cases per week globally. Next up: Bird Flu, which has historically tended to infect birds, is evolving and has begun to infect mammals. For now, that mostly means livestock – so far 129 dairy herds in 12 US states. As far as animals are concerned this is already a pandemic – it’s impacting industries all over the world and could cause shortages of meat and dairy. You may be panicking: IS OUR CHEESE SAFE? Don’t worry, most commercially available dairy products are pasteurized, which kills the virus. There have, however, been three cases of the virus in humans reported in the US. Around the world, more than 50% of people infected with Bird Flu die from the virus. All three of those people in the US worked on farms in direct contact with birds and livestock, and right now the CDC is just limiting their warnings about Bird Flu to folks who also work in close contact with animals. BUT, scientists are warning that at any time the virus could mutate and become transmissible between humans, at which point, we would be facing epic disaster. How likely is that to happen? In August 2023, Dr. Michael Greger said of Bird Flu, “The question is not if, but when.” In addition to COVID and Bird Flu, Mpox (fka Monkey Pox) is having another moment , as is West Nile Virus , so there are a lot of ingredients in the virus stew we’re cooking. So the best indicator of future outcomes is to look at how we’ve fared in similar situations in the past. Luckily (or not), the 2020 COVID outbreak is still fresh in some of our minds. You may remember that we, as a country, were not particularly well-prepared. For one, our profit-driven healthcare system creates disparities of access and care, which were exacerbated by the pandemic. Also, we don’t have a truly cohesive public health program in this country. Health departments in various counties, municipalities, and states work largely independently of each other, so there was little to no coordination on surveillance and testing. We had to rely on private companies for important preventative measures like PPE and, most notably, vaccines (the research and development for which were PUBLICLY FUNDED with our tax dollars.) During pandemics, a lot of people stopped going to healthcare facilities for elective procedures and surgeries – the real moneymakers for the for-profit healthcare system. That led to layoffs of staff at the same time that patients who desperately needed care struggled to get it. In countries with a national health system, hospitals don’t lose money if people stop going; they have a fixed amount to cover the operating expenses based on past history. So you don’t see mass layoffs and shrinking of the healthcare workforce when they are most needed. So if we were to do the whole pandemic over again – and it looks like we might, what preventative measures should we be advocating for? Surveillance, testing, and a readily available stock of vaccines. Medicare For All (doy). One thing we sorta did right was at the height of the COVID pandemic, when so many Americans lost their jobs and employer-based health insurance, we extended Medicaid coverage to millions and required states to provide continuous coverage, preventing them from being kicked off. That ended in mid-2023 when the public health emergency was declared over. At least 23 million Medicaid enrollees have been disenrolled as of June 14, 2024 . (Over 60% are eligible but were unenrolled for administrative reasons.) Before the next catastrophe, wouldn’t it be neat if we had a national health plan that covered every American without worries about income, employment, and eligibility hoops? Don’t forget to stock up on masks and toilet paper. Like and Support the Pod Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org.…

Medicare for All

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The View from Capitol Hill: A Very Special Conference Episode

il y a 1 year

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It’s the most wonderful time of the year! For activists in the movement to make Medicare for All a reality, this is the week when we gather to plot, scheme, and kvetch. Welcome to the 2024 Annual Medicare for All Strategy Conference, “Healthcare Beyond the Ballot Box,” organized by Healthcare NOW! For those of you who are attending the conference right now, you are getting a sneak preview of our Very Special Conference Episode! Since our theme this year is about what happens to Medicare for All in an election year — and beyond — we wanted to invite some of our favorite policy people with their fingers on the pulse of what’s happening in DC to help us sort out what’s happening with healthcare on Capitol Hill and what role we can play to get some justice out of DC in the coming year! https://www.youtube.com/watch?v=n36v0eTV1a8&t=1167s powerpress Our guests are Eagan Kemp and Alex Lawson. Eagan Kemp is the health care policy advocate for Public Citizen’s Congress Watch division. He is an expert in health care policy and served as a senior analyst at the U.S. Government Accountability Office prior to coming to Public Citizen. Alex Lawson is the Executive Director of Social Security Works , the convening member of the Strengthen Social Security Coalition — a coalition made up of over 340 national and state organizations representing over 50 million Americans. Show Notes With one of our major candidates being a guy who is solidly against Medicare for All and the other being Trump, is 2024 a bad federal election cycle, or the worst federal election of our lifetime, and why? Alex puts a positive spin on it: we are closer to M4A with a Biden presidency than any other Democratic presidency. He’s definitely not a M4A guy, but all his other economic policies are based on Sanders-esque populism, rather than Obama-esque neo-liberalism. We’ve seen Biden enact serious corporate reform in several sectors, and in a second Biden administration, taking on corporate greed and sociopathy in health insurance is on the agenda. On the other hand, we know exactly what’s at stake with another Trump presidency, driven entirely by profit for his billionaire friends. Eagan notes that there has been movement on Medicare in recent years, including die-hard GOPs shying away from talking about cuts to Medicare until after the election. At the same time, we’re seeing Biden moving more toward the M4A movement and the folks trying to expand and improve traditional Medicare. We’re seeing insurance companies running scared, feeling the pressure from our movement in a way they haven’t before. Alex notes that Biden’s economic vision contains a lot that Medicare for All folks can work with. Our movement worked hard to expand Medicare to include vision, hearing, and dental, which was ultimately included in Biden’s Build Back Better plan. We didn’t get that, but we did get prescription drug negotiations, which is a huge part of improving Medicare before we expand it to everyone. (Go back and listen to another episode where we were joined by Alex to discuss prescription drug negotiations for more details.) We’ve also seen a lot of good work against Medicare privatization, via Medicare Advantage, and that solidarity has moved the ball a lot – more than ever before to restrain private insurance companies. We didn’t just give up when we knew Biden wouldn’t sign M4A; we pivoted to expanding benefits and reversing the privatization with a lot of success. Eagan found a silver lining in – of all places – the subject of private equity in healthcare. He thinks we’ve passed the peak of PE ravaging healthcare, and they are now backing off the healthcare sector in part because of increased pressure from the DOJ, FTC and HHS . That’s due to pressure from doctors, patients, and whistleblowers. Eagan also notes that the Trump administration pilot of throwing seniors in traditional Medicare into private relationships with providers. Our movement worked with seniors to fight that off, and get the Biden administration to curtail the scariest parts of the “Direct Contracting Entities.” Alex credits FTC Chair Lina Khan for challenging corporate power and winning, in a way the FTC hasn’t in decades. Next up the FTC is teeing up UnitedHealth and their massive monopoly. Industry is scared. The movement is putting on the pressure, the agencies are getting wins and the media is starting to pay attention. Ben says we’re seeing a significant shift in Democratic strategy around healthcare reform, away from the ACA model of just giving more money to private insurance, and toward taking on the industry and cutting off some of their income streams. When we look at issues like prescription drug negotiations or curbing Medicare Advantage where we’ve gained some ground over the past year, it’s been due in large part to activists increasing the pressure. Public Citizen is working on M4A resolutions, seeing more excitement especially in southern states. Alex says politicians are lagging indicators (they don’t start reflecting public opinion for a while after a shift happens) and he’s noting that even some are finally ready to accept that privatizing Medicare is ripping us off and killing people. Another big shift is on the issue of the age of eligibility for Medicare. Not long ago we were fighting off attempts to raise the age to 67. Now President Biden is talking about lowering the age. Biden continues to feel the pressure on healthcare andhas resulted in some real progress. We talk about the good, the bad, and the ugly post-election scenarios. Good would be a Democratic trifecta (there’s a path, if you squint a little) where we could make a lot of progress toward expanding and improving Medicare. In the Fair column would be another Biden presidency with a divided congress, in which case our movement will have to continue to work on executive actions the president could take. Ugly would be a Republican trifecta, which will immediately mean huge corporate tax cuts and possibly right-wing violence like we saw on January 6. In that case, our job will be to stand in solidarity with our allies against fascism. It’s becoming harder and harder for people – politicians and voters alike – to deny that we’re on a bleak path. There’s been a real change on the hill, driven by organized people pushing for a better future. We’re seeing real results like drug price negotiations, insulin price reform, and bills addressing medical debt. If we want to continue the work, one of the most important things we can do is get and stay engaged with our Members of Congress, and start building relationships with the people who are waiting in the wings to run for something in the future. Get involved in local elections now, and those are the folks who will be running for Congress and President in the near future. Tell them your stories! We may never have the perfect scenario with the perfect elected officials, but we need to be ready for M4A to have a moment. Keep building so we will be as ready as we can be. Alex leaves us with the story of Eugene V. Debs . Socialist and labor leader Debs ran for president and lost several times (1904, 1908, 1912, 1920), but was all lost for his pro-worker priorities? A little over a decade after Debs’s final loss, Frances Perkins and the New Dealers essentially put forth his whole platform and got it done during the Roosevelt administration. If we don’t win M4A, don’t throw up your hands and give up. Keep laying the foundation so we’re the ones who are ready when the time comes. TL;DR: organize, organize, organize. If you’d like to hear more presentations from the 2024 Medicare for All Conference, visit the Healthcare-NOW Youtube channel! Like and Support the Pod Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! This show is a project of the Healthcare-NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org. It’s end-of-year giving season, and thanks to a generous matching gift from the United Steelworkers Union, every dollar you give will be doubled, so please make your way to our website and chip in!…

Medicare for All

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Dude, Where’s My Union Health Plan? 42:43

il y a 1 year42:43

42:43

We are in the middle of a resurgence of organized labor in the US. From Amazon workers to auto workers and grad students to baristas at Starbucks, everyone is getting in on the action! One of the big reasons workers are so hot to get that union card is because of… you guessed it, healthcare! Today we’re going to be talking union healthcare plans – how they work and how workers have managed to use collective bargaining to resist the national erosion of healthcare access. Most importantly, we’re going to take a deep dive into why, even with better healthcare, unions have been leaders in the fight for Medicare for All, and how they might save the rest of us from corporate healthcare hell. Our guest Jim McGee has spent his entire career working in union health benefits, starting with the Plumbers and Pipefitters local he belonged to in Harrisburg Pennsylvania. For the past 20 years, he has been the administrator of the health benefits plan for Amalgamated Transit Union Local 689. He’s on the steering committee for the labor campaign for single payer healthcare, and he’s joining us today from Bethesda, MD. https://www.youtube.com/watch?v=cNFBkHBrpUY Show Notes Jim educates us on the two types of union health plans: Unionized workers with a single employer (think nurses or teachers) earn employer-sponsored health benefits much like unorganized workplaces, but the cost and benefit sets of those plans can be negotiated if the workforce is unionized. Taft-Hartley plans are multiemployer plans that are jointly managed by multiple companies and the union within the same industry. The workers pay while they’re working to have health insurance when they’re not. Taft Hartleys exist in industries where there’s a lot of turnover, like the building trades. A worker may have many different employers and many periods of unemployment over their careers. Typically both those options sound a lot better than what your average non-union worker is getting from their employer, though they are still subject to same rising costs and economic pressures as every other health insurance plan. Given that union members are more likely to have health coverage than non-union workers, it’s interesting that unions have been at the forefront of the movement for Medicare for all. Many unions come from a rich progressive tradition that looks past the short term to the long term value of guaranteed healthcare for all workers. Jim also shares that the unions that are more exposed to competitive pressure in their environment are more likely to be supportive of Medicare for All. This is especially evident in less urban areas where locals are facing more non-union competition. Jim notes that throughout his career, healthcare has been #1 cause of strikes. Taking it off the table would not only benefit the workers, it would benefit their entire community. Small businesses and non-union employers that offer poorer or no healthcare benefits to their employees often stay afloat on the backs of the unionized employers in their community that do offer good health benefits; this is an inquitable and unsustainable system. Speaking of strikes, graduate student workers at Boston University are on strike right now over healthcare benefits among other things. Not only would Medicare for All take health insurance off the negotiating table (making more room for workers to bargain for pay, safety and other benefits), it would take away a the ability of employers to weaponize health insurance to break strikes; solidarity can crumble quickly when the employer stops paying those premiums at the first of the month. Follow and Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org .…

Medicare for All

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Mental Health & For-Profit Insurance: A Deadly Combo 58:59

il y a 2 years58:59

58:59

The U.S. is wrestling with a massive mental health crisis – impacting young people in particular. Half of young adults and one-third of all adults report that they always feel anxious or have often felt anxiety in the past year. One-third of respondents could not get the mental health services they needed. Why? 80% say they couldn’t afford the cost and more than 60% said that shame and stigma kept them away. The shortage of mental health providers also means that care can be very hard to find, even when we try hard to find it. Usually on the Medicare for All Podcast, we focus on the stories we think you need to know about. Today we decided to scrap the show and come up with a plan to get an hour of free therapy! * ( * Not really. None of this information is intended as medical advice.) Our guests today are Dr. Pamela Fullerton and Lindsay Baish. Lindsay is a therapist and an Licensed Professional Counselor (LPC) in Illinois and a certified trauma professional – and former volunteer for the podcast. Dr. Pamela Fullerton, Ph.D. , is the founder and clinical director of Advocacy & Education Consulting, a counseling and consulting organization dedicated to ensuring social justice and advocacy through equitable access to mental health and well-being services. She is a Latina bilingual Certified Clinical Trauma Professional (CCTP), a Certified Dialectical Behavior Therapy professional (C-DBT), a Certified Clinical Anxiety Treatment Professional (CCATP), a Certified Grief Informed Professional (CGP), and a clinical supervisor and consultant specializing in working with BIPOC communities, undocumented communities, immigration and acculturation, trauma, anxiety, life transitions, and career counseling. In addition to being a professional writer and speaker, Dr. Fullerton is an adjunct instructor in the Counselor Education department at Northeastern Illinois University. She is also a volunteer contributing writer for three publications and runs a nonprofit to support Latinx youth in the Chicagoland area. Dr. Fullerton consults for two behavioral health advisory boards, Sinai Urban Health Institute (SUHI) and Illinois Unidos/Latino Policy Forum, providing advice and input to assist in promoting health equity and justice initiatives for underserved communities in Illinois. https://www.youtube.com/watch?v=GGql7_NXhts Show Notes Pam tells us that counselling is a subset of psychiatry and psychology that started as a movement for career development for veterans returning from war. The profession started helping people through life transitions puts people and their lives and livelihoods at the center. Lindsay notes that a lot of the language of mental healthcare is used interchangeably, but there are distinctions: psychologists have PhDs and can provide therapists; psychiatrists have MDs and can prescribe medications. Counselors and therapists can diagnose but not prescribe. Congress passed the Mental Health Parity and Addiction Equity Act in 2008 to prevent insurers from providing worse coverage for mental health than they do for medical or surgical treatment. However, mental health providers are not usually treated the same as medical doctors when it comes to insurance coverage and payments. Historically, counselors are the newest mental health clinicians on the scene and are more limited by insurers than more established clinicians like social workers or psychologists. Insurers often only reimburse for certain therapeutic models of care (Cognitive Behavioral Therapy, for example) leaving other kinds of counseling uncovered in the midst of a crisis in mental healthcare. Pam tells us that a big part of her job is the extra work to navigate her patients’ insurance plans, Medicare and Medicaid in order to get coverage for their care. Most Americans can’t afford to pay out of pocket for mental healthcare. Counselors just got approved for Medicare reimbursement on January 1, 2024, but Pam tells us her first application was denied, as was Lindsay’s supervisor’s. Couples and family counselors were just approved for Medicare as well. Lindsay notes that no two insurance companies pay out the same rates, so some plans are not worth taking because the payout will be late, small, and requires hours of red tape to receive. Ben calls this “rationing by inconvenience.” Illustrating the troubling priorities of the healthcare industry related to mental health, Lindsay shares a story about the Diagnostic and Statistical Manual (DSM), the encyclopedia of mental health diagnoses. The DSM is put together by the American Psychological Association, where panels of providers create and refine criteria and definitions for diagnoses. Those panelists are required to disclose who they have received funding from including pharmaceutical companies and insurance companies. A recent study found $14 million in undisclosed industry payments to some of those panelists , representing countless conflicts of interest. Americans have responded in a lot of different ways to the difficulty of getting mental healthcare including millions who go to TikTok for mental health advice. On the bright side, many of us have found out we aren’t alone helping to reduce the stigma of talking about mental health. Unfortunately social media has also disseminated misinformation leading to mistaken self-diagnoses. Lindsay is actually on TikTok , talking about her specialty areas and social liberation issues in psychology, because it provides a space for some people who don’t feel welcome in the traditional healthcare setting. Since COVID, we’ve seen the rapid growth of virtual mental health services. This feels a bit like the Uber-ization or Airbnb-ification of mental health services. In theory these platforms are great for access, but many are poorly regulated and the therapists are often not held to professional standards. The FTC found that one platform, Better Help, sold patients’ data . One of the things we always say about Medicare for All is that it would take the business out of healthcare. What would it look like if we took the business out of mental healthcare? Currently most Americans’ insurance is tied to employment, and that plan can change due to their employer’s bottom line. There’s something particularly insidious about developing a trusting therapeutic relationship with a mental health professional only to lose coverage and having to start over finding another provider who will accept the new plan. Pam dreams of a healthcare system divorced from profit, where we can do more preventative mental healthcare and collective healing, and not wait until someone is in crisis. Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! If you want to support our work, you can donate at our website, healthcare-now.org .…

Medicare for All

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Cyberattacks, Messaging Wars, and the Capitalist Hellscape 41:51

il y a 2 years41:51

41:51

We hear it over and over again – the private sector just does it better. Whether we’re talking education or healthcare or our criminal justice system, the default Republican (and sometimes Democratic) talking point is that competition in the marketplace allows the best ideas and best people (Elon Musk, lookin at you) to rise to the top and lead us to a utopian future (sponsored by Meta). But then something wild happens like the cyberattack on UnitedHealthcare , which is causing massive fallout throughout our healthcare system over the past two weeks – so much so, that the company appears to have paid a 22 million dollar ransom to the hackers who breached their system and now the federal department of Health and Human Services has had to bail them out. That kind of thing really makes you question how anyone is still making the argument that the private sector has this shit handled. This episode, we’re bringing in special guest and political messaging expert Jordan Berg Powers to talk about how we talk about all of this stuff: public healthcare, private corporations, and how to message our way out of the corporate hellscape in which we currently find ourselves! Jordan Berg Powers is a consultant and the former director of Mass Alliance. Most importantly, he is coming up on 30 YEARS of experience in campaigning and organizing for progressive causes and candidates. Jordan is a return guest to the podcast, first appearing in our My Big Fat American Healthcare episode. https://www.youtube.com/watch?v=Z6QvGQja1N8 Show Notes UnitedHealthcare debacle is a little bit fun for us because we get to talk about the failures of a really shitty company, but like any healthcare debacle, there are some serious consequences. What happened here, and what does the UnitedHealth scandal look like for folks on the ground? Starting on February 21, a group of hackers breached “Change Healthcare,” which is the largest electronic medical records and medical claims processing platform in the country. About half of all Americans’ health insurance claims pass through Change Healthcare, which was bought two years ago by UnitedHealthcare, the largest health insurer in the country. Following the hack, Change Healthcare shut down its entire network, leading to complete mayhem in the healthcare system, which is still ongoing: “Hospitals have been unable to check insurance benefits of in-patient stays, handle the prior authorizations needed for patient procedures and surgeries or process billing that pays for medical services. Pharmacies have struggled to determine how much to charge patients for prescriptions without access to their health insurance records, forcing some to pay for costly medications out of pocket with cash, with others unable to afford the costs.” ( source ) This has led to a financial crisis for many hospitals, health clinics, physicians, and pharmacies, none of whom can be reimbursed for the care they’re providing, since they can’t submit medical claims. Provider associations are losing their shit, and the federal government has had to intervene to try to bail providers out in the meantime. The story keeps getting crazier and juicier: apparently UnitedHealthcare made a ransom payment of $22 million to the hackers who breached their system using BitCoin ( source ) – p.s. those are our healthcare premium dollars hard at work Russian hackers may now have access to almost half the country’s medical records. I’m sure that won’t come back to haunt anyone in the years to come! As much as we’d love to dwell on the UnitedHealthcare scandal that is unfolding, this incident really got us thinking about the broader debate over distrust of government, hatred of taxes, and bipartisan worship of market-based solutions. Jordan explains the false dichotomy of government vs marketplace, public vs private; there is no marketplace without government. The question is, which way does the government tilt the marketplace playing field? The debate about government vs private market run healthcare isn’t productive. We should be concerned about the fact that we’re all being robbed to make rich people richer. UnitedHealthcare is owning so much of the healthcare marketplace is the result of 40 years of Wall Street profiteering at the expense of American patients and the security of our data. Over the last 40 years the Right has been very successful at convincing Americans that the government is bad at everything. One slogan or one campaign can’t undo that. The message that does cross party lines is that we’re being ripped off. The reason we need public programs like public education and healthcare is because they give the people oversight. Not only do they provide opportunities to the marginalized in our society, they are the only thing we can control. It often feels like those of us who are fighting for the expansion of the public sector through programs like Medicare for All are constantly fighting the notion that government is dangerous, in part because the private insurance industry has controlled the national narrative about healthcare. A weakness of the Left is letting the opposition frame the debate, and then trying to win the argument on their terrain. Jordan drops the truth bomb we all need to hear: you’ll always lose when you argue in good faith against bad actors . We have to control this impulse, and instead talk about our own good ideas not their dumb ones. Another mistake we make is to fight an intellectual fight, when the Right is fighting about emotions. We need to work in the emotional state: this system is stupid, they’re stealing from us. We have to tell that story. Ben reminds us of a report called “Parroting the Right” by Partners for Dignity and Rights , fka NESRI, which found that the health insurance industry got the entire media and polling landscape to use their framing when discussing universal healthcare. You won’t see terms like corporate-run healthcare or public insurance in polls about Medicare for All; you’ll see questions about government-run vs. private healthcare. It’s actually pretty remarkable with this biased polling language how many people still support Medicare for All . Inside Medicare for All world we spend a lot of time talking about finding just the right words to articulate our cause. We love to talk about talking, but what we love even more is to fight about talking. One really good example is the internal movement debate about whether or not we should talk about healthcare in terms of human rights. A few years ago, Vermont nearly won single payer using rights based language. On the other side of the coin, messaging research in Minnesota found that voters had poor responses to rights-based language. Rather than fighting about how we describe our solution, Jordan thinks that we need to get away from leading with solutions entirely; we need to take voters on the emotional journey first, before we bring them to the solution. We should start by talking about the broken system and lead people through their emotions of outrage. We need to be outside of for-profit hospital HQs and insurance giants, protesting that they’re stealing from us. Instead of fighting about messaging and policy, what our movement needs most is people to have conversations with each other about how terrible healthcare corporations are. As fun as it is to fight amongst the choir, we need to talk to people and build the outrage. We don’t need more people who don’t know what they’re doing arguing about messaging and tactics; we need more people to talk to people, or pay someone to talk to people, says Jordan with the next great Healthcare-NOW t-shirt slogan. Have you donated to Healthcare-NOW recently, by the way? TL;DR: the #1 organizer question is “tell me how awful your life is.” Works in any setting, with any person: another patient in a clinic waiting room, a harried doctor or nurse, or an unorganized worker. The real “messaging” we need to worry about is the conversations we have with individuals. Instead of arguing about a hypothetical ad buy we can’t afford and won’t move the scales, work on the conversations! Follow & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on Apple Podcasts , Google Podcasts , or your favorite podcast platform! This show is a project of the Healthcare NOW Education Fund! How much do you like this podcast? Did you learn something today? Please throw us a few bucks so we can keep providing content that helps you understand exactly how you’re getting screwed by American healthcare system! If you want to support our work, you can donate at our website, healthcare-now.org .…

Medicare for All

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The Battle of the Letters: Medicare Advantage 42:06

il y a 2 years42:06

42:06

Occasional fistfights aside, most of our legislators make the choice to use their words when they’re angry, and a lot of those words go into public letters they write to presidents, officials, and even each other. Despite the fact that no one else in this country has written or read a letter in decades, the public comment letter is still popular with politicians, who have elevated this obscure literary genre to a competitive sport, using these letters to demonstrate their power, build alliances, and shape policy. Today we’re going to focus on one ongoing battle of letters over one of our favorite topics: the privatization of Medicare through a program known as Medicare Advantage. We’ll talk about how all the players in the debate about Medicare Advantage are engaging in that battle, and how it could impact our access to healthcare! https://www.youtube.com/watch?v=MmM6HrIiS8o Show Notes We’ve recorded a bunch of episodes about Medicare Advantage! Medicare Advantage was created as a private, for-profit alternative to traditional (or public) Medicare, was the promise of lower costs… which never happened. Surprise: Medicare Advantage plans are FAR more expensive to taxpayers than traditional Medicare for covering the same person, costing taxpayers $7 billion more per year than if everyone were just covered by traditional Medicare. ( source ) It’s the healthcare Joe Namath, Jimmy JJ Walker, and Big Papi are selling to seniors with big promises of coverage for vision and dental care, transportation, groceries, and more – for $0 premiums. Free shit! Private companies drain public money to provide generally substandard insurance. These companies are exploiting a legit problem in Medicare, where many seniors are forced to pay premiums for medigap plans to cover stuff like chewing and seeing. If you can’t afford the premiums for Medigap coverage, but you need to chew or see, you might be forced into an Medicare Advantage plan just because that’s what you can afford month-to-month. And that could be fine… until you need care and find out that the copays and deductibles are too high, there are super limited networks, or the insurance company refuses to pre-authorize your treatment. But many of these MA plans don’t come through on their wild promises, and in fact, seniors end up being pushed out of MA and back into original Medicare when they are sick and actually need care. Private insurance companies love collecting money,but they hate paying money for the service they’re supposed to provide. Go figure! We put out a report about this! Taking Advantage Who’s Who? AHIP: “America’s Health Insurance Providers” is the trade organization for the health insurance industry. Unsurprisingly, they are big proponents of Medicare Advantage. AHIP has written their own comment letters to CMS (the Center for Medicare and Medicaid Services) advocating for expansions to the MA program since at least 2015. Lately they also began coordinating their besties in the House and the Senate to write letters on their behalf. They claim that Medicare Advantage will expand the program to more seniors, and present some of their own research: MA will bring more money into the Medicare system … because MA plan holders use less care. (nothing to brag about!) MA is serving a diverse populatio “As of 2021, approximately 59% of Hispanic or Latino/a individuals and 57% of Black individuals eligible for Medicare choose Medicare Advantage plans. Overall, 54% of Medicare beneficiaries who belong to diverse populations choose Medicare Advantage.” Turns out if you set out to exploit a diverse demographic of people, you can! In 2021, 70 members of congress signed “dear colleague” letter, initated by initiated by Reps. Val Demings (D-FL), Mike Gallagher (R-WI), Marc Veasey (D-TX), and Gus Bilirakis (R-FL). In 2023 – 60 Senate signers – a good example of how this is insidiously bipartisan, John Fetterman signed right next to Ted Cruz In 2024 – 60 Senators , but only 16 reps signed on to their version. That’s because of the OTHER letter, which Congresswoman Pramila Jayapal has been whipping up support for in the house. The Good Guys Organized resistance to Medicare Advantage is actually fairly new (last few years)! Just a couple of weeks ago a COUNTER letter was to Biden and the agencies that run Medicare calling for major reforms to Medicare Advantage and essentially pointing out that it sucks. The letter was led by three Reps – Jayapal, DeLauro, Schakowski – was ALSO signed by 70 Representatives, so suck on that AHIP! (P.S. there are 435 voting members of Congress, so most of Congress is taking the cowardly fence-sitting approach to Medicare Advantage) ( source ) The letter makes four demands, one of which is already kinda sorta happening: Ban Medicare Advantage plans from creating prior authorization barriers that can’t be used in traditional Medicare, such as “step therapy.” (Banned by Obama, un-banned by Trump, and… allowed under Biden. Grrr.) Require Medicare Advantage plans to include all providers in their networks that are included in the public Medicare plan. One trick MA uses is to have extreme limited networks, so you might not be able to get certain types of care at all in your area. Stop overpaying Medicare Advantage by preventing “upcoding” and paying them the accurate amount for the patients they cover Finally, use all the savings to expand Medicare coverage for everyone : we could cover dental, vision, and hearing with money leftover; or we could reduce or eliminate the premiums and deductibles that Medicare enrollees still have to pay. This last bit is particularly important, since it’s problematic to just end the MA program – this would require many low-income people to spend more to buy Medigap plans. They’d have much better coverage, but many can’t afford that better coverage. There will be a separate Senate letter, but we don’t have details yet. (There’s still time to ask your Senator to sign on.) What does the Other Letter mean? It’s a show of power in a legislature where it’s difficult to put progressive policy up for a vote and actual voting ends in gridlock. Based on the numbers, we can see the tides turning on Medicare Advantage. Remember that even though these letters are important for signaling shifts in the balance of power, the real organizing happens at the grassroots level, not on Capitol Hill. Follow, Like & Support the Pod! Don’t forget to like this episode and subscribe to The Medicare for All Podcast on your favorite podcast platform! You can listen to Medicare for All on Apple Podcasts , Google Podcasts , or visit our website here . This show is a project of the Healthcare NOW Education Fund ! If you want to support our work, you can donate at our website, healthcare-now.org . Resources Jayapal Press release: https://jayapal.house.gov/2023/02/16/jayapal-delauro-schakowsky-lead-effort-to-reform-medicare-advantage/ Jayapal Full letter and signers: https://jayapal.house.gov/wp-content/uploads/2023/02/230216-MA-Letter-Final-with-Signatures3.pdf AHIP press releases: https://www.ahip.org/news/press-releases…

Medicare for All

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Hospital Merger Mania!

il y a 2 years

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Here at the Medicare for All Podcast, we love calling out all the bad actors in our healthcare system – greedy insurance companies, soul-less CEOs in Big Pharma,profit-hungry “non-profit hospitals”, and all our favorite villains. Mostly, we look at the ways those predators target sick people and poor people for exploitation, but today we’re looking at what happens when they start fighting each other for a bigger piece of the pie? Specifically, we’re going to explore the world of hospital consolidation – that’s when smaller hospitals merge to form bigger corporate entities who can battle it out with insurance companies to secure more of patients’ healthcare dollars! What does hospital consolidation mean for regular people? No spoilers, but it turns out that when giant healthcare monsters go at each other, much like when Godzilla took on Mothra, it’s the rest of us tiny humans who suffer! https://www.youtube.com/live/LXBGMk8HEE8?si=9cIQ6G9wkwMSYLrZ Show Notes Like every major industry in this country, healthcare is full of big corporations that will stop at nothing to get bigger, using the time-honored capitalist techniques of mergers and acquisitions to become HUGE corporations. But, of course, we live in America, where bigger is always better – what could possibly be wrong with bigger, better healthcare companies? We start out this episode with a cautionary tale from Massachusetts that began in 1994, when two of Boston’s biggest hospitals merge to create a mega-corporation called “Partners Health,” which over the next two decades bought up… everything. This was a response to a national wave of insurance company mergers and consolidations, which allowed insurers to squeeze both patients and providers under “managed care.” Hospitals, not wanting to be out-squeezed, fought back with their own mergers, ostensibly so they could negotiate with insurance companies. Of course, what actually happened was something much more nefarious – and secretive. In fact, we only know any of this happened thanks to the Boston Globe’s illustrious Spotlight reporting team, who dug up the truth in a 2008 article. Basically, in 2000, Dr. Samuel O. Thier, chief executive of Partners HealthCare, and William C. Van Faasen, chief executive of Blue Cross Blue Shield of Massachusetts engaged in an unwritten agreement between the two entities without putting it in writing to avoid legal implications. The agreement involved Blue Cross Blue Shield giving significant payment increases to Partners' doctors and hospitals, and in return, Partners would protect Blue Cross from allowing other insurers to pay less, effectively raising insurance prices statewide. This "market covenant" marked the beginning of a period of rapid escalation in Massachusetts insurance prices, leading to a significant annual rise in individual insurance premiums. Partners used its clout to negotiate rate increases, pressuring other insurers to match or exceed the payment increases given by Blue Cross, leading to cost increases for consumers. In turn, Partners' significant growth and influence in the healthcare industry compounded the impact of this backroom deal, leading to a substantial rise in medical costs in Massachusetts. Partners employed aggressive tactics, resulting in major payment increases benefiting a few powerful hospital companies while leaving others behind. This led to significant payment disparities, with Partners' flagship hospitals earning substantially more than other academic medical centers. Partners is an outstanding example of the evils of hospital consolidation, but it’s not an anomaly. This episode was originally inspired by our friends at the Minnesota Nurses Association (shout out to Geri Katz), who last year were fighting a proposed merger of Fairview Health with Sanford Health, two giant corporations with dozens of hospitals and clinics. Fortunately, the nurses and MN patients won this fight - merger talks were abandon...…

Medicare for All

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Racial Equity in Healthcare 52:54

il y a 2 years52:54

52:54

Just this Monday, we celebrated Martin Luther King Day, a tribute to one of the great leaders of the movement for racial justice – but something that often gets forgotten in the flurry of MLK quotes that become memes this time of year is that equity in healthcare was a crucial part of King’s vision. Throughout his career in activism, he often stated his conviction that “Of all the forms of inequality, injustice in healthcare is the most shocking and inhuman.” Sadly, over 50 years after his death, racial inequity in healthcare is even more shocking and inhuman. Today, we’re joined by public health expert Walter Tsou to do a deep dive into the horrifying world of racial health injustice, how we got here, and how we make real change. https://www.youtube.com/live/yiq7TBVYc6g?si=QCbGU114cZviZe0G Show Notes The show is joined on MLK Day by Dr. Walter Tsou - past president of the American Public Health Association and former health commissioner of Philadelphia! Gillian asks how Walter dedicated his life to health access and health equity. When Walter graduated from med school he stumbled into a job at a public health clinic in West Philadelphia that treated patients lacking private insurance or the money to afford medications, which gave him his first window into the deep economic, racial, and health divides in the U.S. This launched his career in public health advocacy. Walter served as the Health Commissioner of Philadelphia from 2000 - 2002, and to him the most stark racial inequity he had to deal with was the gap in infant mortality - black infants at that time were 2.5 to 3 times as likely to die before reaching age 1 than white infants. Walter looked up the most recent statistics in preparation for the podcast, and the number had barely changed. The traditional way that states are pretending to do something about infant mortality is to create an Office of Equity contained inside their Department of Health that has maybe two staff people. To make a real difference in infant mortality, Walter says, you have to tackle the largest social determinants of health - education, job opportunities, housing, transportation, and so on. Two or four people in an Equity Office aren't going to make a difference - it's window dressing. On top of this, Walter says, the U.S. has abandoned most of its community health work, which was widespread under LBJ's Great Society programs after WWII, when community nurses would go into communities and address social determinants of health. Gillian backs up to share some of the big-picture distressing findings from the Commonwealth Fund's scorecard on racial equity in U.S. healthcare: Provisional life expectancy report released by the CDC in 2020 shows that Black and American Indian/Alaskan Native people live fewer years on average than white people (see data here) Black/AIAN individuals more susceptible to chronic diseases like diabetes, hypertension Higher rate of pregnancy related complications, higher infant mortality rate (see our episode on maternal health for more details) Poor healthcare outcomes are driven by higher poverty rates, higher-risk environments, less access to healthcare among communities of color Less likely to have health insurance, more likely to incur medical debt, more cost-related barriers to care, less preventative care These unequal health outcomes persist across all states in the U.S. Black women are more likely to be diagnosed with breast cancer at later stages and to die from breast cancer than white women Uninsured rates are much higher in communities of color, particularly states that have not adopted Medicare expansion Black Medicare beneficiaries are more likely than white beneficiaries to be admitted to a hospital or to seek care in an emergency department for conditions typically manageable through good primary care Lower rates of vaccination - example - Black, AIAN,…

Medicare for All

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Mailbag Episode: Super Fans Edition! 50:40

il y a 2 years50:40

50:40

It’s that time again folks… time for a Mailbag Episode! We reached out to our whole audience and all our supporters to find the pressing questions on everyone’s mind. Or at least we would have if Gillian hadn’t been too busy eating turkey to email our list. So instead, Gillian reached out personally to some of our superfans (anyone in her contact list who had previously admitted to listening to the show once) to find out what they wanted to hear from us. And here we are, with questions about everything from Ronald Reagan to elder care to dinner table conversation from some of our favorite stans! https://www.youtube.com/watch?v=pesLv7rekVY Show Notes Question from Liam Meyer in Massachusetts: "Maybe discuss this on your podcast: Facing Financial Ruin as Costs Soar for Elder Care - The New York Times." "You could also talk about elder care and how wildly fucked up it is. One especially galling bit is how Medicaid is basically built to just ignore cognitive stuff. Almost all metrics are about physical health so, like, if someone’s grandpa **could** theoretically cook and shower themselves (ie, “He can stand up and walk, he still has hands!”), Medicaid says it all good even if grandpa doesn’t know where the shower is, leaves the stove on all the time, and continually eats spoiled food." Answer: "elder care" is a vague term that mooshes together lots of kinds of care for seniors. But "long-term care" is better defined, and has been a major focus of ours in recent years, needed not only by older folks but anyone with a physical or mental disability that means they need help with day-to-day living. Most of us will need long term care at some point in our lives. What’s wrong with the U.S. long-term care system? We don’t have one! Very few people are insured for long term care Medicaid covers the vast majority of long term care services - you have to be or become poor to qualify (except in California, where Medicaid asset limits will be eliminated starting January 1, 2024!) We've heard many stories of people who have had to sell homes or farms, affecting their whole family, in order to become eligible for Medicaid. Institutional bias: Medicaid will pay for long term care in a setting like a nursing home, but not home-based care which is cheaper and better for quality of life. Check our our long term care episode for much more. Questions from Geri Katz in Minnesota: "Have you listened to the 1961 Ronald Reagan Speaks Out About Socialized Medicine LP? Why has the AMA historically opposed single payer?" Answer: in 1961, before Medicare passed and before he was elected Governor of California, Reagan was a washed up actor talking about how "socialized medicine" would ruin our country. He sounds like a ghoul: “One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it.” Reagan was paid by the American Medical Association (AMA) to deliver this speech, which was printed on an LP so you could host a house party with your socialism-hating friends. The AMA has a long history of opposing healthcare reform, such as: In 1948 when Truman proposed a national healthcare program - which was supported by an estimated ⅔ of americans - the AMA decried it as socialism and used member dues to fund a political campaign against Truman’s plan. After passage of Civil Rights Act in 1964, the AMA continued to allow medical societies to discriminate against physicians of color. The AMA has been involved in campaigns against Social Security, Medicare and Medicaid. The AMA is a scam! According to Dr Linda Girgis, “Perhaps the biggest example of how doctors lost their trust in the AMA is the way they are funded.…

Medicare for All

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What even is health insurance? 48:42

il y a 2 years48:42

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Open enrollment. Deductible. Coinsurance. HMO. Indemnity plan. If you’re listening this far, you probably have a migraine already. Understanding the language of the health insurance industry, let alone selecting a health insurance plan, can be confusing, frustrating, and disheartening. But never fear - we are here to give you a crash course on everything you need to know about your insurance plan. No need to scroll through Healthcare.gov’s Health Insurance glossary and risk throwing yourself out the window… We want to give you some tools here to understand what you’re choosing when you pick a healthcare plan, but no one but you really knows what’s best for your health, so (for better or worse) we aren’t going to give any actual advice here about what healthcare plan to pick. Also, all health insurance kind of sucks, so you will probably get screwed no matter what you pick. Basically, we’re going to try to decode all the mystifying language that the insurance companies use to disguise the ways they’re going to screw you so at least you’ll be able to anticipate how you’ll get screwed. https://www.youtube.com/watch?v=32vw4LZpelA Show Notes Names Whether you get health insurance offered by your employer, or you have to buy insurance on your own in an exchange or on healthcare.gov, or you have Medicare and you are looking at one of the privatized Medicare Advantage plans, you’re going to be choosing from a series of plans that have totally incomprehensible names and acronyms, so let’s start by breaking down the how the name of the plan itself will tell you something about how your insurer is going to screw you. Generally the first part of an insurance plan’s name will be the name of the insurer (like “Blue Cross” or “United Health”), then you MIGHT get a word that says who is paying for the insurance plan (if it’s a “Group” plan that means an employer is paying for it, an “Advantage” plan is a privatized Medicare plan), and finally there will be an acronym that only 0.005% of people in America understand - and those are the generally people making money from the plans. These acronyms will be something like HMO, HSA, PPO, EPO, or my personal favorite “GTFO” - the “get the fuck out of here that can’t be a real plan” plan! Indemnity Plans (“Open Choice” or “Open Network” plans): are the opposite of managed care; you could use any doctor or hospital, there are no networks, no review of care or pre-approvals, no claims denials. These were the plans that virtually everyone had prior to the 1980s, and plans that virtually no one has today except maybe the extremely wealthy. In 1978, 95% of people had indemnity plans, then that dropped to 71% by 1988, and by 1998 it was down to 14%. Today, only 1% of workers have indemnity plans. Indemnity plans are the opposite of managed care - you can see any doctor or hospital you want, there Today, you probably wouldn’t even want an indemnity plan, because the modern versions usually only pay a percentage of the cost of your care, leaving you with the rest and massive bills. Health Maintenance Organizations (HMOs) represent only 12% of insurance plans today, so after taking over in the 1990s, old school HMOs are going the way of the dinosaurs. HMOs usually limit coverage to doctors/providers who work for or contract with the HMO (“in-network”). It generally won't cover out-of-network care except in an emergency. HMOs can also be limited by location, meaning you might have to live or work in a certain area to be eligible. Exclusive Provider Organizations (EPOs) are a new catch-phrase that are appearing more and more often, but they are VERY similar to an HMO, and you should think of them the same. In fact, that survey that only 12% of workers have HMO plans includes EPOs under the same category. EPOs often have larger networks than HMOs, and unlike HMOs, they don’t require referrals to see specialists - as long as the specialist is in their very limited net...…

Medicare for All

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How the Other Half Lives: Concierge Care 40:49

il y a 2 years40:49

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If you’ve ever had an experience with the American healthcare system, you’ve probably walked away thinking, “Why can’t we have nice things? Or even basic human things??” We get stuck on gurneys sitting in ER hallways, waiting hours for care; we skip other basic needs like food and housing to pay for the healthcare we can’t skip; or we wait for months for preauthorizations from our health insurance and referrals from our doctors. Of course, for the super rich you don’t have to endure any of these humiliating experiences, and they have developed some new, expensive ways to get the healthcare they need when they need it. So put up your pinkies and throw on a monocle – today we’re doing a deep dive into the lifestyles of the rich and famous to find out: just how fancy is concierge healthcare, and can the rest of us get some? https://www.youtube.com/watch?v=YqwLHYrEJvo Show Notes Let’s start with concierge primary care, the latest trend in fancy healthcare! What is concierge care? Some concierge plans (also called Direct Primary Care) work with existing insurance – those are the cheaper ones ($600-1000/year, aka Hyatt Care). Some you actually pay a flat fee that covers all your services. Those are the really expensive ones, which can run from $2400 to $30k per year! But what do you get for your money? 24/7 access to doctors (some promise your physicians direct phone number) Coordination of care (referrals, preauthorizations if necessary) Extra services like a health coach! Some offer really crazy shit like home visits Physicians have fewer patients and can spend at least 30 minutes with each of them. Now there are more than 1,500 Direct Primary Care practices across the country, and 1 in 5 of the top 1% buy concierge physician care. We're also seeing some hospitals, like Ben’s local mega-hospital Mass General, offering "Concierge Medicine." They have dedicated concierge physicians who see fewer patients and are more accessible, available by phone or email 24 hours a day, seven days a week. You also get your own health coach and a dietician. Do you need to maintain insurance? Yes. At Mass General, your $10,000 membership fee covers a high level of "service" and "access" but not the cost of the medical care you need. Your insurance plan will cover the actual services provided by the concierge physician. That means $10,000 on top of your premiums, co-pays and deductibles. Outside of the exorbitant cost, are there downsides to concierge care? You betcha. It exacerbates the primary care provider shortage and creates two-tier system: direct primary care physicians have fewer patients, and also creates a two-tier system where rich people buy their way out of the physician shortage. Despite all the marketing claims, concierge care may not lead to better health outcomes: there is a lack of peer-reviewed studies on care outcomes in concierge practices. But when rich people get to the hospital, don’t they get treated like the rest of us? Nope. Big hospital donors often get to skip the line in the ER and get VIP status. They get fancy luxury suites with fine gourmet dining, high thread count sheets, and suites with custom cabinetry. They also get the best nurse to patient ratios in town, with some luxury units assigning each patient their own nurse who has no other patients, 24/7. These luxury units can be dangerous though. When the hospital is more concerned with pleasing the patient than providing the care they need, it can result in "VIP Syndrome." There's anecdotal evidence that because some patients want to stay in their luxury accomodations instead of being moved to a specialty or more intensive unit due to their condition, they don't get the kind of care they need, which can lead to worse outcomes or even death. At least one study suggests that higher patient satisfaction is correlated with worse outcomes. VIP syndrome can lead caregivers to overtreat patients ...…

Medicare for All

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The Price is Right (for Prescription Drugs)! 55:35

il y a 2 years55:35

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Just over a month ago we lost Bob Barker, the man who taught us all about the brutal nature of capitalism one pricing game at a time. Now, thanks to the Inflation Reduction Act, the federal government is going to be playing a role in determining the prices for some of our favorite products. No, we’re not talking about cars or family vacations to the Bahamas – we’re talking about the prescription drugs that keep us alive! As the Biden Administration enters its own Showcase Showdown with Big Pharma, we’re taking a full episode to break down what that means and whether the result will be prices we can actually afford. https://www.youtube.com/watch?v=cnxbIhEPhs0&t=1s Show Notes Our first (and only) contestant is Alex Lawson! He is the Executive Director of Social Security Works, the convening member of the Strengthen Social Security Coalition— a coalition made up of over 340 national and state organizations representing over 50 million Americans. Alex’s organization played a critical role in moving the Democratic Party (mostly!) away from efforts to cut Social Security, and has been shifting the momentum towards expanding Social Security. Social Security Works is also a key ally of ours in the national fight for Medicare for All! Alex, come on down! Alex starts by telling us about the time he took a camera to PhRMA's (the Pharmaceutical Research and Manufacturers of America) office the day of the Inflation Reduction Act signing ceremony. He conducted person-on-the-street interviews, asking if they knew PhRMA spent hundreds of millions of dollars to keep Medicare from being able to negotiate drug prices, and if they had any messages for the folks in the building? Most of the responses were of the "f-you PhRMA, we got you!" variety. PhRMA has literally never lost until the Inflation Reduction Act was passed. Even though it's modest, Medicare went from having no authority over drug prices to the authority and mandate to find the fairest price for certain drugs is a huge loss to the industry. Alex wants listeners to understand that this win is as simple as it sounds. Who buys the most drugs in the world? Medicare. Why doesn't Medicare tell the pharmaceutical companies what they're willing to pay? This is called the Maximum Fair Price. No other peer nation doesn't have some kind of negotiated standard for drug prices. While our guest and hosts would prefer that Medicare be allowed to negotiate the prices of all drugs used by beneficiaries, PhRMA was successful in limiting the Inflation Reduction Act drug provisions to only apply to ten pharmaceuticals. (Still, pharmaceutical companies are suing to block the implementation of price negotiations.) Negotiating the prices for only ten drugs may seem like a drop in the bucket, but the cost of those ten drugs alone make up a huge amount of Medicare's spending on Medicare Part D. And in coming years Medicare will be able to negotiate over ten more drugs, and so on. This will squish the most excessive profiteering of the pharmaceutical industry and deliver savings of $9 or $10 billion dollars a year. We give President Biden credit for taking an aggressive stance against PhRMA to finally make good on an evergreen Democratic campaign promise to lower drug prices. But we also give ourselves some credit. First there was the debate in Congress in 2019 over HR3, the Lower Drug Costs Now Act. Advocacy by groups likes ours resulted in the House passing a robust bill that would have dramatically lowered drug costs. Then in 2021 both Healthcare-NOW and Social Security Works fought hard to win major expansions of Medicare in the Build Back Better bill (we were on track to win a lot more than prices for ten drugs). But Senators Joe Manchin and Kyrsten Sinema tanked the whole bill in the Senate. Those two battles led us to the Inflation Reduction Act aiming high from the start, and resulting in a bill that will make a big impact on drug spending by Medicare.…

Medicare for All

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Transgender Healthcare Under Attack

il y a 2 years

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With all the threats facing our country – climate change, a predatory economy, corporations buying our elections, and the overt move towards fascism among the far right – you would think that politicians would be laser-focused on the existential crises descending upon us. But instead, politicians in the US are devoting a considerable amount of their energy these days to an all-out assault on the rights of transgender people. Although the war on trans people has taken many forms, from bathroom bills to restricting school curricula, one of the most chilling is the denial of basic gender-affirming healthcare. Now, in places like Texas, elected officials have gone even further by targeting healthcare access for the most vulnerable trans folks – trans kids. In this episode, we’re joined by one El Paso family and a local gender-affirming care doctor who are fighting back! https://www.youtube.com/live/KeSiTiiwjsk?si=Qi8XgotSntheNIHR Show Notes Our guest today is Lori Edwards. Lori is the Director of the Intergenerational Rainbow Link at Borderland Rainbow Center in El Paso, Texas, an organization that provides a number of services to queer people in their community. Lori is a mama bear to her two trans/gender fluid teens, as well as any person who finds themselves in need of a mama bear nearby. She has a BSNS from Purdue Global, is a certified Mental Health Peer Specialist and pulls from backgrounds in both emergency medicine and education to function as a Jane of all trades who's ready to tackle the unexpected. As an El Paso native, Lori returned to the borderland with her husband to raise their children close to family. Liana, who is Lori’s daughter, is a 16-year-old trans girl who loves gaming, singing (rapping in particular) and is a student athletic trainer at her high school. She is also a Girl Scout and local advocate for LGBTQ rights in her city. Along with helping the family foster for a local pug rescue, she loves spending time with her 2 cats, 2 pugs, and 4 fish. Dr. Toni Marie Ramírez is a family medicine physician with several years of experience in gender-affirming care. She received her undergraduate and medical school degree from Brown University and trained in family medicine at the Santa Rosa/UCSF family medicine residency in Northern California. She was born and raised in Socorro and moved back to El Paso in 2020 to be with family. Her work is strongly grounded in social justice and equity, valuing the power of community empowerment. As a family medicine physician and gender-affirming care provider, Toni shares that those entering the medical field with the intention to provide and contribute to the health and well-being of a community, quickly realize that the healthcare system is not set up for this. We pathologize what is outside the norm in this colonized world and the medical community ignores the healthcare disparities of the trans community. Her 10-year experience in providing care has shown that it is astonishing how little medical providers know about gender-affirming care. Gender-affirming care is not part of the curriculum in medical school, let alone residency. This allows medical providers to uphold this gender binary in medicine. Starting from the very beginning, our socialized aspects infiltrate the way medicine is practiced and taught. When it comes to the access aspect that comes from that, physicians are already not educated enough to provide such care. We live in a world that is very binary and the reason why there are so many disparities is not because of anything innate to trans or gender-diverse folks, but because of the transphobia that exists in the world and the transphobia that exists in medicine. Sometimes people don’t access care because of a fear of discrimination or outright denial of care. Even in a progressive area of California, where Toni practiced, there are so many barriers to accessing care: (1) for feeling safe,…

Medicare for All

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Not-So-Nice Ratio 46:27

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Almost every patient in America has had a frustrating experience in a hospital setting where we feel like we’re on a medical conveyor belt that moves WAY too slowly. We sit for too long in a waiting room; then our nurses or doctors speak with us very briefly; we might feel more like we’re filling out an online survey than we’re being listened to; then we might have more waiting; and then we’re pushed onto the next specialist or appointment too quickly. Of course some patients experience FAR worse disasters in hospitals. As patients, we know that something dysfunctional is going on, and it leads a lot of people to distrust their medical providers, and avoid healthcare altogether. But nurses, doctors, and other medical professionals themselves know that behind the scenes, they are being pushed to the brink by hospital corporations, and not really allowed to treat their patients to the best of their abilities. So today we’re going to focus on one of the most crucial behind-the-scenes hospital policies behind patients’ bad experiences: staff-to-patient ratios. https://www.youtube.com/watch?v=am1j0n0ZEfw Show Notes Our guest today is Gerard Brogan, RMN, RGN, RN. Director of Nursing Practice at California Nurses Association/National Nurses United. Gerard has over 40 years experience as an RN. He has practiced nursing in the USA since 1984, before joining the California Nurses Association in 1994 as a Nursing Practice Representative. He is the Director of the Nursing Practice Department for the California Nurses Association/ National Nurses United. Gerard has extensive experience in nurse-to-patient ratio legislation, having been a part of the successful campaign to establish nurse to patient ratios in California and subsequent experience in seeing the efficacy of the ratio law. He serves as an educator for the organization, teaching classes to nurses on a variety of topics relevant to health care in general and the scope of nursing practice and patient advocacy in particular. Most of us will be patients at some point, so unsafe staffing practices in hospitals will have an impact on us or our loved ones. Studies show you have a lower risk of death, higher risk of poor outcomes, and a higher chance of re-admission if your hospital has adequate nurse staffing and your care is guided by providers' professional judgement. Sadly, in a for-profit healthcare system care decisions are made based on more on their budget impact. You'll recognize unsafe staffing when you see it: things like long wait times, or feeling like a number instead of a whole person because your nurse doesn't have enough time with you. The nursing profession takes a holistic approach to care, looking at the entire person and the factors that contribute to their health; that takes time, which the healthcare industry doesn't want to give nurses. Improving nurse staffing levels has been the #1 priority of nurses unions (and most unorganized nurses too) across the country for more than a decade. Gerard tells us that nurses are ethically and legally obligated to be a patient advocate and provide optimal care. When that can't happen due to the business interests of the employer, healthcare workers experience moral distress. (Rather than "burnout" which implies an individual, personal defect, Gerard uses "moral distress" to determine the suffering that happens when nurses are constrained by forced beyond their control from providing the care they should.) There has been a sea change regarding nurse staffing over the last several decades. When Gerard began his career, staffing was "impeccable," he had professional autonomy and the institution's respect of his professionalism. In the 1990s when the Clinton's healthcare reform attempt failed, "let the market decide" became the dominant narrative in healthcare. Corporate interests descended on healthcare to make a buck and nurse staffing began to decline.…

Medicare for All

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The Office 50:15

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50:15

Today we bring you behind the scenes into our office at Healthcare NOW. Just like the TV show The Office, we have our hijinks and wacky characters, including some very smart interns! They have prepped some of their burning questions for this episode. https://www.youtube.com/watch?v=YnG1C8DOZVY First, from Intern Noah from Boston College: In your opinion, what is the most effective way to organize/advocate for Medicare for All? Talk to one person, then another person, and then another! It doesn't start with money, marches, or celebrity endorsements (though if Oprah wants to support M4A, she should give us a call!) Those feel good, but without authentic relationships and networks, they don't make change. Unfortunately there are no shortcuts in organizing; we have to build the power ourselves. Do you have any funny stories from an experience meeting a member of congress? Gillian remembers meetings with former Republican U.S. Senator from Massachusetts, Scott Brown. Unfortunately all Senator Brown cared about was how the policy she was advocating for affected Dunkin Donuts. Gillian fondly remembers the time former U.S. Congressman Barney Frank told her that her hometown in New Jersey smelled bad. He also told a room full of constituents "the only thing that marches on Washington put pressure on is the grass in Washington, DC." Epic one-liner that we don't necessarily disagree with. (He already supported M4A so it was all good.) Intern Gulmeena, a public health student asks: When we talk about Medicare for all - are we thinking of a system with government run hospitals and government employed medical professionals? Do you think such a concept garners resistance or are people open to that paradigm shift? One of the most common attacks on M4A is to call it "socialized medicine." Very few countries actually have real socialized medicine, where insurance is public, all healthcare facilities are owned and operated publicly, and the healthcare professionals are public employees. In the United States, Medicare for All legislation does not socialize the facilities or professionals. By focusing on the payment mechanism, it would give the government a lot of power to reign in the worst parts of for-profit healthcare. Ben notes he has seen a poll showing a majority of Americans support socialized medicine, so who knows, maybe that's the future of the movement. Would Medicare for All include long term care for the elderly such as nursing homes and hospice? This has been a debate within our movement for a long time. Both M4A bills include long term care. The House version is more generous and comprehensive. The Senate bill would cover home-based long term care but not institutional. Currently most people get long term (which also includes care for people with disabilities) care through Medicaid, the healthcare program for the poorest Americans; this forces patients to spend down all their assets to qualify. Medicaid also has an institutional bias: it's much more likely to cover care in residential settings rather than homes, which is usually more expensive. If you're interested in advocacy around this issue, check out Caring Across Generations. Intern Ioanna (who hails from Greece, a country with universal healthcare): Considering that you have been a part of the movement since before Medicare for All was introduced by Sen. Sanders in 2017, how did you first hear about single payer healthcare, and what drove you into the movement at a time when it was not getting much or any (?) media attention? Back in the day of phone books and print newspapers, Gillian learned about universal healthcare from Ben! When her own employer-provided healthcare left her underinsured, a friend in the finance field told Gillian "if your job doesn't give you good health insurance, that's capitalism's way of telling you that your job isn't important and maybe you should get a new one.…

Medicare for All

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Healthcare Goes to Hollywood 59:02

il y a 2 years59:02

59:02

It’s summer, the sun is blazing, and we only have one thing on our minds - the upcoming thirtieth anniversary of the high-octane, expertly paced thriller The Fugitive, originally released August 6, 1993 starring Harrison Ford. Oh, and Medicare for All. We’re always thinking about Medicare for All. Now that we mention it, isn’t it funny how if we had a single-payer healthcare system, The Fugitive wouldn’t exist? In a single-payer system, there would have been no nefarious pharmaceutical executive to frame Harrison Ford for murder in order to cover up the side effects of Provasic. There would have been no need for Walter White to cook meth in order to pay for his cancer treatment. In fact, a lot of our favorite movies and TV shows would be entirely without conflict. In this episode, we take a look at a uniquely American subgenre: movies where our healthcare system is the villain! Plus, we dip into the Healthcare-NOW mailbag to hear from our listeners about your favorite movies where for-profit healthcare is the bad guy. https://www.youtube.com/watch?v=nKat9vjm7tI SPOILER ALERT. Some of these movies are masterpieces, and we'll be discussing spoilers. Seriously, we advise that you pause the podcast and watch Dog Day Afternoon now. Let's discuss the uniquely American film genre that depicts the healthcare industry as the villain. One of the biggest healthcare villain blockbusters was, of course, The Fugitive (1993). Our hero Dr. Richard Kimball is falsely accused of murdering his wife. He escapes police custody and along the way uncovers the truth, that he was framed by an evil pharmaceutical executive who killed Mrs. Kimball to cover up the side effects of a profitable new drug. Fun fact: Tommy Lee Jones was the former college roommate of Vice President Al Gore. The term “healthcare industry” dates back to the 1970s, and so does the reality of for-profit healthcare. Major transformations of our healthcare system have created real-life nightmares and impossible situations for patients, and that growing widespread experience of a healthcare dystopia then creates an audience for Hollywood script writers to build drama around healthcare situations. Two of the films submitted by our members come from the very beginning of the “healthcare industry,” in the early 1970s: The Hospital (1971) stars George C. Scott and Diana Rigg. A serial killer targets doctors by making them patients in their own hospital, where they die due to hospital negligence. CW: weird sexual politics. Dog Day Afternoon (1975) starring Al Pacino and John Cazale, dramatizes a true story of two Brooklyn bank robbers, motivated to steal to pay for gender reassignment surgery for Pacino's character's partner. In 2015, real life dad Bryan Randolph of Detroit robbed a bank to pay for his 1-year-old daughter’s cancer treatment after his health insurance canceled her plan. The next explosion of healthcare plots comes in the 1990s and early 2000s, when “managed care” plans and HMOs spread like wildfire, replacing traditional insurance. Intended to bring down rising healthcare costs, managed care brought us such classics as prior authorization, widespread claim denials and limited networks. This kicked off a new wave of films in the 1990s that start using health insurance villains become key plot points. The failed Clinton health reform efforts also happened in 1994, which created probably a sense of hopelessness around Congress fixing these problems. As Good As It Gets (1997): This cringefest features Jack Nicholson as a cranky, bigoted and obsessive compulsive writer. Nicholson's character can only eat at one restaurant, where he meets waitress Helen Hunt, and pays for her child's cancer treatment so she can continue to work and serve him. All kinds of toxicity, sexism, and structural inequities on display in this one. Patch Adams (1998): features Robin Williams in a real life story about a doctor whose unorthodox ways bump up agai...…

Medicare for All

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But…there will be wait times! 40:00

il y a 2 years40:00

40:00

As Tom Petty taught us all in the 1980s, Waiting is the Hardest Part. That’s even more true when you’re waiting to see a doctor for a problem that needs attention. Anyone who has ever tried to secure a doctor’s appointment in this country knows that a) it’s going to be harder than scoring Taylor Swift tickets and b) you are going to face serious delays before you get your care. In this episode, we’re getting into the nitty gritty of wait times in the U.S. – how bad are they, how do we compare to the rest of the developed world, and why are wait times the right’s favorite scare tactic when it comes to Medicare for All? https://www.youtube.com/watch?v=Y3QJH4eFXY4 The narrative attacking Medicare for All - you’ll NEVER get to see a doctor and everything will be like communist Russia… or, god forbid, CANADA! This is one of the top scare tactics used by opponents of Medicare for All, but their claims about wait times aren't always based on the truth. What our opponents seem to forget is that we have wait times in the US too. Ben, Gillian and our members all have stories about wait times, including Gillian's story of being told "call back next year," and Ben's condition that worsened and turned permanent because he couldn't get an appointment for for months for an urgent matter. We heard from members with horrific conditions that prevented them from working or even do normal day to day activities, but had to wait months or even over a year for care. In our broken system, getting a wait time is actually a privilege; if you don't have insurance or can't afford the copay, you won't even get to make that far-off appointment you need. This is another reason we often end up in the emergency department. In some cases there is no other way to get medical attention for an urgent or emergent condition. The reality of how our wait times compare to other countries' is challenging to capture because the U.S. is one of the only developed countries that DOES NOT TRACK WAIT TIMES. Reporting is not required. In other countries, they track wait times for every service, and in some cases you can look up average wait times online for visits, procedures and hospitals. Research on countries with national healthcare plans shows that wait times vary dramatically, from country to country. We often don’t even talk about the most critical wait times, which are ambulance response times and processing patients in emergency departments. It's hard to find good comparative data on this, but these are major weaknesses of the U.S. healthcare system. Finally, there is evidence of a major equity component here. Poor people and BIPOC have longer wait times for all services (including health services). Hispanic children have longer ED waits. Patients in poor neighborhoods have longer ambulance response times for cardiac arrest. What actually drives wait-times? Unlike the scare tactics from the right, it's not about the payment system. It’s mostly about adequate supply (of providers, specialists, scanning equipment, labs, etc) and accessibility - which is different from our payment/insurance systems. In general we do pretty well at wait times for very profitable services - like MRIs and CT scans. We do very poorly at unprofitable (or low-reimbursement services) like primary care, mental health care, and substance use care. There is an exception to this, because… When it comes to wait times for particular physician specialties, including primary care, a major source of the problem is that physicians control how many medical school slots AND how many medical residency slots are available across the country, in every specialty. Economist Dean Baker calls this a “cartel.” How would Medicare for All impact wait times in the U.S.? M4A might not directly impact wait times, but it would put into place tools that would allow us to control wait times. For starters, we could track wait time data.…

Medicare for All

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The Train Has Left the Station 44:10

il y a 2 years44:10

44:10

Usually we spend our time on this podcast talking about our for-profit healthcare system and why we need to make healthcare a public good, but in this episode we’re taking a detour into another privatized American system that should be public: our railroads! Just like in US healthcare, private companies are falling asleep at the switch on managing our railroads, and just like in the healthcare system, the failure of big corporations is costing money and lives. Today, we’re joined by Michael Paul Lindsey (who goes by Paul, or Railroad Refugee on Tiktok) a locomotive engineer for 17 years. Paul is a Steering Committee member of Railroad Workers United, a huge inter-union labor caucus of railroad workers from across the country that is fighting both for Medicare for All and for making our country’s railroads public. We’re going to talk about the parallels between these two fights, why railroad workers support Medicare for All, and why we think everyone who’s passionate about Medicare for All should also get excited about establishing public railways in this country! https://www.youtube.com/watch?v=qrNWHItT6iw Show Notes RWU has been a supporter of Medicare for All for some time because railroad workers have so much trouble keeping decent healthcare while the rail companies try to gut benefits and use healthcare as a bargaining tactic against workers. Like other corporations, railroads use the increasing cost of healthcare benefits to cut into the other pay and benefits earned by railroad workers. They consistently shift more of the cost onto the workers, while claiming the benefits are so rich they can't also provide workers with paid sick time or better time off benefits. Railroad workers, like so many other Americans, are locked into their jobs because they need the health insurance. In countries with a national health plan, workers have the basic economic freedom to leave their job if they don't like it, without worrying about healthcare. Those workers have better negotiating power because the employer can't hold healthcare over their heads. But in the U.S. railroad companies - and most large corporations - have more control over their employees because their families depend on employer-provided healthcare. Most Americans aren't very aware of railroads and commercial rail. But commercial rail is integral to the entire modern economy. A recent example in California illustrates rail's reach into our economy: Union Pacific wasn't delivering sufficient amounts of grain to Foster Farms, one of the largest chicken and turkey producers in the country. Foster Farms was days away from having to slaughter millions of chickens. Union Pacific blamed congestion, and shortages of locomotives and workers for the delays, while in fact they had cut their own resources relentlessly to buyback stock shares. Only after the Feds ordered Union Pacific to increase grain shipments was the problem resolved. So while many other industries depend on rail for their very existence, the railroad companies' focus on stock buybacks reduces their capacity to deliver goods, potentially wiping out entire industries. , reducing the capacity of railroads to deliver goods. Ultimately, taxpayers make up the difference because the cargo has to be delivered by trucks on the publicly subsidized highway system. It's important to know more about an industry with so much control over the economy. For most of American history railroads have been privately owned. However when there wasn't enough capacity to support the war effort during the First World War, the U.S. temporarily nationalized the railroads, investing heavily in upgrades at taxpayers' expense. That was all returned to private ownership after the war. Since the 1950s and 1960s railroads began to merge and consolidate, at the same time the U.S. government began investing in the competition, with subsidized interstate highways and airports.…

Medicare for All

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American Hospitals – Healthcare Villains? 37:26

il y a 2 years37:26

37:26

Virtually all Americans know that our healthcare system is broken and that it’s working against us. But who is the villain in this story? Who is responsible for maintaining this healthcare system, and using it to profit off of patients? If we had to round up the usual suspects in a lineup, we’d probably end up with health insurance companies and big pharma. But what about hospitals? Many people like the nurses and doctors who care for them, and associate hospitals with those care-givers. But are hospitals equally responsible for the crazy costs of health care, for our poor access to care, and for the medical debt that is like a ball & chain on our personal finances? A new documentary sets out to answer this question. It’s called “American Hospitals: Healing a Broken System,” and our guest today is Wendell Potter, who is associate producer on the film. https://www.youtube.com/live/6uLfGZE26lo Today's guest Wendell Potter is the former Vice President of Corporate Communications for the health insurance company Cigna. In 2008, he resigned, hung up his pitchfork for good, and became one of the industry’s most prominent whistleblowers, testifying against corrupt practices in HMOs before the U.S. Senate. Since then, he has become a prominent advocate for Medicare for All and universal health care. Gillian starts by noting that we usually ID health insurers and Big Pharma as the worst actors in our healthcare system, the "villains" behind our dysfunctional system. She asks Wendell, should we add hospitals to the list? Wendell says YES, hospitals are part of the rogue's gallery specifically because of price gouging - charging far more than they should, and more than hospitals in countries with Medicare for All are allowed to. Hospital prices bear no relationship to the cost or quality of the medical services they're providing, and many hospitals charge as much as they can get away with. They get away with it because they face much less scrutiny from employers, from Congress, the states, and even from advocates. How do they get away with this? Unlike insurers and pharma, hospitals are part of our communities, they develop one-on-one relationships with their legislators and non-profits in their area. Ben asks Wendell to tell us more about the principle crime hospitals are guilty of - price gouging - and how specifically does hospital pricing work? Hospitals charge whatever they can get away with, so even in the same zip code you'll find hospitals charging wildly different prices for the same service, like an MRI. Insurance companies have not been able to negotiate these prices down because some of these hospitals are so big they can't be left out of insurance plans, and in rural areas there might be only one hospital with absolute bargaining power. Moreover, insurance companies don't care that much about hospital costs - they're more than happy to pass those on to the rest of us in the form of higher premiums. If you have insurance, when you get a hospital bill you'll probably see an enormous $ number that represents the alleged "price" of the service you receive, then you'll see a very marked down price that your insurance actually paid, creating the impression that your insurer has negotiated a massive discount on your behalf, sometimes 60% lower or even more. If you DON'T have insurance you might get that massive bill without a discount. Wendell explains that these huge hospital list prices are completely fake. Hospitals know that these prices will be negotiated down, and almost no one will actually pay the list price, so the game is to set that number as high as they possibly can to let insurers look like they've won something. If you're uninsured you are in the worst position because you have very little bargaining power with a hospital, but even then most hospitals will reduce or even eliminate that price for uninsured people - particularly non-profits,…

Medicare for All

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Private Equity’s Path of Destruction in Health Care 49:17

il y a 2 years49:17

49:17

If you missed our annual Single Payer Strategy Conference, it's your lucky day. Today we share a conference presentation all about the impact of Private Equity on healthcare (spoiler alert: it's not good.) Our guests are Eagan Kemp, Health Care Policy Advocate at Public Citizen; Rachel Madley, Health Policy Advisor to Medicare for All Act chief author Representative Pramila Jayapal (D-WA 7); and Robert Seifert, Senior Fellow at Americans for Financial Reform. https://www.youtube.com/watch?v=y0w0pV8EvYE Show Notes Eagan talks about Public Citizen's recent report (with an emphasis on recent PE acquisitions and areas of concern, including end-of-life care, home health care, traveling nurses, reproductive care, and Medicare Privatization/ACO Reach) Robert Seifert on AFR’s recent work in the space (depending on whether you want to present on the broader topic of PE in health care, you could definitely go before or after me)Rachel (as I think folks will be most excited to hear from her and be most likely will stick around for it) on Rep. Jayapal’s Healthcare Ownership Transparency Act and any other PE stuff she wants to raise. https://www.citizen.org/news/action-on-predatory-private-equity-in-health-care-needed-stat-says-public-citizen/…

Medicare for All

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50 Shades of “No”: How to Respond to Your Legislator’s Excuses and Evasions

il y a 3 years

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When kids turn two or three years old, they learn to tell what is called a “primary lie,” which is lying without much sophistication or awareness of how the listener will perceive the lie (hint: you completely failed to fool your parents). But when we turn four, we learn to tell “secondary lies,” which take into account the listener’s likely reaction, and are more plausible. When we turn seven or eight we learn to tell “tertiary lies,” where we also make sure our lie is consistent with surrounding facts. But not until you’ve asked your legislator to support Medicare for All have you experienced the apex of deception: you walk out knowing they didn’t agree with you, but you’re not sure if they disagree with you, or whether you’ve learned anything about their position on the issue! So today we are here to talk about “legislative pushback,” or evasion, or avoidance - basically the whole playbook of tactics that legislators employ to land between “yes” and “no.” We are joined by Eagan Kemp and Vinay Krishnan today. Eagan is the Health Care Policy Advocate at Public Citizen. He is an expert in health care policy, including single-payer systems, and he previously served as a senior policy analyst at the U.S. Government Accountability Office. Vinay Krishnan is the National Field Organizer for the Center for Popular Democracy. We know him as an organizer, but he’s also a writer of fiction and non-fiction, and an attorney based in Brooklyn, NY. https://www.youtube.com/watch?v=N2-A6ubjVII Show Notes Medicare for All bills have not yet been introduced in the 118th Congress, the session that began in January 2023. Healthcare-NOW and our allies are starting our drive to gather co-sponsors BEFORE those bills are introduced. We expect the Medicare for All Act to be reintroduced before June in the House, and hopefully around the same time in the Senate. We aren’t as dumb as Fox News conservatives like to make us seem, so we know that there isn’t a great chance to pass M4A this session, but it’s important to keep the momentum going by getting new cosponsors on the bill. Our past success in gaining co-sponsors has been due in large part to citizen lobbyists asking, pressuring and demanding their elected officials sign on. If you've never called your Senator or member of Congress, we have a guide! https://www.healthcare-now.org/makethecall. Some calls will be easy if you're lucky enough to be represented by die-hards like Senator Bernie Sanders (I-VT) and Representative Pramila Jayapal (D-WA-7), the chief sponsors of the bills. But for many of the rest of us, our elected officials are wishy-washy, or even reluctant to sign on to M4A, so our guests give us some strategies for these conversations. Before we get into the objections, we want you to know you don't need to be a policy or health economics expert to talk to your elected officials. If you've been victimized by the American healthcare industry, you're an expert. While we've heard some wild reasons for not supporting M4A, most objections fall into a few basic categories: Downplaying the importance of co-sponsoring the bill "Medicare for All is just a slogan that's not going anywhere so I don't need to engage" "I'm not on a committee of jurisdiction so I can't co-sponsor" "I'm on a committee of jurisdictino so I can't co-sponsor" "I'm in leadership so I don't co-sponsor bills" Strategy: these answers tell you that the suffering of people in their district isn't important enough for them to take action. Help them understand why healthcare for all is so important for their constituents. Bring personal stories; stories can help break down initial barriers and make way for a real conversation. Next time bring even more people and more stories. "I support M4A but I won't co-sponsor" Strategy: consistent follow-up, so they continually feel the pressure. Allow them to ask questions and follow up with information.…

Medicare for All

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Would You Rather: the Healthcare Edition

il y a 3 years

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Back in 2008, the TV show Breaking Bad asked a question that is still on a lot of Americans’ minds: How far would you go to pay for medical care? In Breaking Bad, the main character ends up building a meth empire to pay for his cancer treatment, which is a solution we don’t necessarily endorse, but you do what you have to do. Today we’re going to be talking about real life (slightly less dramatic) examples of the lengths folks are forced to go to these days to navigate our for-profit healthcare system. From TikTok to Go Fund Me to class action lawsuits and appearances on the Dr. Phil show, ordinary people may not be selling meth, but they are turning to public platforms to get the care they need. We are joined today by Jill Parkinson, who recently went viral on TikTok talking about her own health care horror story and is channeling that experience into Medicare for All activism! https://www.youtube.com/watch?v=QS1dCAqcvb0 Show Notes Jill tells us her healthcare story, which begins with long-undiagnosed stomach pain since she was a teenager. In 2021 the pain got so bad that she went to urgent care. Diagnosed with endometriosis, Jill had two surgeries. She reports she did “everything right”: got marketplace insurance, paid her premiums, and paid the full amount of her deductible and out of pocket max of $7,500 upon checking into the hospital for surgery. Following the surgery, she needed to immediately begin taking a prescription to prevent more pain and surgery yet again. She faced an epic runaround with her insurance company, the specialty pharmacy, and the hospital. Once she sorted that out, she assumed insurance would cover the full cost of the prescription, because that's what insurance is supposed to do! Even though she had met her deductible, she ended up paying $1,500 out of pocket for the prescription, and still didn't get it on time. So Jill took to TikTok, and went viral within hours. https://www.tiktok.com/@jillfrance/video/7197882383864220974 The responses to Jill's video elicited lots of advice and comments: never pay up front or even pay at all. Use Mark Cuban’s Cost Plus Drugs. Getting drugs from Mexico or Canada. (Northwest Pharmacy Canada priced the same drug at $300.) People told me to get a lawyer or call state authorities. Go to the manufacturer’s website for a discount. (This drug was $1,600 and the max that the manufacturer will take off is $300, making it $1,300.) "It’s Obamcare’s fault” Ask for a grant. “Karen as hard as you can. Karen harder than you ever have Karened in your life!!” “Hang in there, medicare is freaking awesome.” “This is why I can’t quit my job. My insurance is too good.” “People with no money just don’t get surgeries. We just die and the world continues on.” “When I had my son (my 3rd c section) the registration woman told me that if I didn’t pay my copay before leaving, I wouldn’t get to take my son home.” Would you rather have a literal pain in the ass or have a pain in the ass lawsuit? Next our hosts and guest play Would You Rather: the Healthcare Edition. Ben tells the story of Christopher McNaughton, who finally found a treatment that changed his life–but insurance company decided he wasn't worth the cost. College student Christopher McNaughton was diagnosed with ulcerative colitis, a chronic inflammatory bowel disease that has no cure. His case was particularly severe, to the point where constant debilitating pain forced him to drop out of school. After years without relief, an unusual regimen of biologic drugs at high doses finally brought his disease under control. McNaughton was insured through UnitedHealthcare (regular listeners may recall how we feel about them…). The high cost of his treatment triggered an internal “review,” wherein United’s doctors claimed it was “not medically necessary.” A lawsuit filed by McNaughton’s family brought to light United’s relentless ...…

Medicare for All

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10 Years of M4A

il y a 3 years

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2013 was a big year -- we had just survived 2012 (the year the Mayans thought the world was going to end), we were all doing the Harlem Shake on Vine, and -- most importantly -- our regular co-host Ben Day became the Executive Director of Healthcare NOW, the nation's leading Medicare for All advocacy organization. In this episode, Gillian interviews Ben about the past decade in the movement for healthcare justice, revisiting the highs, the lows, and the weird in-between shit! Like a lot of folks, Ben Day began his journey to Medicare for All activism as a patient. He was a graduate student in Labor Studies in his 20s when he developed a panic disorder that put him in the hospital and racked up his medical bills. He was so outraged by the experience of getting hung out to dry by the for-profit healthcare system that he decided to change course and spend his life fighting to bring down the system! Back in 2006, when Ben started as an organizer with Mass-Care, the Massachusetts campaign for Single-Payer Healthcare (This was before the term Medicare for All was commonplace in public discourse.), Massachusetts had just passed "Romneycare," a package of healthcare reform laws that became the model for the Affordable Care Act ("Obamacare"), so Ben got a preview of how trying to reform the system without eliminating the private insurance companies can go VERY wrong, resulting in limited networks and other industry tricks to keep profits high. Of course, even with that insight into how reform unfolded in Massachusetts, Ben and other single-payer healthcare activists were marginalized and dismissed as naive radicals throughout the years of debate leading up to the 2010 Affordable Care Act, as moderate Democrats consolidated their efforts into demanding the policy non-solution that refuses to die: the public option. That ended badly both for advocates of the public option and advocates of Medicare for All, who lost out in the final version of the bill, but it was a positive development for private insurers, who now had millions of new customers lining up at their doors! By the time Ben came to work for Healthcare NOW in 2013, the whole country was mired in the backlash from right wing Republicans fighting tooth-and-nail to "repeal and replace" the Affordable Care Act, which had become a political symbol of the Obama administration. Ben explains that this was a turning point for the healthcare justice movement, as regular people who hadn't been involved with politics before stood up at town halls and listening sessions across the country, not just to defend the ACA, but to push legislators further and demand Medicare for All. Since then, we've seen massive growth in support for Medicare for All, and thanks in-part to Bernie Sanders, Medicare for All has been the top issue in the past two presidential elections, and Healthcare NOW is working with thousands of activists throughout the US to make Medicare for All a reality in our lifetimes. Ben speculates that even though we still have a fight on our hands to win, there are enough of us now that we won't be marginalized or dismissed in the debate about healthcare ever again! Want to help us celebrate Ben's 10-year anniversary and make sure we get Medicare for All in a timely fashion so he doesn't have to do this job for another 10 years? Make a donation to Healthcare NOW today!…

Medicare for All

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This Little Pandemic Went to Market 27:01

il y a 3 years27:01

27:01

Starting on May 11, President Biden is ENDING the emergency COVID-19 regulations that have been in place since the start of the pandemic in January 2020. These regulations created (almost) a Medicare for All-type public funding system for vaccines, testing, and COVID-related care. While the pandemic itself is still raging, the end of the official Public Health Emergency (PHE) means that access to COVID prevention and care will become like any other form of care in the U.S.: whatever you can get through the private market. That means prices going up, highly inequitable access, and millions of us falling through the cracks. In addition, the public health emergency added crucially important protections for Medicaid enrollees, millions of whom will start getting kicked off their insurance in April. Brace yourself for a major healthcare catastrophe a couple of months from now. https://www.youtube.com/watch?v=h4yyY_YbOCw Show Notes The COVID-19 pandemic is still happening According to CDC: Still an Average of 40,404 new cases per week (and these numbers are surely an undercount considering how few cases are actually reported to a public health agency.) Still an average of 3,665 hospital admissions per week Still an average of 453 deaths per day Still a lot worse than flu! Among the 2,398 Pneumonia, Influenza, and Covid deaths reported for this week, 998 had COVID-19 listed as an underlying or contributing cause of death on the death certificate, and 50 listed influenza. According to William Hanage, epidemiology professor from Harvard: “It’s beyond question that society has moved into a stage where the pandemic is for most of us if not over then certainly quiet. And that’s a great thing. Long may it remain so. Is it the case that there is no preventable suffering? No. There is still preventable suffering and death.” Why end the Public Health Emergency when the virus is still raging? We all wish COVID-19 would go away. President Joe Biden’s announcement Monday January 30th that his administration would end the PHE along with a separate COVID-19 national emergency in May, winding down services and supports. The Public Health Emergency has been really inconvenient for Republicans, so they voted for a bill in the House to end the PHE immediately. With either approach, the gradual wind-down or the abrupt end, there is no way to legislate ending the pandemic. Germs don't care about politics. What's really ending is the public health safety net for preventing and treating COVID. What were the emergency regulations, and what are the real-life consequences of ending them a few months from now? Let’s start with the single most important thing that’s going to happen: an estimated 15 million people are going to get kicked off of Medicaid starting in April. That’s about 4.5% of the entire population of the United States. When COVID struck, the federal government essentially banned states from kicking people off of Medicaid. People get churned off of Medicaid shockingly frequently - maybe because you started earning just a little too much money, or you moved and your re-determination paperwork went to your old address, or a million other reasons. This mostly stopped during the pandemic, and Medicaid’s enrollment rose - the federal government also provided increased funding to states to pay for the increased enrollment. The next regulation that’s ending has to do with our old friend, Medicare Advantage plans. We’ve talked a lot about how privatized, for-profit Medicare Advantage plans have extremely limited networks, making it hard to get the care you need without having to travel ridiculous distances. During the COVID emergency Advantage plans were required to cover COVID-related treatments at ALL providers as in-network care. That’s going to end starting in May, and if you see the wrong provider for COVID care, you could get slammed with a huge bill. What about COVID tests?…

Medicare for All

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Give Me Healthcare or Give Me Debt! 35:47

il y a 3 years35:47

35:47

Our guest today is Rebecca Wood. Rebecca lived all over Virginia before her relocation to Massachusetts. Rebecca worked with many organizations and offices on Capitol Hill. Her healthcare work includes rallies, protests, press conferences, and conventions. Most notable, she told her and daughter Charlie’s story at the introduction of Senator Sanders’ Medicare For All Act of 2017 and testified before the House Ways and Means Committee hearing on Pathways to Universal Coverage in June 2019 (Rebecca's statement begins about at about 18:10). Rebecca also regularly volunteers for Remote Area Medical, which provides access to healthcare for underserved communities and is active in the push for universal school meals. https://www.youtube.com/watch?v=WK1XiF5Rco4 Show Notes CW: Medical and dental trauma We don’t usually start our podcasts with data or statistics, but last week Gallup released a shocking poll that clearly reflects a new reality for the country: 38 percent of Americans now say they put off medical treatment because of the cost sometime in the past year (2021). This is a HUGE leap over just a year ago, when only 26 percent of Americans were putting off care. Gallup has been conducting this poll for over 20 years, and this is the worst we have ever seen. Even more troubling, 26 percent say they put off treatment for “very serious” conditions or “somewhat serious” conditions, and THAT is another huge leap over just a year ago, when “only” 18 percent of Americans were putting off care for very serious or somewhat serious issues. We’re now three years into the pandemic, and employment rates have improved. So what the fuck is going on here that our access to healthcare is now worse than during the height of the pandemic when the economy was shut down and there were no vaccines?!? Rebecca tells a story that illustrates how delayed care hurts American families. Ten years ago her daughter Charlie was born prematurely due to Rebecca's severe early onset pre-ecclampsia, a potentially deadly condition for both mom and baby. Charlie was in the Neonatal ICU for three months. Their family had "good insurance" through Rebecca's then-husband's employer. Over the next several years, like many micro-premies Charlie needed enormous amounts of care. They faced automatic denials, outrageous deductibles and huge copays from their insurance company. Due to the high out of pocket costs for Charlie's care, they went from being financially comfortable, to going through their savings, putting off their plan to buy a home, and living paycheck to paycheck. Even worse, Rebecca had to make choices between paying for her daughter's healthcare and her own. Like so many American parents, Rebecca put Charlie's needs first, sometimes rationing her own medications and eventually putting off an important dental procedure. That delayed dental procedure led to an infection that spread to her entire mouth and jaw, forcing her to the emergency room. Doctors feared the swelling could cut off her airway. After days in the hospital, Rebecca followed up with her dentist, where she had to have all of her teeth pulled and parts of her jaw scraped away. In 2017 when the Affordable Care Act came under attack, Rebecca feared repeal would make Charlie uninsurable due to preexisting conditions. So Rebecca became a vocal activist. She used her family's experience to call out the profound policy failure that has caused so many American families to suffer. The new Gallup Poll found: “In 2022, Americans with an annual household income under $40,000 were nearly twice as likely as those with an income of $100,000 or more to say someone in their family delayed medical care for a serious condition (34% vs. 18%, respectively). Those with an income between $40,000 and less than $100,000 were similar to those in the lowest income group when it comes to postponing care, with 29% doing so. Reports of putting off care for a serious condition...…

Medicare for All

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Digital Healthcare Dystopia 29:32

il y a 3 years29:32