Health Reform Timeline


Overview of current issues, what’s right and what’s wrong with current law and some very important reference links

H. R. 1384, S. 1129 - Current Single Payer bills in Congress.

Setting the Record Straight on Medicare’s Overhead Costs

Health Over Profit

OECD Health Data 2017 - We spend 2.5 times as much per capita as the average of all OECD per capita spending and 40% more than the next most expensive country.

HealthCare-NOW: Legislative Pushback Guide - Why Improved Medicare for All (S. 1804, H.R. 676) will lead to a net increase of jobs and how the placement and re-training of workers laid off from insurance companies is covered in both bill.

PNHP: What is Single Payer?

PNHP: The Facts On How Much Single Payer Would Cost

PNHP: The Conservative Case for Single Payer

National Nurses United: Nurses Campaign to Heal America

Business For Medicare For All

PNHP: The Public Option Won’t Fix Our System - ...and why.


Children’s Defense Fund: The State of America’s Children 2020 - “One in six children in America (12 million) lives in poverty, with income inequality having grown to the widest gap our nation has seen in 50 years. Millions of children are homeless and millions more are just one missed paycheck away from losing their homes. Far too many children lack access to quality early childhood care during the most critical years of brain development. For the first time in a decade, the number of children without health coverage is on the rise. And across the country, from urban centers to rural towns, our nation’s gun violence epidemic is killing more children, more often.”

Also according to the study, about 1.4 million children experience homelessness in a given year, double the number before the 2008 recession, and 500,000+ are homeless on any given night.

About 428,000 children are in foster care on any given day, and that number has risen every year for the past 4 years. About 11 million children in America go to bed hungry every night.

John P. Geyman, MD: Long-Term Care in America: The Crisis All of Us Will Face In Our Lifetimes


Guardian: Health Experts: US Underprepared for Coronavirus Due to Trump Cuts


Health Affairs: Why Medicare Advantage Plans Are Being Overpaid by $200 Billion and What to Do About It


Vox: In the UK’s Health System, Rationing Isn’t a Dirty Word


Annals of Internal Medicine: American College of Physicians (ACP): Envisioning a Better US Health Care System for All - This is a very long article, but it marks another milestone in the fight for Single-Payer. This is because the ACP, which represents doctors more closely than the AMA, has officially endorsed Single-Payer as one of two ways to achieve universal coverage for a reasonable cost. The other one of the two is a public option, but here’s why that won’t accomplish those goals. The ACP is the largest organization dedicated specifically to patient care, while the AMA has become mostly a lobbying group and a physicians’ guild.


Jacobin: The Labor Movement Should Be Fighting for Medicare-For-All, Not Expensive, Limited Employer-Based Plans


Public Library of Science: Projected Costs of Single-Payer Financing - Simplified billing, negotiated drug pricing, and global budgets for hospitals (just like police and fire departments) are the main drivers of the $500 billion yearly savings.


Truth or Fiction?: 500,000 Will Go Bankrupt This Year From Medical Bills? True


American Prospect: What Medicare for All Really Looks Like - Canadian Medicare is way better than the corporate-greedy system in the USA, but it does have its faults. The Single-Payer outlined at Physicians for a National Healthplan and the Bernie Sanders plan covers those errors. “The Canadian system is good, but underfunded,” says Steffie Woolhandler. “The American system is shitty but over-funded.”


Annals of Internal Medicine: Health Care Administrative Costs in the United States and Canada, 2017 - From this article: Health care paperwork cost US $817 Billion in 2017, 4 times more than Canada. A Single-Payer system would have saved the US over $600 Billion in overhead alone. Overhead costs of doctors, hospitals, long-term care and health insurance were 34.7%, or over 1/3.

Excluding Medicare Advantage, Medicare overhead is less than 2%.

Washington Post: American Families Are Required to Pay the Equivalent of an $8,000 Health Care Poll Tax


Sun Port Charlotte: Is Medicare For All a Good Idea? - The best, short summarization ever of why it is.


NYTimes: In the US, an Angioplasty Costs $32,000, Elsewhere? Maybe $6,400


NYTimes: Crisis Looms in Antibiotics As Drug Makers Go Bankrupt - As previously noted here, some drug-resistant bugs can alter their own DNA on the fly, and Here, to resist all currently known antibiotics. Back in 2012 the FDA lifted all limits on the use of tetracycline and penicillin in livestock. It’s clear that the use of antibiotics in livestock feed is fueling the increasing resistance of superbugs that attack humans, however the FDA has its hands tied when attempting to tighten restrictions. The statistics on the increase in the number of Americans who die yearly as a result of antibiotic-resistant strains of bacteria and how we are falling behind in addressing this issue is very scary, not only on livestock farms, but also in fish.


National Bureau of Economic Research: Medicaid Expansion and the Unemployed - The exact opposite finding of what neo-liberal, austerity promoting politicians would have you believe.


CA Medical Assoc: Looming Anthem/Cottage Termination Could Have Negative Impact on Patient Access in Santa Barbara Area - Hospital corporations and insurance corporations fight it out while sick people suffer. Wouldn’t happen with M4A.

Democracy-NOW: “The First Cell”: Dr. Azra Raza on Why the ‘Slash-Poison-Burn’ Approach to Cancer Has Failed


PNHP: CBO Report on Distribution of Household Income 2016 - 2021


Wendell Potter: The Current System Has Choices?


Otherwords: Who’s Afraid of Medicare for All? - “If the Democratic Party won’t stand up for the transformative structural changes that America’s middle and low-income majority clearly wants and needs, why would those people stand up for Democrats?”


The Hill: ‘Medicare for All’ Backers Notch Win With High-Profile Hearing


Health Affairs: Medicare For All Would Improve Hospital Financing - A fact based article refuting the voices that claim that 100’s of hospitals would close under M4A. The secret is ‘global financing’ like the way the fire and police departments works, and eliminating the bureaucracy in the hospitals dedicated to filing claims against dozens of private payers.


PNHP.ORG: National Healthcare Spending; But What’s the Real Story? and CMS Office of Actuary - US healthcare spending rose 4.6% in 2018, to $3.6 Trillion, 17.7% of GNP - $11,172 per person - almost 20% of median household income. About 30 million Americans remain without any coverage at all and that number is also expected to increase over time. We’re the only OECD country without some form of government subsidized universal healthcare. Under current law it will reach $6 Trillion by 2027. And for this what do we get? Per OECD Health Data - out of the 44 ‘first world countries’, the US ranks 28th in life expectancy and 33rd in child mortality. We are first in cost of health care dollars per capita, as a percent of GNP, and in absolute dollars. Disgraceful.


PNHP: The Public Option Won’t Fix Our System - ...and why.


JAMA: Life Expectancy and Mortality Rates in the US, 1959 - 2017 - The corporate run healthcare system is failing us. US life expectancy has steadily decreased since 2014, unlike every other advanced country. Cause? mainly citizen inaction.

Boston Globe: Bucking Industry Line, Some Hospital Chiefs See Benefits of Medicare for All


Politico: “There’s a Fear Factor, A Fear of Change”


Commonwealth Fund: Trends in Employer Health Care Coverage 2008-2018: Higher Costs for Workers and Their Families - The title says it all. Despite ACA, the cost for medical coverage continues a steep upward trajectory, and “has outpaced the average growth in median income over the period studied.” Under “policy implications” are listed several add-ons, and kludges such as expanding ACA (how?), or adding a public option. Then buried in the last paragraph: “Others have suggested eliminating all private insurance and replacing it with a public plan like Medicare...”

How sad that Commonwealth Fund essentially dismisses this approach by treating it as an unattainable aspiration, when all that’s needed is the political will to get it done.

This whole-corporate driven system, aka capitalism, needs some serious disruption.


Common Dreams: Democratic Naysayers Are Wrong on Medicare for All

Reuters: 3 Separate Polls Reveal Majority of Americans Want Medicare for All - Kaiser: 53%, Progressive Change: 66%. However, corporate lobbying has been successful at confusing a large chunk of America that they would be better off with the ‘known’ (ever increasing premiums, deductibles, co-pays, out of network costs, unaffordable life-saving drugs), than the ‘unknown’ Medicare for All.


Robert Reich: The Real Deal With Medicare For All

Journal of General Internal Medicine: The Effect of Large-Scale Health Coverage Expansions In Wealthy Nations on Society-Wide Healthcare Utilization - “This important study looked at 13 large coverage expansions in 11 nations and found that, by and large, utilization increases were fairly negligible, thus increases in costs and rationing were also negligible. The change that did seem to occur was that there was a limited redistribution of care from low-value care for the healthy and wealthy to essential care for the sick and poor - an actual improvement in health care delivery.”


Critics of M4A like to trot out their groundless canards that if it comes about doctors and hospitals will be swamped and sick people will be forced to wait unreasonable times to receive healthcare. This study uses empirical evidence to show that would not happen.


Washington Post: Elizabeth Warren Is No Longer a Medicare-For-All Purist - She’s back peddling. She’s never had any intention of doing it.

FTI Consulting: Assessing the Impact of a Public Option - FTI is “an alliance of American hospital, insurance and pharmaceutical lobbyists,” so it’s clear what their intentions are. It’s amusing because they arrive at the conclusion that a Public Option would put them at a competitive disadvantage. And yet these are the same neo-cons that are always telling us that more competition is good because it drives out inefficient producers and reduces costs for the consumer.

But the report was not written for the public. It was written as a call for action, for distribution to their member corporations. So look for more ‘public service’ spots telling us how bad the Public Option would be for the consumer. Just more corporate lies.


Center for Economic and Policy Research: Energy and Health Insurance Drive Inflation Higher - Health insurance overhead was up over 20% in 2019. Insurers fuel the increase with their insatiable need for profit, executive level compensation and advertising. Medicare for All would save the US at least $500 Billion per year.

Fierce Healthcare: Blues Plans to Launch “High-Performance” Networks in 2021 - By “High-Performance,” what they really mean is a very narrow in-network set of providers, from whom they can extract the lowest possible costs. It reduces both choice and competition. Result: Higher profits for the Blues, more cost and foregone healthcare for the patients. Again, a more fragmented and dysfunctional healthcare system. It doesn’t have to be that way.


Gallup: Millions in US Lost Someone Who Couldn’t Afford Treatment - 34+ million. We know the simple solution. Do we just walk away?


NYTimes: With Medical Bills Skyrocketing, More Hospitals are Suing For Payment - Typically against poor patients who thought they had health insurance.


Intercept: Joe Biden Campaign Pointing Reporters to Larry Summers For Comment on Elizabeth Warren’s Health Care Plan - American politics has become just a straight up over-dramatized Kabuki Play. The players all change rolls depending on the season, but the end results never change.

Although cheeto-head has added more lobbyists and insider alligators to the swamp than probably any president in history, Obama certainly did his share as well. And now they live on as the neo-liberal wing of the party.

Examples: Kathleen Sebelius Sec. of HHS, now employed as a board member of Devoted Health, a firm specifically created to sell Medicare Advantage plans. Here’s why that program is a neo-liberal’s dream and, Here, Here, Here, Here, Here, Here, Here, Here, Here, and Here. Former Biotech Governor of the Year Tom Vilsack: Sec. of Agriculture. Monsanto provided the jet that Vilsack used to travel the state of Iowa during his gubernatorial campaign. Former Monsanto VP and lobbyist Michael R. Taylor appointed to Food Safety Czar at FDA. Former Citigroup exec. Sec. of Treasury Jack Lew. Penney Pritzker Sec. of Commerce, heir to Hyatt fortune, anti-union, illegal-alien-exploiting, former part owner of Superior Bank, which crashed leaving 1,400 people without their life savings but making her rich.  Keystone XL and fracking promoting Ernest Moniz Sec. of Energy. Charter school and education privatization promoter Arne Duncan Sec. of Education. The appointment of Jeffrey Immelt, Chairman of GE - the biggest exporter of jobs overseas. GE makes about $5 Billion/year, pays no taxes, got a $16.1 Billion government bailout, and is sitting on about $80 billion in cash - to head Obama’s Jobs Creation Commission (Immelt must have gotten confused on which country he was supposed to create jobs in). This is not to mention Robert Rubin proteges Geithner, Larry Summers, etc., all pro austerity and willing servants of corporations.

Prior to her run as the Bernie Sanders-mimic, Elizabeth Warren extravagantly praised all of these Obama appointments on her senate web site. All that has been removed now of course. Now that she has been chosen by the DNC to syphon votes from Sanders, she has to play a brand new role, and these appointees are now portrayed as her political opponents. Naturally,  as soon as the Dem convention is over, and her job of diluting the influence of, and then killing off the progressive wing of the party is complete, she will join the fold and take more “realistic” positions. Soon thereafter, her political career will take off and she’ll go right to the top of the party - after another 4 years of cheeto-head.


JAMA: History Suggests Most Physicians Likely to Remain as Participants in Medicare

Harvard School of Public Health: Americans’ Values and Beliefs About National Health Insurance Reform - PNHP response: “What is interesting is that those opposed to a greater government role nevertheless do support health care justice in that they agree that health care should be a right regardless of ability to pay, that all Americans be treated equally in terms of the health care that they receive, that poor American families receive the same quality of health care as rich American families, and that African Americans receive the same quality of health care as white Americans.”

However, many people are so averse to change, that they would rather hang on to the current dysfunctional, grossly inefficient corporate delivery model they know, and then try to kludge onto it yet another dysfunctional fix. Are people really that stupid? Sadly, the results speak for themselves.


Guardian: Make No Mistake: Medicare for All Would Cut Taxes For Most Americans - Synopsis: It would also lead to the biggest take-home pay raise in a generation for most workers. Health insurance premiums, deductibles, co-pays are essentially taxes paid to health insurance corporations. They reduce wages, are mandatory or quasi-mandatory - required by the ACA and employers with over 50 employees are required to enroll their workers in a health insurance plan.

Unlike food and clothes, there are no cheap ways to treat a heart attack, give birth or handle emergency or any medical need. Unlike haircuts or restaurant meals, everybody needs health care regardless of budget, and it’s not cheap. That’s why every advanced country except the US funds health care via taxes, determined by ability to pay. Insurance premiums are the most regressive type of tax possible, and since we know that in the US, the working class - the 50% of Americans with the lowest incomes - pay higher tax rates than the billionaires. Those billionaires should be the first place we look to help finance Improved Medicare for All.


CounterPunch: The PR Campaign to Hide the Real Cause of Those Sky-High Surprise Medical Bills - Another problem that Improved Medicare for All would solve. Wall Street again. If we give them long enough, they will soon find a way to charge for the air we breath.


PNHP: The Urban Institute’s Single Payer Cost Estimate: False Assumptions, False Conclusions


ProPublica: When Medical Debt Collectors Decide Who Gets Arrested


NYTimes: This is the Most Realistic Path to Medicare for All - Synopsis: Private health insurance is failing. Why? It is not reasonably priced, and administrative costs absorb 20% of each premium dollar, which forces more costs onto increasingly frustrated customers, while insurance companies do everything they can to avoid paying claims. Denial of in-network claims runs about 18% across the board, with some insurers denying 30%. With longer living patients, comes increases in chronic conditions, and thus ever increasing costs. No business model can withstand these pressures over the long run. The only solution: Pooling and financing at the broadest level, aka Single Payer Medicare for All.

About the author.


Universal Health Reform: Congressional Budget Office Report on Single Payer: A Good Start


Houston Chronicle: United Healthcare Takes Choice of Hospital Away From 100,000 Plan Members - This affects plan members enrolled in employer-sponsored plans and Medicare Advantage. These members will lose access to 8 hospitals and 800 physicians. So much for those who say the private market can provide more choices. United is reducing choices of hospitals, physicians, and benefit plans.

Axios: Health Care’s Fraud and Abuse Laws Are Getting Overhauled...and not for the better.


The Nation: The ‘Public Option’ on Health Care is a Poison Pill - ‘Incrementally’ achieving Medicare For All is not possible. This article explains why.


Health Affairs: Lower Drug Costs Now

Presidential Proclamation: Suspension of Entry of Immigrants Who Cannot Afford Health Care - Trump and the complicit Republican Congress want to make sure that immigrants have health care, but waived the requirement for that very thing from ACA. Far more Americans cannot afford health care, about 30 million, than immigrants. It’s another problem that Medicare for All would solve.


Public Citizen: By Increasing Corporate Power Over Medicare, Trump Threatens Health Care for Seniors and Americans With Disabilities


National Bureau of Economic Research: Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes? - “This study provides the first evidence to our knowledge that near-universal access to Medicare at age 65 is associated with improvements in population-level cancer mortality, and provides new evidence on the differences in the impact of health insurance by gender.”


Kaiser Family Foundation: 2019 Employer Health Benefits Survey - To hear the media tell it, this is Americans’ favorite type of health care. Findings: Premiums have risen at over twice the rate of inflation. That great insurance that the media keeps telling us we want to keep has also failed to provide adequate financial protection for low- and middle-income families, and isn't even offered to 43 percent of the workforce.

California Health Care Foundation: A Closer Look at Medi-Cal Managed Care - In 2009 when Obamacare was first passed, private for-profit managed care was all the rage. ‘Let the free market take over and obtain efficiencies, higher quality of care and lower overall costs.’ was the mantra of the day. California led the way. Now that we have 10 years of data on these plans what are the results? Basically none of that is true.

  1. -"Among 41 quality measures collected in two or more years, more than half (59%) remained unchanged or declined."

  2. -“Quality was stagnant at best on most measures.”

  3. -"Six of the nine quality measures currently in use that are related to children declined or stayed the same."

  4. -"Medi-Cal enrollees’ rating of their experiences with their MCP were consistently below the 50th percentile nationally."

- “By ownership, most striking was the substantially lower quality scores of the for-profit MCPs, on average, relative to the nonprofit and public MCPs."

- "Counties that rely on a single public MCP (County Organized Health Systems) had on average better quality scores than counties that furnish Medi-Cal services through either a Two-Plan or competing commercial model."

- “We can conclude that for-profit, commercial Medicaid managed care plans often provide lower quality care, and levels of patient satisfaction are low.

PNHP: “More importantly, counties that rely on a single public managed care plan (County Organized Health Systems) have better quality scores than counties that rely on competing health plans, belying the claim that health plan competition improves quality. This should speak well for the single payer model of Medicare for All.”


NYTimes: Does Anyone Really “Love” Their Private Health Insurance? - “I am alive today not because of insurance companies but despite them.”


People’s Poverty Project: Medicare for All Would Cut Poverty by Over 20%


Guardian: For Rural America, Medicare For All Is A Matter of Life or Death - “Insurance firms are gobbling up airtime in Iowa to attack Medicare for All. They claim it would hurt the very same hospitals their business model has spent years bleeding dry.”


Democratic Underground: Medical Bankruptcy is An American Scandal - And That’s Not Debatable


The Hill: Medicare Advantage For All - This is the dream of most right-wing conservatives, which includes Democrats like Biden, K. Harris, and Buttigieg. It’s tempting with out-of-pocket costs very low, but that’s the idea. Get the majority signed up, drain the life out of traditional Medicare and then stick it to everybody.


National Bureau of Economic Research: Impact of Rural and Urban Hospital Closures on Inpatient Mortality - Conclusion: When hospitals close, people die. Wouldn’t happen with Improved Medicare For All.


Guardian: High Turnover, Understaffing, Low Pay: US Nurses Fight to Unionize


Politico: AMA Drops Out of Industry Coalition Opposed to Medicare Expansion - The sole purpose of this group was to fight Medicare For All. Young doctors are beginning to flex their muscle, and Here. With the loss of the AMA, this industry group is now running out of steam. It is only a matter of time, and Here.


NYTimes: Why Doesn’t the United States Have Universal Health Care? The Answer Has Everything to Do With Race. - “There has never been any period in American history where the health of blacks was equal to that of whites,” Evelynn Hammonds, a historian of science at Harvard University, says. “Disparity is built into the system.” Medicare, Medicaid and the Affordable Care Act have helped shrink those disparities. But no federal health policy yet has eradicated them.” There is one that would.


JAMA: Assessment of Out-of-Network Billing For Privately Insured Patients Receiving Care in In-Network Hospitals - Surprise!! You think you are insured when you go to an in-network physician who treats you in an in-network hospital. Then you get the bill. This is even worse for insured patients who have to go to an ER, but can’t find or don’t have time to go to an in-network hospital. Even if your policy says you are covered in such a situation, you aren’t if an out-of-network doctor drops by your room to take a quick peak. This study shows the trend is getting much worse. This wouldn’t happen with Single Payer.


The Hill: Elderly Couple in Apparent Murder-Suicide Indicated They Could Not Afford Medical Care - This is becoming all too common in America.


Business Insider: 59% of Americans With Employer-Based Health Care Support Moving to Medicare For All -  This directly refutes a popular right-wing canard. We also know from recent polls that 60% of American voters in general want Medicare For All: Pew Research 1/17, Gallup 5/16, and The Economist 4/17 (item 81).


Splinter News: We Will Win Health Justice in America


Kaiser Family Foundation: Financial Performance of Medicare Advantage, Individual, and Group Health Insurance Markets - This and the American Prospect articles just below are closely related. The short AP article succinctly explains how Medicare Advantage plans deny coverage - limit their marketing to younger, healthier populations, and intensely manage their HMO-like therapy strategies. This article shows just how financially successful Medicare Advantage plans are for insurance companies. Their return is about double that of the other types of health plans. Politicians such as Harris, who promote Medicare Advantage, aka ‘medicare buy in’ or ‘public option’ as a way to reach “Medicare for All” are working for insurance companies, not the people.


American Prospect: Kamala Harris’ Fake Medicare-For-All Plan - Medicare Advantage is an intensely managed HMO. It is marketed mainly to younger, healthier retirees. In both ways MA makes its profits by denying care. Harris’ plan would simply expand that private system.


Healthcare-NOW: The Politics of Race and Medicare For All - This 5 min. video explains why the USA is the only 1st world country (or is it really?) without some form of government subsidized universal health care.

National Bureau of Economic Research: The Opportunities and Limitations of Monopsony Power in Healthcare: Evidence from United States and Canada - Using its monopsony power, Canada has forced the cost of drugs down to 54% of what they cost in the US. In the US we hear that forcing big pharma to accept lower prices would stop innovation of new drugs. But the fact is that US pharma corporations spend twice as much on advertising than on R&D, and twice as much on executive salaries than on R&D, and receive 3 times, or 300% of the R&D costs back in revenues over the life of the drug.


NYTimes: How a Medicare Buy-in or Public Option Could Threaten Obamacare - Why are politicians apparently bending over backwards to preserve Obamacare?

It turns out that what seems like a simple desire: ‘Allow people to keep what they have or buy-in to Public Option/Medicare for All’ becomes very complicated when all of the details are considered.

Why do politicians want to preserve the gross inefficiencies of private insurance companies (15-20% overhead vs. 2% overhead with Medicare), the limited in-network choices, the high and rapidly rising premiums and deductibles, and limited availability of Obamacare?

All of these complications go away with Medicare-For-All, and it’s about $500 Billion less expensive per year, and Here. Even a recent Koch-funded study found that it would save at least $200 Billion.


The Hill: Medicare for All: A Voter’s Cheat Sheet


Kaiser Health News: Medicare Advantage Plans Rip-Off  Tax-Payers by the Billions


Current Affairs: Why a “Public Option” Isn’t Enough


JAMA: Association Between Care Management and Outcomes Among Patients With Complex Needs in Medicare Accountable Care Organizations - Benefits of ACO management: zero. And yet the medical community can’t seem to stop trying them and studying them. Why are there no studies or modeling of the benefits of Medicare for All?


St. Louis Post-Dispatch: Think Twice When You Hear the Words ‘Public Option’ - A great, short article that encapsulates the entire case for Single Payer.


NYTimes: Some Democrats Talk About Cosmetic Surgery Insurance. It Doesn’t Exist. - When they say that, they are trying to ride the fence. They are trying to sound like they are in favor of Single Payer, but won’t come out and say that private insurance will go away when Single Payer comes online.


Critical Care Medicine: Health Insurance and Out-of-Pocket Costs in the Last Year of Life Among Decedents Utilizing ICU - What this study found is that our current method of paying for this segment of health care takes very good care of insurance companies and hospitals, but ruins patients financially. So why are politicians so anxious to keep it? Medicare For All would fix this.


ProPublica: The Nonprofit Hospital That Makes Millions, Owns a Collection Agency and Relentlessly Sues the Poor - “The only thing that kept me levelheaded was praying and asking God to help me,” she said. Praying to God to protect her from The Methodist Church.


NPR: When Hospitals Sue for Unpaid Bills, It Can Be Ruinous For Patients


US House Ways & Means Committee: Former Head of CMS Testifies in Favor of Medicare For All


Modern Healthcare: AMA Narrowly Defeats Single-Payer Healthcare - 53% - 47% is not a defeat. Given where we started in 2009, when the AMA was practically unanimous in its denial of single-payer, and when Single-Payer and Medicare For All were essentially unknown to almost everyone, this is a huge victory. The youngest doctors and medical students are now almost unanimous in their advocacy. What is really becoming clear: It’s only a matter of time.

Intercept: Ways and Means Committee Chair Doesn’t Want Medicare For All Hearing to Mention “Medicare For All” - Wait what?


John Geyman, MD: Struggling and Dying Under Trumpcare: How We Can Fix This Fiasco

Guardian: Nurses, Doctors, Med Students: Why We’re Fighting the American Medical Association


Axios: Voters Are Tuning Out the Health Care Debates - Points that voters need to focus on:

With Medicare-for-All/Single Payer...

  1. -Never have to change insurers, ever.

  2. -Free choice always of doctors and hospitals

  3. -No medical bills since care is prepaid through a highly progressive tax structure

  4. -Any increase in taxes is more than offset by the elimination of premiums, deductibles, conditions not covered, pre-existing conditions

  5. -Coverage doesn’t change if you change jobs

Neither Republican nor Democrat health reform proposals are consistent with the above.


JAMA: Single-Payer Reform - “Medicare for All” - an explanation


The Week: How Socialist Health Care Saves Lives


Forbes: Doctors to Test AMA’s Opposition to Medicare for All


AP: Medicare-For-All’s Rich Benefits Leapfrog Other Nations


Modern Healthcare: Health Inflation is Now In Insurance Rather Than Healthcare


NYTimes: ‘Medicare For All’ Could Kill 2 Million Jobs. And That’s OK  - In a nutshell, part of the plan is to retrain those affected.


LATimes: Health Insurance Deductibles Soar, Leaving Americans With Unaffordable Bills - “One in six Americans who get insurance through their jobs say they’ve had to make “difficult sacrifices” to pay for healthcare in the last year, including cutting back on food, moving in with friends or family, or taking extra jobs. And one in five say healthcare costs have eaten up all or most of their savings.”


Guardian: Ady Barkan, Activist Dying of ALS, Gives Impassioned Testimony at Medicare-for-All Hearing

Journal of General Internal Medicine: Prevalence and Correlates of Medical Financial Hardship in the USA - “137 million adults face medical financial hardship.”


NYTimes: Universal Health Care Might Cost You Less Than You Think - This is a must read. If you think of your (and your employer’s) health care premiums, deductibles, co-pays, conditions not covered, out-of-network, etc. costs as a form of tax, it then becomes clear the question is not ‘How are we going to pay for it?’ but ‘What will we do with the money we save?’

Fair: Corporate Media Are Here to Warn You: Medicare For All is a Very Bad Idea - Great article. It clearly explains why, as Single Payer gains is popularity, corporate owned media has recently increased its gloom-and-doom reporting on the subject. It’s because they are “owned by investors with stakes in highly profitable medical and pharmaceutical companies—the very same companies that supply them with millions of dollars each year in advertising. This system of interlocking and conflicting interests is rarely acknowledged by corporate media, who also rely on medical and pharmaceutical companies for funding through advertising and patronage.”


Common Dreams: America’s Biggest Lie: We Can’t Afford Medicare for All


Common Dreams: Private Health Insurance Stocks In Free Fall as Medicare for All Gains Momentum - This is people power in action.


JAMA: Workplace Wellness Programs Do Not Improve Health or Economic Outcomes - But we know something that will.


AMA Student Assoc. Endorses Medicare for All


Healthcare Dive: Healthcare Administrative Costs Will Tally $500 Billion This Year - This is 15% of total US healthcare expenditures. Currently administrative costs of traditional Medicare is under 2% and Here.


Chico Enterprise-Record: Why Butte County Needs Medicare-for-All More Than Ever


USA Today: Take it From An Economist, Medicare for All is the Most Sensible Way to Fix Health Care


Annals of Internal Medicine: Medicare for All and Its Rivals - “The leading option for health reform in the US would leave 36.2 million people uninsured in 2027 while annual costs would ballon to nearly $6 trillion - from $3+ trillion today. That option is called the status quo. That is unsustainable, so there will be changes. Out of the quagmire there is the opportunity for comprehensive, affordable, equitable health care for everyone: the single payer Medicare for All model.”

San Jose Mercury: Why Single Payer Would Improve California Health Care - Written by a health care wonk, very plainly explains the advantages of single-payer health care.


Center on Budget and Policy Priorities: New Arkansas Data Contradict Claims That Most Who Lost Medicaid Found Jobs - 18,164 Arkansans lost Medicaid coverage in 2018 because of a draconian new law that kicks residents off of Medicaid if they aren’t able work. HHS Secretary Alex Azar told a House hearing last Tuesday that most of them found work. That was a lie. Only 1,981 (11%) found work. So 16,183 (89%) are still out of work and now don’t even have health care. Medicare for All would make this question moot.


Bureau of Labor Statistics: Job Openings and Labor Turnover - Total separations in 2018: 66 million. Nothing unusual about this, but that means there were 66 million people in the USA that for one reason or another did not get to keep their health insurance policies. Also, if the US economy can absorb this many people looking for work, then the 1.6 million that now work for health insurance companies (and some estimates are much lower) can easily be absorbed when those companies no longer exist.


The Hill: Why Medicare for Some is the Wrong Idea - “Let’s get real: Commercial insurance is the biggest threat to health care choices and our freedom to receive the health care we need. Employers choose our insurers, and the insurers restrict the providers we can use, the treatments we can receive, and the prescription drugs we can take. Every year, we can be forced to change provider networks, benefits, out-of-pocket costs and, often, insurers. If we change jobs, every aspect of our health insurance changes. And, we are left to fend for ourselves if we leave the job market.”


Health Over Profit: Pharma & Insurance Gave $43M to the 130 House Democrats Not Backing Medicare For All - This article includes names and amounts. None of the leaders of the Democrapic party support this measure. That’s all you need to know about Democraps.

Democracy-NOW: The Time For Medicare-For-All Has Arrived


Intercept: The Special Interests Behind Rep. Pramila Jayapal’s Medicare for All Bill Are Not the Usual Suspects - No, they are the people. You and me.


Fortune: US Health Care Spending Skyrocketed to $3.65 Trillion in 2018 - Trillion with a ‘T’.


The Nation: We Don’t Need Private Health Insurance - "Particularly hot right now is the meme that people would have to sacrifice by giving up their private insurance if we switched to single payer. But private insurers are intermediaries that use administrative mechanisms designed to reduce utilization of health care no matter how beneficial that care may be.

High deductibles and other cost sharing create financial barriers to care. Narrow provider networks limit access to health care professionals and institutions. Administrative interventions such as prior authorization requirements create additional barriers to care. And for this we pay more because of these expensive administrative functions that provide no health benefit. Besides, how many people do you know who have been able to keep their same precious private insurance plan throughout their lives? Nobody. Private insurance is an unstable method of financing health care with constant changes in providers, benefits, and in the insurers themselves, especially with inevitable changes in employment. Switching from private insurers to stable, life-long coverage is not a sacrifice, but rather it is another benefit of a single payer system."

Carving out a niche for private insurance is like knocking a whole in your floor in order to create work for a carpenter.


BAR: Pelosi Sabotages Medicare For All, Corporate Media Pretends Not to Notice


STAT: ‘Cloud of Secrecy’ in Medicare Advantage Plans Can Create an Environment for Fraud


Commonwealth Fund: Eighty Seven Million Adults Are Inadequately Insured


Intercept: Pelosi Aide Tells Insurance Executives Not to Worry About Democrats Pushing Medicare-For-All


Public Citizen: The Case for Medicare-For-All - Very short, and about the Real Medicare-For-All, not the Demopublicans’ version. One more “Key Fact” to add to its very concise list: Employees don’t have to worry about losing their medical care if they decide to quit or change jobs.


WBUR Boston: As Drug Prices Rise, is Boston’s Prosperity Based on a Moral Crime? - Capitalism is the crime. Single Payer would solve this. But money-grubbing Demopublican politicians will not let it happen.

Mario Savio had the answer (begin at 0:34).


CNN: Top Democrats Want to Keep Private Insurance in Play - The headline says it all. Despite the fact that Single Payer is the cheapest, most efficient, covers everybody, greatly reduces administrative overhead, and about 70% of Americans want it, Democrats will never make it happen.


Kaiser Health: The Uninsured and the ACA: A Primer - Before ACA, 44 million Americans were uninsured. Now there are 27 million. What a crummy result for all that work. Sure, some of this is due to Rethug shenanigans. However that was all baked in from the start by both parties under the instruction of the health insurance lobby. Obama said ‘everybody got a seat at the table’ during the negotiations before passage of the law. He lied. Single Payer advocates were frog-marched out of the building. Pathetic.


Gallup: US Uninsured Rate Rises to Four-Year High - According to the article: The uninsured rate before ACA was 18% and today it stands at 13.7%. Health care gets more and more expensive everyday, as do healthcare corporate profits. Poll after poll cited on this portal indicate that the vast majority of Americans want Medicare For All. The Rethugs have no coherent plan. The Democraps want to take us back down the ACA road. Both parties are doing the bidding of their big donors and not that of the American people. This is not democracy.


NYTimes: Trump Proposals Could Increase Health Costs for Consumers


Gatehouse News: CVS Paid Itself Far More Than Some Major Competitors - More capitalism, more corruption...and who always suffers?


Harvard School of Public Health: Poll: America’s Health and Education Priorities For the 2019 Congress - See page 10 of the overall document, POLQ1, c. Overall 68% of Americans want Medicare for All. See also entries of 12/18, and 10/22/18. At least half a dozen polls over the last two years all agree.


NYPost: AOC Slams Critics Calling Her Agenda Too Radical - Here is a recent peer-reviewed study showing that Medicare for All would save the USA $310B per year. Here is another from 2013 showing savings of $500B per year. Here is a collection of peer-reviewed studies that have looked at this same question since 1991. Even a recent Koch-funded study found that it would save $200B per year. For Anderson Cooper to ask AOC ‘how we gonna pay for it’ is more than a bit asinine. The question should really be: “What are we going to do with all the money we save by switching to Single Payer?”

Why does nobody ask ‘how we gonna pay for it’ when Congress gives away $700B per year to military contractors, an $80B increase from last year, and more than all other countries in the world combined? Or when Congress gives a $2 Trillion gift to the ultra-rich? Or when we give a $700B bail out to the banks with all sorts of conditions that were never met, and they just kept the money for stock buybacks and executive bonuses? Or when the Fed institutes “Quantitative Easing” to the tune of $4.5 Trillion.


Kaiser Health News: Coverage Denied: Medicaid Patients Suffer as Layers of Private Companies Profit - Private companies syphon off funds meant to help sick people. Their profits soar while patients die.


Common Dreams: Ralph Nader: 25 Ways the Canadian Health Care System is Better Than Obamacare - Astonishing when you put them all together.

Jacobin: Medicare For All Will Be Good For Everyone But CEOs


America Public Health Assoc.: Economic Vulnerability Among US Female Healthcare Workers - “Conclusions: Many US female health care workers, particularly women of color, suffer economic privation and lack health insurance. Achieving economic, gender, and racial/ethnic justice will require significant changes to the compensation structure of health care.” Many of the people who care for us when we are the sickest are also among the most economically disadvantaged people in the USA. Something to think about during this season of giving.


Vox: Comparison of 8 Democrat Universal Health Care Plans


Medscape: Poll Shows Majority of Healthcare Professionals Support Single-Payer System - 68% support, 52% strongly support


USA Today: Democrats, Don’t Waste Time on Health Care Tweaks. Pass Medicare for All. - A great short article by a former VP of Cigna. Unfortunately, the Democrats are going to promote a bill that sounds like Medicare for all, but is really just a way for insurance companies to profit even more at working class peoples’ expense, and kill actual Medicare in the process.


UK Guardian: Universal Healthcare Could Save America Trillions. What’s Holding Us Back?


Politico: Establishment Democrats Look to Crush Liberals on Medicare for All -  The Democrapic party will never allow Single Payer to happen. Party bosses like Pelosi, Clinton, Kamala Harris, and Cory Booker will continue to support the fragmented, dysfunctional Obamacare, that leaves 1 in 10 people with no insurance and 1 in 4 with under-insurance, regardless of the fact that Single Payer is the far less expensive alternative, and Here, that would cover all Americans, and the fact that almost 2/3 of Americans favor it.

Why will these Dems oppose Single Payer? They don’t want to lose all of that money from insurance, drug and hospital corporations, and the power that the money brings to them. It will be interesting to see on which side some of the fence-sitters, such as E. Warren, will fall, and if rank and file voters will remember come next election.


Commonwealth Fund: Cost of Employer Insurance Is A Growing Burden For Middle-Income Families


Health Affairs: National Healthcare Spending In 2017 - The good news is that the growth in costs has slowed to 3.9%. The bad news is that at $3.5 Trillion, it is almost one fifth of GDP.


Political Economy Research Institute: Economic Analysis of Medicare for All - This is a big deal. PERI is a highly respected economics research body associated with UMass Amherst. Their findings are similar to an earlier UMass study that showed even higher savings. According to this study: 1 in 10 Americans currently have no health insurance. 1 in 4 Americans is currently underinsured, and can’t afford to go the doctor. The US annually spends 17% of GDP ($3.24 Trillion) on health care. Other high-income countries spend an average of 40% less per person, and produce better health outcomes. Medicare for All would save America $310 Billion per year.

It’s worth pointing out that a recent study by the Koch-funded Mercatus Center found, to their chagrin, that Single Payer would save the US about $200B per year. A host of other studies by GAO and CBO have shown similar savings associated with a change to Medicare for All.

There is no valid economic argument against Single Payer.

Democracy-NOW: Medicare for All: Momentum Grows


Business Insider: Medical Students at Cornell/Columbia Explain Why Their CEO is Wrong to Oppose ‘Medicare For All’


BAR: New Democratic House Leaders Steer Clear of Medicare for All


Intercept: Lobbyist Documents Reveal Health Care Industry Battle Plan Against “Medicare For All” - It’s all about swaying the 123 Dems who co-sponsored HR676. After receiving lobbyist money, they now agree that the message should remain ‘moderate’ and ‘tempered’. This is the reason why supporting any Democratic candidate is truly pointless.


PNHP: The Importance of Aligning House and Senate Single-Payer Bills the Right Way - This is a long primer on all of the bills in Congress that call themselves Single-Payer. Synopsis: The only two that would actually cover all Americans under a single, tax funded insurance program are H.R. 676 and S. 1804.

The House version is co-sponsored by 123 Representatives, and is patterned after both Canadian Medicare and the PNHP proposed system.

The Senate version has been endorsed by 16 Senators. It contains a slightly different funding and payment model which would still leave the door open for up-coding and gaming the system by large corporations. It needs to be brought into alignment with the House version.


Common Dreams: Medicare for All Will Destroy the GOP - Because of Voting


Kaiser Health: Quick: What’s the Difference Between Medicare-For-All and Single-Payer? - Nothing. Except when politicians, who only want to keep their $Millions in insurance company campaign contributions flowing, but also want to sound just like Bernie Sanders, start trying to conflate and confuse. Here is what Single-Payer really means. Here is H. R. 676, which is the bill that would put it in place.

Veterans Healthcare Policy Institute: Unreliable Sources: How Corporate Funders Influenced Mass Media Coverage of Veterans’ Healthcare


Sacramento Bee: CA Nurses Go National with ‘Medicare For All’ Campaign - This is a major milestone.


The Hill: Poll: Majority of Republicans Support ‘Medicare for All’ - Actually, we already knew this, but good to get another verification. A large majority of Americans have supported ‘Medicare for All’ for several years, and Here, Here, Here, and Here (q. 81, 82) .


US Dept. Health & Human Services: Medicare Advantage Plans Profit by Wholesale Denial of Legitimate Claims - A truly shocking report. The great majority of rejected claims were overturned on appeal, but 99% of claims were never appealed. So the insurance companies kept the money. Trump-appointed CMS administrator Seema Verma sees no reason to stiffen the regulations against such activity, and in fact has recently relaxed the rules. Doesn’t happen with traditional Medicare and wouldn’t happen with Medicare for All.


NYTimes: 1,495 Americans Describe the Financial Reality of Being Really Sick - Only in America can you have health insurance and still wind up homeless and bankrupt. See entry of 10/22...the majority of all Americans want ‘Medicare for All’ (fix the current Medicare program and then expand it to include everyone), but politicians refuse to consider it, even thought it would save money.


NYTimes: Is Medicare for All the Answer to Sky-High Administrative Costs? - Here’s the answer, from Physicians For a National Health Program:

The 1.1 percent administrative cost of traditional Medicare increases to 6 percent when only one-third of the Medicare beneficiaries are enrolled in private Medicare Advantage plans. The waste of the private plans is diluted by the efficiency of the traditional program.

More importantly, the administrative excesses permeate our entire health care delivery system because of the highly fragmented, dysfunctional financing system which also places a great administrative burden on the providers of health care. When people ask where we are going to get the funds to pay for Medicare for All, they should be reminded that hundreds of billions of dollars are actually recoverable by merely changing to an efficient Medicare for All public financing. That would still leave hundreds of billions for essential administrative services.

Regarding whether or not the private Medicare Advantage plans are providing value for their administrative excesses, the answer is clearly no. Their intrusive care management has been directed more at upcoding to increase profits rather than providing much in the way of truly beneficial services.

It would be much more efficient to roll the extra benefits of Medicare Advantage, retiree plans, and Medigap into the traditional program, creating an improved Medicare for All. The administrative savings along with negotiated pricing is the key to providing affordable health care services to absolutely everyone.

Politico: Controversial Former Aide to Maine’s LePage to Run Medicaid - Mary Mayhew served as Maine’s Health Commissioner for 6 years, leading the Rethuglican Governor’s efforts to tighten Medicaid eligibility rules. During her time, she oversaw a 70% reduction in enrollment in the Temporary Assistance for Needy Families program — one of the sharpest declines in the nation — and a 24 percent decrease in Medicaid enrollment. Measures of hunger and poverty rose even while she oversaw cuts to programs designed to feed and support low-income residents. To all those pseudo-christian Trump voters: What was that in the bible about ‘the least of these?’


Vox: Nobel Prize-Winning Physicist Sold His Medal for $765,000 to Pay Medical Bills - Only in America.


Health Affairs: Immigrants Pay More in Private Insurance Premiums Than They Receive in Benefits - Another study showing that immigrants actually subsidize health care for everyone.


UK Guardian: Ex-UN Chief: US Healthcare System is Morally Wrong


NPR: High Price of Insulin Leads Patients to Ration the Drug. That Can Be Lethal. - The current HHS Secretary, whose previous gig was president of Eli Lilly, thinks that Medicare negotiating drug prices for life-saving insulin would “move us toward socialism.” He is perfectly willing to let 80,000 Americans die per year in the name of profit. It seems that capitalism is more deadly than socialism.


Sacramento Bee: Doctor, Hospital Groups Organize to Oppose Single-Payer in California - Coalitions of vested groups with lots of money are organizing around the country to oppose Improved Medicare for All (S. 1804, H.R. 676). They will attempt to present a positive front by offering expanded coverages within the current dysfunctional and fragmented system.

The good news is that this is because they now view Single-Payer as a credible threat to their current, expensive, avaricious for-profit health care industry.

But nothing can change the fact that Single-Payer is a less expensive overall, more equitably financed system that provides everyone the health care they need without causing financial hardship to anyone.


Reuters: Reuters/Ipsos Poll: 70% of Americans, Regardless of Party, Support Medicare for All and Here  - See bottom of article for this poll’s results. Poll (see Q. 44) after poll after poll after poll (see items 81, 82), after poll, all show the same basic result.


Modern Health Care: Feds Want to Force Anthem to Comply With Medicare Billing Investigation - Medical insurance corporations know how to make an illegal buck off of you and I. They will stall as long as possible and then pay some of the money back. This is why we need to get rid of these scofflaws (this is a family friendly web site or I would have used a more accurate term) and pass Improved Medicare for All.


Jacobin: Even Libertarians Admit Medicare-For-All Would Save Trillions - $2 Trillion over a 10 year period or $200 Billion per year. But even this understates the savings. The study in question was done by the Koch libertarian think tank. See Health Reform entry of 8/2 for details.

NYTimes: Why America Needs Medicare for All

The Nation: Single Payer is Actually a Huge Bargain


ABC News: Immigrants Cost the Health Care Less Than US-Born Americans, and Subsidize Health Costs for Others - ...per a study by the International Journal of Health Services.


Intercept: Trump Officials Team With Obama Officials and Big PhRMA to Keep Drug Prices in Developing Countries Out of Reach For Most of Their Citizens - But it’s fine because prices are up! Good old Capitalism!


The Nation: How Medicare Was Won


NYTimes: ‘Too Little Too Late’: Bankruptcy Booms Among Older Americans - And what’s the one common thread? Soaring health care costs. Would Not Happen With Single Payer. Doesn’t happen in the other industrialized countries - all of which have some form of government subsidized basic health coverage.


PNHP: The Mercatus Center’s Estimates of the Costs of a National Single-Payer Healthcare System: Ideology Masquerading as Health Economics - Synopsis: The Mercatus Center, funded by the Koch Bros., uses false assumptions to blow cost estimates way beyond reality. These are the common bogus talking points - which seem to come up once every 6 months or so - of groups that benefit from the high cost of health care in the US, now including even Trump’s HHS, so they’re worth a quick review.

Mercatus says that administrative overhead would be reduced from the current 13% of total health care costs (13% of $3.8 Trillion is $494 Billion! to pay private insurance administrators whose sole job is to deny you the healthcare you need) to 6%. Current Medicare overhead is less than 3%, and if Part C (the privatized part of Medicare) is not counted, it’s less than 1%. Canada’s overhead is about 1.8%. So their 6% estimate is ridiculous.

The huge overhead borne by doctors’ offices and hospitals in filing claims with hundreds of different plans and forms is not even considered in the Mercatus analysis. Conservative estimates that doctors offices in the US spend 2 to 3 times as much on this overhead as those in Canada,  and US hospitals spend twice as much. Mercatus underestimates these savings by around $8 Billion.

Mercatus predicts that the only drug savings with Single Payer would come from switching patients from brand name drugs to generics, completely ignoring the 40-50% savings achieved by both the VA and other nations that have switched to a similar Single Payer system, and then used their monopsony negotiating leverage. This study underestimates those savings by $1.7 Trillion over 10 years.

Mercatus predicts a massive $2.2 Trillion increase in utilization of health services with no detailed analysis to back up that prediction. There was no increase at all in total utilization when Medicare was first introduced. And then despite predicting a huge increase in those revenues, it then predicts that doctors and hospitals would be driven out of business by some phantom losses.


Portside: Koch-Backed Think Tank Finds That “Medicare For All” Would Cut Health Care Spending And Raise Wages. Whoops.


Politico: Trump Promised Them Better, Cheaper Health Care. It’s’ Not Happening.


ProPublica: Health Insurers Are Vacuuming Up Details About You - And It Could Raise Your Rates


NYTimes: The Astonishingly High Administrative Costs of US Healthcare - This is a short article with a lot of authoritative links.

From the article:

Administrative costs for health care in the USA consist of: advertising for health insurance companies, salaries for their employees whose sole job is to deny you health care, astronomical salaries for insurance company C-level executives, chasing down patients/families that can’t afford to pay their rising shares of the bill, and administrative costs for providers that have to file different forms for dozens of different insurance companies.

A widely cited study published in The New England Journal of Medicine used data from 1999 to estimate that about 30 percent of American health care expenditures were the result of administration, about twice what it is in Canada. If the figures hold today, they mean that out of the average of about $19,000 that U.S. workers and their employers pay for family coverage each year, $5,700 goes toward administrative costs...Like the overall cost of the U.S. health system, its administrative cost alone is No. 1 in the world...At just over 25 percent of total spending on hospital care (or 1.4 percent of total United States economic output), American hospital administrative costs exceed those of all the other places.

We all know the solution.


Vox: “Medicare-For-All” Means Something. Don’t Let Moderates Water It Down


NYTimes: Radical Democrats Are Pretty Reasonable - This is Paul Krugman doing his assignment for the neoliberal party. The Democrapic party, has decided they are going to try to confuse the public, and adopt the phrase ‘Medicare for All’ while changing the definition to that of public option. They realized that the actual, true “Improved Medicare for All” as outlined in H. R. 676, was gaining significant momentum nationally and they want to make sure it never gets a chance.

Their purpose, beyond that of confusing the public, is to retain the campaign contributions of the insurance and pharmaceutical corporations. Soon, we will begin to see the results of that decision as the term suddenly appears across MSNBC, the rest of the cable networks and corporate news outlets.

It became clear that Krugman is nothing more than a bloviating shill for the Democrats back on 6/28/13 when he declared that Obama’s NSA illegal, unconstitutional, universal, suspicion-less, final evisceration of the 4th Amendment was “nothing more than a policy dispute.” Now the NSA, with complete impunity, vacuums up every email, phone call, instant message, tweet, blog post, and not just the ‘meta-data’ and stores it in the worlds biggest data warehouse - in part thanks to flaks like Krugman.

See Here, Here, Here, Here, Here, Here, Here, Here, Here, Here, Here. And now Trump and Sessions want even more powers to snoop on everyone, even though the surveillance has never caught a single terrorist, and Here, Here, Here and Here.

So, no Paul the NSA thing is not just a policy dispute, and the public option is not medicare for all.


Reuters: Soaring Costs, Loss of Benefits Top Americans’ Healthcare Worries: Reuters/Ipsos Poll - “For over a year now, Americans have listed healthcare as the most important problem facing the country...when asked what most concerns them about healthcare, they responded ‘the cost of health insurance’.”

There is a straightforward solution, and most people in the country are in favor of it, and Here, Here, Here (item 81 & 82), and Here.


AMA: Report: AMA House of Delegates Report of Reference Committee - Resolution 108, brought by the Medical Students Section, could be a serious milestone for this organization. The resolution basically says that the AMA should consider supporting Single Payer, along with all other solutions on the table that improve health care availability and affordability. The good news is that the resolution was recommended for consideration by the AMA Board of Trustees, and was not recommended for rejection. Single Payer is now, for the first time, officially being studied by the AMA.

The other positive note is that this resolution was introduced by the next wave of doctors coming out of medical school. Younger, newer doctors are leading the way on this issue. The tide is gradually turning within the AMA - up to now a staunch supporter of status quo medical care for profit.


Stat: Is This the Year the AMA Finally Joins the Single-Payer Movement?

New York Magazine: On Obamacare, Sessions Is Standing Against the Rule of Law - Last February, 20 Republican state Attorneys General filed suit to invalidate the ACA in their states. The states are: Alabama, Arkansas, Arizona, Florida, Georgia, Kansas, Louisiana, Maine, Mississippi, Missouri, Nebraska, North Dakota, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin. Now the Attorney General of the USA has stated that he will not contest the suit. So tens of millions of people in, with pre-existing conditions, diabetes, cancer, high blood pressure and many other life threatening diseases will apparently be left to die unnecessarily because of greedy health insurance corporations. That’s Capitalism!


NYTimes: Justice Dept. Says Crucial Provisions of Obamacare Are Unconstitutional


Violence Policy Center: Guns and Suicide - What do health reform and gun control have in common? In both cases we know the policy changes that will save thousands of lives, but large lobbyist groups backed by rich corporations stand in the way.


LA Times: Trump’s New Insurance Rules Are Panned by Nearly Every Healthcare Group That Submitted Formal Comments - Now the Dems have someone to blame, conveniently disregarding their own sad performance in 2008-09 when they had a majority in both houses and owned the White House, but refused to give Single Payer a seat at the table.


Milliman Research: 2018 Milliman Medical Index - For a typical American family of 4 covered by an employer sponsored PPO the average cost of health care in 2018 is $28,166, up 5.9% from last year. This includes premiums deducted from their paychecks, deductibles, conditions/treatments not covered, coverage limits, and all other out-of-pocket expenses plus forgone wages for the employers’ share. That is roughly 30% to 50% of American mean family income. And what was the first ‘A’ in ‘ACA’ supposed to stand for?

The question becomes: How would the cost of an Improved Medicare for All compare to what I currently pay? Current costs for health care include the above plus the reserves that each family must maintain in case of a major health care catastrophe. Also over half of the health care costs in the US are paid by the government already: Medicare, Medicaid, CHIPS, the VA, other military medical programs, Indian Health Services, and Public Health Services. We all already pay for that through our taxes.

Improved Medicare for All would be paid for through progressive, fair taxes. For all people, with the exception of the wealthiest (who probably notice it very little), that cost would be far less than what we currently pay. This would be health care coverage for life, not just until we leave our current employers, the way it works now.

Unfortunately, neither of the major parties will give Improved Medicare for All a seat at the table because they are both addicted to the millions of campaign dollars they receive from insurance, hospital and pharmaceutical companies.


Avalere: Seniors Pay More for Generics in Medicare Prescription Drug Plans Despite Stable Prices


Commonwealth Fund: Health Insurance in 2018 Finds ACA Gains Reversing - 4 million working age people have lost health insurance since 2016. It’s easy to blame Rethugs for this, but really the blame goes just as much to the Craps. They refused to even give Medicare-For-All a seat at the table and now this is where that took us.


Foreign Policy: The Royal Baby is Lucky He Wasn’t Born in America - “Everyone in the West, royalty or not, gets better maternal health care that parents in the US.” ...and not just maternal health care. There is an easy fix that is very efficient and would save $500 Billion per year. Why don’t we just do that?


Reuters: Trump Administration Issues Rule Further Watering Down Obamacare - News flash: States don’t ‘regulate’ insurance companies. It’s a revolving door. This sets the stage for insurance companies to get rid of pre-existing conditions, increase their MLR (‘cost’ plus whatever they want), increase premiums, etc. If the elimination of the mandate, and Here, wasn’t enough to kill Obamacare, then this rule finishes the job. If it’s just up to the states, insurance companies can do whatever they want. On the positive side, given Trump’s low popularity right now, this could set the stage for Improved Medicare for All. But everybody’s going to have to realize that neither Dems nor Rethugs are going to make it happen.


Kaiser Health News: Medicare Advantage Plans Cleared To Go Beyond Medical Coverage - Even Groceries - ...even gym memberships...”Egregiously Obscene” As pointed out here many times, the idea is to provide US taxpayer financed benefits far and above what ordinary Medicare provides in order to attract more and more over-65s. Once a critical threshold of patients are signed up, traditional Medicare can be discarded, and all will be forced into a voucher model which will allow insurers to gouge the elderly while all of the government savings can go into the pockets of the 1% health insurance companies. As Paul Ryan has explained, budget demands will “require” these reductions to be made - in order to accommodate the tax cuts for the rich - Bush II: $500 Billion, Trump: $1.5 Trillion.


Democracy-NOW: David Skulkin’s Firing at the VA is Latest Step in Trump-Koch Push to Privatize Veterans’ Healthcare


NYTimes: Privatizing the VA Will Hurt Veterans


British Medical Journal: Trump Blames Free Riding Foreign States For High US Drug Prices - BMJ is trying to put it as nicely as they can. But really it’s the Trump Administration caught in yet another corporate friendly lie. The real reason drug prices are so high in the US? Pharmaceutical boards of directors’ and C-level employees’ bonuses, and excess advertising which drives profits. Again, it’s just #GoodOldCapitalism at work.

Ars Technica: Pfizer CEO Gets 61% Pay Raise - to $27.9 Million - As Drug Prices Continue to Climb


Economist: Which Firms Profit Most From America’s Health Care System - Rent Seekers: That segment of society that reaps income not as a reward for creating wealth or adding to the good of society, but by trapping a larger share of the wealth than would otherwise have been produced without their effort. The wealth that they add to society is far smaller than the share of income that they take. Leeches. Who are these rent seekers in the health care system? Insurance companies. With National Improved Medicare Care for All, health insurance companies disappear.

Common Dreams: A Labor-Based Movement For Medicare For All


JAMA: Health Care Spending in the United States and Other High-Income Countries - Conclusion: Health care costs in the US are the highest in all of the OECD countries, and twice the average. Health care outcomes in the US are poorer than the average. Why? The two biggest reasons are prices and administrative costs. End Conclusion.

National Improved Medicare for All would solve both of those problems. Prices, especially pharmaceutical prices, currently are not negotiated. They would be under NIMA. Administrative costs would effectively go away since: 1. provider offices would only have to file one standard form with one payer, and 2. insurance companies, which are essentially a 100% administrative functionality, would disappear.


BAR: The Healthcare Bait-and-Switch: From the Clintons to Obama and Back Again

PNHP: Our Incompetent Stewards for Health IT Interoperability


The Hill: GOP’s Proposed Medicare Voucher Program Would Lead The Demise of The System - “Under the GOP’s voucher system, private plans could tailor their benefits to attract the youngest and healthiest seniors, leaving traditional Medicare with older and sicker beneficiaries. 

Their higher health care costs would lead to higher premiums that seniors would be unable or unwilling to pay, resulting in a death spiral for traditional Medicare.” ...and for those seniors...

It has long been the dream of Republicans to move healthy seniors to the private sector and turn Medicare into a voucher system used only by the sickest seniors.


Commonwealth Fund: Americans’ Views on Health Insurance - 92% of Americans believe that affordable health care is a right. The only way to achieve that for all Americans is National Improved Medicare For All.


Physicians for a National Health Plan: Expect More Fragmentation of Our Dysfunctional Health Care System - As always, the most interesting comment is the last one, by Dr. McCanne. CAP - which makes up the majority of the heavy hitters in the Democratic party - is trying to steal the “Medicare for All” discussion, while still giving insurance companies all they want. Some in the media seem to be buying in.

Remember “if you like the policy you have, you can keep it”? These are the same people.


Intercept: DCCC Internal Polling Presented to Members of Congress Panned Single-Payer Health Care - Neither Democrats nor Republicans will ever support Medicare For All. The reason is that M-F-A essentially eliminates private health insurance companies which contribute very heavily to politicians of both parties. The politicians are addicted to that money. Neither Rethugs nor Democrats are our friends.


Yahoo: Why Are Democratic Party Think Tanks Still Not Backing Universal Health Care? - See the What’s Not to Like? section. Very succinct.


Truthdig: A Proposal Designed to Confuse Public, Prevent Medicare For All - See entry from yesterday. Those who run the Democratic party understand that ‘fixing ACA’ is a non-starter for most Democrat rank-and-file voters. They understand Medicare for All very well and that’s what they and the majority of Americans want. So Democratic leaders are looking for a way to satisfy their Wall St., health insurance corporate donors and bamboozle voters. Not going to happen.


PNHP: CAP’s ‘Medicare Extra for All’ - What It Really Is - The neo-liberal policy group, run by Neera Tanden and John Podesta - the cabal that has taken over the Democratic party and worked to sabotage the Sanders campaign, and in so doing put Trump in the White House - understands that Americans are waking up to the fact that we need to get rid of insurance company involvement in health care. In an attempt to bamboozle the American people they are offering a plan that would keep the waste involved with insurance companies (and its political contributions), but kind of sounds like National Improved Medicare for All, which it is not. At the end of the linked article is Dr. McCanne’s comment, which says it all. It’s just another Democratic ruse. Look for MSNBC to just drool all over this “new and improved” concept.


JAMA: Value-Based Medicare Payments Exacerbate Health Care Disparities - The problem is nobody really knows how to evaluate “value” in medical care. MACRA is just another neo-liberal law enacted to take money away from care-givers that service the old, poor and sick and give that money to care-givers who service the rich, who are generally healthier. It’s another form of welfare for the rich. This would not happen in a properly designed Medicare For All system.


AJC: For Many, Health Care Changes Grim - I keep wondering when Americans are going to wake up.


Common Dreams: Fueled by Broken Social Contract, Study Finds Inequality and Despair Driving US Life Expectancy Down - It has already been shown that politicians from both parties in this country only respond to the needs of the richest Americans. The desires of the majority of Americans makes no statistical difference in terms of laws that are enacted. As long as this continues, the rates of suicide, and of death from opioid addition will continue to rise and average life expectancy of Americans will continue to decline.


British Medical Journal: Failing Health of the United States - In 1960, the US had the highest life expectancy of any OECD country. Now we are well below average. People in Slovenia, Estonia, Chile, the Czech Republic, etc. live longer. One of the causes is that all other OECD countries have some form of publicly financed health care. People who can’t afford to go to the doctor die.


Physicians For A National Health Plan’s Response to Amazon, Berkshire Hathaway, JPMorgan Announcement


NYTimes: Amazon, Berkshire Hathaway and JPMorgan Team Up to Disrupt Health Care


Health Over Profit: The US Healthcare System Increases Income Inequality


American Journal of Public Health: Household Medical Expenditures Worsen Income Inequality - Only in America.


Stat: Drop in Life Expectancy an ‘Indictment of the American Health Care System


Fierce Healthcare: CMS Floats Medicare Advantage Payment Tweaks That Would Boost Insurers’ Risk Scores - This is the latest trick that Dem and Rethug politicians are playing in order to overpay private insurance companies with taxpayer funds. The point of this yearly chicanery is to move the majority of Medicare users into their hands and then close down conventional Medicare - make it a voucher system where all the money goes into insurance company coffers.

NYTimes: Why the US Spends So Much More Than Other Nations on Health Care - Hint: It’s not because of the quality of our health care.

Health Reform 2017