Health Reform Timeline


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

Health Over Profit

OECD Health Data 2015 - 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.

Compare Your Country: Various Health Expenditures of OECD Nations - Guess who’s at the very very top by large margins in almost every expenditure category? USA USA USA!!

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


LATimes: There Are 3 Types of Single-Payer ‘Concern Trolls,’ And Here’s Why They Are All Wrong


UPI: Bernie Sanders Introduces Single Payer Healthcare Bill - This chart compares HR 676 with Sanders’ bill. This chart addresses the transition provisions in the Sanders bill. This bill in NOT a National Improved Medicare for All (NIMA)/Single Payer bill. HR 676 is. See notes of 9/7.

WashPo: “I’ve Watched My Patients Die of Poverty for 40 Years. It’s Time For Single Payer”


JAMA: R&D Spending to Bring A Single Cancer Drug to Market Compared to Revenue - Median cost of developing a single cancer drug: $648 Million - they spend way more on marketing. Median revenue from same: $1.7 Billion. This is mostly because to get ACA passed, Obama made sure Big Pharma never has to negotiate prices. Meanwhile, insurance companies are getting kickbacks from drug manufacturers. Then on top of that the Rethugs tried to give a $28 Billion tax break during the attempt to repeal Obamacare. Later Trump signed an executive order reducing regulations even further.


Health Over Profit: Senate Debates Billions for Insurers While Public Demands Medicare For All


Intercept: Elizabeth Warren Jumps on Board Bernie Sanders’s “Medicare for All” Bandwagon - Miss Johnnie-Come-Lately does it again, as does Kamala Harris. Warren could have supported Sanders in the Mass. primary. If she had there’s a reasonable chance that he would have gotten the additional 2% of the vote he needed to win that primary and the momentum that he needed to win the nomination. We’ll never know because Warren kept silent mostly because she doesn’t want to alienate anyone while she prepares to run for president. Then she actively campaigned for Clinton who represents everything Warren says she is not.

Warren is Pro-Occupation and Pro-Perpetual-War, or you could just say another Corpora-Dem. They are the reason Trump is now president. Corpora-Dems don’t seem to realize that most people know bull shit when they see it - though apparently not rank and file Dem voters.

And by the way, this is not a Single Payer bill. The bill proposes a 4 year delay (giving insurance corporations time to lobby it out of existence - while they line politicians’ pockets), meanwhile there are still insurance companies, co-pays, deductibles, etc. and it also re-introduces the Public Option, which would now become a de-facto high risk pool to which all of the insurance companies would effectively dump their high cost patients. The proposed bill is not available on-line to my knowledge. The information in this paragraph comes from a letter from the Executive Committee of PNHP to Sen. Sanders. The letter has not been released for publication, but I can send you a copy upon request.

These are just Democrats doing what they do best: talk forever about how they feel our pain and how they’re going to fix it if we just send them money and vote them in. But in the end, they do whatever the corporations tell them to, which is usually to screw you and I.


Reuters: Anthem Cuts Back Obamacare Coverage in Missouri in 68 Counties - ...and completely removes coverage in 17 counties. News that has become so routine that we hardly even notice anymore. We are becoming conditioned to accept that insurance companies take care of themselves first and use patients only when they add to the companies profit. Sad. Meanwhile, the CEOs of health care companies take home on average $20 Million per year.


International Journal for Quality in Health Care: Avoidable Emergency Department Visits - A study of avoidable vs. unavoidable ER visits, totally 424 million visits. 3.3% were found to be avoidable, meaning 96.7% were medically necessary. So the canard that poor people routinely use the ER unnecessarily for all of their health care needs is nothing but an unsubstantiated neo-conservative gross generalization having nothing to do with reality, and used only to push a medical-industrial agenda.

This study does indicate that many of these costly ER visits could have been avoided with adequate preventative and proper health management programs, i. e. regular appropriate visits with a primary physician. An Improved Medicare for All would provide this standard of care and would thus bring down the overall costs of health care in this county.


Kaiser Health News: 56% of Doctors Warm to Single-Payer and MedScape - The majority of doctors want it. The majority of the people want it, and Here, Here, Here and Here. What’s holding it back? Politicians of both major parties. Here’s why!

New England Journal of Medicine: Public Opinion About the Future of Affordable Care Act - “Conclusions: ...Finally, the most important change over time was not the increase in public approval of the ACA, but rather the increase in overall support for universal coverage. When confronted with millions of people losing coverage, the public became more supportive of the principle that the federal government should ensure coverage for them.”

The time has come. Let’s get this done. The only thing stopping National Improved Medicare for All is the two major parties in Washington.

PNHP: Response to anti-Medicare-For-All Screed in The Nation


Health Over Profit: Response to Typical Article Against Single Payer - Basically lays out the specifics of why each and every argument against Improved Medicare For All is baseless.

NYTimes: Medicare Advantage Spends Less on Care, So Why Is It Costing More? - Because the amount taxpayers pay the insurance companies is 30%, or $20 Billion, more than what the insurance companies pay out. It’s the old story with privatization - waste, fraud and a bought off Congress, and Here. This extra money allows insurance companies to offer very low premiums to policy holders, attracting more and more people over 65 - great, so far, for policy holders, but terrible for taxpayers. About 1/3 of people now eligible for Medicare are in Medicare Advantage plans. The insurance companies’ plan is to slowly starve traditional Medicare until they have everybody that’s eligible - effectively privatizing Medicare. That’s when the fun begins for them as they begin to gouge older people because then they will have no other alternatives.

PNHP: Paul Krugman Loses His Way on Incremental Path to Reform -

With the Krugman incrementally-reform-ACA approach: The result will get us no closer to universal, affordable coverage, you still can’t choose your doctor or hospital, there is still monumental overhead - both on the health provider side and the insurance company side, 30,000 people still die every year because of lack of health insurance. It leaves people sick, broke and dead.

With Improved Medicare for All: Everyone is covered for life, obtaining care does not create financial hardship, efficiency gains would be more than enough to pay for increased coverage - to name just a few.

AJC: Blue Cross Pulls Back on Georgia Coverage - This, even though I hate to say it, is not because of anything the Rethugs have done. BC was waiting to see if they would have the requirements to cover pre-existing conditions and other Obamacare restrictions removed by virtue of repeal. That didn’t happen, so BC is pulling out of all markets that have competition in GA. They only remain in counties where they are the only providers. Now, out-of-pocket costs in all counties will skyrocket. Obamacare is imploding. Single Payer could easily fix all of this.


AFL-CIO People’s World: Executive Council Backs Medicare for All - This is the first time that the AFL-CIO, including National Nurses United, United Steelworkers, Amalgamated Transit Union, along with the 53 other unions representing 12 million active and retired working people, has come out straightforwardly for Single Payer.

The article notes that the last Democrat who actively pushed for, and got a bill for Single-Payer out of committee was Dennis Kucinich. All other such efforts by Democrats have been limited to introducing/sponsoring bills such as HR 676, but then never actively campaigning for them. It also noted that NNU pushed for a Single-Payer bill in California, which passed in the State Senate, but was stymied by the Democratic State Assembly Speaker and the Democratic governor.

Single-Payer is an issue that is rapidly gaining support as it becomes evident to the majority of Americans that the Rethugs have no idea how to improve on ACA, but also that ACA is causing more and more of them to be priced out of the market, especially when all out of pocket costs are considered.

This is a time when Democrats could seize the momentum if they came out actively and unequivocally for Single-Payer, and don’t think for a moment that they don’t realize that fact. But they also know how much money they would lose if health insurance industry contributions dried up. That should be enough to tell you who they are really working for.

Meanwhile, Bernie Sanders and Elizabeth Warren keep saying they are going to introduce a companion bill to HR 676 any day now.


Common Dreams: Dr. Carol Paris, President of PNHP: It’s Time for the Adults In This Nation To Talk Seriously About Health Care


Common Dreams: Jimmy Carter Latest Ex-Democratic Leader To Back Single Payer. When Will Current Ones? - Much like ex-Democratic leader Al Gore. Not even Bernie Sanders, Chuck Schumer, nor uber-faux-progressive Elizabeth Warren will actually introduce a companion bill in the Senate to HR 676. They are all great at issuing sound bytes in favor of Medicare For All, but when the vote might actually count, they just can’t give up those big corporate health insurance contributions.


Axios: The Sky-High Pay of Health Care CEOs - CEOs of the 70 largest health care corporations have taken home $9.8 Billion since ACA was passed, an average of $20 Million per year. Their earnings keep growing at a faster rate (11%) than most Americans (about 3%). Of course we know that almost all of the growth of the ‘average American’ salary went to the top 1%. John Martin, CEO of pharmaceutical corporation Gilead Sciences, made $863 million in that time period. Much of the income of these execs comes from stock options - which they inflate through the practice of buybacks. This article highlights how this perverted system of executive compensation makes the overall cost of healthcare in the US the highest in the world. Obscene.


AJC: World Shows Way Forward on Health Care

AP-NORC: 62% Agree that It Is the Federal Government’s Responsibility to Make Sure All Americans Have Health Care Coverage - See question 44. Up from 52% in March. Now we have 5 separate polls showing essentially the same thing. See entry of 7/18.


Intercept: Trumpcare Is Dead. “Single-Payer Is The Only Real Answer,” Says Medicare Architect

Democracy-NOW: Dr. Carol Paris: We Must Make It Toxic For Politicians Not To Get On Board With Single-Payer - Even the uber-faux-progressive Sen. Elizabeth Warren has yet to introduce a companion bill in the Senate to HR 676. Dems are not going to get this done without significant pressure. The landscape would be significantly different if we had a Green Party president.


Harvard Business Review: Is The US Ready for a Single-Payer Health Care System? - All the polls say yes, and Here, Here, and Here, and now this prestigious journal also says yes; written by the Dean of the Boston University School of Public Health. Why don’t the politicians also say yes? This article is another landmark in national acceptance for this idea. Note: When the poll says ‘Do you favor an expansion of Medicare to all Americans?’, then 50 - 58% say yes. However if the question is ‘Do you favor a Single-Payer system?’ 33% say yes, while 60% believe the federal government is responsible for ensuring health care coverage for all Americans, and Here. That indicates that about 17% of Americans do not understand that Medicare For All and Single-Payer are essentially the same.

Fusion: Al Gore Breaks With Democratic Party Leadership - Supports Single-Payer Healthcare - Think about that for a second. The Democratic party leadership is now so out of touch with the needs of the people that a previous leader of the party actually has to break ranks to support a measure that would benefit all. But one thing both of the news stories for today show is that Single-Payer has gone from a radical idea to very mainstream, and probably inevitable.


Health Over Profit: The Cost of US Health Insurance Companies: $1.4 Trillion/Year - The return to the people? The highest mortality rate among OECD countries.


YouTube: Senate Republicans Exempt Themselves From Obamacare and Trumpcare

The Hill: Sanders Triumphs Over Trump In Healthcare’s Battle of Ideas


Common Dreams: Upside of Trumpcare Ugliness: Medicare for All Goes From ‘Pie In The Sky’ to ‘Inevitable’


Common Dreams: Nation “Too Broke” for Universal Health Care To Spend $406 Billion More on F-35


Matt Taibbi: Finally Everyone Agrees Healthcare Is A Human Right - Citing Paul Krugman as one example, Taibbi points out how those who were telling us that Single-Payer was not feasible before Trump, are now chanting that health care is a human right - which it is. Let’s hope those same people remember that after Trump is out.


ProPublica: Medicare Halts Release of Much-Anticipated Data - PNHP comments: “We have access to the data for the traditional Medicare program, but the same data have not been available for the private Medicare Advantage plans. We do know that the private plans have been cheating the taxpayers, initially by selectively marketing their products to less expensive, healthier populations while receiving full payments based on average needs, and then, later, by upcoding the diagnoses in order to receive unwarranted higher risk adjusted payments as if the beneficiaries were sicker than they actually are.

Now that CMS is headed by a pro-market ideologue - Seema Verma - the promised release of the data was reversed with the explanation that “there were enough questions about the data’s accuracy that it should not be released for research use.” Yet it is being used to overpay the private plans. Verma has stated repeatedly that the private plans produce higher quality at lower costs, yet she refuses to let us see the data. What data we do have suggest the opposite.

With the overpayments, the Medicare Advantage plans are able to offer their products with lower premiums and cost sharing, obviating the need for patients to purchase Medigap plans. With this perception of a better deal, enrollment in the private plans continues to increase, helping to fulfill the goal of privatizing Medicare. Once the private plans have supplanted much of the traditional Medicare program, the public privatizers plan to decrease the government contribution to the plans (decrease premium support - vouchers) leaving Medicare beneficiaries to pick up more and more of the costs.

Look, it’s our government, our taxes, our Medicare. Keeping us in the dark allows them to surreptitiously inflict their ideology upon us - an ideology that is shifting wealth upwards, away from workers.”

NBC: Democrats Split On Joining GOP For Health Care Fix - So here goes the corporate end game. The payoff  masters at the large health insurance, pharma and hospital corporations have apparently put out the word that any Democrat that’s willing to take the blame for the further fleecing of the middle class and working poor will profit handsomely. It’s an old tactic with Dems and Rethugs - you take the blame on this one and I’ll take it next time, and neither one of us will suffer in the long run.

The payoff masters can also see the handwriting on the wall: if Rethugs fail with this reform bill, there is rapidly building support for Single Payer. Heck, even Elizabeth Warren, who wouldn’t commit to either Dem nominee until it was a no-lose situation for her, has belatedly come out in favor of Single Payer, as has Warren Buffet. The corporate minions know that if they give Bernie Sanders enough time, he may introduce the Senate version of HR 676 Health Care for All. Any of these actions could swing the tide towards Single Payer.  The payoffs are flowing, and none better to cash in than Chuck Schumer.

NYTimes: Tie Congress’s Paychecks to Our Good Health - I don’t often quote Kristoff, but we all should memorize the stats in this article. 12,000 babies per year? Right to Life? BullShit.


New Yorker: Paul Ryan and the Doubletalk About Healthcare Reform - Ryan has never worked a day in his life. He’s been on the very generous health care plan that comes with his job, financed by Americans since he was 28. Americans who just have to hope that they never get seriously ill and that Ryan doesn’t kick them off of any hope of ever getting health care coverage again. When asked why this bill gives mountainous tax breaks to the segment of the population that has reaped all the financial gains ever since the 2008 meltdown, he replies that he’s “really not worried about that” and then more double-speak.


Health Affairs: Health Care War On The Poor - When politicians of both parties (remember Dems’ ACA still leaves 30 million Americans without even the Public Option) are willing to enact legislation that will kill tens of thousands of Americans in exchange for payments from wealthy donors and health insurance companies, that is the definition of Cold Blooded Murder For Hire.

CNN: 22 Million Fewer Americans Insured Under Senate GOP Bill - Various studies have shown that - depending on the number of uninsured people there were when the study was done - approximately 1,000 uninsured people die yearly per 1 million as a direct result of lack of health insurance, and Here and Here. Here’s just one example. We currently have about 30 million uninsured as a result of the Democrat’s ACA. The new GOP bill will increase that number by 22 million, for a total of 55,000 deaths per year from both Democrat and Republican refusals to implement Single Payer - true universal coverage. If that number is 18 X per year the number of people who died as a result of the attack on 9/11, wouldn’t that imply that Democrat and Republican politicians are by far the worst terrorists of all time?

Democracy-NOW: Senate GOP Healthcare Bill Estimated to Kill 28,600 More in US Each Year - Here’s the Annals of Internal Medicine study.


NYTimes: The Senate’s Secretly Biparitsan Health Bill - The interesting part of this article is the way it’s framed. 

PNHP’s description: “Avik Roy’s framing is that there are two polarized partisan views of reform and that somewhere in the middle is the compromise on which we can all agree. Nonsense.

If we are to use linear polarization to frame the debate, then the two sides are health care policies that benefit the patients - all patients - versus health care policies that cater to special interests, whether they be the medical-industrial complex or the political ideologues.

The similarities noted by Roy are due to the fact that the neoliberal views of the Democrats are not that far from the conservative views of the Republicans, in spite of all the noise generated by this debate. Trying to establish policies that benefit the various special interests results in the profoundly expensive, highly wasteful, inequitable, fragmented, dysfunctional system that we have.

A well designed single payer system takes care of patients first, with much greater efficiency, effectiveness, and equity. The special interests that might otherwise appropriately benefit would do well in such a system though they would have to set aside personal greed and vacuous ideology.

CNN: Senate Health Care Bill Gives An Average Yearly Tax Gift of $250,000 to The Mega-Rich - That’s why the GOP wants to give the working poor a ‘punch in the gut.’


New Yorker: The Dubious Counting at the Center of the GOP’s Health-Care Reform - All of the $Billions being cut out of Medicaid go directly for tax cuts to the richest Americans. That is the only reason for those cuts to Medicaid. This is an on-going pattern: the rich pay off the politicians and all of the assets in the country and the world are being funneled up to the rich and away from the working poor and middle class. The MSM has been strangely silent on this point up to now. To the pitchforks!!!


NYTimes: Senate Health Care Bill Includes Deep Cuts to Medicaid - Something Trump said he would never do. But what else is new. Since this version does not repeal the fundamental structure of ACA, it won’t get the support of right wing Rethugs, plus they want to accelerate the vote to next week which does not leave time for real negotiations. But the defeat of this version of the bill is no reason to celebrate, since it doesn’t move us toward the ultimate goal of Improved Medicare for All and might even deter some from the focus on this goal. Its defeat still leaves 30 million + uninsured, and many 10’s of millions underinsured, and in danger of bankruptcy and homelessness in case of catastrophic medical issues. If Democraps had even a lick of common sense, they would advocate for Single Payer, since that’s what the majority of Americans state that is what they want, and Here, and Here. But will never do that because they are just as beholden to the corporate health care industry as are the Rethugs.


Americans For Tax Fairness: Price-Gouging Rx Companies to Get $28 Billion Tax Break in GOP Health Plan

Business Insider: Trump Just Sold Us All Out On Drug Pricing

Portside: Single-Payer Healthcare for California Is Very Doable


Single Payer Action: Joe Manchin Says No To Single Payer, Lindsay Graham Floats Single Payer for Sick People


Truth Out: The GOP Will Free You From Health Care - But in reality only a little faster than what was about to happen with ACA anyway - as insurance companies bail and premiums/deductibles/etc. rise. Either way, the rich will do very well while everyone else suffers.


Chicago Medical Society: Chicago Physicians Favor Single Payer Over ACA By 2 To 1

CNN: Trump Calls House Health Care Bill, That He Previously Celebrated, “Mean” - No matter what the Senate does, their ‘rules’ call for a mandatory savings of $133 Billion, pocket change for Warren Buffet or Bill Gates, but instead they’ll probably take it out of the pockets of the working poor.


CDC: Credible Statistics on the Financial Barriers of High-Deductible Health Plans


NYTimes: The Single Payer Party? Democrats Shift Left on Health Care - Health Over Profit (a much more insightful article) comment: “Democratic voters have been strong supporters of Medicare for All for a long time, but their party has chosen to ignore them and is paying the price. Now it has a choice to make: lead or get out of the way because the people are demanding Medicare for All and nothing less!”

In the Times article Nancy Pelosi is quoted on the possibility of passage of Single Payer: “The comfort level with the broader base of the American people is not there yet.” And yet three major polls, and Here and Here, in the last year all show that approximately 60% of Americans want (and thus are very comfortable with) Single Payer, including 30-40% of self-described Republicans. Maybe it’s Nancy Pelosi and the rest of what’s left of Congressional Dems that are not comfortable with losing the very large contributions they get from the health insurance, hospital and Pharma lobbyists, which would completely dry up the moment they state their preference for Single Payer. Note: The Times article actually misrepresents the poll results, as always keeping in step with the Democratic party line.

The Dems refused to put a Single Payer plank in their platform back in June, and the Congressional Progressive Caucus still  refuses to officially endorse national single payer. They used to be the “party of the people,” but now only represent the oligarchs.

NYTimes: The Doctor Is In. Co-Pay? $40,000


OpenSecrets: Health Care Overhaul: Total Contributions From Healthcare Industry PACS to R’s and D’s - No Difference.


National Nurses United: The Speech CA Dems Don’t Want You to See - They removed it from their Youtube Page.


Center for Public Integrity: UnitedHealth Over-Billed Medicare by Another $1 Billion - This is  a case brought by the Justice Department in March. Medicare Advantage is a corporate welfare, entitlement program designed to make executives for large health insurance companies even more wealthy than they already are and to destroy conventional Medicare. See entry of 3/28 for more links.


AJC: Protestors Railing Against RyanCare Rally Outside His 6th District Event


NYTimes: Whistle-Blower Tells of Health Insurers Bilking Medicare


Common Dreams: “Single Payer!, Single Payer!”: Key Trumpcare Backer Drowned Out During Townhall


Bureau of Investigative Journalism: Big Pharma’s Pollution Is Creating Deadly Superbugs While the World Looks the Other Way - These bugs are worse than MRSA and can alter their own DNA in response to various types of treatment.


ABC News: Trump Praises Australian Universal Healthcare System


NYTimes: What’s In The Current House Version of Repeal-and-Whatever

UK Guardian: Obamacare vs The Revised Republican Health Care Bill: Key Differences - Tens of millions to lose health insurance, tens of $Billions in tax cuts for the rich.


CNS News: Rep. Connolly: If GOP Repeals Obamacare, Democrats Only Fallback Will Be Single-Payer


National Bureau of Economic Research: Cost of Service Regulation In US Health Care: Minimum Medical Loss Ratios - Kind of long and wonky, but this research bears out what I’ve pointed out before. “Loss” is what insurance companies call it when they have to pay for the health care you need. Under Obamacare, insurance companies are guaranteed a 20% profit over and above that amount on all medical claims (loss).

Medicare overhead is less than 2%, and Here because it doesn’t take a profit, doesn’t do any marketing and does not pay exorbitant executive salaries.

But insurance companies want more. And since the rate of profit is capped, the only thing they can do to increase profits in dollar terms is increase medical spending, and use that to increase premiums which increases their profit levels (though not margins). So they encourage more clinical services, which increases the absolute dollars they can take in profits. Note this is the exact opposite of the direction that we as a nation need to go. The goal should be to reduce the overall health care costs of the country - by encouraging preventative measures, reducing drug costs, regular checkups, and not waiting until the patient has to go to the ER, etc.

But under the current system, the money moves from the pocket of the consumers (in the form of premiums) and into the pockets of the already vastly overpaid executives - who only want more and more. Wouldn’t happen with Single Payer.


Health Over Profit: Small Businesses Are Coming Around: Single Payer Would Be Better


The Nation: Single-Payer ‘Medicare for All’ Is The Only Healthcare System That Makes Sense


LATimes: This One Unbelievably Expensive Iowa Patient Makes the Case for Single Payer Healthcare


Bureau of Investigative Journalism: Worse than MRSA: Doctors Call For Urgent Action On Deadly Superbug Threat - These are bugs that can alter their own DNA to be resistant to new antibiotics and have some sort of ‘quorum sensing’ ability so that they wait until there are sufficient numbers of them present before turning on their virulence gene. Stay away from livestock farms, hospitals and nursing homes.


Reuters: Uninsured Trauma Patients, Cured Into Destitution - This is routine in the US, but unheard of in every other OECD countries.

NPR: Report: US Spends the Most For Health Care of All OECD Countries - Complete with charts and graphs. We spend about 2 X as much per capita as the next most expensive countries (UK and Japan), and yet US life expectancy is lower.


Time Money: What is Single-Payer Healthcare and Why Is It So Popular? - A 10-min read that explains all of the basics.


Conway Daily Sun: Ann McGarity: As A Conservative, I Advocate for Single Payer

UK Guardian: Universal Healthcare Supporters See Their Chance - Rallies across the USA occurred Saturday. There is one mis-statement in this article, paragraph 7. The correct statement would be: “Under the New York Health Care Act, New York would pay for every resident not covered by an existing federal health care program. Under a nation-wide Single Payer system the federal government (with an overhead of less than 2%) would pay for everyone’s health care.” Health insurance corporations, under the 80-20 Obamacare rule, are allowed to take a 20% cut for overhead. The nation-wide system could be funded by a 3.5% payroll tax across the board, which would be $59 for every $20,000 earned. Balance that against never having to pay another premium, deductible, co-pay, condition-not-covered, lifetime limit, etc., and that’s a pretty good deal.


Lancet: America, Equity and Equality in Health, All Things Not Being Equal - Here’s an excerpt that provides the gist. This prestigious health journal recognizes that far from achieving the dream of universal, affordable health care, our system is extremely biased in favor of the very rich and to the detriment of those less well off. That’s a sin.


Paste Magazine: An Actual Doctor Debunks 7 Myths About Single Payer - Clear and concise. The only answer to the health care crisis in this country is Single Payer, and there’s never been a better time to push for it.

Salon: Disposable Americans: US Healthcare System Condemns Thousands of Americans to An Early Death - And behind it all is the ever widening gap in wealth, income and job security of the bottom 99%.

Economist Poll: Another Poll Shows 60% of Americans, Including 40% of Self-Identified Republicans/Trump Voters Favor Medicare For All - See item 81 of this poll. This comes on the heels of the Gallup poll last May and the Pew Research poll in January, both showing the same numbers. Hard to argue with 3 separate polls that all show the same numbers.


The Hill: Why ‘Medicare For All’ Is The Best Deal For Trump - Written by a thoughtful doctor.

NYTimes: Iowa’s Largest Insurer Withdraws From Obamacare Exchanges - Neither of the other two insurers in the state will commit. Obamacare is rapidly going under, increasing the number of people nationwide who cannot afford coverage. 60% of Americans want Single Payer, but all Rethuglicans and most Democraps, like Nancy Pelosi, will not sign on to either the House (HR676) or Senate bills (SB562).


Portside: Five Promising Signs For Single-Payer In The Last Week


Health Over Profit: Democrats Against Single Payer - Dems only advocate for Single Payer when it doesn’t cost them anything. But time after time, they renege time.

Intercept: Bernie Sanders Wants to Expand Medicare to Everybody - Exactly What Its Architects Wanted


LinkedIn: Insurance is Driving Physicians Mad; Nearly Half Say They’d Prefer Single Payer

Canada Drugs: Big Pharma Spends More on Advertising Than R&D - The US and New Zealand are the only two countries in the world where this is true. Next time you hear a pharma lobbyist say that drug importation will negatively affect their R&D, think of this.


Kaiser Health News: Justice Department Joins Lawsuit Aledging Massive Medicare (Advantage) Fraud By UnitedHealth - United is one of several corporations that has upcoded and overbilled the government for years, while government auditors are prevented from doing their job by lobbyists and politicians. The total of improper payments across all of the insurance corporations since Medicare Advantage was first created probably runs in the tens of billions. That is in addition to the fact that the typical MA patient costs the government 14% more (even without the fraud) than a patient in traditional Medicare. Medicare Advantage was always designed to be a welfare program for giant health insurance corporations and a nefarious way for these insurers could eventually take over all of Medicare. Imagine how conservatives would howl if this amount of fraud was discovered in the conventional welfare system. Here is JAMA’s perspective.


Common Dreams: “Thunderous Applause” Welcomes Sanders Call for Medicare-For-All - "If Democrats go with a half-a-loaf policy, Republicans are going to blame them for the failures of Big Pharma. They have to immediately pivot to expanding Medicare."

Upworthy: When Her 5-Year-Old Broke His Leg, This Mom Raised $0


Health Over Profit: Let’s build on the Victory Over Ryancare - The failure of Ryancare revealed deep divisions within the Republican party. From the article:

“The impact of the resistance movement, which spoke out at Republican town halls, held rallies and marches, protested at Paul Ryan’s Wisconsin office and sent massive numbers of emails and phone calls into congressional offices, was so evident that even the corporate media and leading Democrats gave the movement credit. Without pressure from below, the Republican divide would not have been so large.”...

“While defeating the extremist Republican version of market-based health care is a victory, the country is still left with the Affordable Care Act (ACA), another market-based system. It allows pharmaceutical companies to overcharge on essential drugs and ensures investors make significant profits from for-profit hospitals, private insurance and healthcare products.The essential understanding that we must share with everyone is that insurance is an investment vehicle to make money for investors, not to provide health care. They make money by charging the highest premium they can and paying the least amount for health services. They are a very costly middleman that is not needed.”

Before 1973, it was illegal to carry out medical care as a profit-making business.


PNHP: After Speaker Ryan Pulls GOP ‘Slash and Burn’ Health Bill, Doctors’ Group Urges Passage of A Single-Payer Health Plan

NYTimes: What Comes Next for Obamacare? The Case for Medicare for All - In clear language, this article summarizes the main advantages of Single Payer:

After 7 years of bitterly complaining about Obamacare, nobody in the “repeal and replace” GOP had taken the time to come up with a reasonable alternative.

“Part of the appeal of Medicare for all is that single-payer systems reduce financial incentives that generate waste and abuse. Mr. Ryan insisted that by relegating health care to private insurers, competition would lead to lower prices and higher quality. Economic theory tells us that this is a reasonable expectation when certain conditions are met. A crucial one is that buyers must be able to compare the quality of offerings of different sellers. In practice, however, people have little knowledge of the treatment options for the various maladies they might suffer, and policy language describing insurance coverage is notoriously complex and technical. Consumers simply cannot make informed quality comparisons in this industry.

In contrast, they can easily compare the prices charged by competing insurance companies. This asymmetry induces companies to compete by highlighting the lower prices they’re able to offer if they cut costs by degrading the quality of their offerings. For example, it’s common for insurance companies to deny payment for procedures that their policies seem to cover. If policy holders complain loudly enough, they may eventually get reimbursed, but the money companies save by not paying others confers a decisive competitive advantage over rivals that don’t employ this tactic. Such haggling is uncommon under single-payer systems like Medicare

According to the Kaiser Family Foundation, administrative costs in Medicare are only about 2 percent of total operating expenditures, less than one-sixth of the rate estimated for the private insurance industry.

American health care outlays per capita in 2015 were more than twice the average of those in the 35 advanced countries that make up the Organization for Economic Cooperation and Development. Yet despite that spending difference, the system in the United States delivers significantly less favorable outcomes on measures like longevity and the incidence of chronic illness.

But advertising expenses and administrative costs are not the most important reason the United States spends so much more. The main difference is that prices for medical services are so much lower in other countries. In France, for example, a magnetic resonance imaging exam costs $363, on average, compared with $1,121 in the United States; an appendectomy is $4,463 in France, versus $13,851 in America. These differences stem largely from the fact that single payers — which is to say, governments — are typically able to negotiate more favorable terms with service providers.

In short, Medicare for all could deliver quality care at much lower cost than private insurers do now. People would of course be free to supplement their public coverage with private insurance, as they now do in most other countries with single-payer systems, and as many older Americans do with Medicare.”


Vox: If You’re A Millionaire, the AHCA Gives You $50K. If You’re Poor It Costs You $1,420


Health Over Profit: For-Profit Health Care Used to be Illegal - Before 1973 (Nixon) medical care was regarded as a service industry, not as for-profit businesses. It was considered unethical for doctors, hospitals or insurance companies to even advertise.


ProPublica: Fired US Attorney Preet Bharara Was Investigating HHS Sec. Tom Price - Price has a history of buying up pharmaceutical stocks just before submitting legislation favorable to the company. But ethical behavior has never been his weakness.

Raw Story: Trump Supporter Credits Trumpcare (Which Hasn’t Taken Effect) For Dramatically Lowering Health Care Costs - Amazing.


HuffPo: Watch This Woman School Tom Price On His Hypocrisy Around Planned Parenthood


The Tennessean: Meet the Protester Who Interrupted Trump’s Rally


Common Dreams: Bernie Sanders’ Town Hall in Trump Country: “Healthcare Is A Right” - He got a standing ovation from a town that voted 75% in favor of Trump. We’d be a far different country right now if the Democratic party had carried out a fair nominating process.


NYTimes: 24 Million Will Loose Healthcare under TrumpRyancare

Intercept: More Guns, Less Medicine: Trump’s Military Spending Binge Would Swamp Savings From Health Care Repeal - The reason AHCA doesn’t save more is because it includes a $600 Billion tax cut for the wealthy.


Vox: The Republican Health Plan is a Huge Betrayal of Trump’s Campaign Promises, And Trump Voters Will Pay the Highest Price


NY Mag: Watch Paul Ryan’s Adam’s Apple When He’s Asked Why His Health Plan Cuts Taxes for the Rich - Rethuglicans: More wealth for the wealthy. More health for the wealthy. Everyone else can go suck on a lemon, and, once they are too sick to exploit either in the workplace or the marketplace, go find a ditch and lay down an die. If there was ever a time for working people to rise up, this is it.

HuffPo: An Open Letter to Trump: The GOP Health Plan Won’t Work, Replace ACA With Single Payer


Democracy-NOW: The GOP Fix For Obamacare: The Rich Get Tax Breaks, Million of Other Lose Health Care


NYTimes: GOP Repeal Bill Will Cut Funding For Poor and Cut Taxes For Rich - The redistribution of wealth continues to trample on those less fortunate.


Health Over Profit: Obamacare Meeting Bends Toward Single Payer Solution


Popular Resistance: Translating Trump’s Healthcare Promises - Trump’s remarks to Congress, followed by an analysis of what they really mean.

Summary: “It looks like Trump’s promise of “insurance for everybody… much less expensive and much better” is deceptive. Insurance for everybody means access to insurance, not actually being insured. Much less expensive means insurance that does not protect your financial assets, it you have any. Much better means that you have a choice of purchasing worthless plans, if you call that better.”


Truthout: Amid GOP Attacks on Health Care, The Movement for Single-Payer Is Growing


Kaiser Family Foundation: Listening to Trump Voters With ACA Coverage: What They Want in a Health Care Plan - Less complicated plans, more transparency regarding treatment costs, lower deductibles and out-of-pocket costs, lower priced drugs, no surprise medical bills, lower premiums, wide networks of doctors and hospitals to choose from, and they have no use for HSAs. There is only one plan that fits.


Annals of Internal Medicine: Single-Payer Reform: The Only Way to Fulfill the President’s Pledge of More Coverage, Better Benefits, and Lower Costs - “Researchers estimate a $500+ Billion savings per year.” This is a ‘breakthrough article’ because it’s the first time such a prestigious medical journal has published anything so pro-Single-Payer. Here are the major points in the article, just in case you don’t happen to belong to the American College of Physicians. 58% of Americans favor Single-Payer over ACA or any other system, including 73% of Democrats and 41% of Republicans. And yet strangely it’s not ‘DP’ approved - except maybe as a great talking point. None of the party bosses from either the ‘DP’ or the ‘RP’ will allow it past committee. Oh, that’s right. It’s not “realistic.” Even though it is realistic in every other industrialized country in the world and even though overhead costs would drop from 20+% to less than 3%. Time for a new approach?


OurFuture: 5 GOP Health Care Buzz Phrases You Need to Inoculate Yourself Against


The Atlantic: A Political Opening for Universal Health Care?


The (Coweta) Citizen: Government Runs The Military (and Police and Fire Departments); It Can Run Healthcare - Medicare has a 3% overhead (not counting Medicare Advantage), private insurance has a 20% overhead. Lots of other good, standard points in this article.


The Citizen: Healthcare Solution: Make Medicare Available to All


US Congress: HR676 Improved Medicare Health Care For All, Single Payer Re-Introduced Into 115th Congress

STAT: In Iowa, Financial Pain Follows Trump-Style Medicaid Reform


WashPo: Repeal of ACA Will Kill More Than 43,000 People Annually - ...unless its replacement is Single Payer.


Pew Research: More Americans (60%) Say Government Should Ensure Health Care Coverage - This is the highest percentage in 10 years and is up from 51% of all Americans who felt this way last year. 85% of Democrats and 32% of Republicans agree that it is the government’s responsibility to make sure that all Americans have health care coverage.

CNN: Paul Ryan: GOP Will Repeal, Replace Obamacare at Same Time


Truth Out: Noam Comsky: The US Health System Is An “International Scandal” -- And ACA Repeal will Make It Worse - "Of all the forms of inequality, injustice in health is the most shocking and inhuman." Rev. Dr. Martin Luther King, Jr.


LATimes: Millions Sign Up For Obamacare as Trump and GOP Lawmakers Scramble for a Way to Roll it Back


NYTimes: The Health Care Plan Trump Voters Really Want - really Single Payer, they just don’t know it. What they really don’t want is exactly what Rethugs are proposing as the replacement: a voucher system to replace Obamacare, Medicare and Medicaid.


Medical Economics: Top 10 Challenges Facing Physicians in 2017 - Not a single one has anything to do with achieving better outcomes for sick people. They all have to do with requirements imposed on doctors by inefficient insurers, superfluous administrators, bureaucrats and legislative bodies. None of these would be a part of Medicare for All.


Des Moines Register: Don’t Pay Managed Care Firms a Penny More - Here’s what happens when health care gets ‘outsourced.’


NYTimes: GOP Plans to Replace Obamacare with ‘Universal Access’ - As opposed to universal coverage. Funny how these days both parties name the legislation the opposite of what it really is. Let them repeal Obamacare and then own the results.


Washington (state) Herald: Democrats Should Let GOP Own Obamacare Repeal


NYTimes: New Coalition Will Push Back on Repeal of Obama Health Care Law - This is not a ‘new’ coalition. This is the very same set of people who originally kicked Single Payer to the ditch, while they pushed for the current dysfunctional system that serves only to enrich the insurance, pharmaceutical and hospital corporations while still leaving over 30 million people with no insurance at all and another 30 million with overpriced, inadequate insurance that will immediately drive them into bankruptcy and make them homeless the moment they suffer a serious illness. Another opportunity to push for the best solution wasted by a bunch of center-right conciliators: NAACP, SEIU, Families USA, Center on Budget and Policy Priorities, HCAN, Healthcare-NOW, Center for American Progress, Neera Tanden, etc.


Health Affairs: More Evidence of Financial Burdens of High-Deductible Plans - This study shows that people at lower income levels choose high-deductible plans more frequently than people at higher income levels. Due to this fact people at lower income levels more often experience high financial burdens when faced with health care needs. This wouldn’t happen with Single Payer, because premiums would disappear and the system would be more equitably funded through a progressive tax system.


VOX: By Picking Tom Price to Lead HHS, Trump Shows He’s Absolutely Serious About Dismantling Obamacare - Here’s Tom Price’s replacement plan. The young, healthy and rich will benefit. The old, poor and sick will suffer. Most of the people who favored Trump are poor and getting older. Wonder what they’ll think of him in a couple of years. There are enough Dems left in Congress who want to “work with” a Trump Admin. to guarantee that a filibuster won’t work. This means that both Dems and Reps are moving the neoliberal ‘austerity’ agenda. All wealth is moving to the top 1%. There will be no limits on premiums, deductibles, etc. Sick people, with ‘preexisting conditions,’ will not be able to afford coverage. Insurance company executives will make even more $$$ hundreds of millions. It’s time for a political revolution, and that can’t be accomplished from our comfy sofas.


Modern Health Care: House Republicans Seek Delay in Case to End ACA Cost-Sharing Subsidies - They are seeking a delay in a case they started, because they realize they don’t have a viable alternative and the results of a ruling ‘in their favor’ would be catastrophic for the American people. Ooops!


PNHP: Health Reform in the Trump Era

The Hill: Which Way For Trump and Progressives on Pharmaceutical Reform? - Synopsis: Trump said during the campaign that Medicare should be allowed to negotiate drug prices with Big Pharma, a move that would save the federal government between $230 Billion and $500 Billion over the next 10 years, and that 74% of Americans favor. However, his new web site makes no mention of this and pharmaceutical company stocks have skyrocketed since his election. Currently Americans pay 4 X as much per capita for medicine as the OECD average - essentially an extra $150 Billion per year. Big Pharma R&D cost is less than half of that. However if we invested that $150 Billion in public sector drug research, directed at real health needs instead of Big Pharma profits, the drugs would be in the public domain and manufactured as generics from day one. Of course Single Payer, favored by the majority of Americans, would make this entire discussion moot.


Black Agenda Report: Time for the Real Left to Double Down on Single Payer Medicare for All - Gallup poll: It’s what the majority of Americans want.


Fair Reporters: The Best Healthcare Systems In The World - An oddly written summary of some of the highest ranked healthcare systems. Very high level, but a decent overview. I wish there were better sources for this.


The Lancet: Reaction to US Election: Interview with Dr. David Himmelstein, PHNP - Here’s the transcript. Roughly 1,000 people die every year for every 1,000,000 who are uninsured. If ACA is thrown out with no replacement, that’s an additional 20,000 deaths, added to the 30,000 current deaths from uninsurance. Death rates for lower-income white Americans - mainly Trump voters - are already rising. They will be disproportionately affected. Medical bankruptcy is extraordinarily common among people with insurance. Trump voters may soon very sorry, for this and many other reasons.


CNN: Obamacare Woes to Linger Long After Obama is Gone


NYTimes: Increase in Costs of US Health Care Plans Average 25% and Reuters - Under Obamacare, this money will be transferred directly from the US Treasury (the taxpayers) into the coffers of the insurance companies.


NYTimes: Harvard Health Policy Professors Ignore the Needs of Their Own Dining Hall Workers

NYTimes: Why the US Still Trails OECD Countries in Access to Health Care


The Hill: Affordable Care Act: Imploding and Beyond Repair - A very succinct summary of all of the problems with Obamacare and what we need to do to fix it.


Hartford Courant: More Than 1 Million in Obamacare to Lose Plans As Insurers Quit


International Business Times: Clinton Campaign Fails to Support Single Payer Ballot Measure in CO - Health insurance companies are major contributors to Democrats and to the measure fighting this initiative.


Bloomberg: Secret Rebates: Why Patients Pay $600 For Drugs That Cost $300 - Patient buys a high-deductible insurance policy that includes expensive drug in its formulary. Patient is prescribed and pays for a $600 drug before meeting the deductible. The insurance company automatically gets a $300 rebate from pharmaceutical company even though it pays out nothing to patient. The pharmaceutical company jacks up the price of the drug to cover the rebate to the insurance company. The patient received no benefit from the policy, but we all pay more for the drug. Insurance companies donate $Millions to Dems and Rethugs to keep things just the way they are.


Wellmark: Wellmark Gradually Putting the Squeeze on Their Customers - A trend that will only continue under Obamacare.


Family Practice Management: Is Direct Primary Care The Solution to Our Health Care Crisis? - Nope. This article shows why.


PNHP: The Public Option is Back - Why it is not the same as Single Payer, and at this point could actually set Single Payer back by decades.


Kaiser Health News: Employer Costs Moderate, Employee Deductibles Soar - Wouldn’t happen with Single Payer.

Modern Health Care: Uninsured Rate Drops, But Medical Expenses Drag Millions Into Poverty


USA Today: As Obamacare Choices Dwindle, Feds Face Consumer and Political Backlash

NYTimes: Obama Marketplaces Are In Trouble. What Can Be Done? - Obamacare is slowly failing. The healthcare system in this country has become just one more way to transfer $$$Trillions from the middle class and poor into the pockets of the very richest. These proposed ‘solutions’ simply take a totally dysfunctional health care system and layer it with new kludges, bandaids and duct tape. Instead of the only fix that makes sense, Single-Payer, this article proposes these fixes:

  1. -Public Option: But insurers won’t allow this because they know that if properly funded, it would eventually become Single-Payer and run them out of business. That’s why it was not included in the first place.

  2. -Further limit doctors and hospitals that a patient can choose. So they want to send you to doctors who have to see so many patients in so little time that they really don’t have time to properly diagnose and treat the illness. Assembly line medicine. That’s not a solution.

  3. -27 million people still can’t afford even subsidized insurance. So the proposal is to give even more generous subsidies to insurance companies than the current $10B per year transferred directly from the Treasury Dept. to insurance company coffers. Make the penalties for not signing up even more severe - then what? Start throwing people in jail if they don’t pay the new penalties? Also proposed: Remove the requirement to cover certain conditions - which eventually means a return to pre-existing conditions. Not a solution.

  4. -Shift more of the costs to taxpayers. So essentially the taxpayers will be subsidizing the 8 digit compensation packages for insurance company executives and board members. This is insane.


Intercept: Obamacare is Failing For Ones Simple Reason: Profit


Robert Reich: Why a Single-Payer Healthcare System is Inevitable


Des Moines Register: Editorial: Government Should Not Rely on Private Health Insurers - A good summarization of everything we’ve tried so far. Correctly argues that profit driven insurance companies should not be in charge of our health care. It also points out that taxpayers pay 14% more for seniors in Medicare Advantage, than those in traditional Medicare. It points out the flaws in every other solution that we’ve tried and failed. The only one that works is the only one we haven’t tried (except for seniors, for whom it works very well): Single Payer.


Health Affairs: Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays - This “pro-market” article kind of shoots itself in the foot. They argue that the fact that Medicare Advantage pays providers less than regular Medicare proves that Med Advantage is controlling costs better. The fact is that Med Advantage is reimbursed from the federal government at higher rates than the actual providers. So Med Advantage insurance companies are receiving more and paying out less. This extra money goes to pay administrative overhead, higher profits and gargantuan compensation for corporate executives - all courtesy of you and I. Wouldn’t happen with Single Payer.


Bernie Sanders Press Release: Statement on Aetna’s Decision to Withdraw From Health Insurance Exchanges

Bloomberg: Aetna to Quit Most Obamacare Markets, Joining UnitedHealth and Humana and NYTimes - Remember that AHIP, the trade association and lobbying group that represents America’s health insurance corporations, essentially wrote Obamacare and then gave it to Max Baucus to pass - which he and the rest of the dems and rethugs did. Their essential idea was that if everyone, both sick and healthy was required to sign up, then the insurance corporations could make a nice profit. Now their model is falling apart because even though 80% of enrollees are receiving government subsidies, they still can’t afford the premiums, deductibles and other out of pocket expenses if they get really sick. Now the insurers have decided that they really don’t want to cover actual health care for sick people, they just want to sell us wasteful administrative services. This model (ACA) does not work and the big insurers are dropping out, making the market much more concentrated and much less competitive. Obama stated at the start of the process that “all voices got a seat at the table.” That was a lie. Single Payer advocates - the one model that would work - were excluded and when they tried to show up anyway, they were frog-marched out of the room.


Dallas Morning News: Are Free Standing ERs Helping Only the Wealthy?

Florida Times-Union: Single Payer Is Best Solution - a GOP politician no less...


Health Affairs Blog: Struggling to Stabilize: 3Rs Litigation and the Future of the ACA Exchanges - Instead of achieving the goals originally set out for ACA, the insurers are consolidating and gaming the current system. There is a very simple solution.


RAND Corporation: Exploring Single-Payer Alternatives For Health Care Reform (short summary) -A lengthy doctoral dissertation, which compares several different definitions of the single payer model, but the basic results show that for the model presented by Bernie Sanders, which is very close to that proposed by Physicians for a National Health Plan, the net savings in national health care spending ranges from a mean of $550 Billion (almost the same as the UMass/Friedman analysis of the Sanders plan) to $1.5 Trillion per year. This is a seminal study.  PNHP comments. The Full Dissertation.


Bloomberg: Obamacare’s Other Success Under Threat - When the Dems and their cable news talking puppets were selling Obamacare, they said the goal was to make health care universal and affordable. It still is neither. Now they just say the goal was to give more people health insurance, even if it’s inadequate.


Kaiser Health News: Covered California Health Plan Rates Jump 13.2% - Wouldn’t happen with Single Payer.


International Business Times: Anthem-Cigna Seeking Merger Approval, Makes Major Donations to State Political Groups - And where do major corporations get the money to make these major donations? From premium payers, the very people who will then pay more when there is less competition in the insurance market. Wouldn’t happen with Single Payer.


NYTimes: Insures, Pushing for Higher Rates, Challenge Key Component of Health Law - States don’t do much to control rates because state officials in charge know they have a cushy job waiting for them in a couple of years if they cooperate - the old ‘revolving door.’ And the Feds don’t have any real control as this article points out. Their excuse is: it’s all subsidized anyway, and there are very cheap policies available to consumers. What they don’t say is: this law amounts to a direct transfer of $Billions per year from the US Treasury to insurance companies coffers, and the cheap policies aren’t so cheap if you actually get sick because of high deductibles, co-pays, narrow networks, etc. Wouldn’t happen with Single Payer.


Health Affairs: Access to Providers and Network Accuracy Lacking in the Marketplace and Commercial Plans - Synopsis: Many people try to pick an insurance policy based on access to a doctor they prefer. After signing up for a particular network for a year, they find that their insurance company’s web site was inaccurate and they have to go out of network to see their preferred ‘provider.’ This doesn’t happen with Medicare today, and wouldn’t happen with Single Payer.


Health Affairs: Health Spending For Low-, Middle-, and High-Income Americans, 1963-2012 and CNBC and PNHP and Common Dreams - Since 2004 actual health care is being redistributed upwards, with highest income Americans receiving the most care. This income disparity was not reflected in those over 64 ;-)


NYTimes: UnitedHealthcare Sues Dialysis Chain Over Billing - A nefarious scheme made possible only because of Medicare Advantage - usually welfare for health insurance companies, but only if their members don’t get sick very often. This particular scheme cheated the insurance company but the real victims were the funders of Medicare - that’s you and me. Sick people in rural Florida and Ohio, where no in-network dialysis machines were readily available, were illegally pushed from regular Medicare, to which almost all doctors/providers participate, and which pays $200 per dialysis, into Medicare Advantage which pays these particular providers up to $4,000 per treatment. Essentially UnitedHealth care is suing the provider, but only because they don’t want sick people in their plans. Here is JAMA’s perspective on Medicare vs. Medicare Advantage. Here is an audit of Medicare Advantage done by the Center for Public Integrity.


Shadowproof: Clinton Democrats Claim to Support Healthcare as a Right, But Oppose It In Their Platform - Sanders’ delegated RoseAnn DeMoro: ““The Affordable Care Act, while an improvement, is not good enough, it is structurally deficient, leaves healthcare as a system based on profit and ability to pay rather than patient need.” It still means tens of millions of American have no “health coverage or ‘insurance'” because they cannot afford “high out of pocket costs.” Plus, the law has systemic problems which undermine quality of care, and it is easy for the health care industry to game the system.” She was over-ruled by the Clinton/Schultz faction. Clearly this is not the party for progressives. It is a party of smug conformists who repeat empty phrases, and never take responsibility for their actions. They are on the wrong side of history.


AJC: Medicare: An Effective Program That Needs to be Expanded


PNHP: Republicans Offer Only Detrimental Tweaking to Our Health Care System

NYTimes: House Republicans Unveil Long-Awaited Replacement for Health Law - Ryan has been hinting around at this for months. This time they reveal a little more, but not much. Raising the eligibility age for Medicare, Social Security and Medicaid will cost more in terms of overall health care costs, not less. Voucher money and block grants to the states will be quickly eaten up by increases in insurance premiums. Then expecting the states to pay for 2/3 of the $3 Billion we spend per year on health care is absurd. As with most rethug proposals it only makes sense if you don’t think about it too hard. That’s why Ryan’s proposal is long on hot-button items, but short on the how and any cost estimates. He and the rest of the beltway politicians are working for insurance corporations, not you and me. See entries of 5/3, 4/27.


PNHP: AMA Adopts Resolution for Study of Payment Models, Including Single Payer


JAMA: Why Many Medicare Beneficiaries Cling to an Allegedly Worse Deal - A pretty good, short article, putting into perspective the ‘cheap’ Medicare Advantage (MA) programs. The private insurance companies wouldn’t be pushing MA so hard if they weren’t reaping significant profits at both retiree and taxpayer expense. See entry of 5/9 below for further clarification.

Dallas Morning News: Blue Cross Asking for 60% Rate Hike for Obamacare Plans in Texas


PR Newswire: Milliman Medical Index: Healthcare Costs for a Typical American Family  Will Exceed $25,000 in 2016


Kaiser Family Foundation: Survey of Non-Group Health Insurance Enrollees, Wave 3 - PNHP: “One of the most important functions of health insurance is to provide financial security in the face on medical need. In spite of the Affordable Care Act, that security is deteriorating.”


Progressive Physician: What’s Wrong With Sanger-Katz’s Single Payer Analysis - A critique of the ridiculous “Worst Single Payer Study Ever.” Here’s the study we should all be focused on. See entry of 5/5. All of the ‘progressive’ critics that have come out of the woodwork critiquing single-payer (the “puppies and rainbows” brigade: Ezra Klein (Vox), Paul Krugman (NYTimes), Paul Starr (Princeton), Ken Thorpe (Emory)), were proponents of single payer before Bernie started to threaten Hillary. This debate is really not about single-payer. It’s about keeping the Democratic party base in line. Here’s a short video that debunks the faux-progressive line. Ken Thorpe is cherry-picking his numbers and uses statistical sleight of hand. Here’s a review of studies that have shown that single-payer reduces costs, and another. Here’s a more comprehensive run down of what’s right with Sanders’ over-all economic plans.


Boston Globe: How to Provide Medicare For All

Vice: More Americans Want Socialist Healthcare Than You Think


Gallup Poll: Majority of US Supports Fed-Funded Health Care System and Here - 58% of US adults are in favor of repealing ACA and replacing it with Single-Payer, including 41% of Republicans and right-wing voters.

Philadelphia Inquirer: Single-Payer Essential to Controlling Health-Care Costs - By the former editor-in-chief of the Journal of the Canadian Medical Association, who moved to the US for personal reasons only to discover how superior the Canadian single-payer really is.


NYTimes: Sorry, We Don’t Take Obamacare - Remember when the Democrats said, “If you like your current policy, you can keep it.”? “Everybody in, Nobody Out”? Remember when all 65 members of the Congressional Progressive Caucus took a solemn oath never to vote for a health law that did not contain a Public Option, collected $400,000 in donations for taking that pledge, then broke the pledge and kept the money? Well all except for Dennis Kucinich. Although 20 million people previously without health care now have it, 33 million still don’t. And this article is about the 20 million. It’s a “two-tiered system” aka medical apartheid. Yes you can insure your children up to 26 years of age, but not if they live or go to school in another state. You can buy a plan that includes your favorite doctor or your most necessary medication, but if the plan removes either one in the middle of the year, you can’t change with it. Most of these 20 million people who now nominally have insurance are no better off financially than they were before the law. The article describes how regulators are trying, mostly in vein, to fix these problems. Why are we trying all kinds of kludges to a dysfunctional system when Single Payer would fix all of these issues?


The Hill: GOP Closing In On Obamacare Alternative, Lawmakers Say - Also buried in this article are some of the details for how the GOP plans to defund Medicare by making it a voucher system. See remarks under the Center for Public Integrity article of 5/9 below. Apparently they intend to conflate ‘the replacement for Obamacare’ into the destruction of Medicare.

NYTimes: Judge Backs House Challenge to a Key Part of Health Law - This will most likely be overturned on appeal, but the interesting part is: $130 Billion over 10 years transferred directly from the Treasury Dept. to health insurance company coffers. Staggering. Wouldn’t happen with Single Payer, which would save $500 Billion per year.


Change.Org: Worst Single Payer Study Ever - Prior to this election cycle, over 40 single-payer studies have been conducted by government agencies, actuarial firms and think thanks. Every one concluded that Single-Payer reduces costs while providing universal coverage. Every country with single-payer spends less on health care (by % of GDP, per-capital, and absolute, real dollars), and gets better outcomes. This new study pulls assumptions out of nowhere, and leaves out the largest sources of savings: reducing administrative overhead from 20% to 1% and the monopsony power of one payer to force hospitals and pharmaceuticals to reduce prices.


Portside: Urban Institute’s Attack on Single-Payer: Ridiculous Assumptions Yield Ridiculous Estimates - The more popular Bernie’s plan gets, the more entrenched, duopoly institutions try to create false narratives. This article shoots down another one.

Center for Public Integrity: Auditors: Feds Failed to Rein in Billions in Over-Tilling By Medicare Advantage - A great report by this fantastic watchdog group.

Synopsis: Medicare Advantage (MA) is the private insurance alternative to Medicare, introduced by Congress in an effort to starve out Medicare and replace it with a private voucher system. The Center for Medicare and Medicaid Services (CMS), driven by Congressional pressure, is complicit in allowing this to go on. MA reimbursements to insurance companies are about 14% higher than than Medicare reimbursements directly to providers for the same services.

On top of that, the insurance companies are gaming the system by ‘upcoding’ their services, reaping an extra $160 Billion annually. Because of all this, the insurance companies are able to offer these plans to retirees at a cost very much lower than the already low Medicare costs. This in turn is bleeding retirees away from Medicare and onto MA. Upcoming audits may result in the recovery of only about 3% of these overcharges from the insurance companies. Already almost 1/3 of Medicare enrollees, deceived by the temporary and artificially low costs, opt for MA, and that fraction is increasing steadily.

Look for Congress to start reducing funding for Medicare, based on reduced enrollments, which will reduce reimbursements to providers causing many of them to drop out. Once most of the enrollees are in MA, Congress can then enact its “premium support” plan - essentially vouchers. At that point, traditional Medicare will be dead.

Once everyone is on the voucher program, Congress can ratchet down the voucher amounts and insurance companies will be free to increase premiums, co-pays, deductibles, etc etc.

Despicable! Wouldn’t happen with Single Payer.


American Journal of Public Health: Moving Forward From the Affordable Care Act to a Single-Payer System - A milestone, detailed proposal for how to switch from the current system that still leaves out 33 million and underinsures another 36 million, saving $500 Billion/year in the process - signed by 2,231 doctors. The Summary; Background Fact Sheet.


Intercept: Prominent Democratic Consultants Sign Up to Defeat Single Payer

Healthcare-NOW: Seth Meyers Explains Single Payer and Its Colorado Corollary - See entry of 4/22.

Health Affairs: Traditional Medicare Vs. Private Insurance: How Spending, Volume, and Price Change At Age 65 - In a nutshell: For people who move from private insurance to Medicare, the volume of services they use remains the same, but their spending and overall healthcare spending goes down - not exactly a bombshell. But moving the eligibility age from 65 to 67 as some neolibs have suggested, would increase national health care spending - mainly because of increased Medicaid spending, increases in ACA premium tax credits and cost-sharing subsidies resulting in tax revenue losses and greater overall outlays - again leaving the volume of services unchanged. From a national healthcare spending perspective, that’s moving in the wrong direction. And the corollary is: Moving the eligibility age down would decrease overall healthcare spending while leaving volume of services unchanged. You have to wonder when the light is finally going to come on.


Monthly Review: Obamacare: The Neoliberal Model Comes Home to Roost - Another interesting, but long scholarly article. But the last two paragraphs are eye-openers. Essentially: the collapse of Obamacare - which is the culmination of the oligopolistic, neoliberal model, where the top wealth strata of  society becomes fantastically rich and everyone else, including doctors, move successively lower - could ultimately become the catalyst for a drastic turn towards a more socialist democratic society overall.


Reuters: Ryan Wants to End Obamacare Cost Protections for Sick People - Republicans keep saying they want to repeal Obamacare. But what’s the replacement going to be and how will it contain the overall cost of health care in the US? Paul Ryan is beginning the reveal. Their idea is to move the responsibility for the care of the sickest people - those with ‘pre-existing conditions’ - to the states, much as the Clintons did with welfare. The top 10% of individuals in health care spending account for 65% of overall health care costs. Telling the states to cover 2/3 - about $2 Trillion per year - of the overall cost for health care in the US is not going to happen.

In the words of PNHP: “With a single payer system this problem disappears. Funding is based on ability to pay, through the tax system, and not on the basis of anticipated medical expenses. Everyone receives the care they need, regardless of their health status. The fragmented plans supported by the repeal and replace people cannot do that.”


Reuters: Health Insurer Centene’s Profits Beat Expectations as Medical Costs Fall - The insurer spent less on health care for sick people - they call it “loss.” They spent proportionally more on administrative overhead and profit. Wall Street considers this a good thing. That’s the upside-down logic that ACA has perpetuated.


Intercept: Health Care Industry Moves Swiftly to Stop Colorado’s “Single Payer” Ballot Measure - From the article: There are a couple of things wrong with this measure - it’s really not ‘single payer’ when a state does it because there are still other ‘payers’ in play: Medicare, etc., and this measure is financed by the workers, not by a steeply progressive income tax as it should be - but it’s a step in the right direction. What’s really interesting is how the insurance companies, who stand to lose a lot of business are trying to kill it. They are about to flood the media, not with an honest discussion of the details, but rather with completely false soundbites: “doubling our state budget”, “diminishing the accessibility and quality of care”, “creating an unaccountable, massive bureaucracy.” None of that is true - but it probably doesn’t matter. Voters are easily fooled by simple soundbites. And to top it off, the Koch Bros. are financing most of the media flood. This strategy has already worked in California and Oregon.


Kaiser Family Foundation: Is ACA Coverage Affordable for Low-Income Families? - Stating that ACA is good because it has allowed lots of people to gain health insurance is disingenuous at very best. The originally stated intent of the law was to make health care universal and affordable. It has done neither. CBO has found that half of the people (27 million) that were not covered before ACA are still not covered. The other half are greatly under-insured. In this study, low-income families respond that having insurance has not alleviated their financial struggles with respect to medical debt, and many can neither afford the total overall costs of coverage nor can they find appropriate providers within their narrow networks.


New England Journal of Medicine: The Virtues and Vices of Single Payer - “When we look at the entire patchwork of the American medical care system and our insurance system there’re still so many holes in it, there’s so much redundancy, and it’s so inefficient. And that’s why the single payer idea is going to resonate far beyond whatever the outcome of the 2016 election is. Because when you have a health insurance that leaves tens of millions uninsured, tens of millions underinsured, that is beset by administrative complexity and is governed too often by profit, there’s going to be an appetite for sweeping change. And whatever its political fortunes are, and I don’t think they’re particularly good, single payer is going to continue to speak to those who are disaffected by what’s going on in American medical care and are looking for something different, something better.”


Peterson-Kaiser Health Tracker: Payments for Cost Sharing Increasing Rapidly


Salt Lake Tribune: High Cost of Hepatitis Meds Makes Good Case for Universal Medicare - People across the nation are slowly beginning to wake up.


BCBS, Health of America Report: ACA Compliant Plans Have Been Subject to Adverse Selection - In a nutshell: Some, but by no means all, sicker people who could not afford health care before ACA, have been signing up for insurance, mostly because they are getting government subsidies (actually these subsidies are $Billions transferred directly from the US Treasury to insurance company coffers). This has driven up the overall cost of these plans. But what about the middle income, hard working families that do not qualify for these subsidies? Costs for their plans has skyrocketed, with no help from the ACA. Wouldn’t happen with Single Payer.


NYTimes: How to Stop the Bouncing Between Insurance Plans Under Obamacare - There’s no way to tweak this totally dysfunctional system. None of this would be necessary with Single Payer.


KQED: Pharmaceutical Companies Hiked Price For Aid-In-Dying Drug


Business In Savannah: Medicare for All Is Way Forward


Healthcare-NOW: Setting the Record Straight: Busting the Media Myths About the Sanders’ Plan

Health Affairs: Don’t Let the Talking Points Fool You, It’s All About the Risk Pool - A very Darwinian article. But think of it this way: If you’re healthy and you buy insurance, then you pay a little bit for the few that are really sick. If you don’t buy, then you’re a little better off...except if you all of a sudden get really sick. Oops! Then you’re screwed. But aside from all that, none of this would be a consideration with Single Payer.

ProMarket: “There Is Regulatory Capture But It Is By No Means Complete” - Wikipedia: “Regulatory capture is a form of political corruption that occurs when a regulatory agency, created to act in the public interest, instead advances the commercial or political concerns of special interest groups that dominate the industry or sector it is charged with regulating.[1] Regulatory capture is a form of government failure; it creates an opening for firms or political groups to behave in ways injurious to the public (e.g., producing negative externalities). The agencies are called "captured agencies".” Kenneth Arrow, youngest person ever to win the Nobel Prize in Economics, and one of the most influential economists of the 20th century discusses Single Payer Health Care. His conclusion: “It’s better than any other system.”


CNN: Full Transcript Hillary Clinton TV One Democratic Presidential Town Hall - About half way down a Teresa O’Donnell asks Hillary a question about the skyrocketing cost of health care. Just search on Teresa O’Donnell. From there you can see Hillary’s approach.

PNHP response:

Hillary Clinton says that one of her proposals is to bring health care costs down. This town hall exchange is significant because it reveals the depth, or lack thereof, as to how she might accomplish this.

She says that she would lower co-pays and deductibles. But the question was about high premiums, and the market is using higher deductibles and other cost sharing to lower premiums. Lowering deductibles will cause higher premiums, not lower.

She says that we need more non-profit insurers like Blue Cross and Blue Shield used to be. But if you compare premiums in California for for-profit Anthem Blue Cross and non-profit Blue Shield, they are the same. The non-profit insurers share the same inefficiencies and administrative excesses as the for-profits.

She says that she wants more competition in the exchanges so that less expensive plans will be available for diligent shoppers, but, again, lower premiums are possible only by reducing coverage - higher deductibles, less accessible narrower networks, etc.

Private plans competing in the marketplace is what we already had before the Affordable Care Act was passed. We merely continued the same system. Adding exchanges did very little except to enable the administration of subsidies and credits for lower-income individuals. For those not eligible for government subsidies and credits, nothing was done to control the very high costs of health care and the insurance products that pay for that care.

Unfortunately, Hillary’s proposal is more of the same. Perpetuate the fiction of lower prices through competition while manipulating the insurance products to have either lower premiums or poorer coverage. In fact, included in ACA is the excise tax (Cadillac tax) which is designed to prevent the marketing of full benefit plans. Making health care less affordable through greater out-of-pocket cost exposure is the exact opposite of where Clinton says she wants to take us. The problem is that the current financing infrastructure will not allow us to go there.

If we want affordable care for everyone, we need a single payer improved Medicare-for-all which will control costs and make the financing more equitable.”


International Journal of Health Services: “Cadillac Tax” On Health Benefits Will Hit the Middle Class the Hardest


HuffPo: Cherry-Picking Statistics to Bash Sanders’ Medicare-For-All Plan


Bloomberg: Bad Debt Is The Pain Hospitals Can’t Heal - Having health insurance is NOT the same as having health care when you need it. Advocates for Obamacare like to say that more people have health insurance, including those with pre-existing conditions - even though sign ups are much lower than predicted. But most of the ones that do sign up can barely afford the premiums. When deductibles, co-pays, procedures not covered, doctors or hospitals out of network, medications not covered, etc. are added on, they very often go bankrupt. Insurance policies can drop your doctor or hospital from your network, and can drop the medications you need from their formularies at any time - but when they do that, you cannot change policies until another year rolls around. Obamacare has amounted to a direct transfer of $Hundreds of Billions from the US Treasury to the coffers of private insurance corporations. It is not a step towards Single Payer.


Intercept: Wall Street Analyst Says Hillary Would Be the Best President for Healthcare Investors


Jacobin Mag: Meet the New Harry and Louise - Maybe you’ve heard on cable news that Bernie’s Single Payer plan is all “puppies and rainbows.” This is a very long article that meticulously dissects each of those recent opinion pieces and shows in detail why they are based on false assumptions, and in all cases were written by so-called experts who several years ago were actually proponents of Single Payer. Essentially those articles are not meant to inform. They are meant to control the Democratic party ‘base’ and keep Hillary on track.


HuffPo: Medicare’s History Belies Claim that Single Payer Would Disrupt Care - 11 months after the original Medicare law was signed, it went live. 99% of those eligible were signed up. The overhead for signup AND coverage for 6 months totaled $882 Million in today’s dollars. By contrast, just setting up the insurance exchanges under Obamacare cost more than $6 Billion. Also, Medicare eliminated several smaller federal health assistance programs, saving $383 Million in today’s dollars (so a net cost of $499 Million). Just like today, industry spokesmen all said there would be major disruptions in health care, and that doctors would not accept the program. None of that came to pass. And today, practically everyone who turns 65 - even those who rail against it - immediately signs up.

USA Today: Costs, Changes Led Obamacare Enrollment to Fall Short of Estimates - Sad. But in a small way funny. After CBO estimated that 21 million formerly uninsured people would sign up for health insurance under Obamacare, only 12.7 million people did so. Then Health and Human Resources Secretary Sylvia Burwell lowered her estimate to 10 million and immediately declared that sign ups exceeded estimates. Talk about spin. So after all of the turmoil surrounding the implementation of Obamacare, and after basically turning over the well-being of the American people to insurance companies, what was supposed to create affordable, universal health care has achieved neither of its goals and the best thing you can say about it is that a very marginal number of additional individuals are now covered.


NYTimes: Disparity in Life Spans of the Rich and Poor Is Growing - On top of everything else, now the rich are actually killing us. How much longer can we avoid calling this a class war?


Columbus Dispatch: InHealth Customers Mad About Late Notice Dropping OhioHealth - Health plans are free to change provider networks anytime during the year, but customers of those health plans are not free to change plans when they do. One more gotcha! with Obamacare. Wouldn’t happen with Single Payer.


PNHP: Review of Studies Showing How Much Single Payer Would Save Over Current System - Reviews by everybody from GAO, CBO to Economic Policy Institute and others all agree. It’s a no-brainer.


Philadelphia Inquirer: Single-Payer Health Plan Would Not Cost US More


Kaiser Health News: Licking Wounds, Insurers Accelerate Moves to Limit Health-Law Enrollment - Broker disincentives help insurance companies avoid the sickest.


New England Journal of Medicine: Effect of Removal of Planned Parenthood from the Texas Women’s Health Program - Result: Low-income Texas women are losing access to all forms of health care, family planning services and pregnancy prevention. Birth rates from unintended pregnancy in this group will now skyrocket, swamping Medicaid rolls. State expenditures for neonatal, early child and female health care will correspondingly skyrocket. Wouldn’t want to be a Texas taxpayer.


NYTimes: Drug Shortages Forcing Hard Decisions on Rationing Treatments

HuffPo: On Kenneth Thorpe’s Analysis of Senator Sanders’ Single-Payer Reform Plan


NPR: Insurers Are Refusing to Pay for Some Common Medications - Drug companies have all started doing what Martin Shkreli (and Here, Here) did: start raising the prices of all of their drugs to whatever they think they can charge. Then drug plans remove those drugs from their ‘formularies.’ Result: Sick people who think they have health/drug care can’t get the drugs they need. This is the result of the deal that Obama struck with BigPharma before Obamacare passed which allows them never to have to negotiate their drug prices. Thanks Democrats!


Kaiser Health News: Check the Fine Print. Some Work-Based Health Plans Exclude Outpatient Surgeries


PNHP: Myths Surrounding the Single Payer Debate

Truthdig: Finding a Cure for Bernie Sanders’ and Hillary Clinton’s Health Care Plans - By Margaret Flowers (Popular Resistance) and Jill Stein (Green Party). Remember that 58% of Americans favor Single Payer. 34% strongly favor. 81% of Democrats favor. Hillary’s approach, to tweak ACA around the edges until everyone gets coverage is clearly pie-in-the-sky. But Bernie’s plan also has issues. ACA is not a ‘step in the right direction’ because it has essentially turned the control of US health care over to the insurance companies. Bernie’s plan gives too much power to the states (which he modified in his latest release), and we’ve seen the results of that in the refusal of red states to expand Medicare under ACA.


Healthcare-NOW: Clinton Opposes Single Payer


Common Dreams: Sanders’ Medicare-For-All Plan Takes Aim at For-Profit Healthcare System - Saving $6 Trillion over the next 10 years and $592 Billion per year.


NYTimes: Even the Insured Can Face Crushing Medical Debt, Study Finds - Patient Protection and Affordable Care Act”...Seriously?


John Geyman MD: The Human Face of Obamacare: Promises vs Reality and What Comes Next - By one of the most well respected researchers in the field, Dr. Geyman starts with 50 patient and family stories, then looks at the major problems with Obamacare - out-of-control insurance costs, narrow networks making it impossible to find the right doctors/hospitals when needed and thus forcing patients to pay out-of-network costs, unacceptable levels of care, inability to keep favorite doctors or original plans, having ‘coverage’ that does not translate into having affordable care - to the point that it is no longer called by its original name “Patient Protection and Affordable Care Act” PPACA. Finally he looks at options for the future: 1) muddle through with what we’ve got, 2) Republican plans for repeal and replace with government ‘voucher’ programs, 3) Single Payer. There is really only one answer.

Health Reform 2015